10010124CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10435 N TANTAU AVE
CONTRACTOR: NOVO CONSTRUCTION
PERMIT NO: 10010124
OWNER'S NAME: APPLE INC
1042 HAMILTON CT
DATE ISSUED: 03/16/20LO
OWNER'S PHONE: 4089748865
MENLO PARK, CA 94025
PHONE NO: (650)701-1500
DECLARATION
❑ LICENSED CONTRACTOR'Sr
r— ELECT T_
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BUILDING PERMIT INFO: BLDG PLUMB
License Class 5/ Lic. # i o
r
Contractor WO%rO 6w5rRumov Date ':1 /;1 V / (L
MECH RESIDENTIAL COMMERCIAL
1 hereby affirm that 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION: TI (I 1,857') OFFICE SPACE INCLUDES STRUCTURAL
(commencing with Section 7000) of Division 3 of the Business & Professions
INTERIOR TENTANT IMPROVEMENTS WJEXTERIOR SITE WORK
Code and that my license is in full force and effect.
MODIFICATIONS FOR ACCESSIBLE PATHS OF TRAVEL.
1 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.
1 have and will maintain Worker's Compensation Insurance, as provided for by
Sq. Ft Floor Area:
Valuation: $I 100000
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
APN Number: 31606039.00
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 non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature VDate 3 (G�� 0
?
Issued by: ----`— — Date: 9146
❑ OWNER -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
RE -ROOFS:
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, l 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
1 hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain aCertificate of Consent to self -insure for Worker's
HAZARDOUS MATERIALS DISCLOSURE
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. i 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.
permit is issued.
Additionally, should 1 use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued, I shall
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
not employ any person in any manner so as to become subject to the Worker's i
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, I must
O r or hor' ec
forthwith comply with such provisions or this permit shall be deemed revoked.
i
Date: 3 6 C7
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
I certify that l have read this application and state that the above information is
1 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
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
with all non -point source regulations per the Cupertino Municipal Code, Section
ARCHITECT'S DECLARATION
—
9.18.
1 understand my plans shall be used as public records.
Signature( Date �116
Licensed Professional
a
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10435 N TANTAU AVE
CONTRACTOR: NOVO CONSTRUCTION
PERMIT NO: 100 10 124
OWNER'S NAME: APPLE INC
1042 HAMILTON CT
DATE ISSUED: 03/16/2010
OWNER'S PHONE: 4089748865
MENLO PARK, CA 94025
PHONE NO: (650)701-1500
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALO
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lie. # 7q i O 2D
TI (11,857') OFFICE SPACE INCLUDES STRUCTURAL
/a�/(
INTERIOR TENTANT IMPROVEMENTS W/EXTERIOR SITE
Contractor NOVO C0n0-rVC ort Date
WORK
I hereby affirm that I am licensed under the provisions of Chapter 9
MODIFICATIONS FOR ACCESSIBLE PATHS OF TRAVEL.
(commencing with Section 7000) of Division 3 of the Business & Professions
03/29/10- DEFERRRED #1 TO (E)PERMIT TO INCLD ADDIT'L
Code and that my license is in full force and effect.
3,974SQ OF ADJACNT EXSTNG TENANT AREA. RMVL OF
(2)WALLS TO CREATE NEW OPEN OFC AREA W/RELOCTD EXITDOORS.NEW
I hereby affirm under penalty of perjury one of the following two declarations:
BREAK RM MILLWORKK.EXISTING CEILING TO
I have and will maintain a certificate of consent to self -insure for Worker's
REMAIN THRUOUT
Compensation, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $1100000
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
APN Number: 31606039.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that 1 have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. 1 agree to comply with all city and county ordinances and state laws relating
WITiIIN 180 DAYS OF 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 FROM LAST 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
granting of this permit. Additionally, the applicant understands and will comply
Issued Date:
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
t -T,11611
RE -ROOFS:
Signatur Date
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.
❑ 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)
I, 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
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.I2 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 pen -nit 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, Secti 5505, 2 3, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized Date:
permit is issued.
agen .
1 certify that in the performance of the work for which this permit is issued, 11 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
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, 1 must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit slmalI 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
ARCHITECT'S DECLARATION
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting 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 � ( 6
M