01110073ta-
iz
IY
'O
iLL
to
or
F
c4
a.
OFFICE
OF TINO
CI out
CONTRACTOR INFORMATION:
DING DIViSRiONPERMIT
BUILDING ADDRESS:
PERMIT NO.
20330 STEVENS CREEK BLVD
HOWARD WRIGHT CONSTRUCTION
CO. 01110073
OWNER'S NAME:
SYMANTEC CORP. (CC2)
PIER 9, THE EMBARCADERO
APPLICA71ONSU OATS
11/15j2001
PRONE:
(206)447-7672
SANITARY NO. CONTROL NO.
O D
ARCHITECTIENGINEER:
BUILDING PERMIT INFO
:n(—(--
BLDG ELECT PLUMB MECH
Zffi
r= I--1 1_) L_)
ae
hi
LICENSED CONTRACTOR'S DECLARATION
Job Description
_a°�,
I hereby affum that 1 am licensed under provisions of Chapter 9 (commencing
-imseeannnao)nfDivision3nnheBnaneesandPretc„iorvOle.andmyranse
TENANT IMPROVEMENT.
Is ll fes and<Rcq� p ' 1, r
License Clas t....a..� {' 7 )�
/A� y C
d �
G
Cmna,our
Date O a cnmmeim J%, ee
Fill M `IG
0
A CHITECF'S DECLARATION
;
0oLicensed
I undersmnd my pian shall be used as public records
FEB
Profession9
0 7 2002
OWNER -BUILDER DECLARATION
v,
1 hereby a1Brm that I am exempt from the Contmnor, Lknow Law for the
za
(o0owingrcason.(5<nionTO31.5. Business and pmfesaionsCode:Anycigorcounry
BUILDING $40000
which re uir' a Permit In or,or,r, alter, improve, demolish, or repair any Consture
- _ _ _ _ __._....
m
-rmanoiu issuance.alsorequimesihe applicant forsich perminofile a signedsmtement.
'-”
�ja� p,� _-
A,_,_, km q� qp �., _
{^;3 B�J.'fY2',V,:itYVl"v1tttr!�^'
Valuation
that heiStlimn.ied pursuvnno the provisions of the Contractor's License Taw (Chapter
(commencing with of Division 3of the Busin'a and Prnffewfons Cade)
,Senica'000,
or thing, ii exempt therefrom and the basis far the alleged eiemptlon. Any violation
\,.'(-� 4
-of Section 7031:5 by any applicant forv permit subjects the applicant to a civil penalty
of nm more than five hundred dollars (5500)
10 3IPN r*Gt UDATI ON
- Occupancy Type
O 1, as owner of the property, or my employees with wag' as their sole compensation.
102 - PIERS
'will do he work, aad the atmeta a i, oat intended o, aff,,cd for sale (5,, 70W,
`Business and Professions Code: The Law en Contractor's License does out apply to
10 3 - UFER Required Inspections' '
owner of property Who builds or improses thereon, and who docs such work himself
104- -
em
Co through his own ployees. provided that such improvements ore not intended or
,oPa<d for sale. If. however, the building or improvement is sold within one year of
_REBAR
- -. - -- -- - - -�� - -
- 165- -ANCHOR BOLTS -
completion, the owner -builder will have the burden of proving that he did nm build or
improve mr puipnse of atria.).
106 - SEWER & WATER
__. _._ -' _. . in - " -- -- - -
Iicenm e to
t7Lxsowner a!jep(See.
- --202 -- UNDERFLOOR- PLUMBING" .... ., _ _. ...
adProfrsiwin
7vine Business Contests
thewdoes (get. coae:lThevesttaemra
203 - UNDERFLOOR MECHANICAL
to owneroaniPmr'sie
LicenseLat who builds or improves thereon,
License Law does not appy m an owner
with a,conoy
_dna who contracts for such projccu with a.comacmrls) Ifcenseal.parsuam to the
_ ... .-.._ 2.04'- — -UNDERFLOOR-FRAME
Contractor's License Law.. _11 1
❑ I am e'nmpt under Sec. s,B& PCforlliisreason
205 - UNDERFLOOR';INSULATION
owner Date
301 - ROUGH PLUMBING
-
WORKER'S COMPENSATION DECLARATION
302 — TUB & OR SHOWER
I herby afErn code, peoulty of perjory one of the following deeamimo:
303 - ROUGH MECHANICAL
❑ 1 have aad will maintain a Cenifient< of Convent to self -insure for workers
304 - ROUGH ELECTRICAL
Compensation, n provided for by Section 3700 of the Lat,or Code, for the
305 FRAME
yirfor aim. of,M work ro, which this .if is issued,
-
❑ 1 have and will maintain Worker's Compensation Insurance, as required by Section
306 - HOLDOWNS
"
3700 of the labor Cade, for the performance of the work for which this permit is
307 - INSULATION
:.
issued. My Worker's Cumpensmu
ion Imran earner and Policy number arc:- „r I
.:-... ... _ ..
camerCa6.'..' voherNa.:'
308;-t,SHEETROCK..::"'
•.t. t CETIFICATION OF EXEMPTION FROM WORKRS'y;
�i, tt.3'09�+=-'`B.`CTERIORI LATH
"'__ ...,.
_.._ _.—_n. . COMPENSATION INSURANCE• „
31-0-,._=�,I-NTERTOR' LATH--_
s(' (This section need not Inc comp e'ted if the permit is for one hundred dollars
_ t) -
311 SCRATCH COAT
(sldo)orless.)
31-3 --ROOF-NAIL-
.l cerify that in In, performance of the work for which this permit is issued
snail in become Workcrs'
501 - FINAL ELECTRI CA'L' 'ENERGY
not employ any per on any manner so as to subject to the
Compensation Laws ofCaifomia.Date
.-Applicant
502. - FINAL. PLUMBING ENERGY. .. ..
NOTICE TO APPLICANT: If. after making this Certificate of Esem,tim. you should
503 - FINAL MECHANICAL ENERGY "
z
become subject to the Workers Compensation provisions of the Labor Code, you must
C
forthwith comply with such provision, of pent it shall be deemed r'akcd. _
504 - -. FINAL BUILDING ENERGY
14
s' CONSTRUCTION LENDING AGENCY
SOS — FINAL ELECTRICAL - •' '
>
I he eby Rrdi that there'. ....v ou t na lend ng age t y f the p rfdnnanca
— t
506 GAS TEST
q
of the worst for which this Permit is issued (Sec. 3897, Civ. c.)
LanderNName -.
507 - FINAL PLUMBING
508 - FINAL MECHANICAL t'
O
1 cerif that I have raid this application d state that the above information is
rrect. I agree to cornply with all ciy and cmty ordinances and.aate laws relining
(odiudie-menstmdion:aertyfo
509 - FINAL GRADE
f,>
dove representatives
510 - FINAL PLANNING
fa7
inspecndeemposeatati.esormiseaym<nm,upon
the menstraed propertyfor inspection ,
d
(we)agree Costive. indemnify and keep hurndesstire City ofCuperinoagainst
514 - FINAL PUB IC WORKS
(n
lubilitiea, judgments, c and eapcmises which may in any way accrue against said
ZCity
in conseque the mniing of 1M1is'Com,
APP -)r NO WILL COMPLY WITH ALL �.p7w
sou
/
Issued by: Date /5
(N'fyJ1
. s: / L /
Signatureo omraaor
Re -roofs
HAZARDOUS MATERIALS DISCLOSURE
..- Wllthe riiiiann or future building o,co,pand store orha hi halardniusmaterial
Type of Roof
-
as def ed by tit Cupcn < p cad Chapter 9.12 and the Health and Safety
Codes ton 25532(o)?;,*i..
oFit, '
-.-All roofs shall be inspected prior to any roofing material being installed.
_ Will the applicant o furore building occupant vet equipment or a ices whim
_..
If a roof is installed without first obtaining an inspection: I agree to remove
mit h ela orcom nt, a q�fined by the Bay Arco Air Q al ty Management
District
all new materials for inspection. Applicant understands and will comply with
• oY o
all non -point source regulations.
1'have read the Conductors materials requirements under Chapter 6.95 of the
Callfdrom Health & Safety Cade, Sections 25505. 25533 and 25534. 1 understaM that
'- if, thabuilding does not currently have a tenant. Char it is or, responsibility to notify the
ducupwal df the requirements which must he, met prior to issuance of a Cenlfcate of
F
Ocaponcy. ,
- k,/
Signature of Applicant _ .. _ Date
All roof coverings to be Class "Bats or better
woer or authouriznine V—
OFFICE