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CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR IIVEURMAT7E),N,
emL,pl,Nq,1p�R LAZANEO DR
REDWOOD CITY ELEC
PERMIT NO.
08060048
OWNERS NAME:
PERM T' L95UE DATE
APPLE INC.
2775 NORTHWESTERN PKWY
06/06/2008
ONE:
SANITARY NO. CONTROL NO.
ARCHITECDENGINEEA:
DISCONNECT EXISTING FEEDS TO
BLDG BELECTPERMITPLUMB MECH
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LICENSED CONTRACIOR'S DECLARATION
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hereby aRnn that 1 am licenced under pmvisiam of Chapter 9(commencing
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wio section TIXp)of Diviaon 3ofthe Business and Profcstimu Code. and my license is
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in foil 1umean4effett jlifefi3
C C)
License CI Lk. 0
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Dass GOnlracOr ✓00 G /7
ARCHITECTS DECLARATION ..�rWt.0
1 undersand my plans mall he used u mord
ord tr y�
1V
Licensed Professional
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OWNER-BUILI)ER DECLARATION
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1 hereby af0rese Nal 1 am arempt (mm the Contractors License Law for the
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following boson. (Section 1031.5, Beat. Ona Profession Code: Any city or enmity
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which requires a permit to constrict. alter. Improve, dcmnlLah, in ¢pair any strocture
pd., w its issuance, also "isimnne applicant for such permit to file a signed stammer,
that he alicenmd the of me Conuacwr'3 license Law( Chapter 9
Sq. Ft. Floor Area
Valuation
purruanu0 provisions
-
c $
(commencing wim Secdon 7000) of Division 3 of the Business and Pruressiom Cade) or
that he is exempt dandrom and the basis for the alleged exemption. My dolsoon of
Section ?8113 by any, applicant fora permit subjeeu the it ,imam. a civil penalty of
APN Number
Occupancy Type
P
s (S
.1 more man five marine d dollYSW).
y yp
the my employees with sale compenuness
medtYtheir
themoy,or
will dome walk. and me
dotheu not inmMcd ar a fanak (Sec. Business
Required Inspections
in an owner
ha Ciar Law aces rat apply lf
aro Cade: The Comncwrs w do of
cn,whoW iodwho it is
pme em was builds mimprovu,heamn, ane was ar erumm work nimtelfor Woude his
awnemployes,prodon for ower R,
imatsuchimpm id witasemyear ofcaraQeme
boitimir me Wildingorimpmwmrntuvula Withinarm)earOfcprovefrtheptemr-
baaM will haw tiss WNcn of proving mat he did ms Wild m improve for purpOu of
tete.).
❑ 1. as Owner of me prepeny, am exelusiwly contracting with licensed convenors an,
construct the pmjcl (Sec. 7W. Business and Professions Code:) The Contractors U.
me Law docs no, apply to an Owner of pmpeny who Wiles or improves mesion, and.
who contracts for such Projects with a con,mwr(U licensed Panamint to me Convectors
License Law.
❑ I am asmp, urWe See ,B B P C fur this ruwn
Ow m Data
WORKER'S COMPENSATION DECLARATION
1 herby affirm under penalty of perjury, aro of me following eeclmdon:
❑ 1 haw and will mainuin a Cenifuaw of Gorman w self -imam for Workers Comperes -
s cion. u provided for by sectina 3700 Of the labor code. far the Performance of the
work fm which this permit is oatmeal,
ED I law YM will maintain Workrs Compewdan Inexistence. as "aired by Sce is n
3700 of me Labor Code, for me p�cuffaarman�aOrme wort farwhichmu permit u Issued.
Wo Made:
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Carder. Podry
CERTIFICATE EXEMPTION FROMWORK ERS'
FROM
COMPENSATION
NSATION INSURANCE
Tho.ccdcm need M, be eamplan d if tic pmmi, is form. hundred saBars ($100)
OF less)
I unify Wt in IW pecformanec or On work far which this amil is issued. 1 andl not
ctnplay any person in my manner so as to become subject to the Wadeco' Cmmpenadon
Laws of Califord a. Dam
Applicant
NOTICE TO APPLICANT: If, after making this Ccnificam of Etemp,ion, you should
become subjm an me Workers COmpmusudim provisions rime Lathan Cada you must
'
OfoMwith
Iwmply With such provision Or this Permit shawl is amount mwka,L
y
CONMUCTION LENDING AGENCY
I hareby.Mrm mu mere tea coluoumdon moiling agerwy for me pa f.sam of
me work for which this permit Is issued (Sec. 3097, Civ. C.)
Name
QLender's
Lcr iAddress
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1 eerily that 1 haw mW this application and sum tett the show informadan or
mance_ I agree w comply with all city and county oNinaes and sum lam relating to
Wilding construction, and hemby tommire mptesemsam of mu city to mass, upon am
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aWYetim,judgepmp for exT-IM p1h
(We) agree w ow, indemnify and keep harml. me City of Cupertino against
Iiabili0es,judgmen
(n
out h-.
oto atW ex rich may in any way urnse agdntsud City
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in cnnfoming mi
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APPLIST S N W Y WITH A NO -POI
Issued by: Date
SOUR
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Re -roofs
b
SI Dam OUSMATERIALSDISCLO RE
Type of RooftOrfor.
Wilding ottvpan. am. m handle lobedion massrial
de0tino Mnicipal Code. Chapter 9.11, and the Health and Safetyoda.
o?
Yes No
All roofs shall be inspected prior to any roofing material being installed.
Worn me applicant future Wilding occupant use equipment or ilede s which
If a roof is installed without first obtaining an inspection, I agree to remove
'
emit harasd us air Vnuminamts Y defied by tha Bay Am", Quality Managcmcnt
all new materials for inspection.
Daudet?
pro
T haw mad'by Ousmso.dau immcna under Chapter 6.95ofthe Califer-
niaHcaW&safe, ,Scotian 5. 33am1 53 Iwdemmnedmnifmc Wilding
ACCs, nm earn
-Liam aSignature
of Applicant Date
All roof coverings to be Class'%r{.a' or better
OWncrorauth reagent