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04090099CITY OF CUPERTINO ' 'd'N a ^' "' ''t" NFO MATION ' BUILDING DIVISION PERMIT CO TOR BUILDING ADDRESS:- HOWARD WRIGHT CONSTRUCTION PERMITNO. CO. 04090099 R'S NAME: PERMIT ISSUE DATE PHONE: RlibARY ft*OL N0. ARCHITECUENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm Nat 1 am licensed under proviso (Chapter 9 (commencing ]01X17 ofDivision3of NC Business d mocisCode,anderylicenmis iSection r a Landetteet Lic,m nicce Clea EVISION--EXTERIOR COURTYARD 0 NEW PERMIT ISSUED ORIG. #04060082 Dal Contractor ARCHHECI'S DECLAKATM- 1 untl m ¢ the I used ss uhlfic come . Lu.cna ~ C G�+raS6 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from she Contractors License Law for the following reoson. (section 703 1.5, Business and professions Code: Any city or county which requires a permit to construct, altar, improve, demolish, or repair any structure prior to its issuance, also requires the applicant forsuch permit to file a signed suimmcnt contractors; License Law (Chapter 9 Sq. Ft. Floor Area Valuation Natbe is licensed pimento in the previsions or the $35 (commencing wish Section 7000) of Division 3 of the Business and Profusions Code) or Nat he is exempt ibemfrom and the basis for the alleged exemption. Any violation of APN Number OCCU anC Te P Y]P Section 7031.5 by arty applicant for a permit subjects Ne applicant to a civil penally of not mom than Ove hundred dollars(S500). ❑ 1, an owner of Ne property, in my employees with wages a their solo eomper adon. 36901020.00 Required Inspections will do the work, and Bleswcare is not intended oralfm d forsale (Sec. 7044, Business and Pmfesslons Code: The Contractor's Lt.. law does not apply to so ...as of property who builds or im proves Nerean, and who does suc h work himself or through his own employees, pmvidcd Natsuch inprov.meamare not Intended aro@red (orale IL however, me building or improvement is sold within one year of co rdikoh n. the owner. builder .01 have the burden of proving mat be did nos Wild or improve for purpose of sale.). ❑ 1, a owner of fee property, am exclusively convecting with licensed canwcters to construct the project (Sec. 7014, Business and Professions Cade:) The Conlmcmr'a Li. cave law does not apply to an owner of papeny who Wilda or improves thereon, and who ca moans for such projecta with a contractoKU licensed pumuanl to the Coatmetors License Law. I ran exempt under Sec. . B & P C for Nis moon er Data WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury ON of the following declarations: ❑ Ihave and will maintain a Ceniriwm ulceration to self-insumforWorkresConpen- selian, as providert for by Section 3700 of the Labor Code, for the rammmance of the work for which this permit is issued. ❑ 1 have and will maintain Worker's Compensation Insuranm, w required by Section 37M of the labor Code. for she parfo... of the work for which this piano, is issued. My Workers Compensation Insurance caner and Policy number am: Cartier. Policy Na.: _ CERTIFICATE OF ECEMFnON FROM WORKERS' COMPENSATION INSURANCE (This section need no becompleted tribe permit isforanc hundred dollars (SIM) or leu.) 1 cannily Nat in the perfmm unc at the work for which this Permit is issued, l shall not employ any person in any monotone as in become subject to thewarkers' Conpensadon Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Cendimm of Exemption: you should become subject to the Worker's Compensation previsions of she Labor Code, you must forthwith comply with such Provisions car this porno. shall W deemed ravager. CONSTRUCTION LENDING AGENCY I hereby from Nat Nem is a construction leading agency for to p.,formace of the work fur which this permit is issued (Sec. 3097, Civ. C.) Lender's Name Lenders Address 1 certify that I have mad this application and sum that me above information is correct 1 agree to comply with all city and county ordinances and suite laws relating N building construction, and hereby auohona mpreaimthaa of this city in enter upon dte above-mentioned property for inspection purposes. (Wo) agree to save. indemnify and keep haonlass the City of Cupcnino against ) liabilities, judgments, costs end expenses which may In any way manse against said City in consequence of on, granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SO RCE R L ONS, Me-roofs Type of Roof gnerurc ol'ApplicambContractorDam HAZARDOUS MATERIALS DISCLOSURE-' Will the applicant or future building occupantseare or handl. he'rmrdaus mamral claimed by Ne Cupenino Municipal Cade, Chapter 9.11, and she Health and Safely section 255320a0? All roofs shall be inspected nor to an roofing material beim installed. being El yes Na P P Y g If a roof is installed without first obtaining an inspection, I agree to remove Will shc applicant or future Wilding occupant use equipment or devices which coil hazardous air cmutroomis as defined by Ne Bay Arm Air Quality Management all new materials for inspection. District? ❑Yes 1 have mad the commons ma crialsoquimmoou under Chapteo 6.95ofthc Califor- nia Health &safetyCode, sections 25505.15533 and 15534, 1 understand thlifthe building dao¢ mol cumcntly caro a censor Nal H ¢ my rcspo .1.1. m notilY she axup ou or Ne myviremcnu who at elp'or iaaaae ace 'team aratuNeu Signature of Applicant Date ! All roof coverings to be Class "B" or better owner mantra I ar stem Dam I L�CZCc,� 3�U _05 00 aAem� wpm F?t z Z C F� a� oz UC OF L a UR CITY OF CUPERTINO PERM ',.=�"° `gcq '++:;,, "`o-.�i Cm1y N) " BUILDING DIVISION .°�,CTbR BUILDING ADDRESS: HOWARD WRIGHT CONSTRUCTION PERMIT NO. CO. 04090099 IFF.R'S NAME: SYSMANTEC PTER Q, !HE EMPARGAPE RG #-I- PERMIT ISUEDATE PHONE: ITARY OL NO. ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 LICENSED CONTRACTOR'S DECLARATION Job Description I hereby of ton that 1 em licensed under proAsi f Chapter 9 (eommcrein{ w Sccdon]IXKI)of Divislon7of Ne Businam d esmm Codc. end mylkcnsc is info eaneertect. Lic Class Lk.# a EVISION--EXTERIOR COURTYARD 0 NEW PERMIT ISSUED/ ORIG. #04060082 Dau conuetar ARCHITECTS DEC A l und�f{u�Omy se H used upuM1lic nNf i tirb LmensrsfcusonIl OWNER -BUILDER DECLARATION 1 hereby artirm that I exempt fare the Lew for me An, 1 lexam. Co : c regrecon. (Section ]11]13, Business and Pmfecsine Code: Any city nr county which demnRiuMFpair my structure prim missorrtnpermhre[nn,flan ,plinafter, ul(.,su priorto slmcnecd e,also the theapplicantforsuchpermit tofileasignedsummers, Sq. Ft. Floor Area Valuation iso UcenscLaw (ChaPtm9 thathe iucingwit pursuamtamc ofof $35 Af Diaiae (commencingwith Section] 000) of cBuarmaga amandon. Ani iCode)tar Nat he ts exempt IMmfrom and Um bels (or the allcgW exempuan. Any violation or Itemst3or alleged APN Number Occupancy Type Scott..7031.5 by any applicant for a permWubjeces me epplinnuo a civil penally of not mom than Ost hundred dollars (S500). 36901020•00 ❑ 1, Or Owner of the property, or my employers with wages m their sole compensation, Required Inspections will do the work end the somelum is WI intended Or offered fonde(SO. 7W. Business and Pmfasdaru Cade: The Conuactor's Lt. Law dors not apply to as owner of property who houses., inpowas thereon, and who does such work himself or through his own employee, provided that such improaments art not intended oroffemd for We. IL however, me building or imprewment Is sold within one yea of completion, the ower - builder will hew the burden of proving that he did not build or improve for purpose of Yale.). ❑ I, u owner of the property, am exclusively commoing with licensed contractors to construct the project (Sec. 70,14, Business and Professions Code:) The Contractor's Lb ecnan law doe not apply to an owner of property who Wilds or improves themon, and who contacts for such projects with a canuactor(s) licensed pursuer, to the Contrecto's License Law. ❑ I sm exempt under Sec. B & P C for this meson er Due WORKER'S COMPENSATION DECLARATION 1 hereby affirm under porosity of perjury one of the following decimations: ❑ 1 have and will maintain aCaNOrate of Consent to sel6seure for WorlmesCompen- sation, as provided for by Section 5700 of me, Lues Code, for the performance of the work for which this permit is tissued. ❑ 1 have and will maintain We kc,'s Compensation leunnce, ns required by Section 3700 or to Labor Code, for the Performance of me woh for which this permit is hated. My worker'! Competuatlan Insurance artier and Policy number ate: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This m do. need nm becompleted Ifthe peanut Is foronc hundred dollars(SIM) or loss.) I certify that in the performance of Box work for which this permit is issued. I shall not employ any person in any manner an as Or become subject to the Workers' Compeeat on Lawn of California. Dau Applicant NOTICE TO APPLICANT: If. after making this Certificate or Exemption; you should become subject to the Worker's Compurgation provisions of the Labor Code, you mug forthwith comply with such provisions Or this Permit shall be deemed revoked. 1 CONSTRUCTION LENDING AGENCY 1 lu mby error mm thea h s comwcdnn lending agency for six Performance of ' the work for which dila permit is issued (Sus:. 3097, Or. Q Lenders Name Lender's Address i 1 comfy that I have read this application and utte met the aWst information is ' correct. I agree to comply with all city and county oNimmom and state laws relating to building caewvion, and hereby authmia cop osenutiveS of mus city to enter upon the property for Inspection an Purposes. ahovc (We) a the City of (Wc) agree It cost, indemnify and kith hay l id City against said may inany way eccrvc againstacid City i in liabilitigenceofthe costsandof inal this this permit. of UNDERSTANDS T A APPLICANT APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date SOURCEll L ONS. fAe-roofs Type of Roof gnetum afApplicaH ZARDOUS MATERIALS DISCLOSURE ' Delta Will me appllanttarfutum WIldingacupantstom orhandlehais inusmaterial as du0ned by the Cupertino Municipal Cade, Chapter 9.11, and the Health and Safety dc, Section 25532(.)?0Ye All roofs shall be inspected to any roofing material being installed. Nu prior If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or room building occupant use equipment or devices which emit havardnus air contaminants u dcrinc l by the Bay Arca Air Quality Management all new materials for inspection'. District? / ❑Yes j;? I have mad the huraNnusmateriahrequirements under Chapmr6.95 of the Califon nulkalm&Sdcty Code Sccdom253O5,15533ud2553,1.lundemmtdmmifdm Wilding alae nal cumendy haw a tenant Nm it is my rempo ihility m notilj me occupant of me requimmem, whi st ct or issuance ace niremarGcrup�cy.' Signature of Applicant Date `Dam All roof coverings to be Class "B" or better - owner. thodaednsem • CUPERTINO 9fTY OF CUPERTINO(4 o PERMIT APPLICATION FORM C�9�o7o�q� APN # Date: Fee Group BAPPLOTHER Building Address: Mailing Address (if different from building address): O 33 ry �ea /✓a[ Owner's Name: Phone #:675 n BBOILER2 Contractor: License #: - t7ow S GJ 6 0 -5 Contact: Phone: 4.4e' /i Fax: Y/'! �f' dory Cupertino Business License#: zs 7 Boiler> 1M to 1.75 M Btu MECHANICAL Building Permit Info: Bid Elect Plumb ❑ Mec Job escription: ` Residential E�- STs �s� �o�< vs, Commercial ❑ Sq.Ft. Floor Area: $/Sq.Ft.: Cost of Project4l o o Occupancy Group: Type of Cons ctio : Please check this box if the project is a Con. Tax for BQ Zone second -story addition: ❑ Project Size: Standard Q Laze ❑ Major ❑ Hotel and Motel Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOILER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL OZ BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING Iof3, r� Q Z a F V Lt. Q U CITY OF CUPERTINO r �> BUILDING DIVISION PERMi� ° CiSNfiRACTbRIN;�'ORMA'�N Y AilP titri`� u�0�� '�xu5v'YT SLY(. �plu' fon . au1LDlNanooacss: HOWARD WRIGHT CONSTRUCTION PCO. 04090099 El NAME: PERMITISUEDATE PHONE: ITARY OL NO. (20r)447-716 0 ARCHI=rENGINEER: BUILDING PERMIT INFO BLDG ELECT' PLUME MECH LICENSED CONTRACTOR'S DECLARATION Job Description 1 h.rcby affirm that 1 am licensed under provid f Chapter 9 (commencing P Senion]IXIU)of Diviaion7of the Businesv d essiuns Cotic.and myliccnse is inrr .tderfect. EVISION--EXTERIOR COURTYARD Uc Clms Lk,a a Dote Cantmctm 0 NEW PERMIT ISSUED/ ORIG. #04060082 ARCHITECTS DEC A 1. du'(j illany chat nsedaapab�lleJ.aCcards Lic.ma mfcsson a �b �� OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Commator's License Law for the following mason. (Section 703 1.5, formation! Pofassimu Code: Any city m county which requirca a Permit 10 construct, almr. improve, demoluh, or repair any structure prior m its issuance, also requires the applicant forsuch xinailto fleasignedstatement train allocated pursuentiodoprvisiom afthe Commotor's Limns law(Chap¢r9 Sq. Ft. Floor Area Valuation $35 (commencing with Section]000) of Division 7 attic Business end Professions CMc) or Nat he u exempt ihemfrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of APN Number Occupancy Type not mom than five hundred dollar (55(10). 01, as Owner ofthe property, or my employees with wages u their sole compensation, 36901020.00 will do the wady and the truck mis not immadedoroffued forsala(See 70 ,Business Required Inspections and Poemashms code: TTm outhouses Lt.. Law does con apply m ,a owner or 9 P popenywho build.., improwts thereon, end wh.d.,such work himsellor through his own employeas, provided that such Improvements arc not Intended orof(emd formic. IL however, the building or Improwmenl is sold within one year of completion. are owner. builder will hew the burden of Proving that he did not build or improve for purpose of .it ❑ 1, as owner of the property, am exclusively contracting with Ikemed contractors to construct the project (See. 7044. Business and Professions Code) The Conuaeoh Lt. came Taw does not apply to an owner of popery who Wilda or Impovaz theman, and, who c mmmm far such Projects with a contrach r(s) licensed pursuant to be Combustors Licenm raw. ❑ I am exempt under Sea . B & P C for this reason Dam WORKER'S COMPENSATION DECLARATION 1 hereby affrrn under penalty of perjury mm of Ne following Eechra,lons: 1 have and will mainmin a Cord Beate ofCaosent to self-insum for Worker'sCompcn- mtian, u provided fm by Section 3700 of Ne labor Code. (a, the performance or the work for which this permit is issued. ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 3700 of are labor Code, for the Performance of the work for which this permit is issued. My Workees Compensation Insurance carrier and Policy number are: Cosier: Policy No,: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thissecdon need not M completed If the permit is foram hundred Jolles ($1IX) arks..) 1 cenify Out In Ne performance of the work for which Nis permit is Issued, I shell net employ any person in any moneran ear to become subject to the Workers' Campensadon Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Ccnificalc or Exemption; you should become subject to the Worker's Compensation provisions of the Labor Code. you must Oforthwith comply with such provisions at this Permit shall b. deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm Nm then lac construction lending agency lot the performance of Ne work fur which this penal, u issued (Sec. 3(1 Cu. C.) QLenders Name Z Q F' C) [Z7 faA z Lenders Address I mnlfy Net I haw mad this application and sum that the above infor ordun is torten. I agree to comply with all city and county ordinances and stsm laws slating o building.omuuction, and hereby mth.rim reprcmnmtives of this city to enter upon the .hove-memiumd property for inspection purposes. (We) agree to saw, indemnity and keep harmless Ne City .r Cupertino against liabilities, judgment, costs and expenses which may in any way accone against mid City in his APPLICAeNTeUNDERSTANDSof the loading oftAND WILL COMPLY WITH ALL NON -POINT Issued by: Date SO ARCERAgUL ONS. Ae-roofs Type Of ROOF / 440Q gna"i'm of Ap"canoc mane Data HAZARDOUS MATERIALS DISCLOSURE Will the applicant or from building occupant Marc or handle hazardous material az defined by he Cupertino Municipal Code, Chapter 9,12. and the Health end Safety de Section25532(a)? All roofs shall be inspected to any roofing material being installed. [j Yet C,Nu prior If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occomm. um equipment or dcvicm which Caulk hazardous air conmminams u dchncd by the Bay Asa Air Quality Management all new materials for inspection. District? / ❑Yes 1 have sad the h t ark., materials mgrircments under Chopmr6.95.f the Cthfo- nit Health & SafetyCode, Savours 25515.25537 and 25534. I undcraund thatifthe Wilding dotsnotcurenrlyhawastem,Nm unmymsp.n hilityo nndl'ydscaccupmwfthe ou wrement,whi or issuance aCcurkma foxy. SignatureofApplicant Date !Dam All roof coverings to be Class "B" or better Owner car Norizcd agent -12 Project no: Refere ce: Issued o: Date: 03-00358-21 -2- C)-!> o �y n • Scale: Sketch No. 3 o Sheet Title: Project info N oo HELLMUTH, OBATA + KASSABAUM, INC. M ARCHnWrURR, ENGMEERMO, PLANMNO, NlEMORS, GRAPMCS CONSULTING One Bush Street, Suite 200 T: 1 415 243 - 0555 o San Francisco, CA 94104 F. 1 415 882 - 7763 Internet: www.hok.com f ryJ E O O O N *e. d ,n NTq pV U I v ° d qL 0 .-1 W U • _ _ Z W a � W a_ II 'o ISII 0 :1 6 2004 01 D] Project no: Refer e e: Issued to: Date: 03-00358-21 l:. # 1 d S Q C� 9/1's 01 • Scale: S Sketch No. Sheet Title: Project info HELLMUTH, OBATA + KASSABAUM, INC. ARCMl MME, ENaNEEMG. PLANMNO. NMTUORS, GR MCS coNSM. Q One Bush Street,- Suite 200 T: 415 1 243-- 0555 - - Son Francisco, CA 94104 F: 1 415 1 882 — 7763 Internet: www.hok.com