B-2017-1977 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1977
20450 STEVENS CREEK BLVD STE 700 CUPERTINO,CA 95014-2265(369 01 028) DPR CONSTRUCTION
A GENERAL
PARTNERSHIP
REDWOOD CITY,CA
94063
OWNER'S NAME:CUPERTINO CITY CENTER BUILDINGS DATE ISSUED:04/06/2018
OWNER'S PHONE: PRONE NO:(
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lia#9�L3 4@
Contractor DPR CONSTRUCTION A GENERAL PARTNERSHIP Data 10/31/2018 K 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 fn full force and effect. - JOB DESCRIPTION:
AMAZON T.I.7th FLOOR-(2582 SF)-PARTIAL REMOVAL OF NON
I hereby affirm underpennity of perjury one of the following two declarations: STRUCTURAL WALLS,BUILD(N)WALLS,CEILINGS&LIGHTING
i. I have and will maintain a certificate of consent to self-insure far 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.
I have and will maintain Worker's Compensation Insurance,as provided for by
Sectiou 3700 of the Labor Code,for the performance of the work far which this
permit is issued Sq.Ft Floor Area: Vahntion:$1500000.00
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 369 01 028 A(Tenant hnprovements),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 PERMIT EXPIRES IF WORT{IS NOT STARTED
may accrue against said City in consequence of the granting of this permit WITHIN 1 SO 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 04-06-2018 Issued by:Kim Dunbar
Date:04/06/2018
OWNER-BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the RE-ROOFS:
following five reasons; All roofs shall be inspected prior to any roofing material being installed.lie roof is
r. 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)
z. I,as owner ofthe property,am exclusively contracting with licensed Signature fApplicant:
contractors to construct the project(Scc.7044,Business&Professions Cade). Date;018
1 hereby affirm under penalty of perjury one of the following them declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
t. I have and will maintain a Certificate of Consent to self-insure for Worker's
Compensation,m 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 Cade,for the performance of the work for which this Calif—In 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
s. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)should 1 store or handle hozardous
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,efler making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Wet tier's Compensation In of the the Health&Safety Code,
Labor Code,I nmst Forthwith comply with such provisions or this permit shall
be deemed revoked Owner or authorized agent:
APPLICANTCERTIFICATION Date:04-06-2018
I certify that I have read this application and State that the above information IS COIS'1'RIICTION LENDI NC 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, Lender's Address
judgments,costs,and expenses which may accrue against said City in
consequence of the granting of this permit.Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal At2CH1'ITAC'I"S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Licensed
Signature Date 04-06-2018