04110176CITY OF CUPERTINO
q,°'D.s%'
BUILDING DIVISION PE MIT
INFORMAT ION .
BUILDING ADDRESS:
INFINIT LP
SOUTH BAY CONSTRUCTION CO
IT"04110176
OWNER'S NAME:
PERMITISSUEDATE
APPLE COMPUTER
511 DIVISION
E:
SANITARY NO. CONTROL NO.
408)379-0400
1
ARCHITEC (ENGINEER'
h
+ BUILDING PERMIT INFO
,BLDG/ ELECT PLUMB MECH
Q 011
LICENSED CONTRACTOR'S DECLARATION
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- Job Description
1 here ffirm N t I am Iicenand under provisions of Chapter 9 (commencing
wife Scdttgo IMq Of Divi ion Jaf the Bu9ressaodlsrofcssiou Code. andmy liccucis
m ten rota arw err«I. '1J 'l --I
Liccnr!'�lua_Lic.N
TI
Dale \ � 12_ i .,,I Comracbr
--f ��� ARCHITECTS DECLARATIDN�
�unticmand my plans shall uu�p Bl�cnrda'
INjta
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_� OW Em DECLARATION
exempt f License law for the
f I hcmby alum that 11. exempt ram be Conlns
Co C
following noon ](n ioli Coca: Any city or county
B. altar and Pronow.
\
i Construct. improv. dcmolBb, at repair any atrocmrc
which rtyuire Permit ct, do
permit ac,.i.
d
priormits issuance.also mqo the dte inion of for techptuar's hiessig«dstammem
r applicant
pursuant a Nc de Cam
Natbe ending
Sq. Fl. Floor Area �
Valuation -
of Divisions
Coded or
lNCmlc) nr
sines nd Professions
(commencing with Serono 7") to Division J of me.,,d ca and
it
(cat
$100000 1 0 0 0 0 0
he is m. Any
Nat he is uempt thca(rom and the buts far the alicgcd Gumption. Any violation of
�f
APN Number Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant a a civil penalty of
not more Nan five hundred dollars (3500). .
0 I, u own« of the property. m my employees wife wage u Nensole wmpewtion,
ill de Ncwork. and Iheswcwn is notintendW m oRcmd forsale(S«.70z4, Busim_es
and Prefessiou Code: The Combustors Lime Law does not apply a in owner of
Required eCtlOn
property who buildsorimproves thcmon,andwho deessuch work himselforNmugh his
own employee, provided that such imprommnst are not intended oroRucd ferule It.
O "(••!g)lyrC�n�i/s
however, Ne building or improvement is sold within one year ofcompletion, the owner-
.- -
builder will base me burden of provinS that M1c did not build or improve fur purpose of
tile.).
0 I. u Owner of Ibc property, am exclusively contracting wife licensed contractors be
construct the project (Sec. 7014, Business and Prefet'ou Code:) Tse Coruras 's Li.
-
cense law does not apply to an owner of pmpeny who builds Or implant thereon, and.
who contracts for such projects with a eentsutorts) licensed pursuant m the COntraetn S
License Law.
0 I un exempt under Sec. . B dr P C for this reason
Owner Dot
WORKER'S COMPENSATION DECLARATION
I hereby of ism under penalty of perjury One of be following declarationsit :
haw and will maintain aCcruftcate of Coucm to salf-insum for Workcr'sCo rPar-
az providW for by Secuun 37W of me labor Code, for the performance of de
- - --- _
work for which this permit is issued.
0, I have and will maintain Worker's Compensation Insurance, as re uimd by Section
W of the Labor Code, for the performance Of Ute work for wh thi7nnit is issued.
My
-Woe Comn(pp)eensation lTnsunna earticr and Poliey numM
s
rrie CiiL I .TA7SJ--i-POlicy No:
_Ca
// CERTIFICATE OF EXEMPTION FROIpIWORKERS'
COMPENSATION INSURANCE
(This section recd not Wcompleted if the Permit is for one hundred dollars ($1 00)
or less.)
I cenifv that in the perfmmance Of the work for which this permit is issued. I shall not
employ any person in any manner so as W become Subject o the Workers' Compensation
Laws of Califomia. Dam
Applicant
NOTICE TO APPLICANT: If, after making this CeniOcate of Exemption, you should
become subject in the Worker's Compensation previsions of one labor Code, you must
forthwith comply with such provisions or this permit shall he deemed rooked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that mere is construction Xn agency for the performance of
s 7, C,vg
fee work for which this permit is issued (Sec. 7()97, Civ. C.1
Landers Name
Lender's Add.
j I certify that I haw read Nis application and sum that the thew information is
and state laws to
1 agree to comply with all city and county eunina
WilCtt
Of r upon re
uNodremies Of this City mcnter upon fee
tbovengcouuuetpm,.d for
ter emnify ankeeppurposes.
anovc-nonuogree
\
to ove City of Cupertino against
(Wc) agmen to sew, indemnify and keep harmless
w
j expenses which may in anyway accnc against soil City
liabilities,omen n,hc
�
coming
in c wen« of the granting of this permit.
)
ILL MPLY WH A L NON -POINT
LICA'NT UNDERSTANDS A WIT
Issued by: Date
OUR REGULATIONS.
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Re -roofs
Type of Roof
as FApplicanUComncmr te
HAZARDOUS MATERIALS DISrt 11
Will the applicant Or furore building occupant stem or handle hanNeus material
az denned by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety
Code, Seecc Yon 25532(x)? Nn
All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or building Occupam tau cyvipmem or dcvims which
bemoans air contaminants az defined by fee Bay Arca Air Quality Management
all new materials for inspection.
m?
e M1anrdousmaterials myuimmcnts under Chapter 6.95 of me Califor-
Code, S«riots 25585.25573 anJ 25574, I un@rsmntl thm if me building
ability a notify s c Occupant of them
L-1w
tb mm pripraiazem«nr a Certificate lar cnpano
Signature of Applicant Date
All roof coverings to be Class "B" or better
d anent ate