08060220CITY OF CUPERTINO
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CON 6_TOR�INFORMAT�ON
BUILDING DIVISION PERNUT
TRA
BUILDING ADDRESS:
PERMIT NO.
2 INFINITE LOOP
DPR CONSTRUCTION INC
08060220
:R'S NAME:
P RAH ISSUE DATE
APPLE COMPUTER
1450 VETERANS BLVD
06/25/2008
PHONE:
SANITARY NO. CONTROL NO.
(650)474-1450
ARCHITEC (ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
Job Description
1 beeby state, that 1 am licessed under proviekm of Chapter 9 (commencing
withS don7OOWofDis on3oftheBudneumdPrafeWomCode.a mylicc=is
COMM'L DEMO, MOD 0 INTER FINSHS, MECH/ELEC/PLMB
in fall farce and cff gs,�
Lk=nm clssr Lk. g
Cortmmr
INCLUDED
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ARCHITECTS DECLARATION
1 uMersund my plans shall W used as public meet&
Licensed Profcuianal
OWNER-BUIIDER DECLARATION
1 hereby alum that I am exempt from the Conuanofs Ucenac law far the
i fallowing wan. (Sauon 1031.5, Busucas and Profemmm Cade: Any 61, or only
which hequin a permit w mmorner ager, improve, demolish, or mpalt my awnum
prior to its imumum. slat squires tui applicant fur such permit w file a signed statement
he is licensed to the of the Conmem'sLicense lawtChapm9
Sq. FL Floor Area
Valuation
1 that pursuant provisions
(eommenangwith Section 7")of Division 3ofli
$eBusinessandprofessionsQW[c)or 155000
fthat he It exempt therefrom and Ore basis for the alleged c.pro.n. An, violatfot or
�7�7Number
Occas
Occupancy Type
Section 1031.5 by any applicant for, permit ubjects due applicant to a civil Penalty of
oat mare than live hundred dallaas(Ssml.
31602106 .'l7V'
❑ I.uavrc of tic pmputy,mmY unPlayw with wagesush'v role compenu0on,
Required Inspections
will do the wank, and the amcture is not intended or offered for isle (Sm. 70". Business
and Professions Cade: The Committees License law dors not apply toan owner of
property who Wilds orimproms thrscon, andwhodoessuchworkhimseb orthrough his
we employees. provided that such improvements me not inmedcd or offered forsake If.
however, the Wilding or improwment is sold within oro yerr of completion, the owner.
builtim will have the burden of proving that he did not Wild or improve far' puts. of
sakJ.
0 1, as owns of duce Property am exclusively conoatling wide llceved comsmmrs to
cormmn the project (See. 7W. Business and Profession Code:) The Corwaetets U.
cease law dose or apply, to m awns of Property who Wilds or improves Nemo., and.
who cmuacts fer such projects with a contractor(s) licensed pursuant to Ute Conuuctor's
License law.
I am exempt under See ,B St P C for this heated
r Date
WORKER'S COMPENSATION DECLARATION
.1 hereby affim under penalty of Perjury m of tk following dalan0am:
Thaw ab will muntsina CenK%mw -
u6m, Labor
Tor by Section 3'1110 of the Labor code. for dm performance of due
woes far which Nis permit u iuucd
r hick this
1 have and will maintain Workers Compensation Imunmz, u required by Section
3700 ofthe labor Cade, for due performance ofthe work for which this permit is issued
'
My WarkCs Campenuuen Insurance arricr,pO P0liry number are:
Cartier. N IkT poi-aAl- U t`7 us> 6Y�6iicy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Ibis seNm need nos W completed if do permit is Worse hundred dollars (5100)
or less)
1 certify that in the performance of the wart for which this Permit is issued, I shall not
employ anyperen in my matter an v to become subject to lM werhmi Compemadon
Laws of California. Dam
Applicant
NOTICE TO APPLICANT: If. ater making this Cenificam of Exemption, you should
become subject to the Worker's Compensation provisions of the Labor Cade, you most
• foMwith comply with such immisiom or this permit shall W deemed naked.
i
j CONSTBUCnON LENDING AGENCY
I heathy aRtm that Nese is a cmtsrucuon lending agency for the performance of
mese swath for which this permit is issued (Sits'. 3091, Civ. C.)
,
i Lender's Namc
Lenders Address
1 cemary that 1 have and do. applicatim and sum that the above infamsWud Is
cancel. I agree In comply with all city and county ordinances aM aisle lam retuning to
Wilding construction, and hereby anthema representatives of this city to enter upon the
ahovcmenuonedpropeny for puryoses
(We) agree m taw, indemnify and keep hamlets the City of Cupertino .Salm%
expenses
liabilities judgments. costs and which nary in any my attmc agums uid Ciy
of th a ps
in gucoceordmgranOngof AA'ND mit.
A LI NT UNDE0.5TANOS AND WILL COMPLY WITH ALL NON/POINT
Issued by: Date
Sor 6D
61-
Re-roofs
Type of Roof10 '
-- -S7
stgnuureo'ieAppOamV�o'nuaemr Dam
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future building occupant a.re or handle hvarumo material
de0ned by the Cupertino Municipal Calc. Chapter 9.13. and 1W Health and Safety
vc, Seauon 35532(a)?
El Y. OkNe
All roofs shall be inspected prior to any roofing material being installed.
Will the, licmt or future building occupant use aur lit
PP P equipment
If a roof is installed without first obtainingan inspection, I agree to remove
P
emit hvardnm afr conuminmts u defined by due Bay A. Air Quality Management
d Qua Mann ement
all new materials for inspection.
P
DisuinT
❑ Ya ON.
1 have seas the hvardous materials repuircmenu under Chapter 6.95 of the Califor,
nice Health& safety Code, Secuau]5505,15533 and Z5534. l understand this if Nit Wilding
drerandy how a vent Nu it is my rmpomihility w notify the =upmt of duc
req hammer whor, cetirmwafampancy.
Signature of Applicant Date
6L J
All roof coverings to be Class's"
8 or better
own agent seta