09100077I CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19333 VALLCO PARKWAY 1 CONTRACTOR: DPR CONSTRUCTION INC I PERMIT NO: 09100077
OWNER'S NAME: APPLE COMPUTER 11450 VETERANS BLVD I DATE ISSUED: 10/13/2009
OWNER'S PHONE: 4089745951
LICENSED CONTRACTOR'S DECLARATION
License Class Lie. #
Contractor(( Date lb i D
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
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
permit is issued.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
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. �j� % }
Signature'` / t/ � r DateqU%�
OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the stricture is not intended or offered for sale (Sec.7044,
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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
pemvt is issued.
1 certify that in the performance of the work for which this permit is issued, 1 shall
not employ any person in any manner so as to become subject to the Worker's
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
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
cr and expenses which may accrue against said City in consequence of the
6 ig of this permit. Additionally, the applicant understands and will comply
witn all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date
REDWOOD CITY, CA 94063 1 PHONE NO: (650)474-1450
BUILDING PERMIT INFO: BLDG r— ELECT r— PLUMB f—
MECH r- RESIDENTIAL f- COMMERCIAL f—
JOB DESCRIPTION:TEMP PERMIT,ORIG#09070108,FOR SITE WORK
IMPROVEMENTS; NO WORK IN PUBLIC RIGHT OF WAY OR
IMPACT ON PUBLIC RIGHT OF WAY OR EASEMENTS -
Sq. Ft Floor Area: I Valuation: $100
APN Number: 31620075.APL I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued bf. Date:
RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent:
Date: 10 l 4"
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19333 VALLCO PKWY I CONTRACTOR: DPR CONSTRUCTION INC PERMIT NO: 09110111
OWNER'S NAME: APPLE COMPUTER 11450 VETERANS BLVD j DATE ISSUED: 11/19/2009
OWNER'S PHONE: 4089740551 1 REDWOOD CITY, CA 94063 1 PHONE NO: (650)474-1450
LICENSED CONTRACTORSQ
DECLARATION
License Class Lic. # -57 19
Contractor L— Date l t
1 hereby affirm that 1 am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
1 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
permit is issued.
APPLICANT CERTIFICATION
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino MuniWCodde,tion
9.18.
Signature Date�
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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 & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
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
permit is issued.
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 Worker's
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
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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
indemnify and keep hamiless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
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.
Signature Date
BUILDING PERMIT INFO: BLDG T_ ELECT r— PLUMB F
MECH F RESIDENTIAL r COMMERCIAL F
JOB DESCRIPTION: TEMPORARY PERMIT GOOD THRU 11/19/2009 TO
12/19/2009
Sq. Ft Floor Area: I Valuation: $6000000
APN Number: 31620075.APL I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued bye Date: e��
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(x) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or &ntho a agen
Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF
CUPEkTINO
CITY OF CUPERTINO
TEMPORARY PERMIT
PERMIT APPLICATION FORM
/--)C )I t --)1l i
APN #
Fee ID
Date:
Fee Group
Permit Type
oc
Original Permit #
Temporary Permit Good
Building Address:
1TEMPPMT
(Flat Fee)
Owner's Name:
Phone #:
only.
Contractor: APhone
#: (o5 (--)
1BCBSC
Cal Bldg Standards
Fax #: (0 5-0 Z_ Z,3
Contact:
Phone #:
1,
511 -2—
Contractor
Contractor License #:
Cupertino Business License #:
Job Description: ; PE o�
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Valuation (cost of project):
Type of Construction: A WO?
(a
(
Project Size: Over the Counter
Quantity
Fee ID
Fee Description
Fee Group
Permit Type
1TEMPPMT
Temporary Permit Good
B
1TEMPPMT
(Flat Fee)
for 30 days —Commercial
only.
1BCBSC
Cal Bldg Standards
B
ALL PERMIT
Commission Fee
TYPES
01/07/09
F,D
CITY OF
CUPEI�TINO
CITY OF CUPERTINO
TEMPORARY PERMIT
PERMIT APPLICATION FORM
09/000-p
APN #2 + A /� —
G U i'
Date:
d �
Original Permit #
� q ado 1 6 8
Fee Group
Building Address:
I q 2,.3
Temporary Permit Good
Owner's Name:
Phone #:
AVVL-eCo"
Y00 5?51
Contractor:
Phone #: &50 <868 Sq.3 Z
Fax #: -2-6 Z4�
Contact:
Phone #:
Contractor License #: 15 y y 5 4
1BCBSC
Cupertino Business License #: -2j
B
Job Descriptio�/ U �aS[c n
n �, i � t ✓Yl -IJP
Commission Fee
awe
Valuation (cost of project): �,
Type of Construction:
Project Size: Over the CounterG�J,
Quantity
Fee ID
Fee Description
Fee Group
Permit Type
1TEMPPMT
Temporary Permit Good
B
1TEMPPMT
(Flat Fee)
for 30 days —Commercial
only.
1BCBSC
Cal Bldg Standards
B
ALL PERMIT
Commission Fee
TYPES
01/07/09