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06030126CITY OF C UYr xi>lr��iTRACQ j�>M�°l l �JPI BUILDING DIVISION PERMIT 4. NOVO CONSTRUCTION PERMIT "G. 06030126 BUILDING ADDRESS: , OWNER'S NAME: APPLE COMPUTER JNE: ARCHITECr /ENGINEER: i O C LICENSED CONTRACTOR'S DECLARATION VP I hereby affirm that I am licensed under provisions of Chapter 9 (commencing Z �d with Section 7000) of Division 3 of die Business and Professions Code, and my license is o H in full force and effect �L v� Z License Lam• r = p Datc Conuat"^•� ARCHITECTS DECLARATION I understand my plans shall be used as public records )yU G y Licensed Professional OWNER - BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the ca following reason. (Section 7031.5, Business and Professions Code: Any city or county < 1. Pi which requires a permit to construct, alter, improve, demolish, or repair any structure u — y prior to its issuance, also requires the applicant for such permit to file a signed statement - Z < that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 Y F G (commencing with Section 7000) of Division 3 of the Business and Professions Code) or i that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ❑ 1, 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 and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and � Molt ork htrnseIf or through his own employees, provided that such improvem is n o e. If, however, the building or improvement is sold with cocti builder will have the burden of proving that to di, ld` F, i ve ft sale.). ❑ I, as owner of the property, am exclusi y contracting with ttnsedGas toy construct the project (Sec. 7044, Business Professions Code,fie Contractor's Li- cense Law does not apply to an owner of property who ba s or #Oproves thereon. grid . who contracts for such projects with a contractors) rtcerift itt to t�e Contractor's License Law. C3 am exempt under Sec B & P C for this reason Owner Dam WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: 0 O Z o. A �z U w F. C Uz r- ] I have and will maintain a Certificate of Consent to self -insure for Worker's Compen- ation, as provided for by Section 3700 of the Labor Code, for the perform— of the cork for which this permit is issued. -11 have and will maintain Worker's Compensation Insurance, as required by Section 700 of the Labor Code, for the performance of the work for which this permit is issued. dy Workers C pennon insurance carrier and Policy number am: .artier. Policy No.: E ATE OF EX EMPTION FROM ORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) )r less.) I certify that in the performance of the work for which this permit is issued. I shall not :mploy any person in any manner so as to become subject to the Workcrs' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lender's Name Lender's Address 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 concoction, 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 in any way accrue against said City in consequence of the granting of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT SOURCE RWMRT10NOS /'v Signature of Applicant/Contractor 1, Datc HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety Codc,Section 25532(a)? ❑ YesNo Will the applicant or fu re building occupant use equipment or devices which emit hazardous air contaminants at defined by the Bay Area Air Quality Management District? ❑ Yes No I have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & Safcty Code, Sections 25505, 25533 and 25534.1 understand that if tic building does not currently have a tenant, that it is my responsibility to notify the occupant of the require�u ichmu y ^ met pn w issuance of a Certificate of Occup 11�23ii�o Owner or authorized agent Date 2 (650) 701 -1500 PERMIT! ISSUE DATE SANITARY NO. CONTROL NO. Job Description BUILDING PERMIT INFO ELECT PLUMB T.I. OFFICE - STRUCTURAL /ELECTRICAL /PLUMBING MECHANICAL THROUGHOUT SEE TEMP PERMIT #06040185 FOR SOME INSPECTIONS Ft. Floor Area Required Inspections Issued by: Re -roofs Type of Roof valuation $3425223 Occupancy Date S_ 23 e:6 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 All roof coverings to be Class "B" or better Date 1 CITY OF P T APPLICATION CUPE�TfN© 040_,3��Ie�)c AFN # Fee ID Fee Description Date: \ D Oy � I,0 Building Address: BBOILERI Mailing Address (if different from building address): MECHANICAL BBOLLER2 Owner's Name: MECHANICAL Phone #: Boiler > 500K to 1M Btu MECHANICAL Gsz� �b 2 Contractor: MECHANICAL License #: Boiler > 1.75M Btu MECHANICAL BCONSTAX Contact: BUILDING Phone: (SD col ► x µS Cupertino Business Licens #: i�f1 tS �M Fax: .null ng rerm l info: Pk Bldg Elect [ Plumb K1 Mech Job Description: Residential ❑ Commercial �1 Sq_Ft. Floor Area: 2 q.Ft.: � (per Cost of Proiect: Occupancy Grouv: 2, ioD, c oD Type of Construction: Please check this bog if the project is a v/ 4 i second -story addition: ❑ Proiect Size: Standard 0°' ❑ Mai or ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBOILERI Boiler <= 100,000 Btu MECHANICAL BBOLLER2 Boiler > 100K to 500K Btu MECHANICAL BBOILER3 Boiler > 500K to 1M Btu MECHANICAL BBOILER4 Boiler > 1M to 1,75 M Btu MECHANICAL BBOILER5 Boiler > 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ead/Off/Comm/Quasi BUILDING 13CONSTAXBQ Con. Tax for BQ Zone BULLDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC1000 Elec 600V < =1000A ELECTRICAL BELEC1001 Elec 600V > 1000A .ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of 3 Wtv�.; . CUPERTINO PERILT A-PPLICATION FCSM Quantity Fee ID Fee Description Fee Group BMISCELL Miscellaneous Fee BUILDING BMTTIGATC Comm. Housing 1 Iit. Fee BUILDING BNUCOMME New Comm Electric ELECTRICAL BNUC011RVD�Z New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBINTG BOVERT3, E Inc ection Overtime BUILDING BPBACKFLOW Atnos heric Vacuum PLUMBING BPCESSPOOL Cesspool PLUMBING BPER14FEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGAS Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUTOING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUII DING BPLANCKREP Plan Check Re eat Fee B=D\TG BPREPIPE Re i e Of Fixtures PLUMBING BPS!+ WAGE Se-wage Disposal PLUMBING BPSEWER SeRvers PLUMING BPSPRINK Lain S rinkh r/Baclflo PLUMING BPSTORM ' torm%Rain Water PLUMBING BPIF-AP Kitchen Trap PLUMBING BPVENT Alt of Drain & Vent PLUMBING BPWATER In`ctaWAIter Water Pie PLUMING BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Re ecti on Fee BUILDING BREMACOVER A/C Unit > 10,000 cfm MECHANICAL BREI�ti4IRHAN A/C Units <= 10,000 cfia MECHANICAL BREMAPPLI Apphanct Install ?`�CHANICAI. BRENMUSWAY Remodel Bus-ways ELECTRICAL BREMFIXT Lighting Fixtures ELECTRICAL BREINg'URN BREMFURNOV Relocation of Furnace Relo Furnace > l OK btu MECHANICAL MECHANICAL BREnIHEAT Heater Installation MECHAMCAL BREAUINTHOOD Installation of Hood HYCE ANICAL BREM,MSC Misr, Apparatus ELECTRICAL BREND RP PP Rem Non -Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixturc ELECTRICAL BRR POWER Power Device/Apparatus ELECTRICAL BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT R f--p air /Alter Heating MECHAACAL BREMRESAPP Remode] Res Appliance ELECTRICAL 2 o'13 Z U U :a rn i? f� i� U �F ha h J i� ,y :p 'Om CITY OF CUPERTINO PERMIT AT BUILDING DIVISION BUILDING ADDRESS: NOVO CONSTRUCTION PERMITNO.06030126 20730 VALLEY—GREEN T)R OWNER'S NAME: FERMTT ISSUE DATE APPLE COMPUTER 1042 HAMILTO PHONE: SAMTARY NO. CONTROL NO. (650) 701 -1500 ARCHITECTIENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION IOb Description hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and ef(wL a oln T.I. OFFICE - STRUCTURAL / EL E CTR I CAL / PLUMBING License (files Lic. N Date contractor MECHANICAL THROUGHOUT SEE TEMP PERMIT ##06040185 FOR SOME INSPECTIONS I understand my plans shall he used as public records shall Licensed Professional OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct. alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation that he is licensed pursuant to the provisions of the (commencing with Section 7000) of Division 3 of the Business and Professions Code) or $3425223 that he is exempt therefrom and the basis for the alleged exemption. Any violation of APN Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than rive hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as the -hr sole compensation, ' Required Inspections will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or trough his own employees, provided that such improvements are not intended or offered for sale. if, however, the building or improvement is sold within one year of completion, the owner- builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code :) The Contractor's U. tense Law does not apply to an owner of property who builds or improves thereon, and. who contracts for such projects with a conuactor(s) licensed pursuant to the Contractor's ' License Law. ❑ 1 am exempt under Sec B & P C for this reason Owner Date WORKERS COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations ❑ I ham and will maintain a Certificate of Consent to self -insure for Workers Compen- sation, 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 Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued My Workers Co pens ton Insurance carrier and Policy number are: Carrier. 'Ill Policy No.: E IFICATE OF EXEMPTION FROM WORKERS* COMPENSATION INSURANCE r (This section need not be completed if the permit is for one hundred dollars (S100) or Icss.) I certify that in the perfornanee of the work for which this permit is issued 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Cenifi ate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Coda you must forthwith comply with such provisions or this permit shall be deemed mvokcd. CONSTRUCTION LENDING AGENCY hereby an that there is a construction lending agency for the performance of I ffhr the work for which this permit is issued (Sec. 3097. Civ. C.) " Lenders Name Lenders Address 1 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 in any way accrue against said City in consequence of the granting of this permiL APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date �� SOURCE R ggTI-ONS. Re -roofs Type Roof .�/l� 512. �(L Signature of Applicant/Contracior C Dare HAZARDOUS MATERIALS DISCLOSURE of Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(x)? No All roofs shall be inspected prior to any roofing material being installed. ❑ Ye If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑Yes Nu I have read the hazardous materials requirements under Chapter 6.95 of thc Califor- nia Health & Safety Codc, Sections 25505.25533 and 25534.1 understand that if thc building does not currently have a tenant. that it is my responsibility to notify the occupant of the require ich muse met pn. to isstrancc of a certificate of Occupancy f Signature of Applicant Date 3 C M Z" ` All roof coverings to be Class "B" or better Owner or authorized agent Date CITY OF CUPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777 -3228 Fax(408)777 -3333 Building Department JOB ADDRESS: PERMIT # 6 6'J OWNER'S NAME: C(9y PHONE # 6'-6 %l IS-0b x I GENERAL CONTRACTOR: FAX # Isd l I am not using any subcontractors: Signature Date PIPacP rhPc-k annlicable subcontractors and complete the following information: 1� (nMX i�zz o Owner/ Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing �( Electrical�� Excavation Fencing �( Flooring: Carpeting Linoleum / Wood Glass / Glazing TF�D Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal X Painting / Wallpaper --rzb Paving Plastering Plumbing Roofing Septic Tank Sheet Metal x Sheet Rock —tom Tile 1� (nMX i�zz o Owner/ Contractor Signature Date