B-2016-2470CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2470
3 INFINITE LOOP CUPERTINO, CA 95014-2086 (316 02 107)
NOVO
CONSTRUCTION INC
MENLO PARK, CA
94025
OWNER'S NAME: APPLE COMPUTER INC
DATE ISSUED: 08/08/2016
OWNER'S PHONE: 408-547-7302
PHONE No: (650) 701-1500
BUILDING PERMIT INFO:
LICENSED. CONTRACTOR'S DECLARATION
License Class B Lie. #791022
Contractor NOVO CONSTRUCTION INCDate D2/28/2017
X_ BLDG _ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— M ECH — RESIDENTIAL COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect. ,
JOB DESCRIPTION:
I hereby affirm under penalty of perjury one of the following two declarations:
1ST FLOOR; T.I. - LOBBY (428 S.F.) - APPLE
i. 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.
z. 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: $45000.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
316 02 107
A (Tenant Improvements),B (Tenant Improvements)
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
PERMIT EXPIRES IF WORK IS NOT STARTED
accrue against said City in consequence of the granting of this permit.
Additionally, the applicant understands and will comply with all non -point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations—per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 08/08/2016
Issued by: PAUL O'SULLIVAN
OWNER -B T1I,nFltDECLARATInN
Date: 08/08/2016
_
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. 1, as owner of the property, or my employees with wages as their sole
installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
2. 1, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (See.7044, Business & Professions Code).
Date: 08/08/2016
I hereby affirm under penalty of perjury one of the following three declarations:
1. I have and will maintain a Certificate of Consent to self -insure for Worker's
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
HAZARDOUS MATERIALS DISCLOSURE
2. 1 have and will maintain Worker's Compensation Insurance, as provided for by
I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code, for the performance of the work for which this
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the
material. Additionally, should I use equipment or devices which emit hazardous
Worker's Compensation laws of California. If, after making this certificate of
air contaminants as defined by the Bay Area Air Quality Management District I
exemption, I become subject to the Worker's Compensation provisions of the
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply, with such provisions or this permit shall
be deemed revoked.
— —'_—
Owner or authorized agent:
' APPLICANT CERTIFICATION
Date: 08/08/2016
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a construction lending agency for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is issued (Sec.. 3097, Civ C.)
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18. 1
understand my plans shall be used as public records.
SignatureDate 08/08/2016
Licensed
Professional
CONSTRUCTION PERMIT APPLICATION 5X16 ,
COMMUNITY DEVELOPMENT DEP ARTM, ENT - BUILDING DIVUSHON
10303 TORRE AVENUE - CUPERTINO, CA SM14-3255 B
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