B-2019-0062 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2019-0062
3 INFINITE LOOP CUPERTINO,CA 95014-2086(316 02 107) NOVO
CONSTRUCTION INC
MENLO PARK,CA
94025
OWNER'S NAME: DATE ISSUED:03/12/2019
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:
APPLE IL3-T.I.(153,294 SF)
I hereby affirm under penalty of perjury one of the following two declarations: REV#1 -CHANGE TO 1 ST FLOOR MENS ROOM N 1035 4TH FLOOR
1. I have and will maintain a certificate of consent to self-insure for Worker's LABS,4TH FLOOR BREAK ROOM-ISSUED 5-22-2019
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:$11000000.00
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 02 107 A(Tenant Improvements),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 WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
Additionally,the applicant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 5-22-2019 Issued by:Haley McKee
Date:03/12/2019
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)
2. 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:5-22-2019
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. HAZARDOUS MATERIALS DISCLOSURE
2. 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,Section
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date:5-22-2019
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.
Licensed
Signature Date 5-22-2019 Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
3 INFINITE LOOP CUI'ERTINO,CA 95014-2086(316 02 107) CONTRACTOR: PERMIT NO:B-2019-0062
NOVO
CONSTRUCTION INC
MENLO PARK,CA
94025
OWNER'S NAME:
DATE ISSUED:03/12/2019
OWNER'S PHONE:
PHONE NO:(650)701-1500
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class B Lic.#790-22
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:
I hereby affirm under penalty of perjury one of the following two declarations: APPLE IL3-T.I.(153,294 SF)
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.
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
Sq.Ft Floor Area: Valuation:$11000000.00
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 e:
and state laws relating to building construction,and hereby authorize 31602 107 p y TYp
representatives of this city to enter upon the above mentioned property for A(Tenant Improvements),B(Tenant Improvements)
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. FPERMIT EXPIRES IF WORK IS NOT START
Additionally,the applicant understands and will comply with all non-point WITHIN ED
source regulations per the Cupertino Municipal Code Sectio p 180 DAYS OF PERMIT ISSUANCE OR
Section 9.18. 180 DAYS FROM LAST CALLED
INSPECTION.
Signature Date 9--x-3/ 2/-19 Issued by:Haley McKee
OWNER-BUILDER D LARATION Date:03/12/2019
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons: RE-ROOFS:
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
compensation,will do the work,and the structure is not intended or offered for p e to remove all new materials for
inspection.
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 Co Signature of Applicant:
Code). 2/19
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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. HAZARDOUS MATE
RIAI 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials quire DISCLOSURE
ment
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,s under Chapter 6.95 of the
permit is issued. maintain compliance with the Cupertino MunicipalCode,Cha25533,
25534. I will
9.12
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
and the
shall not employ any person in any manner so as to become subject to the material. Adrdous
Additionally,should I use equipment or devices which emit hazardous
Worker's Compensation laws of California. If,after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I
exemption,I become subject to the Worker's Compensation provisions of the will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
Labor Code,I must forthwith comply with such provisions or this permit shall the Health&Safety Code,Sections 25505,25533,and 25534.
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION Date:3/12/19
1 certify that I have read this application and state that the above information is CONSTRUCTION E
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a con ING AGENCY
relating to building construction,and hereby authorize representatives of this city p construction lending agency for the performance
to enter upon the above mentioned property for inspection purposes. Lender's
for which this permit is issued(Sec.3097,Civ C.)
to save indemnify and keep harmless the City of Cupertino against liabilities,
agree er's Name
judgments,costs,and expenses which may accrue against said Cit in ties,
consequence of the granting of this permit. Additionally,the ali y Lender's Address
and will comply with all non-point source regulations per the Cupertino Municipal
Code,Section 9.18. p cipal ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date 3/12/19 Licensed
Professional