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BUILDING DIVISION PERMIT
CONTRACTOR INF0RMATI0N ` '
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BUILDING ADDRESS:
NOVO CONSTRUCTION
PERMIT NO.0909O236
2052
R'S NAME:
PERMIT ISSUE DATE
APPLE COMPUTER
1042 HAMILTON COURT
o9/-io/2n05
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SANITARY NO. CONTROL NO.
FARC�IITECT(ENGINEER:
(650)701-1500
BUILDING PERMIT INFO
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LICENSED CONTRACTOR'S DECLARATION
Job Descri tore
1 kreby affirm Nei I am licensed under previsions ors 9 (commencing
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Code.
with Senior ]OTU) of Division 3 of the Business and Professions Code. and my license is
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in full force and effect
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DEMO PARTITIONS & FINISHES
Lkenm Clan Lic.g
Date 6J Contractor19NI21nO
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ARCHITECTS DECLARATION
I undersush retorts
nd my all k u used
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plans public
Licensed Professional
OWNER -BUILDER DECLARATION
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I hereby affirm that I am exempt from the Convenors License Law for the
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following reason. (Section 7031.5, Business and Prefc ions Cale: Any city or county
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which requires a permit a constmet. surer impmve, demolish, or repair any structure
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prior to its issuance also rcquims tW applicant for such FCMLL 10 file a signed statement
that k u licensed pursuant to the previsions ortk Commatm's L'acuc Law (chapter 9
Sq. Ft. Floor Area
Valuation
(commencing with Section 7000) of Division 3 of the Business and Praressions Code) or
that he is exempt Ousefrom and the Buis for the alleged exemption. My violation of
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Occupancy Type
Section 70315 by any applicant for a permit subjects the applicant w a civil penalty of
not mans than fOe hundred dollars (5500).
❑ I. u owner of the property, or my employees with"gum their sole compenmtion,
Required Inspections
will do the work and the swcwm is mA imended moffered f0ualc (Sec. 7W4, Business
and Professions Code: The commerce, Liaise Law dos not apply to an Owner of
progeny who builds orimperoves thereon, and who doessuch work himaelfor through his
own employees. provided that such improwmenu arc not intended or offered for tile. If,
howevcq the building or improvement is mid within ore year of completion, the owner -
builder will Nue the burden of proving that he did nut Wild or improve for purpose of
sale.).
❑ 1. as owner of the property. am exclusively conducting with licensed contractors in
convect the, project (Sec. 7014. Business and Professions Code:) The Contractor's Li.
cense Law does not apply 0 an owner of property who Wilds or improves thereon, and
who contracts for such projects with a contractor(&) licensed pursuant on the Contractor's
Licenm law.
❑ I am exempt under Sec. . B & P C for this reason
er Data
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury ons of the following declarations:
I have and will maintain a Certificate of Consent to self -incur, for Waters Compen-
.
section, as provided for by Section 37M of the Labor Code. for the peRormanrx of the
work nor which this permit is issued.
❑ I hoe and will maintain Workers Compensation Iruurma, as required by Secdon
37W Of the La W, Cade, for the perfurrona Of the, work for which this permit is issued.
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My Workers Compensation Inmrance carrier and Policy number are:
Carrier, 12Ey`iA3L-Ir- TkXYABq Na.: k �—,2olo UL'I_
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not k completed if tW permit is intone hundred dollars (SIO()
or less.)
I eeniry dint in the be fmmerce of tk work for which this permit is issued, I shall not
employ any person in any manacro as to become subject to the, Workers Compensation
Laws of California. Dau
Applicant
NOTICE TO APPLICANT: If, ager making this CcniBau of Exemption, you should
become subject to the Worier's Compensation previsions of the labor Cale. you mut
forthwith comply wish such provisions or this permit shall be doomed rewku.
CONSTRUCTION LENDING AGENCY
I hereby alarm that there is convection banding agency for tW perfurmarce of
the work her which this permit is issued (Sec. 3D97, Civ, C.)
Lender's Name,
Lender's Address
I certify that 1 have read this application and sud'e that she above in(ormatiun is
correct. l agree to comply with all city and county ordinances and state laws minting to
building counction, and hereby aushariM MPMWOIatiW$ of this City to enter upon the
aW e-mcndoncd property, for impaction purpOma
(We) as. to taw, indemnify and keep harmless due City Of Cupcnim against
Iiabilides.judgmcots, costs and expenses which may in any way accrue against mid City
in conmquanec of the granting of this permit.
APPLICANT UNDERSTANDS AN WILL COMPLY WITH ALL NON -POINT
SOURCEREGUL S.
Issued by: Date 30--G t-
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Re -roofs S
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Signature of ApplicW— ontractor Lyate
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will the applicant or future building Occupant store or handle hazardous material
&I'mod by Ne, Cupertino Municipal Code. Chapter 9.13. and the Health and Safety
de.sceWnzss3z(nn).All
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roofs shall be inspected prior to any roofing material being installed.
thea licant of future buildin occa ant ume which
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If a roof is installed without first obtainin an ins ection, I agree to remove
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haudous air cantsmirtsnu u @fined by tk Bay Acca Air Quality Mwgcmcnr
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all new materials for inspection.
vicO�N�❑Yes k.1
haw mind the hzzardau matefials rquirements under Chapter 6.95ofthe Califor-
Health & SafctyCoM. Seed. 25505,25533 and 25534.1 understand than if Ne, Wilding
s nm cure ntly have a Nmol Na inti my responsibility to notify tha a<upant of dwt9eay
v{nrc mm 'rto issuance or a cerdhatc of Occupancy.
Signature of Applicant Date
Owner m authorized agars pans
*
All roof coverings to be Class "B" or better
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