07090107 CITY OF CUPERTINO
BUILDING DIVISION PERMIT � � � IN �] MAITION.
PERMIT No.
BUILDIJJQP�D, TJALLCO PKWAY CAC-04 DINYARI INCORPORATED 07090107
l y l y PERMIT ISSUE DATE
OWNER'S NAME:
APPLE COMPUTER 500 PHELAN AVE 09/18/2007
SANITARY NO. CONTROL NO.
NE:
(408) 2E9-5400
BUILDING PERMIT INFO
ARCHITECTIENGINEER:
BLDG ELECT PLUMB MECH
a a 0 0
p LICENSED CONTRACTOR'S DECLARATION Job Description
V I hereby affirm that I am licensed under provisions of Chapter 9(commencing
:Z� with Section 7000)of Division 3ofthe BusinessandProfessionsCode.andmylicenses ADD 1" SOLID INSULATION MECANICALLY FASTENED
r<d in full force and effect J b 6 j 6!�
;�z License Class G S17 Lic.B INSTALL 60 MILL WHITE TPO; HOT AIR WELD &
Date Contractor /K ya—,- 1—r
^T ARCHITECTS DECLARATION MECHANICALLY FASTENED.
i a< l understand my plans shall he used as public records
)yU
U.F Licensed Professional
a
OWNER-BUILDER DECLARATION
A-r
>- 1 hereby affirm that 1 am exempt from the Contractor's License Law for the
jin 00 following reason.(Section 7031.5,Business and Professions Code:Any city or county
m 01 which requires a permit to construct,alter,improve,demolish,or repair any structure
prior to its issuance,also requires the applicant for such permit to file a signed statement Ft.Floor Area Valuation
?< that he is licensed pursuant to the provisions of the Contractor's License Law(Chaptcr 9 Sq $139000
t T (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
u that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of310 2 0 0 i 4:'lJ Number Occupancy Type
not more than five hundred dollars(5500).
❑1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,Business Required Inspections
and Professions Code:The Contractor's License Law docs not apply to an owner of
property who builds or improves thereon,and who does such work himself or through his
own employees,provided that such improvements are not intended or offered for sale.If,
however,the building or improvement is sold within one year of completion,the owner-
builder will have the burden of proving that he did not build or improve for purpose of
sale.).
❑1,as owner of the property,am exclusively contracting with licensed contractors to
concoct the project(Sec.7044,Business and Professions Code:)The Contractors Li-
cense Law does not apply to an owner of property who builds or improves thereon,and,
who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's
License Law.
❑1 am exempt under Sea B&P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑1 have and will maintain a Certificate of Consent to self-insure for Workers Compen-
sation,as provided for by Section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑I have and will maintain Worker's Compensation Insurance,as required by Section
3700 of the Labor Code,for the performance of the work for which this permit is issued.
My Workers Compensation Insurance carrier and Policy number are:
Carrier:.'--o^Tr'a.n/ /Iit 4,0 'olicy No.:.4—r C w 3 6 Z°0 7
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars(E 100)
or less.)
I certify that in the performance of the work for which this permit is issued.I shall not
employ any person in any manner so as to become subject to the Workers'Compensation
Laws of California.Date
Applicant
NOTICE TO APPLICANT:If,after making this Certificate of Exemption,you should
become subject to the Worker's Compensation provisions of the Labor Code,you must
O forthwith comply with such provisions or this permit shall be deemed revoked.
Z'" CONSTRUCTION LENDING AGENCY
H Com. I hereby affirm that there is a concoction lending agency for the performance of
> the work for which this permit is issued(See.3097,Civ.C.)
W Q Lenders Name
az Lender's Address
U 0 1 certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating to
rJ U building construction,and hereby authorize representatives of this city to enter upon the
W ahovc-mentioned property for inspection purposes.
CL (We)agree to save,indemnify and keep harmless the City of Cupertino against
,may rn liabilities,judgments.costs and expenses which may in any way accrue against said City
U Z in consequence of the granting of this permit. Date
►+ APPLICANT UNDERSTANDS,AND ILL COMPLY WITH ALL NON-POINT Issued b):
SOURCE REGULATIONS. 1y-/r-a7
Re-roofs
Signature oficaDare
HAZARDOUS
e of Roof
HAZARDODO Type MATERIALS DISCLOSURE
Will the applicant or future building occupant store or handle hazardous material
as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Code,Section 25532(a)? ,� All roofs shall be inspected prior to any roofing material being installed.
❑Yes U No
W
If a roof is installed without first obtaining an inspection,.I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new r.Iaterials for inspection.
District?
C]Yes
1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- O
nia Health&Safety Code,Sections 25505,25533 and 25534.1 understand that if the building
does not currently have a tenant' is my responsibility to nodfy the occupant of the
requirements which must bew1d n issuance of a Certificate of Occupancy. SignaturL. Applicant Date
All roof coverings to be Class"B"or better
Owner or ri-zcd agent Date I --
070 Q/ 07
CITY OF CUPERTINO
=' RE ROOF
CUPEkTINO PERMIT APPLICATION FORM
APN# 3f / 2 .-. � �3 r()aU 0-7 Date:
!z_j ,?-e77
Building Address: Q (a VC,10;, PC, (e- c.,vT /
Owner's Name: Phone#: 409 _Z-9c?_ S4 a
Contractor: License#: 5-X'16 56,
Contact: �?✓G _ �3 _ WSJ g q44 Cupertino Business License #:
.,2q3 V7
Type of hoof Covering:
Existi Proposed:
Q Built-Up Roof ❑ Built-Up roof
❑ Asphalt Shingles ❑ Asphalt Shingles
❑ Wood Shakes ❑ Wood Shakes
❑ Wood Shingles ❑ Wood Shingles nj
❑ Other(Specify) ❑ Other(Specify)
Number of existing coverings ❑ Provide I.C.B.O.Report#
❑ To be Removed ❑ Provide Mfgr.Installation Specs.
I Have Read, Understand and Will Comply With Cupertino's Tear Off Policy: l
Job Description: 49dyv rcQ rns�tu7-� n►�r4.�,rV�r �'c,sTc�c4�P
.n i w ito ' 07` ��✓ weI-e uIJ M' e'.(//y
n esti
S'tc�lI rz.s �A
�� � �P� W c �•
Residential ❑ Commercial
Fire Zone: Yes ❑ No Confirmed with Planning Dept. if
there are any restrictions: LJ
Cost of Project: Type of Constn�ction: Occupancy group:
Qty. if
Applicable Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILDING
BENERGY Energy BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSEISMICOM Seismic Commercial BUILDING
BPLANCHK Plan Check Fee BUILDING
BUSLIC Business License BUILDING
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408)777-3333
Building ]Department
Subject: Re-roofing policy for the City of Cupertino
1. Prior to permit issuance,you must agree to comply with 1997 UBC Standards
and manufacturers specifications on re-roofing.
2. New roof coverings shall not be applie I without first obtaining all inspection
and written approval from the building inspector. A final inspection and
approval shall be obtained from the building inspector when the re-roofing
is completed.
3. All roofs shall be inspected prior to amr roofing installation.
4. To receive a final sign off from the City,the following steps are
required:
1) Pre-inspection and/or tear off approval.
2) In-progress inspection approval.
3) Final inspection approval.
a) Spark arrester installation.
5. If plywood is installed,a plywood nail inspection is required.
6. Any roofing which is applied without.-irst obtaining an inspection,
will require the removal of all new ma serial down to the sheathing,
so a proper City inspection can be perf armed.
7. NOTE: If you call for a plywood nail inspection and the job is not ready,
you will be charged a re-inspection fee of$176.18. The re-inspection fee must
be paid before another inspection car be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/4" per foot slope and demonstrate
that there is no ponding.
2. An I.C.B.O. report is required to be on the job site at the time on inspection.
I understand and will comply with the above stated policy on re-roofing.
Homeowner's Name:
Job Site Address: ( Ct( � <<C� PCAI(,:�' C-1a 7`
Roofing Company Name: C� n Ct t,?C
-�
Applicant's Signature: ,��.-.-� ,�_ Date:
Greg Casteel
Building Official
Revised 11/2/04
Community Development Department
Building Division
City of Cupertino
10300 Torre Avenue
Telephone: (408)777-3228
Fax: (408) 777-3333
Building :Department
REROOF TEAR OFF POLICY
1. You must schedule an inspection for the tear off the day before
you wish the inspection to be made. The procedure is to call the
Building Division (408) 777-3228 between the hours of 7:30 a.m. and
3:30 p.m. to request a next-day inspection.
2. When the roof is torn off, the mails have been removed or driven in,
and all of the dry-rotted wood has been replaced, you must call the
City Building Division. An inspector will be there within one hour.
There are special hours for this; service: from 7:30 a.m. to 10:30 a.m.
and 1:00p.m. to 3:30 p.m., Monday through Thursday and from
7:30 a.m. to 10:30 a.m. and 1:00 p.m. to 2:30 p.m. on Friday. (Note:
Building inspectors are on lunch break from 11:30 a.m. to 12:30 p.m.
and will not be called during that time. City Hall is closed between
12:00 and 1:00 p.m. daily.)
3. If you call for a tear-off inspection and the job is not ready, you will
be charged a re-inspection fee of $176.18. The re-inspection fee must
be paid before another inspection can be scheduled.
Greg Casteel
Building Official
RevisFd 8/13/04
CITY OF CUPERTINO
2 ITEMS OF 2 PERMIT' RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . . 31020074 .00
DATE ISSUED. . . . . . . : 09/18/2007
RECEIPT #. . . . . . . . . : BS000002671
REFERENCE ID # . . . : 07090107
SITE ADDRESS . . . . . : 19191 VALLCO PKWAY CAC-04
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : APPLE COMPUTER
ADDRESS . . . . . . . . . . : 1 INFINITE LOOP
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : FARBOD DINYARI
CONTRACTOR . . . . . . . : FARBOD DINYARI LIC # 24367
COMPANY . . . . . . . . . . : DINYARI INCORPORATED
ADDRESS . . . . . . . . . . : 500 PHELAN AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 289-5400
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 139, 000. 00 1019 .52 0. 00 1019 .52 0. 00
BSEISMICOM VALUATION 139, 000. 00 29 .19 0. 00 29 .19 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 1048.71 0. 00 1048.71 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 1, 048.71 #1042
---------------
TOTAL RECEIPT 1, 048.71
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
305 FRAME 307 INSULATION
601 ROOF TEAR OFF 602 ROOF PLYWOOD NAIL
603 ROOF BATTENS 604 ROOF IN-PROGRESS
Community Development
10300 Torre Avenue
' Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
',UPEkTINO
Building Department
JOB ADDRESS: PERMIT #
Vatc-Dof?0 4;;�Oel
OWNER'S NAME: PHONE # 40 9^
GENERAL CONTRACTOR: 114 -. FAX #
I am not using any subcontractors: y'
,nature Date
Please check applicable subcontractors and cornAete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum/ Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
_ _ ✓� `�— /g-vim
er/Contractor Signature Date