09110146CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10355 N DE ANZA BLVD I CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 09110146
OWNER'S NAME: APPLE 11042 HAMILTON CT I DATE ISSUED: OIM/2010
OWNER'S PHONE: 4089742131 1 MENLO PARK, CA 94025 1 PHONE NO: (650)701-1500 1
❑ LICENSED CONTRACTOR'S DECLARATION r
License Class g Lic. # �� t ZZ 2/2�1 `
Contractor N O0 (.uwsfin;� }� lN) Date D I 7 — &0 O
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
l 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 ource regulations per the Cupertino Municipal Code, Section
9.18.
Signature (WVUVate / 1 D
❑ OWNER -BUILDER DECLARATION
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,
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
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 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. . / � n
Date
BUILDING PERMIT INFO: BLDG ^ ELECT PLUMB
MECH F RESIDENTIAL F1 COMMERCIAL r
JOB DESCRIFTION: TENANT IMPROVEMENT FOR THE 1ST, 2ND & 3RD
FLOOR OF
AN (E)OFFICE BLDG. NEW CONFERENCE
ROOMS,OFFICES,FINISBES FIXTURES & ACCESSIBILITY
Sq. Ft Floor Area: I Valuation: $350000
APN Number: 32633113.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Date:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Own ` o a a oriz ent
Date: / 21 '7U'o
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO BUILDING PERMIRMION
BUILDING ADDRESS: 10355 N DE ANZA BLVD
CONTRACTOR: NOVO CONSTM7T1
146
OWNER'S NAME: APPLE
1042 HAMILTON CT
DATE ISSUED: 01/25/2010
OWNER'S PHONE: 4089742131
MENLO PARK, CA 94025
PHONE NO: (650)701-1500
❑ LICENSED CONTRACTOR'S DECLARATION
f— F f—
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic. e1<li. Z%2$f t I
MECH RESIDENTIAL COMMERCIAL r
Contractor Novo e�v►s�1>v uyt Date 01 2 I0
hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: TENANT IMPROVEMENT FOR THE I ST, 2ND & 3RD
(commencing with Section 7000) of Division 3 of the Business & Professions
FLOOR OF
Code and that my license is in full force and effect.
AN (E)OFFICE BLDG. NEW CONFERENCE
ROOMS,OFFICES,FINISHES FIXTURES & ACCESSIBILITY
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 tite
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: $350000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 326331 13.00
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
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 DAYS OF PERMIT ISSUANCE OR
with all non -point source regulations perlhe Cupertino Municipal Code, Section
180 DA OM LAST CALLED INSPECTION.
9.18.
Signature. �.. y / Date fYL 10 i,
C
Issued by: 7 " o l r�C� Date:
❑ OWNER-BUI DER DECLARATION
1 hereby affirm that I am 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 being installed. If a roof is
I, as owner of the property, or my employees with wages as their sole compensation,
installed without first obtaining an inspection, I agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec.7044,
inspection.
Business & Professions Code)
I, as owner of the property, am 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:
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
HAZARDOUS MATERIALS DISCLOSURE
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 2-5532(a) should I store or handle hazardous material.
I certify that in the performance of the work for which this permit is issued, I shall
Additionally, should I use equipment or devices which emit hazardous air
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. 1( after making this certificate of exemption, 1
Health & SafetyC e, Sections 25505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such or this be deemed
Ow r t ed g n
provisions permit shall revoked.
Date: dviud
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
CONSTR CTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws relating
I hereby affirm that there is a construction lending agency for the performance of work's
to building construction, and 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
ranting of this permit Additionally, the applicant understands and will comply
l non -point so c regulations pe the Cupertino Municipal Code, SectionARCHITECT'S
DECLARATION
Lwith
1 understand my plans shall be used as public records.
ure Date Iv
Licensed Professional
I CITY OF CUPERTINO BUILDING PERMIT -� 1 n.'7 -I-' I
BUILDING ADDRESS: 10355 N DE ANZA BLVD
OWNER'S NAME: APPLE INC
OWNER'S PHONE: 4089742131
❑ LICENSED CONTRACTOR'S DECLARATION
License Class
�j lLiiy.L—
# O 2Z
Contractor �{ �J Date Cb` 7 [j
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. PVIV
APPLICANT CERTIFICATION
l 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 th Cupertino Municipal Code, Section
9.18. Signature (,j,,J/ �' Date S' 7Z /0
❑ OWNER -BUILDER DECLARATION
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,
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
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. t 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.
CONTRACTOR: NOVO PERMIT NO: 091 10146
CONSTRUCTION
I042 HAMILTON CT DATE ISSUED: 01/25/2010
MENLO PARK, CA 94025 PHONE NO: (650)701-1500
BUILDING PERMIT INFO: BLDG ELECT r PLUMB
Ul r- r
MECH RESIDENTIAL COMMERCIAL
JOB DESCRIPTION: TENANT IMPROVEMENT FOR THE IST, 2ND & 3RD
FLOOR OF
AN (E)OFFICE BLDG. NEW CONFERENCE
ROOMS,OFFICES,FINISHES FIXTURES & ACCESSIBILITY
5/3/10- REVISION #2- ADDED IDF COOLING & ASSOCIATED ROOF
STRUCTURAL, ADDED ELECTRICAL @ELEVATOR ROOM.
Sq. Ft Floor Area: I Valuation: $350000
APN Number: 32633I 13.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued bDate: tr r% -14
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 ofAppl
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, Secti rs 5�05,5,-25/5-3-3, and 2 534.
Owner or authorized agent: Uv: r "�-- 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 Address
ARCHITECT'S DECLARATION
1 understand my plans shall be used as public records.
Licensed Professional
Date