08040227 BUILDING DIVISION PERMIT #C01TRAGTQRINORMAT-IO,�N
PERMIT NO.
,m'T"W fiRUNERIDGE AVE XL CONSTRUCTION 08040227
R'S NAME: PERMIT ISSUE DATE
PPLE COMPUTER 851 BUCKEYE CT 06/04/2008
PHONE: SANITARY NO. CONTROL NO.
(408) 271-2425
ARCHITECrfENGINEER: BUILDING PERMIT INFO
BLDGEIPCT PLUMB MECH
0 0 0 0
900 LICENSED CONTRACT'OR'S DECLARATION Job Description
I thereby snum bol I..licensed under pmvisimu 0SCi1 of Chapter 9(commencing P
m wiJ&clion7OW)ofDiAion3ofdmBudnmwdNofcasiam dc,and my license is T. I COMM BUSINESS NO STRUCTURAL WORK INCLUDE
^=m in full fame and effect A
License aas Lie.• `+ (M, E)
n�n Dam�bl nw Conlracmr
uuuy��� rg ARCHITECTS DECLARA N (N) INTERIOR FULL HEIGHT PARTITION WALL, (N)
< 1 undersunJ my plans shall ho uud u public record
�6c ELECTRICAL LIGHTING & POWER (N) WALLS, FLOOR -
g H Licensed Professional
u 3 OWNER-BUILDER DECLARATION
E 1 berehy a1Rm,Nn 1 am cxmpl from the Courage.License Law for due
—
00 following moon.(Sinden 7(131.5.Business and Fofesdons Coe:Any city er county
m which requites a permit m cons=4 aline improve,dcmolhh,or mptir any s=tum
5zy
no,to its iu......1.rtquims msapp1mant for such permit to file a signed statement
s< that.the is licensed purwant to the pmvwms of the Communeslicense lsw(charter 9 Sq.FC Floor Area Valuation
xF$ (commencing with Section 7000)of Division 3 of the Busi^eu and Professions Code)or $498000
— that he W exmpt thmefrom and the basis for the alleged exemption Any violation of
Secalon 7031.5 by say,applicants for a permit subject the applicant in a civil penalty of Number Occas ane—Type
not mart than mm hundred dollars(M). 316 0605 i � P Y YP
I,a owns allhe pmpeny,or my wployca with wagex as teW noire eompenxdon,
will do theworlre and doe structure unotimended or offered fmsak(See.7014,Business Required
and Prefecdoru Cade:The Commoner U.law don net apply m an owner e Inspections of q
pmpco,who Willa or(mpro ms dharce.and whodas suchworkhimxvar through his
own employees,provided that such improvements art not intended mot(med image.If.
however.the Wilding or improvement is sold within aro year of completion,the owner.
Wilder will have de terd<n of pmving Wt he did not Wild or improve fm purpose of
sale.).
. ❑I.as owner of the properly.w aeluuWy conuacung with licensed contractors;m
const.,the project(Sec.7044.Business and Professions Cade:)The Co messes Li- .
cense law does not apply to an owner of property who Wilds or improve Merton,and
who e.nuacts for such projects wits a eonuxmr(s)licensed purswm m IW Contraelm's
License law.
❑I am exempt under Sec ,B d:P C for Nis reason
r Dam
WORKER'S COMPENSATION DECLARATION
1 hereby all under penally of Majmy ez of me following declwioa:
❑i haw cell will maintain a CmtiOete of Conxm m self-insert(mWarF YsCompcn-
nation,a provided for by Section 31M of the Labor Code,for the performance of the
weds for which this permit is issued.
❑1 have all will maintain Workce,Compensation Inst..as myvired by Section
3700of the labor Code,far th e9ormance of me wink for which this permit in issued, '
My Wm mpenuDo.W rance a Policy our 05
Cama IcSallo.: ACM .....
CERTIFICA OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thusecllon need not bectumpleud if the permit Is fora..hundred dollars(SIM)
tsr leu)
1 certify that in the performance of the work for which this permit is issued,1 shall not
employ any person in any maser x a to become subject to the Wodsmo'Compeeaum
Laws of Califomia.Dam
Applicant
NOTICE TO APPLICANT:If,after making mu Ccoificate of Eacmption,you should
bxa oro subject to the WM1ma`3 Compensation provisions of the labor Code,you mow
.J O forthwith comply with such Provision m MW this permit all second mwked.
z'y CONSTRUCTION LENDING AGENCY
F 1 hereby alrirm IMI Nem is a c.nsuucfinn bonding-1e for the performance of
a > the work for whim this permit Is issued(Sce.31197,Civ.CJ
0 undeh Name
z 1-cmees Ammar
V Q 1 certify that I hale read this application and sum that tm show inromr,mm is
U. correct.1 agree to comply with all city and county ontinances and sok laws relating to
0 buildingcoiuuuctioo.and hereby udinire mprtxntauveof0m city menmr ort pe
+hovo-menu°ned property for casemntiNcumn purposes.
W (We)agree m save,indemnify and keep Mantes the City of Cupertino.gaunt
(~h 'ncoidnetreftLAND'W'1LL
u,cmmand
"'M It which may in any way accrue against City
U 1 z incomcgcenef OCOMPLY WITH ALL ON-POINT Issued by:
RCE Date '
`
Re-roofs 1t_.
."earn of Applicen✓C raemr Date
XAZA RIALS DISCLOSURE Type of Roof
WIIl tae applicant mfutum Wild i arupanlmommMndlchaaNeus material
as defulN by me Cupertino Muni u ode.Chapter 9.11.and the Health and Safety
. Oyer
lss3z(a)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yrs
If a roof is installed without first obtaining an inspection,I a
Will the applicant or future bud i g aruPam vu cyvipmem ar devices which g P gree to remove
emlo havar cors air conumirumu a oned by the Bay Arta Air Quality Management all new materials for inspection.
D staid?
❑Yn u
1 have read the haardwa materud-myvimmems under Chapter 6.95 ofd.Califon
ria Hulth&Safety exons 15505.25533 and 15534.1 understand third lithe Wilding
does no @pu'yI� :Tie 't'u MY mspomfhilioy m notify IW upanl of the
rementaw + emetpdar auaarafaCrenif.amof Signature of Applicant Date
Owner authmired1,c.l D,te All roof coverings to be Class'W'or better