10100086 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10431 N DE ANZA BLVD CONTRACTOR:DEVCON PERMIT NO: 10100086
CONSTRUCTION NC
OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 12/07/2010
NER'S PHONE: 4089744876 MILPITAS,CA 950(35 PHONE NO:(408)942-8200
LICENSED CONTRACTOR'S DECLARATION r
2(�G BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# .] I 1 r—
'� MESH RESIDENTIAL COMMERCIAL
Contractor 1 /f?{)/� 1 .�1��% Date � JOB DESCRIPTION:FI�tST FLOOR(LOBBY)-COFFEE BAR COMM'L TI MINOR
MODIFICATION AT FIRST FLOOR LOBBY(138SQ);NO
I hereby affirm that I am licensed under the provisions of&0ter 9 RE-ROOF&NO STRUCTURAL
(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. Sq.Ft Floor Area: Valuation:$25000
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 APN Number 326331100 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.l agree to comply with all city and county ordinances and state laws relating WITHIN 180E DAY 19F PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FR ST CALLED INSPECTION.\
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ,�
costs,and expenses which may accrue against said City in consequence of the I t C-7" )a)
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: /
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
-? (/ RE-ROOFS:
V
Signature Date 1� ) All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,1 agree to remove all new materials for
inspection.
U OWNER-BUILDER DECLARATION
Signature of Applicant:—:,- Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,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 HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will
hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
1 have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. /7�j
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent / Date'—
permit is issued.
1 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,1 CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
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 ARCHITECT'S DECLARATION
'emnify and keep harmless the City of Cupertino against liabilities,judgments,
s,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
Wanting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional_
9.18.
Signature Date
CITY OF CUPERTINO BUILDINGI P4
BUILDING ADDRESS: 10500 N DE ANZA BLVD CONTRACTOR:DEVCON ICON UCTION PERMIT NO: 10080064
INC
O R'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 10/14/2010
OWNER'S PHONE: 4089744876 MILPITAS,CA 95035 PHONE NO:(408)942-8200
❑ LICENSED CONTRACTOR'S DECLARATION r
/ BUILDING PERMIT IN BLDG ELECT PLUMB
License Class43 Lic.#
_ MECH r RESIDENTIAL COMMERCIAL
Contractor PFLIC-01V�/ Date Z
1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:FLOOR 2-COMM'L TI PROVIDE FOUR(4)NEW SHIELDED
(commencing with Section 7000)of Division 3 of the Business&Professions ROOMS ON FLOOR EL SURFACE FOR EQUIPMENT(1528SQ);
AL ARCHITECTURAL WORK,
PROVIDE NEW LEVEL
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations: uk—j��+—c,-n C.V,t
1 have and will maintain a certificate of consent to self-insure for Worker's �Jd-_yy`r71_"-i,.�� e -� , ' .,liy� jj
Compensation,as provided for by Section 3700 of the Labor Code,for the W-0cl r u E-,•m• ; P 1 G ty+�-t. � .� 1•2-/%-
performance of the work for which this permit is issued. r�-1''(
have and will maintain Worker's Compensation Insurance,as provided for by i
Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$60000
permit is issued. j
APPLICANT CERTIFICATION APN Number:31622017.00 Occupancy Type:
certify that 1 have read this application and state that the above information is
correct.1 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 non-point source regulations the Cupertino Municipal Code,Section
�S Issued by 1 __ Da —
Sir• -ire Date lv
❑
OWNER-BUILD TION
RE-ROOFS:
1 hereby affirm that 1 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,1 agree to remove all new materials for
1,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
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 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
1 have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertlino 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 bythe Bay Area Air Quality Management District I will
1 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,I
become subject to the Worker's Compensation provisions of the Labor Code,1 must O r!f or autho ized
forthwith comply with such provisions or this permit shall be deemed revoked. Date:_—��
LSTRU N LENDING AGENCY
APPLICANT CERTIFICATION
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.1 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
up--the above mentioned property for inspection purposes.(We)agree to save
i :ify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
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 regula' ns per the Cupertino Municipal Code,Section 1
9.18. 1 understand my plans shall be used as public records.
Signa Date Q Licensed Professional