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07020072CITY OF CUPERTINO =77777777�? sr rH BUILDING DIVISION PERNA II BUILDING ADDRESS: PERMIT NO. 10400 RIDGE VIEW CT SOUTH BAY CONSTRUCTION CO 07020072 OWNER'S NAME: INC PERMIT LSSUE DATE APPLE COMPUTER 170 KNOWLES DRIVE PHONE: SANITARY NO. CONTROL NO. (408)379-5500 ARCHTTEC IENGINEER BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Description I hereby affirm that I am licensed under provisions of Chapter 9 (commencing .lob with Section 70DO) ofDivWon 3 of the Busiriess and Professions Code, and my license is INSTALLATION OF 2 CHAMBERS. INCLUDES ELECTRICAL & and efface 2, ufull Li,., 6q 7 Dam Contractor��' ...IA P;MECHANICAL AlJ ARCHITECTS DECLAR TA ION I understand my plans shall he used as public recorder Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county 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 that he is licensed pursuant to to provisions of the Conractors License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 70D0) of Division 3 of the Business and Professions Code) or $5 0 0 0 0 that he is exempt therefrom and the basis for the alleged exemptfoa Any violation of Number A Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (SM 316 0 6 0 4 6 ❑ L as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work, and the structure is not intended or offered for sale (Sec. 70", Business and Professions Code: The Contractors License Law does not apply to an owner or 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 yew of completion, the owner - builder will have the burden of proving that he did not build or, improve for purpose of salt.), ❑ L as owner of the property, am exclusively contracting with licensed contractors to construct 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 Tor such projects with a contractor(s) licensed pursuant to & Contractoes Lirsnse law. Q 1 am exempt Amder See. - -_ - -_. BA PC for this reason Owner -._-_ Date .... .. WORKER'S COMPENSATION DECLARATIO:. N I hemby+ill?hVuna pry one of thkfollowirig;peclaratfprm y.. c. - - ... .. ._.._ -.... •. - _ _ . ... . _ _ ❑ I have and will maintain a Certificate of Consent to self -insure for Woikies Compen- - salon, as provided for by Section 3700 of the Labor Code, for the performance of the " work for which -this permit is issued. jam#'have-ari i 1),"•mj-rt4�i1F, Clfinprnsaiion Instance. as required by Section --- - - ,- • tSi'�O[['S '9700oF1(,cFAnneoafihe work for which this permit is issued �pesl'-� _ .._, _. ;�,1fy � s• My Worker' Compenaagtm Insurance carrier and Policy number are: - - Carrier.'- 1 SC,S .-a(`D - Policy No.: C'�i ZZ%rt Z - - ,� .�:> �... r .•.. .. �CMI -OFF L7 WPTION FROM WORKERS' . - COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars (3100) or less) I unify that in the puformanee 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. Dam 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 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance: of the work for which this permit is issued (Sex- 3097, Civ. C.) L.endcrs Name ' Lenders Address 1 certify that 1 have read this application and state than to above information is conecL I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorim represcntadt cs of this city to ener upnn the above -mentioned property for inspection purposes. (Wet) agree to save, indemnify and keep harmless the City of Cupcnino against liabilities. judgments. toss and expenses which may In any way accrue against said City in co .caste of thegnntiog of this p=IL L ANT UNDERST AND W COMPLY WITH by: Date SPOINT'Issued OURCE REGU[ ATfONTN- g Re -roofs Type of Roof Signature of Applican Dale HAZARDOUS MATMAL.S DISCLOSURE Will to applicant or future building Occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.1 Z and the Health and Safety Code. Section z553z(a)7 All roofs shall be inspected prior to any roofing material being installed. ❑Yes Yes . If a roof is installed without first obtaining an inspection, I agree to remove Will the applie ant or f. building occupant use equipment or devices which emit ha`ardous air contaminants inants as dcfhncd by the Bay Area Ale Quality Management all new materials for inspection. District? 4No C] Yes I have read the hazardous materials mquhemcnLs under Chapter 6.95 of the Cahifor. nia Health & Safety Code, Sections 23505, 25533 and 25534. I understand that if the building rmntly have a nouf it o my its bihty to notify aesupant of Ue ts which mthst r to issuarhce a Ccnffto T-2 �, E�acl. Signature of Applicant Date J7 � All roof coverings to be Class "B" or better 0 cr or authorind agent Dac x v VL/L1/CVVI 11.- 1.n 1VV 111 VVVV V�� � vv� r•r•.•.V YA Disabled Access Unreasonable Hardship Application Project Address: Owner. A P1(2 Co y/P�I Telephone No.: f Ade -24V I.. _... - --I A Liearae: Penoait No.: (COMpIdePare l OR Parrs l & J77) FA rtt 1: I are the owner/agent for the above referenced property mad attest that ALL required accessible features meet the latest edition oftfle 24. Therefore, an unreasonable hardship for disabled access is not rppliea p 'rty or the project. SIC*j(7VJRE DATE 11 PRINT NAM - Part II: i4J4ae. J. I) What is the cost of the project (valuation)? 2) What is the cost to provide ALL required access features? 3) To provide ALL required access features would increase coastruetlon cost by how much? (%) 4) What is the amount necessary to qualify for the exception? (20% of valuation) (Sore ammmt ar skmm to Section G. Part III) 5) X am -me owneria-geve oftht above referenced- pro ptM and-nttest drat tire above costs are accurate and true. I also agree to allocate expenditures for the accessible features as described oa tb a back of this application. SIGNATURE DATE PPON i` NANO-: vLlcricvvr ,,.vis rIIn tiVo Ilr uuoa Yi I 1 VVI GIl l iI1V 1 Acces:4 Features t Access 41 Y O of Trs to Ca,raas I (parking stall(e), laading zotsesr curb rumps, etc.) ' Accessible NACrr B (door hsrdwarc, landlnp, tbrasbolds, etc.) t rav to r wodeled yea or C addition from #ntranee. n I Renrocm(s) ■1" PuDllc bone(a) ((/ provided) (;/provided) Does this feature watt the latest edition of Title 24° If not, is cbe feature (or I What is the cost of making portion Lbereof) to be made the feature (or portion accessible at this time.' I thereof) actesaiblet yes/no I yes/no . y45/no , ywno yevno I yeSIno yeslno j yw�o yes/no 1 yes/n0 y es1ho i ye no Dollar amount Dollar amount Dollar amount Dollar amount Dollar amount Dollar amount Total; cost of accessible Textures provided (Min. 20% of valuation) G Note: All cosh to be c1mmented by actual bids or otber farormation accepted by the Building OMd&L Dollar amount Complete description of accessible features provided: (LlsQ eddieional sheets tf necessary)