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B-2016-2850
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2850 1 INFINITE LOOP CUPERTINO,CA 95014-2083(316 02 105) BARRON BUILDERS INC SANTA CLARA,CA 95054 OWNER'S NAME: APPLE COMPUTER INC DATE ISSUED:01/05/2017 OWNER'S PHONE:408-996-1010 PHONE NO:(650)964-4493 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class fa Lic.#916366 Contractor BARRON BUILDERS INC Date 07/31/2017 X BLDG X ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing 1VIECH_RESIDENTIAL X COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: APPLE-LOBBY-UPDATE(5)ELEVATORS,EQUIPMENT IN I hereby affirm under penalty of perjury one of the following two declarations: BASEMENT;REPAIR SHAFT DUE TO REMOVAL OF FIRE 1. I have and will maintain a certificate of consent to self-insure for Worker's SPRINKLER HEADS- Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 2. 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:$100000.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 316 02 105 A(Tenant Improvements) representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree fo save indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF'WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date Issued by:Kim Dunbar Date:01/05/2017 OWNER-BUILDER DECLARATION 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. I,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. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date: I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I 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 air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the 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: I certify that I have read this application and state that the above information is S ONSTRTJCTION 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. I understand my plans shall be used as public records. Licensed Signature Date Professional ; CONSTRUCTION PERMIT APPLICATION ;INV t` COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE.CUPERTINO,CA 95014-3255 _` (408)777-3228- FAX(408)777-3333. buildingcupertino.orq CUPERTINO 'u 2416' — � � - D NEW CONSTRUCTION El ADDITION [ALTERATION/TI 0 REVISION/DEFERRED ORIGINAL P RMIT# PROJECT ADDRESS AIN r- . - I�i.►Fi� ill: LVO 3/(a 0� 165 OWNER NAME ja QV a PHONE E-MAIL ____ ____ STREET ADDRESS 1 414• I r ITE 7 100 CITY, STATE,ZIP , PAX CONTACT NAME N ESTO,O, 3 R"Ni " ,66D- 26c/- 7061 E-MAIL I1 I17 A 2„r� tlt tQ1 S IB+4 STREET ADDRESS CITY STATE,ZIPFAY. 2. -.4-(e. GilZL& DcL_ MuAi0C S /41---A, c C , ' ❑ OWNER 0 OWNIR-BUILDER ❑ OWNER AGENT r CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGLNEER 0 DEVELOPER 0 TENANT COIVTRACTO T E f LICENSE ti14t E LIC E TYPEfr BUS,LIC tf COMPANY NA eiEeX10/ J t 4A V t I-I�4 E-MAIL 'lam i yIV 1 @ t�`GA`-t N cA I oP�J. 60 SET.ADDRESS _ CITYSTATE,ZIP PHONE, L , c A.RCHITECT/ENGINEERNAME �-_. __r�_ VV 1 LICENSE NUMBER ` - BUS.LIC;--- COMPANY NAME E-MAII. • FAX STREET ADDRESS CITY,STATE,ZIP • PHONE DESCRIPTION OF = RIS F L L�1%A-1'Q L Qu i e m e 71 D 1J Z 2AfT eL-WI.0vA L e- 6',Aw4t lJT eV CAW I P OA (J c$' C Pr fk.voia___i went z. -vo t.LE VA"T'DC.- SN I\FTS WILL. f LI I tt ' -rt) Qo re tk�©.e.,Pf�le- OV yc��T7/0 r1Z.t >►,,R . cU__sTRUC-�i 00J EXISTING-USE PROPOSED USE CONSTR.TYPE #STORIES -�- s USE —TYPE OCC- SQ.FT. VALUATION(5) EXISTG NFLOOR DEMO TOTAL - - - -. --- EW AREAEM AREA AREA NET AREA BATHROOM KITCHEN - OTHER . • REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK'PORCH AREA GARAGE AREA: ❑DETACH 0 ATTACH MIMI *DA'ELLAG UNITS: ISA SECOND UNIT 0-YES SECOND STORY OYES BEING ADDED? DM0 ADDITION? 0N , FREAPPLICATION-❑YES IF YES,PROVIDE COPY OF • IS THE BLDG AN 0 YES • - •-• ��/`. 4:,...71:7,,,,,47 =;z_;_ ;rr Q;4-_r TOTAL VALUATION: PL. NNINGAPPL V ❑NO PLAN\LAG APPROVAL.LETTER EICHLER HOME? ❑NO �` ..= :'w.� :.F_-Ai: 4:22 A.,:FuA:i'.I - - `..�= a:; / • By my signature below,I certify to each of the following: I am the properly owner or authorized agent to act on the property owner's behalf, I have read this application and the information I have provided is correct. I have read the Description of Work and verify itis accurate, I-agree to comply with all applicable local " ordinances and state-laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. - SimratureofA •licant/A•ent: Date: T TREQUIRED SUPPLEMENTAL ;__ .nr _.s.;?A;-' N .r:f._-,PIr�:?�:CI3ECK�T.YPE�_`;.„r.:-ri ,r,,,:-,»:-,v_�;I�;':ROUTIf\G.SLIPim".= �„•' New SFD or Multifamily dwellings: Apply for demolition permit for rte.;. _ _--- =;�.:r .- __..._,>.-. ,. ;__r' OLEF.=TFIE-.90,L TER- f'.��=i BUL„pg".GPLA�REpP)i:},_•._.;.= g gbuilding -' °- -_- - __ 'iY`'':n.r=�_:”: :.55-55"'5,--g_4.;.-.` __2�:%t=w :;., existing buildtll_s. Demolition pel,nit is required prior to issuance of :�--#��== _;�=zc;F==::�_•�"-�� ""`- ___ _ - - _ erinitfor nec=building. s :;E w�Ss'`x •` ,. `=;l�? .rPLA.A\L�VGPL:ANRE\E S,.,-.s;. „ ' �,-sI�• yflRI.S_: : ==.Commercial Bldgs Provide a completed Hazardous Materials Disclosure *0-STartnARD_< Mi;- �z " .,PI.0 ;.-. �; _'_ form if any Hazardous Materials arobeingused as part of this project. k= ;k�_ ' y. a< -:;c-::':_` = ;, ^ r� :,._-,_-: u:>::e- _-,__ :- -:�;;IA4RGs E-:� _I _ __ = .FLtEDEPT.iR=== ,_ _ . .. .,ys;_ - _ _ __Y: _ tRin-i=_<'m= -_ y __..{ Copyof PlanningAProvalLetter or Meeting with Planning prior to t- :S= _ ,=- s: w : ^. .=_: =,