B-2017-1482 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1482
10100 N TANTAU AVE CUPERTINO,CA 95014-2540(316 19 062) NOVO
CONSTRUCTION INC
MENLO PARK,CA
94025
•
OWNER'S NAME: PR CUPERTINO GATEWAY LLC DATE ISSUED: 10/17/2017
OWNER'S PHONE: PHONE NO:(650)701-1500
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B' Lic.#791022
Contractor NOVO CONSTRUCTION INC Date 02/28/2019 X BLDG _ELECT -PLUMB
MECH RESIDENTIAL X COMMERCIAL
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. JOB DESCRIPTION:
APPLE-INSTALL NEW MECHANICAL EQUIPMENT ENCLOSURE
I hereby affirm under penalty of perjury one of the following two declarations: (DEMO EXISTING TEMP MECHANICAL ENCLOSURE;(1254 S.F.)TO
t. I have and will maintain a certificate of consent to self-insure for Worker's INCLUDE SMALL EXTERIOR GAS STORAGE.
.Compensation,as provided for by Section 3700 of the Labor Code,for the
r.erformance of the work for which this permit is issued.
r• 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:$400000.00
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 19 062 A(Tenant Improvements),B(Tenant Itnprovements),B
representatives of this city to enter upon the above mentioned property for (Tenant Improvements),A(Tenant Improvements),A
inspection'purposes. (We)agree to save indemnify and keep harmless the (Tenant Improvements),A(Tenant Improvements),A
City of Cupertino against liabilities,judgments,costs,and expenses which (Tenant Improvements),A(Tenant Improvements),A
may accrue against said City'in consequence of the granting of this permit. (Tenant Improvements),A(Tenant Improvements),A
Additionally,the applicant understands and will comply with all non-point . • (Tenant Improvements),A(Tenant Improvements)
source regulations per the Cupertino'Municipal Code,Section 9.18.
ignature Date 10/17/2017
PERMIT EXPIRES IF WORK IS NOT STARTED
�
WITHIN 180 DAYS.OF PERMIT ISSUANCE OR
OWNER-BUILDER DECLARATION 180 DAYS FROM LAST CALLED INSPECTION.
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons: Issued by:Abby Ayende
1. I;as owner of the property,or my employees with wages as their sole Date: 10/17/2017
compensation,will do the work,and the structure is not intended or offered for •
. sale(Sec.7044,Business&Professions Code) RE-ROOFS:
2. ,I as owner of the property,am exclusively contracting with licensed All roofs shall be inspected prior to any roofing material being installed.If a roof is
Contractors to construct the project(Sec.7044,Business&Professions Code). installed without first obtaining an inspection„I agree to remove all new materials for
I hereby affirm under penalty of perjury one of the following three declarations: inspection.
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 Signature of Applicant:
performance of the work for which this permit is issued. Date:10/17/2017
2. Ii 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 ALL ROOF COVERINGS.TO BE CLASS"A”OR BETTER
permit is issued.
3. I certify that in the performance of the work for which this permit is issued,I HAZARDOUS MATERIALS DISCLOSURE
shall not employ any person in any manner so as to become subject to the I have read the hazardous materials requirements under Chapter 6.95 of the
Worker's Compensation laws of California. If,after making this certificate of California Health&Safety Code,Sections 25505,25533,and 25534. I will
exemption,I become subject to the Worker's Compensation provisions of the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Labor Code,I must forthwith comply with such provisions or this permit shall Health&Safety Code,Section 25532(a)should I store or handle hazardous
be deemed revoked. material. Additionally,should I use equipment or devices which emit hazardous
• air contaminants as defined by the Bay Area Mr Quality Management District I
• APPLICANT CERTIFICATION will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I certify that I have read this application and state that the above information is the Health&Safety Code,Sections 25505,25533,and 25534.
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 •
judgments,'costs,and expenses which may accrue against said City in CONSTRUCTION LENDING AGENC
consegtjence of the granting of this permit. Additionally,the applicant understands I hereby affirm that there is a construction lending agency for the performance
and will Icorhply:with all non-point source regulations per the Cupertino Municipal of work's for which this permit is issued(Sec.3097,Civ C.)
Code,Section 9.1'8. Lender's Name•
1�
Lender's Address
Signature Date 10/17/2017
ARCHITECT'S DECLARATION
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CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1482
10100 N TANTAU AVE CUPERTINO,CA 95014-2540(316 19 062) NOVO
CONSTRUCTION INC
MENLO PARK,CA
94025
OWNER'S NAME:PR CUPERTINO GATEWAY LLC DATE ISSUED:10/17/2017
OWNER'S PHONE: PHONE NO:(650)701-1500
LICENSED CONTRACTOR'S DECLARATION BUILDING"PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic.#791022
Contractor NOVO CONSTRUCTION INC Date 02128/2019 X BLDG_ELECT—PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH—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-INSTALL NEW MECHANICAL EQUIPMENT ENCLOSURE
I hereby affirm under penalty of perjury one of the following two declarations: (DEMO EXISTING TEMP MECHANICAL ENCLOSURE;(1254 S.F.)TO
r. I have and will maintain a certificate of consent to self-insure for Worker's INCLUDE SMALL EXTERIOR GAS STORAGE.
Compensation,as provided for by Section 3700 of the Labor Code,for the REV#1-CHANGES TO DIMENSIONS OF UTILITY YARD,
performance of the work for which this permit is issued. STRUCTURAL FOOTINGS-ISSUED 4/10/2018
x. 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:$400000.00
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 19062 A(Tenant Improvemcnts),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,jud rents,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in con qua a of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understo ds and ill comply with all non-point
source regulations per the Cupert' - uni pal code,section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature _ Date4/10/2018 Issued by:Abby
Date:10/17/2017
OWNER-BUILDER DE - TIO
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
r. 1,as owner of the property,or my employees with wages as their sole installed without fast 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(See.7044,Business&Professions Code)
z. 1,as owner of the property,am exclusively contracting with licensed Signature ofApplicanC
contractors to construct the project(Sec.7044,Business&Professions Code). Date: /104 /2018
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 1 have and will maintahr,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
z. 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
a. I certify that in the performance of the work for which this permit is issued,I Health&Safety Cade,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,I£,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 Data:4110/2018
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,
Licensed
Signature Date 4110/2018 professional