07090064CITY OF CUPERTINO
BUILDING DIVISION PERMIT
PERMIT NO.BUILDING ADDRESS:
19191 VALLCO PARKWAY CAC-04 TBD -TO BE DETERMINED 07090064
OWNER'S NAME: PERMIT fSSUE DATE
APPLE COMPUTER 12/03/2007
PHONE: SANITARY NO. CON1R(>L NO.
A~HITECTIENGlNEER: BUILDING PERMIT INfO
BLDG ELECT PLUM MECH
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t:l g I hereby affirm thai I am lia:nscd under pmvisians of Chapu:r 9 (commencing Job Description :
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withSeetian7000)afDivisian3aftheBusinessan!Lf'"~c:ssiansCade,andmylieen",is
in full faree and elfoct. ~IC>1'1..T. I • -PHASE 2 I NEW OFFICES, INTERIOR REMDL METAL'I
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Dau: \"2?i) lO£ Contractor XbVV Ch0::.\ t. A~HmcrsDECuRmON
STUD
FRAMING,T-BAR DRYWALL,CC6 BREAKROOM,CONFER
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RMB,NO
_ [ understand my plans shall be: used as public records 1 ~u NEW ROOFTOP EQUIP. SEE TEMP PERMIT 07100026 1 FOR
u. f~ :s :c :::;;
Licensed Professional
OWNER-BUILDER DECURATION
I hereby amrm thai I am exempt frum the CanlraOlar's Lieenso Law for lbe:
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Q 0 following reason. (Section 703 U, Business and Pmfessians Code: Any eily or county
i ~ which requires a permit to conslrUCl. alter. improYl:. demolish. or repair any slruclurc
-CIl prior Ii> ils issuance, alsu requires tho applicant lor such permit 10 file a signed sLalOmenl \---------:,......-::;-=~-~--------,--------,;-;-_;_-:----+------i ~ Lilli he is licensed pursuant 10 the pmYisians of the CanlnlClur's License Law (Chapter 9 Sq, Ft. Floor Area $ 5 7 9 5 8 63Valuation
f-i (commencing with Sootian 7000) of Division 3 of the Business and Professions Code) or
i-thaI be: is ..empl Illcrefrorn and the hasis for tlle alleged exemption. Any Yialation of ~b~I~_~_~ba~U.=tlle_~loa~pe-~1---3-1-0-2-0-0-7-4-A7.=PW~N~u-m~b-e-r------~------~O~C-C-U-p-~-c-y~T=y-p-e-+-----
nal more than five hundred dollars ($500). '. L! t!
o I, as owner afllle pmperty, or my employees willl wages as Illeir sale compensation, \------------------::---:---:-.....l..---------------+-----
will do tlle work, and tlle struelUre is not ;nu:nded or arrered for salc (Sec, 7044, Business R ' d I •
and Professions Code: The Can_lor'S Lic.".. Law docs not apply 10 an owner of eqUlre nSpeCllOnS
pmpeny who builds or impravesthcrcon,and who does such work himself or thmagh his
own employees, provided thai such improvemcn15 are not inu:ndcd or arrered for sal.. If,
however. \he building or improvemenl is sold within one YCJU' of completion. lhc owner-
builder will have the burden of praYing thaI be: did nal build or improve for pUlJlD50 of
sale.).
o I, as own.... of the pmperty, am ..clusively cantnu:ting with licensed contractors 10
conslrDel tlle projeel (Sec. 7044, Business and Professions Code:) The CanlnlCIor's Li·
cense Law docs nal apply 10 an owner of propeny who builds or impmves tllerean, and .
who contracts for such projects with a conlractor(s) licensed pursuanllD the Conlractors
License Law. o I am ..empl under Sec. , B & PC for this reason
Owru:r ====-========-= Dau: ...,---_WORKER'S COMPENSATION DECURATION
I hereby affirm under penalty of peljury one of Ille following declarations:
o I h.... and will maintain a Certifioau: of Cansonlla ",If-insure farWarlc<:r's Campen
salion, as provided for by Section 3700 of the Labor Code, for the perfarmana: of the
work for which this permil is issued.
o I have and will mainlain Worker's Compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of tlle worl: for which this permil is i....d.
My War Comp~sa~on Insorance carrier and Policy nU~bcf_are:
Carrier: I I Policy No,: ) :''204 q
CERTJACATE OF EX ON FROM WORKERS'
COMPENSATION INSURANCE
(This section need nal be: eampleU:d if Ihe permi' is for one hundred dollars ($100)
or les5.)
J certify thal in Ille perfarmanco or tlle work for which this permil is issucd, I shall nol
employ any person in any manner so 15 10 become subjccllo the WorkeD' CompensationLaws of California. Dau: _
Applicanl=====,-::---:_---:.,-----,..,---:---:-:-_-:-::__,---__,..........,
NOTICE TO APPliCANT: If, al\cr makinB this Ccrtificau: of Exemplian, you should
become subject lO the WOrUr's Compensation provisions of the Lahor Code. you mUSl
forthwith comply with such provisions or this pc:~iL shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1bcrcby aflirm that there is a construction lending 31;ency (or the pcr(onnancc o(
the work for which this permil is i..ued (Sec. 3097, CiY. C.)Lender's Name -_
Lender's Address _
I certify thaI I have read·lhis application and stau: thal Ille above information is
correct. I agree 10 comply with all city and eaunly ordinances and SIlU: laws relaling 10
building construction, and hereby authoril.e representatives o( this city 10 enler upon the
ahaye-mentianed pmpeny for inspeOlian pUlJlOS05.
(We) agree 10 save, indemnify and Ic<:cp harmle.. Ille Cily of Cupertioa againsl
liabilitiCS,judgmenls, casls and ..pen... wbich may in any way aecrue againsl said Cily
in consequence of the granting 01 this permiL
APPLICANT UNDERSTANDS AND WILL COMPLY WITli ALL NON·POINT Issued by: Date
SOURCE REGULATJOr lQ LcvL \").J~
Re-roofs /
Signalure of Applic:antlConlraClar Dau:
HAZARDOUS MATERIALS DISCLOSURE Type of Roof \
Will tlle applicanl or fUluro building oceupanl slore or handle hazardous mall:rial
as defined by tlle Cupertino Municipal Code, Chapu:r 9.12, and the Health and Safety
Code, ScOIian 25532(a)1 ~ All roofs shall be inspected prior to ~y roofing material being installed. jDYes Nu
If a roof is instaI1ed without first obtaining an inspection, I agree to remOveWilt IJu: appHcant or Cut n: building occupant usc equipment or devices which
emit hal.ardous air contaminants IS dcCined by lite Bay Area Air Quality Management all new materials for inspection. ..
Disuict?
DYes j{NU
I ha.. read the h=nlaus materials requiremcnls under Chaplcr 6.95 of tlle Califar·
nia Health & Safely Code, Sections 25505, 25533 and 25534. [ undorslmld thal if tho building
docs no' eum:ndy ha"" a 1cOant, dial il is my responsibilily 10 notify the occupanl of tlle
rcqu' which must mel prior to issuance o( a Cenilicale o( Oc~pancy.
~
Signature of Applicant Date
All roof coverings to be Class "B" or betterOwner or authorized agent