10070023 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20605 LAZANEO DR CONTRACTOR:DEVCON CONSTRUCTION PERMIT NO: 10070023
INC
OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED:09/10/2010
OWNER'S PHONE: 4089428200 MILPITAS,CA 95035 PHONE NO:(408)942-8200
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r.
License Class a Lic.# r r-, r
MECH RESIDENTIAL COMMERCIAL
Contractors (y rc4s5 T. t[Date c7
hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:COMM'L TI TO EXSTNG BLDG NEW WALLS,DOORS
(commencing with Section 7000)of Division 3 of the Business&Professions SUPPORTING ELECT,MECH&PLMBING ADA ACCESSIBILITY OF
Code and that my license is in full force and effect. THE EXTERIOR;NO RE-ROOF&HAS STRUCTURAL
hereby affirm under penalty of perjury one of the following two declarations:
have and will maintain a certificate of consent to self-insure for Worker's
Compensation,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 provided for by
Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$I 100000
permit is issued.
APPLICANT CERTIFICATION APN Number:32633096.00 Occupancy Type:
I certify that 1 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 building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all
r� V
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1 hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the labor Code,for the 1 have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
1 have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should 1 store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,1 shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,1
become subject to the Worker's Compensation provisions of the Labor Code,I must
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that 1 have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO BUILDING PERMIT DATE
BUILDING ADDRESS: 20605 LAZANEO DR CONTRACTOR:DEVCON CONSTRUCTION PERMIT NO: 10070023
INC
OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED:09/10/2010
OWNER'S PHONE: 4089428200 MILPITAS,CA 95035 PHONE NO:(408)942-8200
❑ LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class Lic.# 3�q 1p3
� 1 �,, �� MECH r RESIDENTIAL r COMMERCIAL r
Contractor �V ����J Date
1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:COMM'L T1 TO EXSTNG BLDG NEW WALLS,DOORS
(commencing with Section 7000)of Division 3 of the Business&Professions SUPPORTING ELECT,MECH&PLMBING ADA ACCESSIBILITY OF
Code and that my license is in full force and effect. THE EXTERIOR;NO RE-ROOF&HAS STRUCTURAL
10/15/10 REVISION 41-REVISE EXTERIOR UTILITY PAD W/(1%I,E2P)-11/4/10
1 hereby affirm under penalty of perjury one of the following two declarations: REV#1 ISS'D
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
have and will maintain Worker's Compensation insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which 4thispermit is issued. Ft Floor Area: Valuation:$I 100000
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above informatioN Number:32633096.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is
1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,1 agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
1 have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. 1 have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(a)should 1 store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
1 certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by he Bay Area Air Quality Management District 1 will
not employ any person in any manner so as to become subject to the Worker's m%
)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. ARCHITECT'S DECLARATION
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
REVISION
CITY OF CUPERTINO BUILDING PERMIT DATE v
BUILDING ADDRESS: 20605 LAZANEO DR CONTRACTOR:DEVCON CONSTRUCTION PERMIT NO: 10070023
INC
OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED:09/10/2010
OWNER'S PHONE: 4089428200 MILPITAS,CA 95035 PHONE NO:(408)942-8200
d� LICENSED CONTRACTOR'S DECLARATION
F- r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.N _ P r r F-
(�.± , _ 1 MECH RESIDENTIAL COMMERCIAL
Contractor �. CnNJ Date 5
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:COMM'L TI TO EXSTNG BLDG NEW WALLS,DOORS
(commencing with Section 7000)of Division 3 of the Business&Professions SUPPORTING ELECT,MECH&PLMBING ADA ACCESSIBILITY OF
Code and that my license is in full force and effect. THE EXTERIOR;NO RE-ROOF&HAS STRUCTURAL
*--24,-A0 �' `Jt 3"l i.,Sam+' i-SibY��
1 hereby affirm under penalty of perjury one of the following two declarations: /r-�k_f- q o ly%A n 2.—fi/A ,/LSP(�---0166f
1 have and will maintain a certificate of consent to self-insure for Worker's n` a6
Compensation,as provided for by Section 3700 of the Labor Code,for the i�y d SId 3
performance of the work for which this permit is issued.
1 have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$1100000
permit is issued.
APPLICANT CERTIFICATION APN Number:32633096.00 Occupancy Type:
I certify that I have read this application and state that the above info anon is
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspectegrior to any r ofing material being installed.If a roof is
the following two reasons: installed without first obta' ing an inspe tion,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Scc.7044,
Business&Professions Code) Signature of Applicant. Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)should 1 store or handle hazardous material.
Additionally,should 1 use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will
I certify that in the performance of the work for which this permit is issued,I shallmainmin
for the performance of%wrk's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this.city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. 1 understand my plans shall be used as public records.
Signature Date Licensed Professional