08070238CITY OF CUPERTINO
BUILDING DIVISION PERMIT
BUILDING ADDRESS:
10435 N TANTAU AVE
NOVO CONSTRUCTION
OWNER'S NAME:
APPLE COMPUTERS INC 1042 HAMILTON CT
PHONE
ARCHI7ECf/ENGINEER
i O p LICENSED CONTRACTOR'S DECLARATION
i 1 hereby affirm that I am licensed under provisions of Chapter 9 (mmmencing
Z with Section 70DD) of Division 3 of the Businecc�P ns Code, and my license is
in full
< ll force and effect v i.�
2 License Lle. Y
Date ► CuntncC �( u� a -VCR r
44 ARCHITECTS D ATION
i a i I understand my plus shall be used as public records
ryU
O t; Licensed Professional
„r OWNER -BUILDER DECLARATION
I hereby affirm that 1 am exempt from the Contractors License Law for the
00 following mason (Section 703 ". Business and Professions Code: Any city or county
e m ii which requires a permit to construct, alter. improve, demolish, or repair any si uaum
r — w < prior to is issuance, also requires the applicant for such permit to file a signed statement
"?
- ss that be is licensed pursuant toraco the provisions of the Contrs License Law (Chapter 9
2 F O (commencing with Section 7000) of Division 3 of the Business and -Professions Code) or
that he is exempt therefrom and the bash 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 (S500).
❑ L as owner of the property. or my employees with wages as their sole compensation,
will do the work. and the srticlure Is not intended or offered for sale (Sec. 7044. Business
and Professions Code: The Contractors 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 omtploy= 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
salc_).
❑ L as owner of the property, am exclusively contracting with licensed contractors to
construct the project (See 7044. Business and Professions Code:) The Conracmes U.
cause Law does not apply to an owner of property who builds or improves thereon, and
who contracts for such projects with a contractor(s) licensed pursuant to the Conuactors
Lk -tense Law.
❑ I am exempt under Sex , B k P C for mourns
Owner _G V C, l__0 r1 C'Nj V M o t-i Due Za I D
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a Certificate of Consent to self -insure for Workers Compen-
sadoa, 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 required by Section
3700 of the Labor Code, for the performance of the work for which this permit is issued.
My Workeez Compensation Insurance carrier and cy number are:
Carrier: le-� g V:• \ �► 1 W � a� a: 15 &2H -9
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(This section need not be completed if the permit is for erne hundred dollars ($10D)
or Icss)
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 Workest Compensation
Laws of California- Date
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
become subject to the Workcrs Compensation provisions of the Labor Code, you most
z forthwith comply with such provisions or this permit shall be deemed revoked.
OCONSTRUCTION LENDING AGENCY
I hereby affirm that there 1s a conxtruction sending agency for the performance of
Z the work for which this permit is issued (Sec 3097, Civ. C.)
QLenders Name
z Lenders Address
Q 1 certify that 1 ban read this application and state that the above information is
y F correct. 1 agrec to comply with all city and county ordinances and state laws relating to
U building construction. and hereby authorize representatives of this city to roue upon the
W above -mentioned property for inspection purposes
y L]. ) agree o save, indemnify and keep harmless the City of Cupertino against
fn liabi ti jodgm ts. costs and expenses which may In any way luxe against said qry
7 in the granting of this permiL�
t� A PLIC U ERSTA.NDS AND COMPLY WITH ALLN-POIPfr
UR TiONS.
t 4v
S i—p, f App ..! Co Data
US MATERIALS DISCLOSURE
tall the applicant or future building occupant store or handle hamrdous material
as defited by the Cupertino Municipal Code. Chapter 9.12, and the Health and Safety
Code, Section 25532(a)?
❑ Yes o
Will the applicant or future building occupam use equipment or devices which
emit hazardous air contaminants fined by the Bay Area Air Quality Management
District?
❑Yes No
1 h mad hanrdous materials requirements under Chapter 6.95 of the Califor-
nia Health afcty Sections 25505.25533 and 25534.1 understand that if the building
does nor oily yF a tenant that it 1sRny responsibility o notify the occupant of six
require n whi r Ly be nF1 prior tpjs�uan�of a Ccnificaic QL99 npanfy.
(650)701-1500
LIFE SAFETY REPORT
Sq. Ft. Floor Area
31606039( Number
Issued by:
Re -roofs
Type of Roof
A 6'ION:
PERMIT NO.
08070238
PERMIT ISSUE DATE
07/31/2008
SANITARY NO.
CONTROL NO.
BUILDING PERMIT INFO
BLDG ELECT
PLUMB
Job Descfiption
Valuation
$100
Required Inspections
Occupancy
Date
J
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'%.' or better
Owner or ajuhorvrd rfgcnt r Date