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02090159CITY OF CUPERTINO BUILDING DIVISION PERMIT 0' CONTRACTOR INPORMAI*ON: BUILDING ADDRESS: HALLMARK CONSTRUCTION PERMIT NO. 10101 BUBB RD 02090159 OWNER'S NAME: 3360 DE LA CRUZ BLV APPLICATION SUB DATE APPLE COMPUTER 09/23/2002 PHONE: (408)727-4422 1 SANITARY NO. CONTROL NO. ARCHITECT/ENG[NEER: O p LICENSED CONTRACTOR'S DECLARATION U I hereby affirm that I am licensed under provisions of Chapter 9 (commencing Z with Section 7000) of Division 3 of the Business and Professions Code, and my license is w < a in full form nd fe Z o z License Cl s �?�+ X332 I �_ ` D Co Iract r UA % (.—.i D V_ P t: ARCHITECf`S A ATION�3V4I A -W l T ,C 1 understand my plans shall he used as public records MOW() L to '3 u. � Licensed Professional F" = O OWNER -BUILDER DECLARATION H 1 hereby affirm that I am czcmpl from the Contractor's License Law for the a a 00 following reason. (Section 7031.5. Business and Professions Code: Any city or county >< $ which requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement t= < that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 h (commencing with Section 700(1) of Division 3 of the Business and Professions Code) or a that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1, 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 and Professions Code: The Contracto(s License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li- cense Law does not apply to an owner of property who builds or improves thereon, and , who contracts for such projects with a conlractor(s) licensed pursuant to the Contractor's License Law. ❑ I am exempt under Sec. . B & P C for this reason Owner Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a Certificate ofConsent to self -insure for Worker's Compen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My rker's Compensation Insurance carti�er anndr o y n her are: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) or less.) 1 certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workeri Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must O Z forthwith comply with such provisions or this permit shall he deemed revoked. Z O CONSTRUCTION LENDING AGENCY Z [-t ►r I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) W Q Lender's Name aZ Lender's Address U (� I certify that I have read this application and state that the above information is IL P correct. I agree to comply with all city and county ordinances and state laws relating to Q U building construction, and hereby authorize representatives of this city to enter upon the LTa above-mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against y liabilities, judgments, costs and expenses which may in any way accrue againstsaid City U Z to consequence of the granting of this permit. wr APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT ggnature of Applicant/Contractor Dalb HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? ^' El Yes / gvo Will the applicant or future building occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District? ❑ Ycs F0111- 1 have read the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & Safety Code, Sections 25505, 25533 and 25534.1 understand that if the building does not currently have a tenant, that it is my responsibility to notify the occupant of the requirements which must be met prior to issuance of a Certificate of Occupanery. or authorized aecni BUILDING PERMIT INFO ELECT PLUMB MECH Job Description TENANT IMPROVEMENT MODIFICATION TO THE GENERATOR ENCLOSURE Sq. Ft. Floor Area Valuation $10000 35720003.00 Occupancy 101 - FOUNDAff%*ed Inspections 102 - PIERS 103 - UFER 104 - REBAR 105 - ANCHOR BOLTS 106 - SEWER & WATER 202 - UNDERFLOOR PLUMBING 203 - UNDERFLOOR MECHANICAL 204 - UNDERFLOOR FRAME 205 - UNDERFLOOR INSULATION 301 - ROUGH PLUMBING 302 - TUB & OR SHOWER 303 - ROUGH MECHANICAL 304 - ROUGH ELECTRICAL 305 - FRAME 306 - HOLDOWNS 307 - INSULATION 308 - SHEETROCK 309 - EXTERIOR LATH 310 - INTERIOR LATH 311 - SCRATCH COAT 313 - ROOF NAIL 501 - FINAL ELECTRICAL ENERGY 502 - FINAL PLUMBING ENERGY 503 - FINAL MECHANICAL ENERGY 504 - FINAL BUILDING ENERGY 505 - FINAL ELECTRICAL 506 - GAS TEST 5A2 FINAL PLUMBING 08 FIN HAN C L 5 JAI FIN EJI `�&ar!_'1ti r11 Re -roofs-•= =- Type of as 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 of Applicant Date All roof coverings to be Class "B" or better CITY OF CUPERTINO ' BUILDING DIVISION PERMIT ` CONTRACTMINFORMATION: k: ': Vii: BUILDING ADDRESS: HALLMARK CONSTRUCTION PERMIT NO. 10101 BUBB RD 02090159 WNER'S NAME: 3360 DE LA CRUZ BLV APPLICATION SUB DATE APPLE COMPUTER 09/23/2002 PHONE: (408) 727-4422 SANITARY NO. CONTROL NO. ARCHM.0 iENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 Maioo LICENSED CONTRACTOR'S DECLARATION JobDescri tion m4 F I hereby affirm Nu I am licensed under provisions of Chapter 9(commencing p with Section 7q)(1)of Division J of Ne Business and Professions C de,and my license is in ranBlm w re Y, X3321 3 TENANT IMPROVEMENT ZOY? License Cl sy !t"" oz— D oRamryAI%th,-Aalc MODIFICATION TO THE GENE O E F- ARCHITECTSSIAAtAT10N�[Jy..I ST I&ICT � � � C< I undenumd my plans shall he used as puhlic records Wu ; Licensed Professional JAN' 3 0 2003 OWNER-BUILDER DECLARATION s < 1 hareby affum Thal I am exempt from the Cummelor's License law for the �a Ea following moon.(Section 7031.5.Business and Professions Code:Any city or county a $(v which requires a permit to construct,alter,improve,demolish,or repair any structure Fz< palm to its issuance,also requires the applicant for such Permit o File a signed suremcm �o that he is licensed pursuant to The provisions of the Choosers's License Law(Chapter 9 Sq.Ft. Floor Area 100 $ (commencing with Section 7(M)ofDivision 3of the Business and ProfessionsCode)or w .. t he is exempt derefmm and the basis(a,the alleged exemption. $10000 Any violation of 4 Section 7071.5 by any applicant for a permit subjects the applicant to a civil penally of APN Number Occupancy Type not more than five hundred della.($5110). 35720003 . 00 I,as owner of the property.or my employees with wages as Their sole compensation, will do The work,and the sumewm is not intended or offered for sale(Sec.7W,Business ,QQpW� and Professions Code:The Contractor's License Law,does nut apply In an owner of 101 — FOUNDA I-11J1V ed Inspections pmpeny who builds or improves thereon,and who does such work himself or through his own employees.provided Net such improvements an,not intended or offered for We.If. 102 — PIERS haswarr.the building or improvement is sold within one year of completion,the owner, 103 — UFER builder will have the burden of proving that he did not build or improve for purpose of sale.). 104 - REBAR El 1.as owner of the propeny,am exclusively contracting with licensed contractors to 105 - ANCHOR BOLTS consumer the project(Sec.70 ,Business and Professions Code:)The Contractor's Li- ce.Uva doeeoor apply to an owner,of property who hilds or improves thereon,and, 106 — SEWER & WATER who contracts for such pmjccm with a contrachms)licensed pursuant to she Contractors License Law. 202 - UNDERFLOOR PLUMBING ❑I am exempt under Sec. .B&PC for this Touch 203 - UNDERFLOOR MECHANICAL Owner Dat 204 - UNDERFLOOR FRAME WORKER'S COMPENSATION DECLARATION 205 - UNDERFLOOR INSULATION I hereby alrtrm under penalty of perjury one of the following declarations: 3 01 — ROUGH PLUMBING ❑I have and will maintain aCeniricate o(Comart to self-insure for Worker'sCompen- Wimn,as provided for by Section 374p of the labor Code,for she performance of de 302 - TUB & OR SHOWER work for which this Permit is issued, 303 - ROUGH MECHANICAL ❑I have and will maintain Worker's Compensation Insurance,as required by Section 304 - ROUGH ELECTRICAL 71011 of the labor Code,for the performance of me work for which this permit is issued. My rkeri Compensation lnsumnce caricnd yn her are: 305 — FRAME STkfC �oM'E�Syy T t X75 306 - HOLDOWNS CERTIFICATE OF E%EMPYRIN FROM WORKERS' COMPENSATION INSURANCE 307 - INSULATION Crhis section need not he completed Bore Permit is formic hundred dollars(SIR)) 308 - SHEETROCK ter less.) 309 - EXTERIOR LATH I ccnify that in the Performance of the work for which this permit is issued,I shall not 310 - INTERIOR LATH employ any person in any manner so as m become subject to The Workera Compensation U.of California.Dam 311 - SCRATCH COAT Applicant NOTICE TO APPLICANT:1(,arm,making this Ccrtilicate of Exemption,you should 313 - ROOF NAIL hccmme Subject o the Worker's Compemation provisions of the UNIT Code,you must 501 - FINAL ELECTRICAL ENERGY Z forthwith comply with such provisions or this permit shall he decreed revoked. zo CONSTRUCTION LENDING AGENCY 502 - FINAL PLUMBING ENERGY (•+� Ihereby aThrrn that there is a construction lending agency ler the performance of 503 - FINAL MECHANICAL ENERGY C� the workfor which this permit isissued(Sca)(197.Civ.Cd 504 - FINAL BUILDING ENERGY tp p U clers Address ar'aName 505 - FINAL ELECTRICAL Lend U O 1 ccnify that I have read this application and shim that she chow information is 506 - GAS TEST rrem.l agree m comply with all city and county mulin cures and aisle laws relating to OF mbuilding consuuction,and hereby amhotlxrcpreaenutivesofThis cirytocrrterupnndc 5 FNAL PLUMBING above-mentioned property for inspection purposes. O8 "FlNg"C L (We)agree m save,indemnify and kap harmlcas the City of Capcnino against W27 y liabilities.judgments,costs and expenses which may in any way acerae against said City rj z in conscyuencc mf do graining of lois permit.U APPLICANT UNDERSTANDS AND WILL COMPLY WIT11 ALL NON-POINT Issued by51G Date SOUR E EGULATIONS, Re-roofs Ignalurc mf AppliwnUConuactor Da IWAR000S MATERIALS DISCLOSURE Type of Roof Will me applicant or future building occupant sum,or handle havardous material pIddcOncd by mCupertino e Municipal Code,Chapter 9.12,and the Heald and Safety e.sectimnzss)xan ❑vas /Rfs,No All roofs shall be inspected prior to any roofing material being installed. Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove emit hr"mous air contaminants as defined by the Bay Arca Air Quality Management all new materials for inspection. DisWn'/ ❑Yes J 1 haw mad lode SNouns 25915, requirements 55under Chapter hadofhe Califon friss not &monly aw aScminrvshatit i myrmnd]SSJ4.l undcrsiandfy I ,orcucbuofbe Joe not commonly how a tenant,thin it is my rupumibility m notify rM acupenr of the requirements which must he met pdonmissuancc ofa Cenir. to(0ecopan Signature of Applicant Date ncr or ewhorivaJ agent No All roof coverings to be Class "B" or better