06060090CITY OF CUPERTINO
a
BUILDING DIVISION PERMITzlCiil`d"CRaA-CIN',t�?,.,tM'i'r�lWE
BUILDING ADDRESS:
SOU BAY CONSTRUCTION CO
rrN006060090
740 VALLEY GREEN D
lR.S NAME:
PERMIT L55UB DATE
(APPLE COMPUTER
170 KNOWLES DRIVE
6
E:
SANITARY NO. CONTROL NO.
(408)379-5500
ARCHI7ECT(ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLO MEOCH
LICENSED CONTRACTOR'S DECLARATION
- lob Description
1 hereby affirm Nn 1 am licensed under pmvisi ms of Chapter 9 (commencing
wjmsecdon7gg)) of Div lon3ordm Bustnevamd Professions Wda.arld myl.orma is
Nil forte antl clfmt. '33b!2-74
NEW ROOF SCREEN FOR PROTECTION
Licenso CI s lJc. g
Li
.SOUND
Dau: Contractor,pK
ARCHITECTS DECLA O
I understand my piens shall he used as public records
Licensed P drew.nal
OWNER -BUILDER DECLARATION
I hereby at7irm that 1 am exempt from the Convectors License Law for the
fallowing mason. (Section 7101.3. Business and Profession Code: Any city or County
$50000
which requires a permit to eommoms, altea improve, demolish. or repair my su ectum
prior to its issuance. aim requires the applicant forauch permit in file a signed statementValuation
License Law
Sq. Ft. Floor Area
that he is liconscd pursuant to the provision Cruse Contractors (Chapor9
(commencing with Section 7000) of Division 3 of me Business and Professions Code) or
that be is cumin therefrom and the basis for the alleges emmpdon. Any violation of
Section 7031.5 by any applicant for a permit anbjeeu the apPllcmL m a civil penally of
a
Occupancy Type
not mom man five hundred dollars (@500).
❑ 1, as owner of the property, or my employees with wages as their sole compensation,
Required Inspections
q p
will do the work, and the structure is net Intended ora@md for sale(Sec. 7044, Businm
and Prefeadmu Cade: The Cowsmoes License Law does set apply w an owner of
property who builds or im prove thereon, and who does such wank himself or through his
awn employees, provided thaumh improvements me notuntended aro0+ed parade. B,
however. the building or improvement is Cold within one year ofcomPleuon, the ower.
builder will hew the burden of proving that be did ant build or improve for purpose of
sale.).
❑ 1, as ^wear of ft property, me emlmovely wnum i, with licensed Convenors to
controm the project (sen. 7044, Business and Profession Cade:) The Convaerars Ll -
Coors Law does not apply in an owner of property who builds or improv thereon, and.
who contracts for such projects with a commmKs) licensed pursuant in the Conmetors
License Law.
Inmexemptunder Sea .B&PCfwmuflzmw
r Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the fallowing deciantian:
I have and will maintain a CeniOnm of Conwm m self -ince for WarkcexCompen-
sation, as provided (w by Section 3700 of the Inbar Code, for the performance of the
work for which this permit is issued.
❑ 1 have and will maintain Worker's Compensation Buurance, as required by Swaim
3700 of the Labor Code, far me performance orthe work forwhich this permit u lewd.
My Worker Com enation Ileo ane carrier n Poli nu her are:
gY A7?.0 ;rltE C-
C' Poliry o.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
77
COMPENSATION INSURANCE
Crh section wed notbecompleted if the permit Is forme hundred dollars (5100)
or ICM.)
I certify that in the performance of the work for which this permit is iasmd 1 shall set
employ any person In any manwran as to become subject to the Workers' Co rrenatian
Laws of California. Dam
Applicant
NOTICE TO APPLICANT. If, after making this Cenificam of EsemPuon, you should
become subjmt as the Workces Compensation provisions of the lahm Code, you mel
forthwith comply with such provision or this permit shall be deemed revoked.
iCONSTRUCnON LENDING AGENCY
1 hereby alErm than mem is dint agenry ser the performance of
30 7.
a theLe work for which this permit b issued (Scc.3(197, Civ. Cd
sued (Sec.
Lender's Name
'
Landers Addre••
�
1 cemiry that I have mad this application and atom that the above information is
conecL. I agree to comply with all city and county ordinances and was laws minting to
14 building conswee n. authandkze eprcsommiv of anis to
Ll abon-mcrooncd properly for Inspection purposes.
to saw. indemnify or Cupnmrmnnthc
L (We) agree to cave, indemnify and keep harmless me City of Cup
inino id City
Cala andPe they in my soy acerw againLwid City
of this match
in corrsegwnce of the @rantin6 of this permit.
in consequence of the
APP ANT UNDERSTAND AND WILL COMPLY WITHAL NON -POINT
Issued by: Date
7 tT�6.
Re -roofs
Type of Roof
Signuum or ApplicmUContrmmr
HAZARDOUS MATERIALS DISCLOSURE
Will the applicmtor future building occupant stare orhandle hazardous material
by the Cupertino Municipal Code. Chapter 9.12. sed the Health and Safety
Ifte0wd
k. 3cction 25532(a)?
All roofs shall be inspected prior to any roofing material being installed.
❑secs ][]Na
If a roof is installed without first obtaining an inspection, I agree to remove
Will me applicant or future building occupant use equipment or devices which
emit haaNee aur cmmminate a tlnOwd by the Bay Am�Air Quality Ma^agement
all newmaterials for inspection.
District? ���111
❑Yes UfINo
I have mad the hazardoussmeurtais requirements underChaptcr 6.95 ofthe Caiifor.
lie Halm& Safety Code. Secuan 25505. 533 and 25534.1 understood that lflM building
does
��E �)
All roof coverings to be Class rB" or better
0w zctl agent Dnte