06010108 CITY OF CUPERTINO xI ^'�•'^ �` ' "` `` " '" '�"
BUILDING DIVISION PERMIT NFORMATIONn
BUILDING ADDRESS: f9 � SOUTH BAY CONSTRUCTION CO TT�J!171,10.06010108
400 RIDGE VIEW CT
VS NAME: PERMIT ISSUE DATE
':
APPLE COMPUTER 170 KNOWLES DRIVE STE 12 01/31/2006
PHONE: SANITARY NO. CONTROL NO.
(408) 379-5500
ARCHITEC rENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
l� t D !�
uOp LICENSED CONTRACTOR'S DECLARATION
F 1 hereby from that I em licensed under pmNslom of Chapter 9(commencing Job Description
withSemion 7")of Division 3 of NC Businam and Professions Coda.and my license is
^ a mfull forteand C17m. 3• �7 REVISION--FIELD REVISION HANDICAP STALLS
Liccnsc C
L. N
g—o Dam�`�SyoZe con or -h t PARKING STALLS . ORIG. #05090056
^ � TCrSDECLARATION NO NEW PERMIT ISSUED
< I understand
my
Plans shall be used as public records
JyU
g G t� Licensed Pmfessinnal
3 OWNER-BUILDER DECLARATION
<F I hereby ollirm Nat 1 am exempt from the Cemacmfs License Law for the \
no fallowing mason.(Section](n I.5,Business and ProdrWons Cade:My city w county
K m which sa permit ac cnnsWCL Jkc impmea,do permit
t nr repair ed suuaum
that In inissuance.
ensed c.a@u requites(be applicant o Tar each c Contrctow'5 rrleasLow(Chtemcm
£FC£ < (comma cingwidputwam7")orDin the ivionsn ofOcBtupr'sUttnulaw(Cedia) 9 Sq.Ft. Floor Area Valuation
that he
(commencing Section7")till ODi Whoon for
of theBedexem Businessland Ction of $1
that be u exempt therefrom aM the huts fm the alleged exemption.Any violation a( T
Section 7031.5 by any applicant for a permit subjects the applicant m a civil penalty of ane APN Number Occupancy Type
mm than five hundred dallara(M). P Y YP
❑1,an owner of the,prepery,or my employees with wages m dmb We compensation,
will do One work,a ad Neswaare is not intended molfered ret We IS".7044.Butudes Required Inspections
and Professions Cade:The Conamm's License taw dors hee ns not apply to an awr of q p
property who builds or im,neves thereon,and who does such work himself or duough his
own employees,provided Not such improvements are not intended mortemA for We.If.
however.Ne building or improvement is sold within oro year of romplatica.On ow.-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑I,as owner of On property,am exclusively contracting with licensed contractors in
consumer the project(Sec.7(314.Baines and Profesmns Cade:)The Contractors U.
care,taw dean not apply to an owner of property who builds or impmvan themon.and
who contracts for such projects with a convector(&)limaed pursuam an the Gendarmes
nu ave.
m eaempt under Sec. ,B&P C for this reason
Dole
Da
f WORKER'$COMPENSATION DECLARATION
I hereby affirm under permsty of perjuty aro of On following declarations:
❑Tlow and will main 37M of the
Labor sedib.for Performance,
me
Wind.
r provided for mi Secondissued.3]00 of dm labor Code,far the perfamunm of the
were for which this permit is issmd.
❑1 have and will maintain Waka'3 Compensation Bssan
ura,as acquired by Section
3700 of the labor Cade,for Ne perfomarm or the work for which this Permit is ounce.
My Workcfs Compensatioo/n+laourantt carrier and Policy number arc:
Carrier. b�lC..1a'gIPrM•{-1 Policy No.: O 3 t Z 22
CERTIFICATE OFE PITON FROM WORKERS'
COMPENSATION INSURANCE
(Thu section head an,be completed tribe permit is foram hundred dollars($100)
arc loss.)
I certify that in me performance of the work for which Nis Permit is issued,I shall not
employ any person in arty manner an as w become subject to me Workcri Compensation
Laws of California-Dam
Applicant
NOTICE TO APPLICANT:IF,after meting Nis Ccnifrmte of Exemption,you should
become subject to the Worker's Compemsauon pmvimm.or the Labor Coda,you mon
.JO forOwiah comply with such provisions or this Permit mall he deemed invoked.
Z'"' CONSTRUCTION LENDING AGENCY
E-t.N. 1 thereby afford mat Vert is...,I.lending agency for the perf...ser _
G'r7 the work fur which this Permit is issued(Sec.3097,Civ.C.)
aA lender's Name
2 Lenders Addrass
U Q 1 certify mat 1 have read this application and sum that the above information is
it, as aortI agrm m empty with all city and county ordinances and sae laws relating to
C)U Wilding constructed,and herch mile ere represenutisuof this city to enter upon the
W above-mentionedproperty for Inspection which may
gy (We)agree to ave,indemnify and Imp harmless the City of Cupertino against
Z liabilities. therosuend expenses which they in any wayattrm against aid City
f,z A consequenec of the grating of this permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE NIS.
5. _ //7!/e�
_J—ff7/rd Re-roofs
Srgnuure of ppbeanUC for am
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant ser future Wilding occupant stem or handle board.trauand
fined by the Cupertino Municipal Code,CTapmr 9.12,and the Health and Safety
e,Schon 253320)?
❑Yan a All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant sou equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air cuntaminanu as defined by fee Bay Area Air Quality Management all new materials for inspection.
District? /
❑Ycs Mi
I have toad the hvardamsmveriau requirements under ChmenT6.95 of the Califor-
nia Health&SafctyCodc,Scions 25505,25533 and 25534.I understand thal Wilding
docs rpt currently have a tenant,that it a my maponsibility m mtify do occupant of the
"hi/mc ave chmust metpiiorwi anccofaCcmficamofOccup g Signature of Applicant Date
�i"'�' All roof coverings to be Class "B"or better
Own r or�n agent am