B-2017-1034 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1034
3 INFINITE LOOP CUPERTINO,CA 95014-2086(316 02 107) NOVO
CONSTRUCTION INC
MENLO PARK,CA
94025
OWNER'S NAME: DATE ISSUED:06/29/2017
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 02/28/2021 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:
INSTALL(72)DUAL HEAD EV CHARGERS WITH SERVICE
I hereby affirm under penalty of perjury one of the following two declarations: ENTRANCE SWITCHGEAR'SES' 1200A, 12.47KV,NEMA 3R WITHIN
1. I have and will maintain a certificate of consent to self-insure for Worker's (E)EMPLOYEE PARKING LOT.
Compensation,as provided for by Section 3700 of the Labor Code,for the REV#3-STORM DRAIN RELOCATION-1 SS U CZ
performance of the work for which this permit is issued. REV#1-VOLUNTARY SUBMTL OF REVISED ELEC PLANS TO
have and will maintain Worker's Compensation Insurance,as provided for by MATCH THE CIVIL SHOWING THE(6)ACCESSIBLE EV STATIONS
Section 3700 of the Labor Code,for the performance of the work for which this AS APPROVED ON CIVIL(TOTAL EV IS 72); SUBMTL OF CIVIL
permit is issued. SHEET C-2(2)SHOWING THE CORRECT CONDUIT LOCATION AT
APPLICANT CERTIFICATION SERVICE ENTRANCE TO MATCH THE APPROVED ELEC PLANS.-
I certify that I have read this application and state that the above ISSUED 10/3/18
information is correct.I agree to comply with all city and county ordinances
and state laws relating to building construction,and hereby authorize REV#2-ADD 2"HIGH CONCRETE HOUSE KEEPING PAD TO
representatives of this city to enter upon the above mentioned property for ELEVATE THE SWITCH GEAR EQUIPMENT OFF THE PAD-ISSUED
inspection purposes. (We)agree to save indemnify and keep harmless the 1-16-2019
City of Cupertino against liabilities,judgments,costs,and expenses which
may accrue against said City in consequence of the granting of this permit. Sq.Ft Floor Area: Valuation:$1000000.00
Additionally,the applicant understands and will comply with all non-point
source regulations
� Date 2-11-2019
OWNER-BUIL DECLARATION PERMIT EXPIRES IF WORK IS NOT STARTED
I hereby affirm that I am exempt from the Contractor's License Law for one of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
following two reasons: 180 DAYS FROM LAST CALLED INSPECTION.
1. I,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&Professions Code) Issued by:Phuong Devries
2. I,as owner of the property,am exclusively contracting with licensed Date:06/29/2017
contractors to construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations: RE-ROOFS:
1. I have and will maintain a Certificate of Consent to self-insure for Worker's All roofs shall be inspected prior to any roofing material being installed.If a roof is
Compensation,as provided for by Section 3700 of the Labor Code,for the installed without first obtaining an inspection,I agree to remove all new materials for
performance of the work for which this permit is issued. inspection.
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 Signature of Applicant:
permit is issued. Date:2-11-2019
3. I certify that in the performance of the work for which this pen-nit is issued,I
shall not employ any person in any manner so as to become subject to the ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
Worker's Compensation laws of California. If,after making this certificate of
exemption,I become subject to the Worker's Compensation provisions of the HAZARDOUS MATERIALS DISCLOSURE
Labor Code,I must forthwith comply with such provisions or this permit shall I have read the hazardous materials requirements under Chapter 6.95 of the
be deemed revoked. California Health&Safety Code,Sections 25505,25533,and 25534. I will
APPLICANT CERTIFICATION maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that I have read this application and state that the above information is Health&Safety Code,Section 25532(a)should I store or handle hazardous
correct.I agree to comply with all city and county ordinances and state laws material. Additionally,should I use equipment or devices which emit hazardous
relating to building construction,and hereby authorize representatives of this city air contaminants as defined by the Bay Area Air Quality Management District I
to enter upon the above mentioned property for inspection purposes. (We)agree will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
to save indemnify and keep harmless the City of Cupertino against liabilities, the Health&Safety Code,Sections 2505,2553 d-25534.
judgments,costs,and expenses which may accrue against said City in `` --
consequence of the granting of this permit. Additionally,the applicant understands Owner or authorized agent:
and will comply with all non-point source regulations per the Cupertino Municipal Date:2-11-2019
Code,Section 9.18. CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued(Sec.3097,Civ C.)
Signature Date 2-11-2019 Lender's Name
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-201.7-1.034
3 INFINITE LOOP CUPERTINO, CA 95014-2086 (316 02 107) NOVO
CONSTRUCTION INC
MENLO PARK, CA
94025
OWNER'S NAME: DATE ISSUED: 06/29/2017
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 02/28/2021 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:
INSTALL (72) DUAL HEAD EV CHARGERS WITH SERVICE
I hereby affirm under penalty of perjury one of the following two declarations: ENTRANCE SWITCHGEAR 'SES' 1200A, 12.47KV, NEMA 3R WITHIN
1. I have and will maintain a certificate of consent to self-insure for Worker's (E) EMPLOYEE PARKING LOT.
Compensation, as provided for by Section 3700 of the :Labor Code, for the
performance of the work for which this permit is issued. REV fl-VOLUNTARY SUBMTL OF REVISED ELEC PLANS TO
I have and will maintain Worker's Compensation Insurance, as provided for by MATCH THE CIVIL SHOWING THE (6) ACCESSIBLE EV STATIONS
" Section 3700 of the Labor Code, for the performance of the work for which this AS APPROVED ON CIVIL (TOTAL EV IS 72); SUBMTL OF CIVIL
permit is issued. SHEET C-2 (2) SHOWING THE CORRECT CONDUIT LOCATION AT
APPLICANT CERTIFICATION SERVICE ENTRANCE TO MATCH THE APPROVED ELEC PLANS. -
certify that I have read this application and state that the above ISSUED 10/3/18
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize REV #2 - ADD 2" HIGH CONCRETE HOUSE KEEPING PAD TO
representatives of this city to enter upon the above mentioned property for ELEVATE THE SWITCH GEAR EQUIPMENT OFF THE PAD-ISSUED
inspection purposes. (We) agree to save indemnify and keep harmless the 1-16-2019
City of Cupertino against liabilities, judgments, costs, and expenses .which
may accrue against said City in consequence of the granting of this permit. Sq. Ft Floor Area: Valuation: $1000000.00
Additionally, the applicant understands and will comply with all non-point
source regulations per t e?Cupertino Muni i,pl"Code, Section 9.18.
�- APN Number: Occupancy Type:
Signature
31602 107 A (Tenant Improvements)
�- .. ° ' Date 01/16/2019
OWNER-BUILDER DECLARATION PERMIT EXPIRES IF WORK IS NOT STARTED
I hereby affirm that I am exempt from the Contractor's License Law for one of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
following two reasons: 180 DAYS FROM LAST CALLED INSPECTION.
1, I, 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 & Professions Code) Issued by: Phuong Devries
2. .I, as owner of the property, am exclusively contracting with licensed Date: 06/29/2017
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations: RE-ROOFS:
1. I have and will maintain a Certificate of Consent to self-insure for Worker's All roofs shall be inspected prior to any roofing material being installed. If a roof is
Compensation, as provided for by Section 3700 of the Labor Code, for the installed without first obtaining an inspection, I agree to remove all new materials for
performance of the work for which this permit is issued. inspection.
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 Signature of Applicant:
permit is issued. Date: 01/16/2019
3. I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
Worker's Compensation laws of California. If, after making this certificate of
exemption, I become subject to the Worker's Compensation provisions of the HAZARDOUS MATERIALS DISCLOSURE
Labor Code, I must forthwith comply with such provisions or this permit shall I have read the hazardous materials requirements under Chapter 6.95 of the
be deemed revoked. California Health & Safety Code, Sections 25505, 25533, and 25534. I will
APPLICANT CERTIFICATION maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
I certify that I have read this application and state that the above information is Health & Safety Code, Section 25532(a) should I store or handle hazardous
correct. I agree to comply with all city and county ordinances and state laws material. Additionally, should I use equipment or devices which emit hazardous
relating to building construction, and hereby authorize representatives of this city air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
to enter upon the above mentioned property for inspection purposes. (We) agree
to save indemnify and keep harmless the City of Cupertino against liabilities, the Health & Safety Code, Sections 25505, 25533, and 25534.
judgments, costs, and expenses which may accrue against said City in ., ---- "�
consequence of the granting of this permit. Additionally, the applicant understands Owner or authorized agent
and will comply with all non-point source regulations per the Cupertino Municipal Date: 01/16/2019
Code, Section 9.18. CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction Fending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Signature Date 01/16/2019 Lender's Name
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1034
3 INFINITE LOOP CUPERTINO, CA 95014-2086 (316 02 107) A M S ELECTRIC INC
DUBLIN, CA 94568
OWNER'S NAME: APPLE COMPUTER INC
DATE ISSUED: 06/29/2017
i OWNER'S PHONE: 1 1 PHONE NO: (925) 961-1600
License Class ELECTRICAL Lic. #835815
Contractor A M S ELECTRIC INC Date 04/30/2018
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.
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
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH _ RESIDENTIAL X COMMERCIAL
JOB DESCRIPTION:
INSTALL (66) DUAL HEAD EV CHARGERS WITH SERVICE
ENTRANCE SWITCHGEAR'SES' 1200A, 12.47KV, NEMA 3R WITHIN
(E) EMPLOYEE PARKING LOT.
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: $1000000.00
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
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 accrue against sai ty in consequence of the granting of this permit.
Additionally, the_�pplicqht.unclerstands and will comply with all non -point
source regulatiol�a�ber thb Cupertino Municipal Code, Section 9.18.
Signature�
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. I, 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 & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Sec.7044, Business & Professions Code).
APN Number: Occupancy Type:
31602 107 B
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: SEAN HATCH
Date: 06/29/2017
RE -ROOFS:
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 of7
Date: 6.29.17
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.
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.
s. I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California. If, after making this certificate of
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
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 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 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
Code, Section 9.18.
Signature Date 6.29.17
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by thea Area Ai uality Management District I
will maintain compliance with the ertino icipal Code, Chapter 9.12 and
the Health &Safety 25534.
Owner or authorized agent:
Date: 6.29.17
CONSTRUCTION LENDING AGENCY
AGENCY
hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1034
3 INFINITE LOOP CUPERTINO, CA 95014-2086 (316 02 107) A M S ELECTRIC INC
DUBLIN, CA 94568
OWNER'S NAME: APPLE COMPUTER INC
OWNER'S PHONE:
LICENSED CONTRACTOR'S DECL.ARRATION
License Class c10 Lic. #1335815
Contractor AM S ELECTRIC INC Date 04/30/2018
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.
Iy affirm under penalty of perjury one of the following two declarations:
c:l�k
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.
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.
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
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 accrue against said City in cnsequence of the granting of this permit.
Additionally, the
! Date 10/3/18
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
r. I, 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 & Professions Code)
z. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three 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
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.
3. I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California. If, after making this certificate of
exemption, I become subject to the Worker's Compensation provisions of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
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 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 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
Code, Section 9.18.
Date 10/3/18
DATE ISSUED: 06/29/2017
PHONE NO: (925) 961-1600
BUILDING PERMIT INFO:
Y� BLDG —ELECT —PLUMB
_ MECH _ RESIDENTIAL X COMMERCIAL
JOB DESCRIPTION:
INSTALL (72) DUAL HEAD EV CHARGERS WITH SERVICE
ENTRANCE SWTTCHGEAR'SES' 1200A, 12.47KV, NEMA 3R WITHIN
(E) EMPLOYEE PARKING LOT.
REV #1 -VOLUNTARY SUBMTL OF REVISED ELEC PLANS TO
MATCH THE CIVIL SHOWING THE (6) ACCESSIBLE EV STATIONS
AS APPROVED ON CIVIL (TOTAL EV IS 72); SUBMTL OF CIVIL
SHEET C-2 (2) SHOWING THE CORRECT CONDUIT LOCATION AT
SERVICE ENTRANCE TO MATCH THE APPROVED ELEC PLANS. -
ISSUED 10/3/18
Sq. Ft Floor Area: I Valuation: $1000000.00
APN Number: Occupancy Type:
316 02 107 1 A (Tenant Improvements)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Phuong Devries
Date: 06/29/2017
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without fust obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
Date: 10/3/18
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment oi`4evices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cuperfino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent:
Date: 10/3/18
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.