09070211CITY OF CUPERTINO
BUILDING ADDRESS: 5 INFINITE LOOP
dER'S NAME: APPLE COMPUTERS
OWNER'S PHONE: 9259568376
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LICENSED CONTRACTOR'S DECLARATION
ense Class Lic. # J
ntractor
fJIDyo Ce,N�tftNGf'�a�1 Date Jt/ $
ereby affirm that I am licensed under the provisions of Chapter 9
immencing with Section 7000) of Division 3 of the Business & Professions
ode and that my license is in full force and effect.
BUILDING PERMIT
CONTRACTOR: NOVO
CONSTRUCTION
1(42 HAMILTON CT
MENLO PARK) CA 94025
ereby affirm under penalty of perjury one of the following two declarations:
ave and will maintain a certificate of consent to self -insure for Worker's
>mpensation, as provided for by Section 3700 of the Labor Code, for the
rformance of the work for which this permit is issued.
lave and will maintain Worker's Compensation Insurance, as provided for by
xtion 3700 of the Labor Code, for the performance of the work for which this
,rmit is issued.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above information is
orrect. 1 agree to comply with all city and county ordinances and state laws relating
building construction, and hereby authorize representatives of this ity to to enter
,Pon the above mentioned property for inspection purposes. (We) agree
ndenrnify and keep harmless the City of Cupertino against liabilities, judgments,
sd City in consequence of the
;osts, and expenses which may accrue againstlicant understands and will comply
;ranting of this permit. Additionally, the app
ns per the Cupertino Municipal Code, Section
Nith all non -point source regu
�Z��Date % 0 lLure
PERMIT NO: 09070211
DATE ISSUED. 08/17/2009
PHONE NO: (650)701-1500
B JILDING PERMIT INFO: BLDG ELECT PLUMB
MECH I— RESIDENTIAL f— COMMERCIAL
J DB DESCRIPTION: REVISION OF COMM'L TI INTERIOR
OFFICEC REMODEL,N OF
NON-STRUCTURAL. REVISION CONSISTSOF
ORN OR OF
(2) pARTIONS ON 2ND FLOOR @ SOUTHWEST
Valuation: $0
;q. Ft Floor Area.
APN Number: 31602109.05
Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 OM S OF LAST CALLED INSPECTION
IT ISSUANCE OR
180 DAYS FROM
Issued by:
11 OWNER-BUILDERDECLARATION
I 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
ructure is not intended or offered for sale (Sec.7044,
will do the work, and the st
Business & Professions Code)
er of the property, am exclusively contracting with licensed contractors to
1, as own
construct the project (Sec.7044, Business &Professions Code).
I hereby affirm under penalty of perjury one of the following three
declarations:
1 have and will maintain a rovided forCertificate
by Section 3700 of the sf-insure for
the Worker's
Compensation, as p
performance of the work for which this permit is issued.
l maintain
orker's Compensation
for by
I Section 37001of the Labor�Code, for the performance of the wok for wce, as hich Sehave and ich 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 m' rst
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 esentatices ves ofthis city t state centering
' nilding construction, and hereby authorize rep agree to save
the above mentioned property for inspection purposes. (We)
'auerunify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in understands amend will comply
of the
granting of this permit. Additionally, the applicant
with all non -point source regulations per the Cupertino Municipal Code, Sectior
9.18.
Date_._�
Civnature
Date:
RE_ R_ OOFS.
Il roofs shall be inspected prior to any roofing material being installed. If a roof is
stalled without first obtaining an inspection, I agree to remove all new materials for
,spection.
Date:
ignature of Applicant:_
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 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
u e, Chapter 9.12 and
the Health & Safety Code, SectioYi(7 O 9
Date:
Owner or authorized agent:
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
1
CITY OF
CUPEkTINO
APN # G
Building Address:
CITY OF C.UPERTINO
REEZOOF
PERMIT APPLICATION
/0 v, C'� 0
Owner's Name- ,4m n h
HOA: Yes ❑ No -M" If
Contractor:
9 i
Cupert'no Business License #:
lei ter from HOA
WX
Type of hoof Covering:
Existing:
❑ Built -Up Roof
❑ Asphalt Shingles
Wood Shakes
❑ Wood Shingles
❑ Other (Specify)
Number of existing coverings _
❑ To be Removed
Job Description:
If (e -v
Residential
o �0? 0 c-) / -7
Proposed:
❑ Built -Up roof
Asphalt Shingles
❑ Wood Shakes
❑ Wood Shingles
❑ Other (Specify)
❑ Provide I.C.C.E.S. Report #
❑ Provide Mfgr. Installation Specs.
j�f�OlZ� `ids
Commercial
Green Building: Please complete relevant portion of the
Green Building Checklist & attach it to the application or if
applicable, include in plan set & the sheet index.
Valuation.
I Have Read, Understand and Wi
Contirmect wim riaiuu16 "v v • it
there are any restrictions:
th upertino's Tear -Off Policy:
Signature ,,/- Z/-/ r Revised 02/05/09
CITY OF
CUPEkT1NO
Number of
Squares
Fee ID
CITY OF CU)?ERTINO
RERO OF
FEE SCHEDULE
1REROOFCOM
1BCBSC
1BSEISMICO
1 REROOFRES
/ 1BCBSC
1 BSEISMICRE
1 REROOFMRES
1BCBSC
1 B SEISMICRE
1BUSLIC
Fee Description
Re -roof Commercial
Cal Bldg Standards
Commission Fee
Seismic Commercial
Re -roof Residential
Cal Bldg Stwidards
Commission Fee
Seismic Residential
Re -roof Multi -Family
Cal Bldg StE.ndards
Commissior. Fee
Seismic Residential
Business Lizense
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 2007 IBC Standards
and manufacturers specifications on re -roofing. All roofs are Class "A" per Cupertino
municipal code 16.04.080.
2. New roof coverings shall not be applied without first obtaining all inspection
and written approval from the builc ling 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 any 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 withc ut first obtaining an inspection,
will require the removal of all new material down to the sheathing,
so a proper City inspection can be F erformed.
7. NOTE: If you call for a plywood miil 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 :an be scheduled.
IMPORTANT:
1. Flat roofs must have a minimum of 1/ " 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 abovestated policy on re -roofing.
Homeowner's Name:
Job Site Address: /,Q fir :Z A f V
Roofing Company Name: A L % a
Applicant's Signature: Date:
Greg Casteel
Building Official
Re Ased 07/30/08
1' Ilse ioo1No-VOC Palm
1 IAQ/Health pts
y=yes
2. Use Low VOC, Water -Based Wood Finishes
2 IAQ/Health pts
y=yes
3. Use LowffiIoVOiCAdhesives
3 IAQ/Health pts
y=yes
4. Use Salvaged Materials for Interior Finishes
3 Resource pts
y=yes
5. Use Engineered Sheet Goods with no added Urea
5 IAQ/Health pts
y=yes
Formaldehyde
61AQ/Health pts
y=yes
6. Use Exterior Grade Plywood for Interior Uses
1 IAQ/Health pts
y=yes
7. SSW All EVosed"PA*Wm d°a MDF
41AQ/Health. pts
y=yes.
8. Use FSC Certified Materials for Interior Finish
4 Resource pts
y=yes
9. Use Finger -Jointed or Recycled -Content Trim
1 Resource pts
y=yes
10. Install Whole House Vacuum System
3 IAQ/Health pts
y=yes
N. Flooring
'
1. Select FSC Certified Wood Flooring
8 Resource pts
y=yes
2. Use Rapdy Renewable Flooring Materials
4 Resource pts
y=yes
3. Use Recycled Content Ceramic Tiles
4 Resource pts
y=yes
4. Install Natural Linoleum in Place of Vinyl
5 IAQ/Health pts
y=yes
5. Use Exposed Concrete as Finished Floor
4 Resource pts
y=yes
6. Install Recycled Content Carpet with Low VOCs
4 Resource pts
y=yes
Total Points Available:
Total Points Project Received:
G:data/progs/g
140 13-01 57
0 01 0
12.04protected.xis
CITY OF
XPEkTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS: C, PERMIT #
d
OWNER'S NAME: =g'
' li�IJ PHONE #
GENERAL CONTRACT R: D /Vee
AX #
I am not using any subcontractors:
cDate
r d cors lete the followinginformation:
Please check a ucablub tt an
Date
Owner o tractor Signature
ne scoac ors
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Wood
--Linoleum/
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Date
Owner o tractor Signature