07120007-
BUILDING DIVISION PERMIT
BUILDINQADDRESSN TANTAU 'AVE
G
NOVO CONSTRUCTION -
PERMITNO
07120007
R'SNAME:
PERK I'ISSUEDATE
PPLE COMPUTERS INC
1042 HAMILTON CT
01/07/2008
PHONE:
SANITARY NO, CONTROL NO.
(650)701- 1500 -
ARCHITEC iENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0
LICENSED CONTRACTOR'S DECLARATION
Job DI:SCOPIIOn
I Wteby affirm that I an licensed under provisic es of Chapter 9 (enmmenchig
.10Section701K1)afD"i n3oftheBU nmmdPrg domCade.andmylicenseis
-
COMMIL TI MECH /ELCT MISC RELOCT 5 NEW OFCS& 1 NEW
in full (arse and effect
License Clas Lic.11 Z%
CONF RM; PAINT,CARPT,NEW CIELNG TILES THRUOUT
Dam Condacmr
DECLARATION
ARCHITECTS
1 understand my plans shall he used as public meet&
Licensed Professional
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Cen"ctor's License Law for the
following mason. ( Section 703 1.5, Business and Prolarnons Code: Any city ar..my
which requires a permit to contract, sheer, impmw, demolish, or repair any scrommic
! prior in its issuance. also requires the applicant for such permit to File a signed summers,
CammctufWccnm law 9
Sq. Ft. Floor Area
Valuation
Net he is licensed financial to the provisions of the (Chapter
$85000
I (commencing with Section 7") of Division of the Business and Profruinm Codc) or
Net he is exempt therefrom and the basis for the alleged esempdon. Any violation of
A Number
Occupancy Type
Section 7031.5 by any applicant for a permit Subjects the applicant 10 a civil penalty of
not roam does five hundred dollars ($500).
316 0 6 0 3 9
❑ Luowser of die propemytur my emrmadadwith sett
Required Inspections
q i)
,Busintien,
eredWste,(
will do thosal.. and. 7094, Business,
wmisnmmmnameraw de (mot
end Professions Code The Contrecwr's License Law not apply lf an mvner is
The apply
uch
property who improvudweogand who deeseuch wart himeel
red Busghhk
s, provided web improvements for sale B,
in ne year fcamplRemtl
howewn the buildingnrimprovementbhat within One year or completion, the
howemployeeuildin or improvement
purpose of
builder will have dm harden of proving the, he did not Wild or Improve for prrynse of
❑ 1, as Owner of the property, am exclusively contracting with licensed conuuvma in
constmct dre project (Sec. 7044. Business and P afnsdans Cade) The CoatraaWs U.
'
cents Law does Out apply in an owner of property who Wilda as improves Wemmn and
who commets for such pmjecu with a canoactor(U licensed pursuant in the Conuw.Tm's
-
License Law.
❑ l sm exempt under See ,B &P C for this rears
-
Dam
WORKER'S COMPENSATION DECLARATION
1 hereby dfnres under pemlty of perjury arse of the following declerulons
(] 1 hate atd will maintain aCeNfinTm of Consent w self-Insum fire Worke SCOmpen.
sation, as provided for by Section 3700 of the Labor Cade, for the performance of the
work for which this permit is issued.
❑ 1 have and will maintain Worker's Compensation Insurance, as required by Section
3700 of dm Labor Cotle. for the performance of the work for which this permit is issued
My Works Compensation Inamen¢ and Polcy numb� r KZE
ryNo.:
Cartier. —t �4 oS'
R:
ERTI ICATSOF NRO K
COMPENSATION INSURANCE
(This section need notbe completed if tbe permit is forma hundred dollars; ($IOM
or [am)
I certify that in the perfmmance of the work for which this permit is issued. I shall not
employ any person in any manner so as in became subject o the Worksrs' Compevadan
Laws of California. Dam
Applicant
NOTICE TO APPLICANT. If. after making this Certificate of Exemption, you should
become subject to the Worker's Compensation previsions of the Labor Code. We muse
v forthwith comply with such pmvisinm or this permit shall be deemed mvoted.
^
CONSTRUCDON LENDING AGENCY
I hereby dfithi that them is 3 lending agemy for dm perfurmanm of
s ed (So..
y the work fm which this permit is issued (Ste. ]097, Cie C.)
-
Lender's Name
-
Lender's Address
I certify that I have road this application and sure that the above information is
coned I agree w comply with all city and county ordinances and state laws mladng an
building construction, and hereby authmim mprescnuriws of this city to can:r upon the
G atim menti areal pm,rLy for inspection purposes.
(We) agree to save, indemnify and keep harmless the City of Cupcnim against
r4j liabilities. judgment, casts and expenses which may in any way acme against said City
> in consequence of the granting of this permit.
0 COMPLY WITH ALL NON- 'NT
Issued by: Date /�'i0 0
APPLICANT UNDERSTANDS AND WILL
SOURCER�
DISCLOSURE
Type of Roof -
Will the applicant or future building mcapanumre orhandle hazardous material
s darned by the Cupertino Municipal Code. Chapter 9.12, end the Health and Safety
. setae. 25532(.)7
All roofs shall be inspected to any roofing material being installed.
0Yen No
prior
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant at fu m building uccupans use cquipmem m devices which
emit hazardous air mnuminauts as derived by the Bay Area Air Quality Management
all new materials for inspection.
Muria, t�//
K.
Oyer
I have mad the Wrarcous materials requirements underGuil mr6.95 ofdte Califor-
nia Hcaldt&
Dam'