11110166 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7463 BOLLINGER RD CONTRACTOR:FAST WATER HEATER PERMIT NO: 11110166
OWNER'S NAME: DEVINE TRUST ANITA THE 12601132 AVE NE DATE ISSUED: 11/29/2011
ER'S PHONE: 4082537086 KIRKLAND,WA 98034 PHONE NO:(800)454-8955
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class Lic.# MECH r RESIDENTIAL rl COMMERCIAL
Contractor Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVEIREPLACE GAS WATER HEATER
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
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. Sq.Ft Floor Area:0 Valuation:$1735
1 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. APN Number:35923023.00 Occupancy Type:
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 and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION.
costs,and expenses which may accme against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Issued by: Date:
9.18,
Signature Date
• ROOFS:
OWNER-BUILDER DECLARATION All roofs shall be inspected prior to anyy roofing material berg installed.If a roof is
1 hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
the following two reasons:
I,as owner of the property,or my employees with wages as their sole compensation,
Signature of Applicant Dale:
will do the work,and the structure isnot intended or offered for sale(Sec.7044,
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
1 hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations: I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District 1 will
permit is issued, maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,l shall Health&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's Owner or authorized agent:
Compensation laws of California. If,after making this certificate of exemption,1 Date:
become subject to the Worker's Compensation provisions of the Labor Code,1 must
forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance of work's
APPLICANT CERTIFICATION for which this permit is issued(See.3097,Civ C.)
1 certify that I have read this application and state that the above information is Lender's Name
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter Lender's Address
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
ng of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records.
all non-point source regulations per the Cupertino Municipal Code,Section
9.18. Licensed Professional
Signature Date
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10165 BONNY DR CONTRACTOR:MANA GENERAL PERNIrr NO: 11090185
CONTRACTOR
'R'SNAME: LAMBIE RICHARD TRUSTEE 1839 TAMPA WAY DATE ISSUED: 11/10/2011
OWNER'SPHONE: 4082030298 SAN JOSE,CA 95122 PHONE NO:(408)375-4288
9 LICENSED CONT'RACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License ClassLic.q
1' t 2G( `O SFD ADDITION,447 SF, ADDING TWO BEDROOMS,
_ KITCHEN, AND DINING ROOM. SFD REMODEL,ALSO 447
ConmlcmrynLXr)C( ZcX,`Wek I `q r Date 11110 L SF, KITCHEN, BATHROOMS, AND LAUNDRY
1 hereby affirm that 1 am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license Is in full force and effect.
hereby affirm muter penally of perjury one of the following two declarations:
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 whiclithis permit is issued. Sq.Ft Floor Area: \'oluation:$130000
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of die work for which this APN Number:35912029.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and stale that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and comity ordinances and slate laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION,
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accme against said City in consequence of OleDote:
granting of this permit. Additionally,the applicant understands mrd will comply Issued,by�
with all non-p 'a once regulations per the Cupertino Municipal Code,Section
9.18.
RF.-ROOFS:
rare ale 1 /0 (/ All roofs shall be inspected prior to any roof ng material berg installed.If a roof is
aS installed without first obtaining an inspection,I agree to remove all new materials lin
inspection.
❑ OWNER-RIIILDER DECLARATION Date:
Signature of Applicant:
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: ALI,ROOF COVERINGS TO BE CLASS"A"Olt BETTER
I,as owner of the property,or my employees with wages as their sole comp:nsa(ion,
will do the work,aid the structure is not intended or offered for sole(Sce.7044,
Business&Professions Code)
1,as owner of the property,ran exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
hereby affirm under penalty of perjury one of the following three maintain compliance will,the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous
Compensation,as provided for by Section3700 of the Labor Code,for the air contaminants as defined by the Bay Arco Air Quality Management District I
performance of the work for whichthis permit is issued. will maintain complianceject
Cupertino Municipal Code,Chapter 9.12 and
the Ilealth&Safety Cods 2 9 ,25533,and 25534.
I have and will mninain Worker's Compensation Insurance,as provided for by 1Section 3700 of the Labor Code,for the performance of the work fonvhich(his Date:Owner nr authorized age
permit is issued.
I certify that in the performance of die work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's CONSTRU ION LENDING AGENCY
Compensation laws of California. If,after making this certificate of exemption,1
become subject to die Worker's Compensation provisions of the Labor Code,I must 1 hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
APPLICANT CER'TIFICAT'ION Lender's Address_
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 mid state laws refining
to building construction,and hereby authorize representatives of this city to enter
pARCIn the above mentioned property for inspection purposes.(We)agree to save
I ARCHITECT'S DECLARATION
unify and keep harmless the City of Cupertino against liabili(ies,judgments,
.Is,and expenses which may accrue against said City in consequence of die I understand my plans shal I be used as public records,
grunting of this permit Additionally,the applicant understands and will comply
with all non-paint source regulatiahs per the Cupertino Municipal Code,Section Licensed Professional
9.18,
Signature Date
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10231 BUBB RD CONTRACTOR:UNITED MECHANICAL INC PERMIT NO: 11080177
OWNER'S NAME: APPLE INC 2161 OAKLAND RD DATE ISSUED: 11/02(2011
i KS PHONE: 4089744876 SAN JOSE,CA 95131 PHONE NO:(408)232-906)0
LICENSED CONTRACFOR'S DECLARATION r r r
's s BUILDING PERMIT INFO: BLDG ELECT PLUMB
r r
. MECH � RESIDENTIAL COMMERCIAL
Contra""-
Date 4 12
V . ' t )' x".fb ,u el nllnil"Ual„NByi¢S Wr' JOB DESCRIPTION:APPLE,REPLACE EXISTING 8 HEAT PUMPS
hereby aBimn that lam licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in fall force and effect.
hereby affirm under penalty of perjury one of the following two declarations:
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. Sq.Ft Floor Area: Valuation:$112000
1 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. APN Number:35720007.00 Occupancy T•• -.—
APPLICANT CERTIFICATION
I certify[hal I have read this application and state that the above information is
cortect. I agree to comply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT ED
10 building construction,and hereby authoriu representatives of this city to enter
upon die above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ]gU DAYS FROM LAST CALLED INSPECTION.
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source re uI I ons per the Cupertino Municipal Code,Section Issued Date:
9.18.
/
Signature
i
RE-ROOFS:
OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any rooting material beng installed.If a roof is
hereby affirm that 1 am exempt from the Contractor's License Law for one of installed without fir obtaining an inspection,I agree to remove all new materials for
Y P inspection.
the following two reasons:
I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant:_ Date:
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct die project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three IIAZARDOUS MATERIALS DISCLOSURE:
declarations: I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain a Certificate of Consent to self-insure for Worker's California health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Ileaith&
performance of the work for which this permit is issued. Safety Code,Section 25532(x)should I store or handle hazardous material.
I have mid will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,l shall health&Safety Code,Sections 25505,25533,and 25534.
not employ any person in any manner so as to become subject to the Worker's er orlaut tori n
Compensation laws of California. If,after making this certificate of exemption I lay �- b fl 7 -'
become subject to the Worker's Compensation provisions of the Labor Code,I must �• ``"'9' �"
forthwith comply with such provisions or this permit shall he deemed revoked. CONSTRUC7-ION LENDING AGENCY -
I hereby affirm that there is a construclion lending agency for the performance of nark's
APPLICANT CERTIFICATION for which this permit is issa:d(Sec.3097,Civ C.)
I certify that I have read this application and state that the above information is Lender's Name
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter Lender's Address
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
s and expenses which may accrue against said City in consequence of the L1,RCHITECT'S DECLARATION
mg of this permit.Additionally,the applicant understands and will comply I understand my plans shall be used as public records.
all non-point source regulations per the Cupertino Municipal Code,Section
9.18, Licensed Professional
Signature Date