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04010076CITY OF CUPESION CONTRACTOR INFORMATION:' BUILDING DIVISION PERMIT BUILDING ADDRESS: -74C) 17ATIPY r_PPFN DR SOUTH BAY CONSTRUCTION CO PFj4j.11T NOO4OIOO%F) tPPER`MIT ER'S NAME: ISSUE DATE 2 ONE: SANITARY C NTROL NO. ARCHITECT(ENGINEER: BUILDING PERMITINFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I hmeby affirm thu 1 sm licensed under provisions of chapter 9 (commencing with Section TOM)of Division Sof the Business and Professkn Code,andm license is m fret fora a dcff.L f�, '9 TI-DATA CENTER EXPANSION License Lk. Y Dam CSr ARCNIIECI'S DECDEri=,TION I y ansffitllWusedasp rbcmds Licensed Pmfcsaional OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Commictofs Licen¢ Law for the following maxon. (Section 7031.5, Business and Profession, Cade: Any city or county which requires a Permit in emuntct, abor. impra, demoluh. or repair any someone prior to its Issuance. also mqumo the applicant farsuch permit m rile a signed xlamamnt License Law 9 Sq. Ft. Floor Area auahon Rut he u licensed pursuant to the povisimu of the Contractor's (Chapter (commencing with Session 7000) of Division 3 of bW Business and Profession, Code) or Nat Im u exempt therefrom and the beau far the alleged maroption. My violation of 3 2VTU*41 <r0 0 Occupancy Type Section 703 1.5 by any applieant fm a permit subjects the applicant to a Civil Nasky of not more than five hundred dollars ($500). ❑ 1. as owner of Um pmpery, or my amployces with wages as their sole compensation, ns P Required Inspections e will do the work and the swmure is at mundd or offered far ask (Sec. 7044. Business and Pmfte ioru Cade: The Comment' Limine Law don not apply m an Owner of 9 property who builds or imp oe ms Hereon, andwho does such work himself or through his own employee, provided thatsuch impmvemmassum notiaterch d mortared forsae. IL however, the building or imprOwnwit is sold within ane year mcompletion, the owar- Wilder will have the burden of proving that he did not build or improv for purpose of side.). Ej 1, as owner of de, property. am exclushely contracting with licensed contractors in cum um the project (gee. 7044. Business aad Prfexsiam Cade:) The Contractors U- ceme Law does not apply to an Owner of property, who Wilds art improves thereon, and who contracts for such pmjecu with acom o cmr(s) ho and pursuant to the Connectors / 7 License law. ❑lam esempt underSid. .B&PC far thu recon Due Q 1 '♦� O I (TJ WORKER'S COMPENSATION DECLARATION I meby inns under penalty of pointy one of the following deciwtiom: 1 hoe and will maintain a Certificate of Consent to self-imure for Wmier'sCompen- xaion, as pmvidcd for by Section 37W of the Isom Coda, for tar performance of the work for which this permit is issued ❑ I have and will maintain Worker's Compensation Imurana, as required by Section 3700 of the Isbor Code, far the p olumaxnee of to wore for which this permit is issued. My Workers Compe on lnsunna carrier and Policy number art: r� CERTIFlGATE OF EXEMPTIONFlOM WORKERS' / COMPENSATION INSURANCE (Thu section mood not W completed Kim permit is foram hundred dollars (SUM) or less.) I anify that in the perfomanec of the wart fm which this permit is issued. I shall not employ any person in any insurer so as M become xubjVCHO to Winters' Compemation Laws of California. Dam M,Ikam NOTICE TO APPLICANT: If, after making this Condition, of Exemption, you should absence subject to the Workers Compensation provisions of Ne labor Cnde, you must f-Mwith comply with such provision, or this permit scall he deemed rewked. CONSTRUCTION LENDING AGENCY 1 W Nitre Nat there is a ro lending agency for the performance of ' de work far which Nu permit is issued (Sce. (Sid. 309f, Ci, C.) Lenders Name Leaders Actress 1 anify Nst I haw red tus application sand sum that due eW- imear-tiom is ' conn l agree On comply with all city and county ordinances and sum laws mining in shoOo-g comswction, and hereby auNarx mprexnutiws of this city to cnmr upon the aWVC.(We)as an ertysen. fmlmpefy and lucep, la. (WC) ag and hep harmlm NC safe apCNna agtiml a, cove, i al l y ac u,cosuad expembcnint. may in any way acme against said City j en expenses r inconsequence of D granting of this permit. inciliunuence f + APPLICANT STA D AND WIq LL MPLY WITH ALL ON DINT, Issued by: Date 5 RCER 0 a Re-roofs Type of Roof Sh ofAppi o serrM L, am HAZARDOUS MATERIALS DISCLOSURE Will ton applicant or future Wilding occupant stow or handleoars mammal ss Ocfincd by the Caption- Municipal Code, Chapn,r 9.12, and de HnIN and Safety . Section 25532()?` ' El Y. 6[No All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove future Will the applicant or Wilding occupant use equipment or devices which it hawardnm air contaminants as defined by an, Bay Area Air Quality Maugcmcnt all new materials for inspection. Gavin? ❑Yes 1 now real am WwaMmsmamrals requirements under Boner 6.95ofde Cidifon nia Hcalth&SafctyCd s.CuOmn-'QS.2A533endn534. 1udosmndbhaiftm Wilding docs not currently h a R- 4N y mapomi to binary ftoccupant o mf wqucnuwhk) sofkamofOceupaney.` nature of Applicant Date All roof coverings to be Class "B" or better ow aatho irDa e :eb CITY OF CUPESION CONTRACTOR INFORMATION:' BUILDING DIVISION PERMIT BUILDING ADDRESS: -74C) 17ATIPY r_PPFN DR SOUTH BAY CONSTRUCTION CO PFj4j.11T NOO4OIOO%F) tPPER`MIT ER'S NAME: ISSUE DATE 2 ONE: SANITARY C NTROL NO. ARCHITECT(ENGINEER: BUILDING PERMITINFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I hmeby affirm thu 1 sm licensed under provisions of chapter 9 (commencing with Section TOM)of Division Sof the Business and Professkn Code,andm license is m fret fora a dcff.L f�, '9 TI-DATA CENTER EXPANSION License Lk. Y Dam CSr ARCNIIECI'S DECDEri=,TION I y ansffitllWusedasp rbcmds Licensed Pmfcsaional OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Commictofs Licen¢ Law for the following maxon. (Section 7031.5, Business and Profession, Cade: Any city or county which requires a Permit in emuntct, abor. impra, demoluh. or repair any someone prior to its Issuance. also mqumo the applicant farsuch permit m rile a signed xlamamnt License Law 9 Sq. Ft. Floor Area auahon Rut he u licensed pursuant to the povisimu of the Contractor's (Chapter (commencing with Session 7000) of Division 3 of bW Business and Profession, Code) or Nat Im u exempt therefrom and the beau far the alleged maroption. My violation of 3 2VTU*41 <r0 0 Occupancy Type Section 703 1.5 by any applieant fm a permit subjects the applicant to a Civil Nasky of not more than five hundred dollars ($500). ❑ 1. as owner of Um pmpery, or my amployces with wages as their sole compensation, ns P Required Inspections e will do the work and the swmure is at mundd or offered far ask (Sec. 7044. Business and Pmfte ioru Cade: The Comment' Limine Law don not apply m an Owner of 9 property who builds or imp oe ms Hereon, andwho does such work himself or through his own employee, provided thatsuch impmvemmassum notiaterch d mortared forsae. IL however, the building or imprOwnwit is sold within ane year mcompletion, the owar- Wilder will have the burden of proving that he did not build or improv for purpose of side.). Ej 1, as owner of de, property. am exclushely contracting with licensed contractors in cum um the project (gee. 7044. Business aad Prfexsiam Cade:) The Contractors U- ceme Law does not apply to an Owner of property, who Wilds art improves thereon, and who contracts for such pmjecu with acom o cmr(s) ho and pursuant to the Connectors / 7 License law. ❑lam esempt underSid. .B&PC far thu recon Due Q 1 '♦� O I (TJ WORKER'S COMPENSATION DECLARATION I meby inns under penalty of pointy one of the following deciwtiom: 1 hoe and will maintain a Certificate of Consent to self-imure for Wmier'sCompen- xaion, as pmvidcd for by Section 37W of the Isom Coda, for tar performance of the work for which this permit is issued ❑ I have and will maintain Worker's Compensation Imurana, as required by Section 3700 of the Isbor Code, far the p olumaxnee of to wore for which this permit is issued. My Workers Compe on lnsunna carrier and Policy number art: r� CERTIFlGATE OF EXEMPTIONFlOM WORKERS' / COMPENSATION INSURANCE (Thu section mood not W completed Kim permit is foram hundred dollars (SUM) or less.) I anify that in the perfomanec of the wart fm which this permit is issued. I shall not employ any person in any insurer so as M become xubjVCHO to Winters' Compemation Laws of California. Dam M,Ikam NOTICE TO APPLICANT: If, after making this Condition, of Exemption, you should absence subject to the Workers Compensation provisions of Ne labor Cnde, you must f-Mwith comply with such provision, or this permit scall he deemed rewked. CONSTRUCTION LENDING AGENCY 1 W Nitre Nat there is a ro lending agency for the performance of ' de work far which Nu permit is issued (Sce. (Sid. 309f, Ci, C.) Lenders Name Leaders Actress 1 anify Nst I haw red tus application sand sum that due eW- imear-tiom is ' conn l agree On comply with all city and county ordinances and sum laws mining in shoOo-g comswction, and hereby auNarx mprexnutiws of this city to cnmr upon the aWVC.(We)as an ertysen. fmlmpefy and lucep, la. (WC) ag and hep harmlm NC safe apCNna agtiml a, cove, i al l y ac u,cosuad expembcnint. may in any way acme against said City j en expenses r inconsequence of D granting of this permit. inciliunuence f + APPLICANT STA D AND WIq LL MPLY WITH ALL ON DINT, Issued by: Date 5 RCER 0 a Re-roofs Type of Roof Sh ofAppi o serrM L, am HAZARDOUS MATERIALS DISCLOSURE Will ton applicant or future Wilding occupant stow or handleoars mammal ss Ocfincd by the Caption- Municipal Code, Chapn,r 9.12, and de HnIN and Safety . Section 25532()?` ' El Y. 6[No All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove future Will the applicant or Wilding occupant use equipment or devices which it hawardnm air contaminants as defined by an, Bay Area Air Quality Maugcmcnt all new materials for inspection. Gavin? ❑Yes 1 now real am WwaMmsmamrals requirements under Boner 6.95ofde Cidifon nia Hcalth&SafctyCd s.CuOmn-'QS.2A533endn534. 1udosmndbhaiftm Wilding docs not currently h a R- 4N y mapomi to binary ftoccupant o mf wqucnuwhk) sofkamofOceupaney.` nature of Applicant Date All roof coverings to be Class "B" or better ow aatho irDa e :eb