01080055 OF CUPERTINO
OJ BUILDI c DIVISIONPERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10480 RIDGE VIEW CT LSI 01080055
OWNER'S NAME: APPLICATION SUB DATE
CIENA CORP. 256 E HAMILTON AVE 08/09/2001
PHONE: SANITARY NO. CONTROL NO.
(408) 370-1970
q Z ARCHITECT/ENGINEER: BUILDING PERMIT INTO
LES U BLDG ELECT PLUMB MCC
< —
N6
Z,w LICENSED CONTRACTOR'S DECLARATION Job Description
O Z hereby afE.m that l am licensed under provisions of Chapter 9(commencing
of w Section 70001 ofDivixion3aftheBusinessandProfessionsCade,andmylicenu TENANTENT IMPROVEMENT.
< f in full force and a t.
ane anaeclaaa_13— Li<.g 5lo�i� �� MODIFY COMF. /TRAINING RMS &
1zor
- °" ARCHITECr'SDEContCLARATION CONVERT TO A CLASS RM & EQUIPMENT RM.
it�= 1 undcrsmad my plans shall be uud ns public records
W O Licensed Professional
OWNER-BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractor's License Law for the
E? following reason.(Section 7031.5.Business and Profession Code:Any city or county,
N x which requires a permit to construct.alter,improve,demolish,or repair any structure
a3 prior to its Issuance,also requires the applicant for such permit to file a signed statement. ---- ---
that heislicensed pussuwttohis Provisions ofineContrarorsLicense Law(Chapter 9 ,Sq, Ft. FI007 Arps ' JlanOn
(cmmovmcing with Section 7")of Division 3 of me Business and Professions Cade) 15 O O V V
or that he is exempt therefrom and the basis for me alleged exemption.Any violation
-of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ap N�nI
.of am mare man too,hundred dull...($50p). 316-Q6 0-4u t� Occupancy Type
❑1,az ownerof the propery,or my employees with wages as their sole eompenution,
'will do the work;and the succus,is not intended an oRered for sale(Sec.70 1, z.
Business'und'Profenums Code:The Contractor's License Law due,not apply to an 101 F 1 e On
owner of property Who builds or improves therem,and who does such work himself ®Y/
err ugh his own employees.provided mat such improvemema ems not intended or _. . ..._. 10 2 ..PIER
-i throoffered for anle.If,however,the building or improvement is sold within mu year of 103 — UFER
completion,the owner-builder will have me burden of proving that he did not build or
improve for purpose of arca). 104 - REBAR
- O1, ne - —pert _ -. ... ting -- se - ... 105- -- - - -
l,as owner of the .. -. .. _.__. ....... .
Property,am a Business
a contmaing ns Cacenscd cantmctors m - ANCHOR BOLTS
icewc theLaw
does
(Sm.]Doan Business and emyProwho
Cade:)The Improves
the ms's v
Lice,1 Law doe not apply man owner of Property who builds or improves thereon, 106 — SEWER & WATER
and ho commitsms f h-p / u.wuh a.wntr reds)limned pursuant m the ___..
conua<m aLi«naev ,. � `� � � 202— '— -UNDERFLOOR- PLUMBING
❑lamexe Ptunde,Se< B&PCImthisrearan 203 — UNDERFLOOR MECHANICAL
one
o mer _ WORKER'S COMPENSATION DECLARATION 204 - UNDERFLOOR FRAME
Ihereb affirm 205 - UNDERFLOOR INSULATION
ya ,x�altYorperj�rraarmerollawingd«mratiuns: 301 — ROUGH PLUMBING
':.• O 1 have and will maintain a Certificate of Content to self-insure for Worker's 302 - TUB & OR SHOWER �t
_ Compenamion, as Provided for by Section 3700 of the Labor Codc. for tW
performance of the work for which thisprmitisissued. 303 - ROUGH MECHANICAL
❑1 have and will maintain Workers Compensation Imdtunce.as required by Sectio" 304 - ROUGH ELECTRICAL
3700 f the Labor Cade,for the rformance of the work for which this permit is
_D n 7 Policy rumba,are; 3 0 5 - FRAME
is d.MY Workcra Compenvtian Insumrce carrier•arW Poli _
Came.: h •°'. . 1 :' bd'189G13 30.6 : ,AHOLDO,WNS ;I''.,,1. •'
E EXEMPTIONFROM.WORKERS';-'�— — 307 — INSULATION
COMPENSATION INSURANCE.- , . ,-„ _. . . inert
. . __ tint_ __ _ ___..._._ .. ._ _
' (This section nocd not he complaedif the permit is forone hunds,d dollars 3 0 8 SHEETROCK
(S100).H...) 309 - EXTERIOR LATH: -
31'0 - INTERIOR LATH _ -
I certify Rut in the perforname of the work foe which this permit is is.ud.l _
scall not employ°sty person in any rtunmr so as'become an tutee Workers'. 311 — SCRATCH COAT
Con er t La of California Daie - -
ApIdecom - . 313 - -ROOF NAI.L.._- _. .. . . .... ..
NOTICE TO APPLICANT:IL e@rmakingm Certificate rExemption.yauu most 501 — FINAL ELECTRICAL ENERGY ,
NOsubjectt the ANT:Worker's Compensationprovisions tethLeo ode.y u tea
ccld
fiarth,withe ply with such pmvsiona or this-psomishall he deemed revoked 502 -- FINAL PLUMBING--ENERGY
CONSTRUCfIONLENDMGAGENCY
1 hereby co lrm that there I,a comrucian leading agency forme yed'ormaroa 503 — FINAL MECHANICAL ENERGY -
of thewarkforwbmhthispermitiiisaa.d(S..3ag7,civ.c) 509 FINAL BUILDING ENERGY
_. _. . .. - .. -
q `Cegde ,Name 505 - FINAL ELECTRICAL .,
� z 'Lender's Addrec. .
...I certify than 1 have read this application and sure that the above information is 506 — GAS TEST
correct.1 agree to,comply,wim all city and county ordinances and state laws relating 507 - FINAL PLUMBING
4';O'�V ❑o building construction,and hereby authorize representativesorthix city mercer upon
W 'lb,anose'm^Iia^ed Property for inspection purposes., 508 - FINAL MECHANICAL
..a. (We)agree m save.Indemnify and keep hadmlesl be City of Cupertino agaimsr —
llG��n Vl liabilities,judgmcros,soars and eapcnua which mayin a wog ocerue against said 509 FINAL GRADE
Mkill
u<neeofthe ting ofthisit.,NDERST SAN of Oh ITHALLN-POIM1T [.sued NANGDate
UI:ATIO m . Date Re-roofs
asd ed AZARD ATERIA ISCL REpp Il meta ai'u store 1.handle Health an S airyr a re nee p Type of Roof.scant or but
the Cofferdam Municipal Cmle,Chapter 9.11,and the Health sad SoPory 'sr
Code.Section 2553;(al^..;, ..� ....,...
❑res ^ • O No• < All.roofs shall be inspected prior-to any roofing material.being-installed._
,Will the applicant or rums,Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection, I agree to remove
emit hazan ods air contaminants as defined by me Buy Amen Air Quality Management
Diatri<t^, all new materials for inspection.-,Applicant understands and will comply with
❑ser 12 No '- all non-point source regulations. t .'I have mad me tmmdous materials mquiremenu under banter 693 of me
California He &Safety Cole,Sections 8505.25533and 3 a.lundersmad mat
ff
d •v not curcntly ha nouto t is myr P romilaym mnify the
e uummwr to s ce of a Ce 'Rema of
SignatureofApplicant Date
a ed gent .,e All roof coverings to be Class"B"or better
OFFICE - - -