B-2017-1903 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1903
10101 N DE ANZA BLVD STE 3 CUPERTINO,CA 95014-2264(326 34 071) REDWOOD ELECTRIC
GROUP INC
SANTA CLARA,CA
95051
• OWNER'S NAME: WATERDRAGON 289 LLC DATE ISSUED: 11/30/2017
OWNER'S PHONE:408-783-2338 • PRONE NO:(408)450-4800
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-10 Lie.#318433
Contractor:_.' 000 _ G:• ► Date 01/31/2018 X BLDG X 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:
T.I.-APPLE;TEMPORARY GENERATOR(12-16-2017-12-23-2017)
I hereby affirm under penalty of perjury one of the following two declarations:
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
tiro"qmance of the work for which this permit is issued.
dt* 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:$27000.00 /
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
information is correct.I agreeto comply with all city and county ordinances APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 326 34 071 A(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 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.
400 ignature �J//�.a/ � / r Date 11/30/2017 Issued by:AbbyAyende
Date: 11/30/2017
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)
z. 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:11/30/2017
I hereby affirm under penalty of perjury 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
a 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 9
be deemed revoked. ea0 ner or authorized a ent /7,
�
APPLICANTCERTIFICATION Date:11/30/2017
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. I understand my plans shall be used as public records.
Signature Date 11/30/2017 Licensed
Professional
CONSTRUCTION PERMIT APPLICATION
\' COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
[ 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
(408)777-3228 • building@cupertino.org PEMIT UB-20 1 - i 9%0.3
CUPERTINO. REV# DEP#
❑NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. Q MEP El RE-ROOF ❑SWIMMING POOL/SPA
PROJECT ADDRESS I APN? f 2.6
7 ,/ �9 r�
10101 North De.Anna Blvd,Cupertino,CA ' u r
OWNER NAME PHONE t-idt--/gI-, 2-33% E-MAIL
Apple Iuc Christine De Guzman cdeguzman@apple.com
STREET ADDRESS I CITY,STATE,ZIP
0he- N4-1INi1"a Lf. _ Cvpage Ina 4+,95014
x❑CONTRACTOR NAME ❑OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE
Danny SUR R-r wood.Electron Gt p 31V'33 — J v
STREET ADDRESS ¢ CITY,STATE, EP
2.1 ?S.- (1ei---l4,w e c'i—er,ir- ¶iwrv� so.•r+A Cl A r an- q'- --0 s- 1
E-MAIL. i PHONE t i HUS,LTC k
Oake I'N s4- OreiVi ec1:�evCorr. 'ldS'_ ��6.-Lk-WI
0 ARCHITECT OWNER ❑OWNER AGENT El CONTRACTOR AGENT❑ NGINEER El DEVELOPER❑TENANT / , . ,
CONTACT NAME E-MAIL
STREET ADDRESS CITY,STATE,21P PHONE ,
DECRIPTON c ,
' Install temporary 300kw mobile generator set to provide temporary power to select building systems during building
I ,.
shutdown starting on Saturday 12/16/17 through Saturday 12/23/17
1
.j ,
❑SINGLII-FAMILY/DUPLPJC ❑MULTI-FAMILY El INDUSTRIAL [COMMERCIAL
•EXISTING'.USE EXISTING SF NEW PLOO1t SF PORCH SF DECK SP DEMO SF STORIES S TOTAL NET SF
I! 1 USE TYPE OCC SQ.FTJ VALUATION($)
II , '
REMODEL i REMODEL KITCHEN REMODELOTHR GARAGE ❑ATTACjIED '
'BATHROOM SF 1 SF SP SF ❑DETACHED '
j EXISING ; , , :I'M EICII1 ER,0 YES SECOND STORY ADDITION E N
'OwSPRINKS LER0 No ;❑ NO
!DWELLING SECOND. DWELIING El ❑ATTACHED❑'DETACHED OTHER
'j,Ls# , IUNITADDITON• ❑'No . SF
POOLS! ; l]FIBERGLASS. ❑VINYL-LINED ❑GUNITE El PREFABRICATED
,:POOL-SFSPA-SP I SPA ATTACHED 1:1 YES 0 NO l TOTAL-SF
R. I , /o3_41,..VALUATION:
Cmun+ercin,m Multi'-Family Buildings iuithPnLIic 5ruinnninR Pools requires Depnrlinen[ofEnoirornuc++tnl Heath approval �71 CjC,O
RE:-R1301 EXISTING ROOF TYPE: ,❑BUILT-UP ROOF El ASPHALT SHINGLES❑WOOD SHAKES WOOD SHINGLES❑TILE OTHER(SPECIFY)II
REMOVE:/REPLACE Q NO 1 IF NO PLYWOOD ❑rA" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS '
FOFLAYERS THICKI:1NESS 5/8" OTHER ❑OSB ❑CDX OTHER •12 A
Iyes
PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT.SHINGLES❑WOOD SHAKES❑WOOD SHINGLES 0 OTHER '
"Provide a signed copy of the Cupertino's Tear-Off Policy SP #of SQUARES
.By my signat ire below'I certify to,each of the following: I am the property owner or authorized agent to act ori the propdrty 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. I a #ledge and authorize all information contained on this application form
to be made available for public rec.r . / ,, l
Signature of Applicant/Agent.'( , i _IA.i,a 4, ARAW�7`P Date: t.f if)W ) I
SUPPLEMENTAL INFORMATION REQUIRED '
*New SFD/Second Dwelling Unii,s/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction.
*CommerciatBuildings: Provide'a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
*Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ,
*HOA-Provide'a letter of approval from the Home Owner's Association
rpLl. 1 BidgApp_20I Zdoc revised 08/0.1/17
•-• Pte. ,