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09090005CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10300 N TANTAU AVE FLR 1 CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 09090005 INC t Z'S NAME: APPLE 690 GIBRALTAR DR DATE ISSUED: 09/23/2009 OWNER'S PHONE: 4088629799 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r- PLUMB License Class Lie. # l a 3 f— r COMMERCIAL r— Contractor J?,1,4✓60V ' '//1i0�ate Zc3 MECH RESIDENTIAL 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:COMM'L TI TO PORTION ON THE 1 ST FLOOR OF (commencing with Section 7000) of Division 3 of the Business & Professions EXISTING Code and that my license is in full force and effect. BUILDING; NEW INTERIOR WALLS, CEILING MODIFICATIONS, NEW ELECTRICAL/DATA OUTLETS(3760SQ) 1 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 Sq. Ft Floor Area: Valuation: $85000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 31618025.FLR1 Occupancy Type: 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 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 p the Cupertino Municipal Code, Section 9.18. 17, b 14 Issued byz � � � Date: Date ❑ OWNER -BUILDER D ON RE -ROOFS: I hereby affirm that I 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, I 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: 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 a Certificate 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. 1 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(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 by the Bay Area Air Quality Management District I will 1 certify that in the performance of the work for which this permit is issued, I 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, I must QvAter forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION C STRU ION LENDING AGENCY I certify that I 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. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to ' "ding construction, and hereby authorize representatives of this city to enter Lender's Name U e above mentioned property for inspection purposes. (We) agree to save inucnunify 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 ARCHITECT'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10300 N TANTAU AVE FLR 1 CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 09090005 INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 09/23/2009 OWNER'S PHONE: 4088629799 MILPITAS, CA 95035 PHONE NO: (408)942-8200 �S LICENSED CONTRACTOR'S DECLARATION n I— r ELECT PLUMB r 7 / BUILDING PERMIT INFO: BLDG License ClassLic. # r r i` ? � � MECH RESIDENTIAL COMMERCIAL � `� Contractor,1 i� Date r� 1 hereby affirm that 1 am licensed under the provisions o Chap er 9 JOB DESCRIPTION: COMM'L TI TO PORTION ON THE 1 ST FLOOR OF (commencing with Section 7000) of Division 3 of the Business & Professions EXISTING ; NEW INTERIOR WALLS, CEILING Code and that my license is in full force and effect. MODIFICATIONS, MODICATIONS, NEW ELECTRICAL/DATA LC) I hereby affirm under penalty of perjury one of the following two declarations: of 03Q_(v — _b (r �� r 1 have and will maintain a certificate of consent to self -insure for Worker's47 �Q� Compensation, as provided for by Section 3700 of the Labor Code, for the /%1^� �/Yl/1/1 c S u-�- �� ¢ �'1 n t c �''s 'a ✓'�� performance of the work for which this permit is issued. t �" -� -' 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. Sq. Ft Floor Area: Valuation: $85000 APPLICANT CERTIFICATION APN Number: 31618025.FLR 1 Occupancy Type: 1 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 apAcant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non -point source regulations per a Cupertino Municipal Code, Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signatur;< ! Date Issued by: = ❑ OWNER -B ILDER DECLARATI N I hereby affirm that 1 am exem om the Con or'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 1, as owner of the property, or my employees with wages as their sole compensation, installed without first obtaining an inspection, 1 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) 1, as owner of the property, am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's HAZARDOUS MATERIALS DISCLOSURE 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 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 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued, l shall contaminants as defined by the Bay Area Air Quality Management District 1 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. If, after making this certificate of exemption, I Health & Safety Code, Sections 25505, 25533, and 25534. become subject to the Worker's Compensation provisions of the Labor Code, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. Own authori ed a --� ' Date: APPLICANT CERTIFICATION C N LENDING AGENCY 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 1 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 granting of this permit. Additionally, the ap licant understands and will comply with all non -point source regulations pert a Cupertino Municipal Code, Section 9.18. ARCHITECT'S DECLARATION / 1 understand my plans shall be used as public records. Signature Date 7 Licensed Professional CITY OF CUPERTINO BUILDING PER1VMSION I -" �"' BUILDING ADDRESS: 10300 N TANTAU AVE FLR I CONTRACTOR: DEVCON COiLM0005 INC OWNER'S NAME: APPLE 690 GIBRALTAR DR DATE ISSUED: 09/23/2009 OWNER'S PHONE: 4088629799 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r- ELECT r— PLUMB License Class Lic.# Contractor Date 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 -points pr"ce regulations per the Cupertino Municipal Code, Section 9.18. u 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: 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. Additronally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. g Signature Date_V MECH F RESIDENTIAL F COMMERCIAL F JOB DESCRIPTION: COMM'L TI TO PORTION ON THE 1 ST FLOOR OF EXISTING BUILDING; NEW INTERIOR WALLS, CEILING MODIFICATIONS, NEW ELECTRICAUDATA ,4.> V, t a, .X a -`� j 01k -C -17-4v. - CJrL c*Y`Lt11>zsc. 41&C ,-►+- �yGrSY Sq. Ft Floor Area: I Valuation: $85000 APN Number: 31618025.FLRI I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: 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 Quaiity Management District I will maintain complian�,a with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety,•Co`de, Sections 25505, 25533, and 25534. Owner . / `© 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 I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10300 N TANTAU AVE FLR I CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 09090005 INC OWNER'S NAME: APPLE 690 GIBRALTAR DR DATE ISSUED: 09/23/2009 OWNER'S PHONE: 4088629799 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION PLUMB License Class Lic. # 16 BUILDING PERMIT INFO: BLDG ELECT r_ jj�� Contractor DF_ ecvy Date MECH RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: COMM'L TI TO PORTION ON THE l ST FLOOR OF (commencing with Section 7000) of Division 3 of the Business & Professions EXISTING BUILDING; NEW INTERIOR WALLS, CEILING Code and that my license is in full force and effect. MODIFICATIONS, NEW ELECTRICAL/DATA I hereby affirm under penalty of perjury one of the following two declarations: a c� i- �c� �u-.V`�'"ems 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 Sq. Ft Floor Area: Valuation: $85000 permit is issued. APPLICANT CERTIFICATION APN Number: 31618025.FLR1 Occupancy Type: 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, 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 180 DAYS OF PERMIT ISSUANCE OR with all non -point source regulations per the Cupertino Municipal Code, Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signature Datei Issued by` Date: ❑ OWNER -BUILD DEC TION I 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). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER declarations: HAZARDOUS MATERIALS DISCLOSURE 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 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 25532(a) should I store or handle hazardous material. Additionally, should I 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 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 Califomia. If, after making this certificate of exemption, 1 Health & Safety Code, Sec ' ns 25505, 25533, and 25534. 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. Own or autho ze a nt: Date: �� _—i APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is �NSTRUVX��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 granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations er the Cupertino Municipal Code, Section 9.18. ARCHITECT'S DECLARATION Date__ /Q Licensed Professional