08010037 CITY OF CUPEIYPINO
BUILDING DIVISION PERMIT. CCIVTRACTQI2INI+'ORMATIO:N `
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Bu1LD1yBQApQIsPERMITNO.
N TANTAU AVE SHOOT.- NOVO CONSTRUCTION 08010037
lipE 'UN*ME. PERMIT ISSUE DATE
APPLE INC. 1042 HAMILTON CT 02/29/2008
PHONE: SANITARY NO. CONTROL NO.
(650) 701-1500
ARCHTIECTIENGINEER: BUILDING PERMIT INFO
., BLDG ELECT PLUMS MECH
�Op LICENSED CONTRACTOR'S DECLARATION lob Description
LI C I amrtby affirm INt I am lianrea miler pd Nof ss of Chapter 9(mmamaw.ing
,2w with5cai°n]OfM0af0ivision3ofthcBusincsu-dProfeadam Baas is COMM'L T. I . — MISC NONN—STRUCTL TNANT IMPROV
'<d mlull forte-def( Q �0�
Liaanegan tic.» INCLDNG OPEN OFC AREAS, BREAKRMS,RESTRMS
�Fw Dam Conlracmr_
cxITELTSDECLARATOh MODIFCTS/EEXPANSN. NEW T—BAR CEILNG IN SELCTV
ioie IundcrswnJ Plmam.11 beacd.,.Lake recnNs
)yU
aOg LiccnuJ Pmfcssionol
s s, OWNER-BUILDER DECLARATION
C.. era _
10 1 hc.hy than 1 1. cxcmpt from the Crshors o License Law far the .
pO following m-n n.Permit
RI3LS Business ad improve.
deiooa Code:Any dry scmomy
e m which requires a Pctmit to cnnswcL altar,improve,dcmmkat, fierepairsig any sumturt
!iNy priorm its iauancc,also requires the applic-tfor such permit to fie asigmJ sWement
G That he is licensed pursuant othe pmvisiomofthe Canmacmr'sLeenwLaw(ChaPta9 Sq. Ft, Floor Area Valuation
e (commencing with Section 7000)of Division 3 of the Business-d Professions Code)car 2000OO
that he u exempt therefrom-d the hais for Ne alleged co m anon.My violadoa m
Section 7031.5 by any applicant for a Permit subjects the appBcant m a civil pevSy,of Occupancy IYP
nm ream than five hundred doll..asaB). 316 05 05 6 ANM'2 ber ecu ane e
do
vowmrof the property,rcmy employees withwageaathL'v a.Comp-noon,
and dodmworLndoes ock,C he CleRln red ctmes License aw rd!cls,lorsak s.1apply to an BY9'nea Re uired Inspections
-d Preproperty
who
Cade Them thereon.Liceand
who law doa not apply lf-adv m Required P
own erty wbm huiIdsor ed tat such Impr,and who arcasuchwcok himwlfrctbroogh his
however.the
uiproNor I prsuch nt4 semwt are not ear roRertd far sat r,
builder,Ne building or LmProssmot u said within rem year of romped°q do wter-
buildr WII have the Wrdcn of proving that he did mu miW or impwse[a pmpoo of
wkJ.
C 1.a owtor m the property.am inclusively canuwting with liamed oovamars to
construct the project(Sec.7014.Beed. ad Profeadatss Cade:)The Camamfs Li,
cause law 4.Out apply m an awnr of property who haulds a,imp.theses,.me.
who comose sfarsuch projects with a canmactm(s)licensed pursuant us ft Cou.aafs
License law.
❑Tameaemptundr See ,B&PCfnrlhil,ealm
or Dasa
WORKERS COMPENSATION DECLARATION
I hereby aRrm under Penalty of perjury ane of the(.]rowing declarationc
C 1 have-d will maintain a CertiRcate of Conserv to calf-inwm(or WodmfsCampo-
.sation,u provided for by Section 3700 of the Labor Code,fa the p°Aormana of the
work for which this prmf is issana.
C I have and will maintain Workcls Compensation Instar-a,as required by Sectio
3700 of the labor Code.for the Performance of the weak for which thin permit is laded.
My Wmkee C pena`tion l^sur-(eA�c��o��gr/1 try number abc
Cd111Cr: V I arra al a.: LL
CERTIFICATE OF 'XEMPr10N FROM
COMPENSATION INSURANCE ,-
(MT mmimmcdmtb°campkwdifLMl mitisfwomhundlWddlasa($100)
L"less.)
I certify that in the performame of the work for which this permit is issued,l shd4 rem
.mploy my pawn in my m-mrw as to become wbjm to the Workers'Carepo¢uio
Laws of Califomia.Dam
Applicant
NOTICE TO APPLICANT:IL after making this Ceaifieate of Exemption,you shoakf
become subject in the Worker's Compensation provisions of the Labor Code,you coma
.J O forthwith comply with such provisions or this permit shall be dames motel '
Z N CONSTRUCTION LENDING AGENCY
[-+ IhemhyafOam deal there u a commando Imdmgageney far ft Pa ..[
D:7 the work fur which this Permit is issued(Sec.3097,Civ.Q
G A Lcndcr's Name
ma
0.Z Undoes Adds
U C) 1 c rtify that I have read this mplicuion and sum dor the about infooaio is
comet.1 agree m comply with all city and county mliamets and stak laws relating an
O U building construction,and hereby authorize representatives of this City to enter noun the
4s] sbovcmemianed P.N,ty(o,im,cuen proposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
liabilities,judgments,costs and expenses which may in my way accrue against said Cty
U Z in conaegmnce of the gmming of this Permit.
k' APPLICANT UNDEBS'rANDS AND WI L OMP Y WITH Issued by: Date 2 i 2. —ray'^
SOUR �aGX1t NDEROS[A �F//t—ND
y2A Re-roofs
Signmu p 6k
cant/ o trwmr Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the apPlics or future building oce.panutore a handle haaard°us material
defimd by the Caperton Municipal Code.Chapter 9.11,and the Health a d Safry
Je,section 25532nd? All roofs shall be inspected prior to any roofing material being installed.
CYca 7 N.
future building occupant use rquipmem or devices which If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or
emit hmvdos air contaminants as dkOmd by the Bay Area Air Quality Mamgemot all new materials for inspection.
Dismct7
❑Y �Nu
I have read the Wand.materials requirements under Chapter 6.95 olds,Califs-
asHealth&Safety Cade,Saxons 15X15.25533 and 25534.I madams nd thaifthe building
Jana not cuneady have a mndnL that it is my responsibility an miry Ne accrf are of the '
mm� met atm wan.A.Cotieroteor0c Signature of Applicant Date
Owner oT ,,eaas �� A +a I, All roof coverings to be Class "B" or better �g