07100005 CITY OF CUPERTINO (� ' �`'� ` } '
BUILDINGDIYISIOiV PERMIT `-"���'�^����^'^����1QNf .
<: ..:: _.: :; .
PERMIT NO.
BUILD �N����ESSN TANTAU AVE SOUTH B1�Y CONSTRUCTION CO 07100005 •
�--'- pERMIT LSSUE DATE
R'S NAME: ,
APPLE COMPUTER 170 KNOL �LES DR 10/10/2007
SANiTARY NO. CON7ROL NO.
PHONE:
(408) 37`)-5500
8U(LDiNG PERMIT INFO
ARCHITECiBNGiNEER: BLDG ELECT PLUMB MECH
� 0 � �
i p�p LICENSED CON7'RACfOR'S DECLARATION JOI� D05Ci1pL1017
:�� t hcrcby aCfirm that I am licensed undcr provisioas oC Chaptcr 9(commencing
; X� wi�h Secuon 70cxp ot Divisian 3 of �hc Busincss and Profcssiuns Codc, and my Iicense is RE PA I R , 3 TRUC TUR.AL C � L�
�= y in fu0 force and c((ect 7
� v� Z Licensc a;s L�. �
p Datc �� O Conuacwr
: �" � ARCHITECI'S DECLAR N
j� a
Q 1 undcrstand my plans shall Uc used as public rccords
)yU
° a y Licensed Pmfcssianai
; � < OWNER-BUILDER DECLARATiON
�N�]
I hcrcby alTirm �hat 1 am exempt Crom the Contractors Liccnsc Law far �k�c
� p O [ollowing rcason. (SccGon 7(I31.5, Business and Profcssions Codc: Any city or rnunty
<,°, � which requires a pcanit ta conswct. alter. improvc. dcmoiish. or mpair any swcwcc
�'" � prior w i�s issuance, also rcquires thc applican� for such permit to file a signed stalement �. Valuation
-?< tltat he is ticcnsc d pursuan t to t hc p ro v i s i o n s o f � h c C o n v a c w r' s L i c c n s c L a w ( C h a p t c r 9 ,� q. Ft. Floor Area � 1 O 0 O 0
r�� (commcncing wi�h Scction 7000) of Division 3 of thc 8usincss and Profcssions Cadc) or
i�� that Ae is exempt theiefrom and tAc basis Cor �he allcgcd exemplian. Any violauan of
Section 703I.5 by airy applican� Cor a petmit subjecu the applicant to a civil pcnalty of 31618 0 2�!°'�� Number Occupancy Type
not more than five hundred dollars (5500).
❑ I, as owner o[ [t�e property. ar my employca with wages as the'v solc compensadon,
wilidothcwork.andthesiruaumisnotintendedorutCeccdforsale(Sec. Required Inspections
and ProCessions Code: 'Ihe Canuactar's License Law does noe apply w an ow�rcr of
propeny wtro builds or impraves thercon, and who does such work AimselCar theough his
own employecs, provldcd ihat sueh improvementc are not intended or o[fered for sala 1[,
however, �he buildiag or improvement is sold within one year o[ completion, ihe owner-
builder witl have ihe bur�n of proving Wat he did nat build or improvc for puryau of
salc.).
� I, as awner of the propeny, am uclusively conuacting with licensed rnnvactnrs W
conswct the projen (Sec. 7044. Business and Pro(essions Code:) 7Lc Coatnttars Li•
cense law dacs not apply to an ownu af propeny wtw builds or improves ttrc�eon. and . _
who con�racts for such projecls with a convxtor(s) liansed pursuant to Uu Convxtor's
License Law.
n�� �xempt under Sec . B& P C for �his mason
,er . Date _.. _
WORKEIt'S COMPENSATiON DECLARATION
16ercby affitm under penalty a( perjury one of �he fallowing declazuians:
❑ I haoe and will main�ain a CeniGcatc ot Conacnl to scl(-insurc far Workers Comprn-
satian, as providcd for by Secrion 3900 of che Labor Code. far We pcAortnance ot che
work [or whicd Ihis permi[ is issucd.
❑ I havc and will maintain WorkePs Compensation Insurance, u�cquired 6y Scction ,
3700 0( the Labor Code. Cor the performance af the work for which �his permit is issued.
My Worke�s Compensation Insucance cartier and Policy number are:
Cartier. � 1 �P G4-'f'L/ ]uC O�U � Policy No.: b�f Z ZZ �� �
CERTI CATE F EXEMPIION FROM WORKERS'
COMPENSATlON INSURANCE
(ihis uction need no[ be canpleted if the permit is for one hundrcd doitazs (5100)
or Icss.)
1 cenify thxt in thc performance of thc work for which this permit is issucd. I shall not
employ any person in any manncr so az to bccomc subjcct ta the Workcrs' Compensadon
Laws of Cali(omia. Datc
Applicant
NOTiCE TO APPLICANT: If, aftcr making this Ceni�catc o( Excmption. you should
become subject w �he Worker's Compensation provisions of the Labor Code, you must
� O (oMwith comply with such provisions or this pecmi� sha0 bc dccmcd revokcd.
z '"� CONSTRUCCION LENDING AGENCY
(� ��-. I hereby aflirm that there is a consuvctian lending aEcncy lbr the perCormance uf -
a. thc work Cur which this permit is issucd (Scc. 3097, Civ. CJ ,
W Q Lendcr's Namc
a � C,cnder's Address
V � I certify �hat 1 havc read Ihis application and sta� ihat thc abovc info�mauun is
w � cortcct. ! agrce to comply wi�h all city and county onlinances and sute laws relating to
� U building conswction, and hereby authori�e reprcseniatives of �his city to enter u{mn lAc
� a above-memioned property for inspecUOn purposes.
(We) agrce to save, indcm�ify and kecp harmleu the Ci�y of Cupenino agtinsi
�� liabilidcs, judgmcn�s, cos�s and expenses which may in any way accruc against said City /
U z in conscqucncc oC the granung af this permit. Date �� "�
►� APPLICANT UNDERSTANDS N WILL COMPLY WITH ALL NON-POINT Issued by: �� �
SOU R ULA'I'IONS. �
t�' l e: b Re-roofs
Sign pplicanUCo �o� ° ae T e of F.00f
HAZARDOUS MATERIALS DISCLOSURE YP
Wil1 thc apptipnt or futurc building accupant uoro or handlc ha•rardous matcrial
dcfincd by the Cupenino Municipal Cadc. Chapter 9.12. and [hc Hcalth and Sa[ay
�. SccUon 25532(a)? All roofs shall be inspected prior to any roofing material being installed.
�Ycs �o .
wll thc applicant or future building accupant usc cyuipmcnt or dcvias whic6
If a roof is installed without first obtaining an inspection, I agree to remove
cmit harardous air contaminants as dcfincd 6y the Bay Area Air Qualily Managcmcnl all new kaEa,�ials for inspection.
Disvict? d
❑ Ycs �
1 havc rcad the ha�acdcws maicrials requircmcnts undcr Chaptcr 6.95 of thc Califor- � � r+'^L �/.� -/_ l� 1
nia Hcalih & Safciy Cadc. Sccdons 25505, 25533 and 25534. I undcrstand thaz iCthc building �[l/V ! Q O
docs no� cu havc a tcnan6 ihat i� is m nsibility ro notify thc occupant o� ihe
requirc �s w ch musi bc met priq�rto is �a Ccyifica�c of Occ7ipanry/ S natu of Applicant Date
/1 'r�< <�� � e �� All roof coverings to be Class "B" or better
Owncr or authorized agcn� ��