11060151 CITY OF CUPERTINO BUILDING PERMIT
'tUIL.DING ADDRESS: 20563 STEVENS CREEK BLVD CONTRACTOR:HATHAWAY DINWIDDIE PERMIT NO: 11060151
l �:R'S NAME: BANK OF AMERICA 565 LAURELWOOD RD DATE ISSUED: 10/03/2011
OWNER'S PHONE: 4153143584 SANTA CLARA,CA 95054 PHONE NO:(408)988-4200
❑ LICENSED CONTRACTOR'S DECLARATION F1
BUILDING PERMIT INFO: BLDG ELECT ' PLUMB
�nr
License Class Lic.# Z� CD C. i
' \ MECH RESIDENTIAL COMMERCIAL
Contractor 1� xJ �eL.00LdDate -S- 1k
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:BANK OF AMERICA-COMM.T.I-ACCESS UPGRADES TO
(commencing with Section 7000)of Division 3 of the Business&Professions EXTERIOR&INTERIOR OF EXISTING COMMERCIAL
BUILDING;NEW TELLER LINE,MODIFY EXISTING WORK
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
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.
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:$50000
permit is issued.
APPLICANT CERTIFICATION APN Number:32634044.00 Occupancy Type:
I 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 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. Addition all the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non- oint sour a regula' s pe e Cupertino Municipal Code,Section
9.18.
1 1) - 1\ Issued by: Date:
S ur Date
❑ OWNER-BUI ER 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:
I,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(a)should I 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,I 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 J a &Safegy Code ons 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must Owne r'u ri agent:
Date:
forthwith comply with such provisions or this permit shall be deemed revoked. 1 J
C NSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I hereby affirm that t is a construction lending agency for the performance of tiork'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 huilding construction,and hereby authorize representatives of this city to enter Lender's Name
I he above mentioned property for inspection purposes.(We)agree to save
I .mify 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. I understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20563 STEVENS CREEK BLVD CONTRACTOR:HATHAWAY DINWIDDIE PERMIT NO: 11060151
OWNER'S NAME: BANK OF AMERICA 565 LAURELWOOD RD DATE ISSUED: 10/03/2011
O NER'S PHONE: 4153143584 SANTA CLA RA,CA 95054 PHONE NO:(408)99a-4200
u
LICENSED CONTRACTOR'S DECLARATION r I— I—
m,... � -1 /� /' / BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lie.q I '-� 1 2'l \Oleg r— r
C'Z", i�\ �� a , 1 I MECH RESIDENTIAL COMMERCIAL
`1` Z
Contractor T Date U
I hereby affirm that 1 am licensed un r the provisions of Chapter 9 JOB DESCRIPTION: DANK OF AMERICA-COMM.T.1-ACCESS UPGRADES TO
(commencing with Section 7000)of Division 3 of the Business&Professions EXTERIOR&INTERIOR OF EXISTING COMMERCIAL
Code and that my license is in full force and effect. BUILDING;NEW TELLER LINE,MODIFY EXISTING WORK
11/4/2011-REVXI -REVISE ACCESS,PATH OF TRAVEL&TREES 11/28/2011 REVH I
I hereby xDlrm trader penally of perjury oSS'Dne of the following two declarations: ,
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.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the perlbnnance of die work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$60000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:32634044.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances mid state lows relating
to building construction,mid hereby authorize representatives of this city to enter
upon the above mentioned properly 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 expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source rcg; a�li� er the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18Si iietur Vi��;.:,nt _^ ` K I' ` `
g Date 1 - 7- f�—\ Issued byl �� Dale:/2_,4`i Z+
O%VNE - MILDER DECLARATION
eby affirm that I our 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 beteg installed, If a roof is
I,as owner of the property,or my employees with wages as(heir 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(See.7044, inspection.
Business&Professions Code)
I,as owner of the property,1111 exclusively contracting with licensed contractors to Signature of Applicant:_ Date:
construct the project(Sec.7044,Business&Professions Code).
1 hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will mutation a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,far the
performance of the work for which this permit is issued. I 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&
permit is issued Safety Code,Section 25532(8)should 1 store or handle hazardous material.
P Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work forwhich this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,Aller making this cenihcale ol'exemption,I Health&Safely Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I muss
wn r thorn ed agent \\_26 -1I
forthwith comply with such provisions or this permit shall be deemed revoked. d
r,^'c � T,:. Dalt.
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify(hat I have read this application and state that the above information is
correct.I agree m comply with all city and county ordinances mid slate laws relating I hereby affirm that there is it construction lending agency for the performance of wok's
to building construction,mid hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
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
®
ig of this permit.Additionally,the applicant understands and will comply
I lath-11(11111 Source ICgIIIAlllnti per (Ile Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
I understand any plans shall be used as public records.
Signature Dale
Licensed Professional