06090110 CITY OF CUPERTINO
BUILDING DIVISION PERMIT .CONTRACT0". NFOR_MA.TION �;e
1-°S •—F.
BUILDING ADDRESS: v PERMIT NO-06090110
20730 VALLEY GREEN DR
OWNER'S NAME: PERMIT ISSUE DATE
jft APPLE COMPUTER 09/15/2006
a SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
p0 LICENSED CONTRACTOR'S DECLARATION Job Description
.P 1 knotty affirm Na
r 1 am Hamed under Provision of of Chapter 9(commencing
:Zbiz with Smile.7")of Division Bpf the Business and Professions Code,and dr,he..is
!'cN a.fall fame andefrecL INSTALL TEMPORARY POWER BACKUP GENERATOR
h�? Liccnm Class Lic.N
r;,p Dow Contractor
ARCHITECTS DECLARATION
I understand my plan shall the used ss public records
a.ayU
o y Licensed Pro@ssional
OWNER-BUILDER DECLARATION
<E I lumpy aRrm that I am exempt from the,Cunuatsors License Law for the
.❑O fnllnwing mason.(Section 703 1.5.Business and Pmfessinn Coda:Any city or county
3 29 which requires;a permit tip consort after.a. m..demolish,or repair any suuesuro $100
.miprior m its issuance.also requires the applicant for such permit to file a signed statement
that he is licensed Pa..,to the provision of tk Contractors licove Uw(Chapter 9 Sq. Ft. Floor Area aluation
1FG (commencing with Section 70M)of Division J of the Business and Professions Cede)or
`s that he is exempt therefrom and to thou for the alleged exemption.Any violation of
Section 7071.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more Nan five hundred dollars(SSW). ter QC u ancy Type
0 1,as owner of the property,a my employees with wages as their sole eompmandon, v
will do 0.work.and teswcsum u not intended or offered for red,(Sm.TBad,Busiass Required Inspections
and Profession Cade:The Cmunizor's Liars Law does not apply to an owner of q p
property who WiMsorimpmv tbecim.and who doessuch work himxlforthrough his
awn amployen.provided that such impmvemenss are not intended proffered forsask.If.
howevn.Ne building or improvement is sold within one yea,of mmplmice.the owar-
builder will have the burden of proving that he did not Wild at improve for purpose of
sate).
1,as owner of the property,am exclusively contracting with Ilaaae i cunmetors to
/Mistrom the pmjca(Sec.7U44,Business and Professions Code:)The Conuacmrs Li.
came Law does not apply ro an owner of property who Wilds or improv Merton,and
who conpacu for such pro'ssts with a eonr m Oliansed Painumtrotheonaacmrs
Llecrs Law.
01 am...at under C B&PPcf Nis an
Dow Date • Z ab
WORKER'S COMP NSATION DECLARATION
1 kmby aIDmt under ty of petjury t a of the following declarations:
0 l ham and will maintain CenifsateofCame.,to self-imum for Workers Compere
station,w provided for by Session 3700 of the tabor Code.for Ne performance or the
work for which this permit is issued.
0 1 bave and will maintain Workers Compensation Insurance.as mquimd by Section
7700 allies Labor Code,for the pcRprmance of the were:for which this permit is issued.
My Workers Compemadon Insurance carrier and Policy number are:
Carrier. Policy No.: '
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE .
OTU section need not W completed if the permit Is foronc hundred dnllare(SIM)
in Icss.)
1 certifv that in the Ferfprmana of Ne k fppr which Nis permit u issued,1 shall not
..ploy any,..in any.parer ],h[Mp�nhbjecsade Woftes'Compermdon
Laws of California.Do a�Y VV�3l]
Applicant 1,1�
NOTICE TO APPLI If.at mm h this cnificate of EaC�emption,you should
become subject w the Worker pcnration provisions of tk Labor Code,you most
OfoMwith comply with such pro slow or this permit shall to deerned revoked.
z CONSTRUCTION LENDING AGENCY
(-+ I hereby of rms that tete I..construction lending agency fpr tk perrurmancc of
!Y the were for which this permit is iuucel(Sec.yr19T,Civ.C.)
W� Lender's Name
r7 z Lender'sAdd=
U Q 1 certify that I have mad this application told sato that the above information is
tis. H coned.1 agree ro comply with all city and county ordinances and state laws relating to
0 U building conwaion,and hereby authorim representatives of this city to enter upnn tk
G above-mentioned pmpcny forinspection whihpurposes.
(We)agree to saw.indemnify and keep th.less the City of Cupertino against
f~h Iiabilities,judgmcnLs.costs and expenses which may in any way accrue against said City
V z m commiserate of the 1.11.agofih permit.
^ APPLICANT ERSTAND ND ILL COMPLY WITH ALL NON-POINT Issued by: Date —/1f'GC
SOURCE R TIONS.
�� Re-roofs
Signature of Applican onuxmr Data
AZARDOUS MATERIALS DISCLOSURE Type of Roof
Will tk app not or future Wildinga 1.1 store a handle helamous material
as dcrined by tk Cupertino Municipal Code.Chapter 9.11,and tk Health and Safety
Code, nRom15552(a)T All roofs shall be inspected prior to any roofing material being installed.
❑Na
If a roof is installed without first obtainingan inspection,I agree to remove
Will tk applicant or future building occupant tax equipment or devices which P g
emit havaNnn air contxmimnts as defined by the Bay Ara Air Quality Management all new materials for inspection.
Disuic
�ycs ❑Nu
Ihave road thehvasd6 maeri5X53 imd255 1.1 undbreandt95ofthe Califon
nicer nolt cu Safes Cv!. atiom 25 i1555Jamm25534.1undcrsund thatifte Wilding
docs not tune me a tenant u u y mtponibility m notify Ne oaupant of Uhc
mquirtmen eh most at a or venaof.Comfica,e Signature of Applicant Date
r>
Owner or authorind gent D,ro All roof coverings to be Class"B"or better