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02060136�WWo 6u rn6 � OZL �4t: as ce 0 30 t u. O s y s� �3 CITY OF CUPERTINO BIIILDWCDMSION p IT - - ._ - • a., •:. , ""' ,_'CONTRACTOR E"IFO 'ION! . ri-- a . s,. T BUILDINGADDRESS PERMIT NO. 18880 HOMESTEAD RD SOUTH BAY CONSTRUCTION CO INC 02060136 - OWNER'S NAME: APPLICATION SUB DATE RATIONAL SOFTWARE 511 DIVISION STREET 06/21/2002 PHONE: SANITARY NO. CONTROL NO. (408)379-0400 ZO ARCHITECT/ENGINEER: BUILDING PERMIT INFO F BLDG ELECT PLUMB MECH i LICENSED CONTRACTOR'S DECLARATION I hereby affirn that l am licensed under provisions of Chapter 9 (commencing Job Description p with Section 7")of Division 3 of the Business and Professions Code, and my license is infngforceandefect. REVISION SUBMITTED , NO NEW PERMIT ISSUED. uLice^:eel^aa uc.g ORIGINAL # 02050176. Due to ARCHITECT'SSDECLARATION DECLARATION g I understand my plans shell be used as public rcmrds Licensed Professional OWNER -BUILDER DECLARATION 1 hereby aRrrn that I am exempt fmh the Contractor's License Law for the following reams. (Section 7031.5, Business and Professions Code: Any city or county D which requires a permit to construct. alar, improve, demolish, or repair any structure, $ - prior an itsissuarrce. alsosequucs the applicant for such permit to rile a sigvedsutemem — that hq it licensed pd'auml to the Psovisioa of the Contractors License law (Chapter 9„t (cbhmepcing with S«tion 7000) of Division 3 of she Business and Professions Code) .(`'q, Ft., FJoor Ares S *•' nation and she basis for Ne alleged exemption. Any violatione or Nes he h exempt tang applicant to ofB«bona the. by anydredd ll ter opemrit subjects the applicantmacivil penalty' l ty of not mare Nan five hundred dollars (5500). In e , Occupancy Type Cl 1, as owner of the property, ser my employees wish wages ex their, stile compensation, will do the work, and the gwmure is not intended or offered for sale (Sec. 7 , Basm«a and Profa.imr, Code: no Connector's License Law docs or apply to an 102 - FE)T- - - PIERS Required Inspections owner of property Who Wilds or improves thereon, and who does such work himself or throw{h his own employees. provided Nat such improvements are nm intended or oReiW for We. however, the building or improvement is Bold within one year or 103 — . UFER completion, the owner -Wild « se will hethe bro uNen of proving that he did not Wild or 104 — REBAR improve for purpose of uleJ 105 — ANCHOR BOLTS OL a owner of the property do exclusively contracting with licensed contractors to 106 — _ SEWER & WATER . consumer the pmj«( (S«. 7094. Business and Professions Cade:) The Contractor's License Law does not apply to an owner of property who builds or improves thereon, 202 — UNDERFLOOR PLUMBING and who o Contractor's License s for Law. Co hcontracts such pmjens with a comrecmrts) licensee pursuant to the • 2 0 3 - UNDERFLOOR'MECHANICAL C l am exempt order Sec. ,B&P C for this uewn 204 — UNDERFLOOR FRAME Owner Date WORKER'S COMPENSATION DECLARATION 205 — UNDERFLOOR INSULATION Ihereby affirm under Faulty of enjury one ofthe following d«Iaradtrns: 301 — ROUGH PLUMBING 302 — TUB & OR SHOWER ❑ 1 have and will maintain • by Certificate of Conant the Liinsure for Worker'she emnpern,tian, a pro.ieoe for by Section noB of the IaWr ende. for the 303 — ROUGH MECHANICAL perfomtanceoftheworkforwhichthisperritisiound. 304 — ROUGH ELECTRICAL ❑ I have and will maintain Worker's Compensation Insurance, as required by Section 305 — FRAME FRAME 3700 of the LaWr Code, for the performance or the work for which this permir is lamed. My Workrs Compensation e ' on Insurance carrier and Polity number am: 306 — NS "Policy Na' .3,07 !—...INSULATION...,,.. TIONOOFMEMP IONMOMWOR� 308 -” SHEETROCK ' is (Tota s«rion Med our W completed it the permit is for one hundred dollen 309 — EXTERIOR LATH .. _.. - � (sloo)orlea.) 310 — INTERIOR LATH 11 due in the pnfono a of the work for which this Partin is issued, ) 311 — SCRATCH COAT ' ilial) not employ any person In any manner so as to become subject to the Workers' Compemotion Laws of C difom ss ta Da 313 — ROOF NAIL AppiCEIafter this Lesions of of Euhptiod ynuahmuld n. NOTICETO APPLICANT:theWorkers 501 FINAL ELECTRICAL ENERGY Compensate become subject the Workers Compensanon prtivtaioa of the Labor Code, you must 502 — FINAL PLUMBING ENERGY jt farnwithctimPlywimachprnairmnsorrmapem,itan.11xa«medreankoa. 503 — FINAL MECHANICAL ENERGY 3 CONSTRUCTION LENDING AGENCY I hereby which this a wm there is eon lending agency for the pcAortnence 504 — FINAL BUILDING ENERGY Lathe work whim this Peron is issued (s«. 3897. ay. c.' I Lender's Name 505 — FINAL ELECTRICAL Under, 506 — GAS TEST I certify that 1 have read this application and monitor the above information is 507 — FINAL PLUMBING correct. 1 ague to comply with all city and county ordinances and stere lows relating to Wilding constmction. and hereby authonse representatives of Ibis city to enter also. 508 — FINAL MECHANICAL thenbruse.mamicnedpmpenymrmspechonparpa«. (Wel agree m save, Indemnify and keep harmless the Cry, of Cupertino against 509 — FINAL GRADE Iiabilisiu, ji dgmems, costs andexpanms which may in any way same against said 510 FINAL NG APPLICAVTUHDERSTA VpS`AgD WI LL=COMPLYN'ITHALLNON-POI\T r— l4 I$$ued C WORKS Date SOURCE REGULATIONS. Signature of ApplicunVCmn.to, Data Re -roofs HAZARDOUS MATERIALS DISCLOSURE Will the applicant or mare Wilding «capant store or handle haalloua ormarsal _ Type of Roof -- -• as defined by the Cupertino Municipal Cade, Chapter 9.12, and the Health and Safety Cade. section 255324), r'• OYcs QNo i All roofs shall be inspected prior.to.any.roofing material being installed. Will the applicant or future building occupant use equipment or devices which hazardous If a roof is installed without first obtainingan inspection, I agree to remove p g =mit air contaminants a defined by the Bay Area Air Quality Management District? all new materials for inspection., Applicant understands and will comply with Na all non -point source regulations. I have read the haamdous materials requirements under Chapter 6.95 of the California Health & Safety Code. Sectiom 25505, 25533 and 25534. 1 understmd that if rhe building does not currently have 0(count. that it is my responsibility to notify the occupant of the requirements which must he mer prior to issumen of a Cmiftmte of 0.�pon, Signature of Applicant Date All roof coverings to be Class "B" or better Owner or anthanaad agent Date OFFICE BUILDING DIVISION V PERMIT I CONTRACTOR BUILDING ADDRESS: OWNER'S NAME: (RATIONAL SOFTWARE O O ARCHITECT/ENGINEER: u Ha z v=toi Z LICENSED CONTRACTOR'S DECLARATION ZO Z I hereby aBirm that 1 am .3licensed under provisions of sCode9 and (commencing r<` MM' with fall section 7000) of Division 3ofthe Business end Profession CWe, and mylicense l as I is in full forte and elTect. N" tt0 i U License Class Lic. x Dam SDECLAl LL LLO fn ARCHITECT'S DECLARATION I understand my plans shall be used as public records seO O Licensed Professional & 6 o OWNER DECLARATION 1 hereby of0rm hat I ton exempt from she Contractor's License Law fm the f-ZQ followingreumb.(Sectioni Business and Professions Code: Any city mcounty tz- C which requires a permit m eonstmet. elect, improve, demolish, or «pair any structure, i 3 m ., poor m us issmnce, also «quires dan apPlinm fw such permino hie a signed smmment. that hgid Iicen6N ponuanf to the provisions nl the Contractor's License Law (Chapter 9 (commencing with Section 91XKq of Division J of she B.Imcvs and Professions Code) or Chas he Is exeme, Ifierelsom and the basis for the aIle%ed exemption. Any violation --of Section ]031 5 by any applicant fora permit subjects the applicant to u civil penalty of not mom than five hundred dollars (S50 )L C I, a .owner of the p petty, or my employees with wages as theirsole eampen+udoo, '- will 'do'the work: und'the strucmrc'is'not intended or offered for 'sale '(See. T , Busibass'andProfessions Code: The Contractor's License Law does not apply to an caner of property Who builds or improves thereon, and who does such work himself inmpletion, the owner -builder will have the burden of proving that he did not build or mprove for parpnce of vale.). I 01 aeowner of the peopenyam exclusively contracting nt with licensed comcmm onrs cnruct the project (Sec. 7B . Business and Professions Curie:) The Contractor's c _ License Law des not apply Io an owntt of DroPcrtY who Wilds or improves .hereon, - and who contracts foLsuch TMjccls with a commnw(s) licensed pumtant.m the _ Contractor's License Law, Q 1 am exempt under fire ; B k P C for this reason Owner' Date WORKER'S COMPENSATION DECLARATION I hereby affirm under penally of perjury one of the following dedamtirm:- It- ❑ 1 have and mill maintain a Cenificate of Consent to self -insure for Worker's Compensation, as provided for by Section 37M of the Labor Code, for the 'perfommnce of the wufk for which this permit is issued.,, C 1 have and will meinmin Worker's Compensation Insurance, as required by Section 3700 of the Labor Code, for the peifomunce of the work for which this permit is i"dcd. My Workers Compensation Insurance earier and Policy number arc: -Ca tort 9t : }r{j s. f!ipaliby Nod u rr,'I L CERTIFICATION OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE,'„°! • (This section ted tot be a .ateled it Ilan permit is to, ne hundred dollars IS 100) or less.) I,:.I' n ry Ih i in the Performance' fth k h htl permit is .sued -1 hell nI employ any Anon in any manner sn as to become subject I. the Workers fonhsvith comply with such provisions or this permit shall be deemed revoked ”ie ""-�" °'CONSTRUCT,ION LENDING AGENCY ' " 1 hereby a(Erm that .here is m construction lending agency for the performance bf dwork for which this permit is issued (Sec. 3097. Civ. C.) L, der's Name :. -_:,.. ... .. _ Lender's Address, sl ccnify that I have read this application and state that the above information is correct. 1 agree In comply with all city and rosary ordinances and smu, laws relating to building conswetion, and hereby authorize representatives of this city m enter upon the above-memi... d mpF,ty for inspection purpows. IN's) agree m save„indemnify and keep harmless the City of Cupertino against liabilities, juJgmenm, costs and expenses which mey.ln any way sceme against stud City in consequence of the gtmning'af this panni): APPLICANT UNDER WANDS AND WILL COMPLY WITH ALL NON -POINT SOURCE REGULATIQNS: Sigwmreof Apph ano,"ato tou Duret ;. ,`t -HAZARDOUS MATERIALS DISCLOSURE ' � I IcuPptinnt or form, building aecupant at.rcu, handle huzardousnmecdat se defined bysdic Cupenim!Mmudlat Code. Chapter 9.12, and the Health and Safety 11,61v r,A Sea on 553_( ) ❑Y . Wdl the applicant or furore building occupant use ectiti,nner, or devices which emit hazardous air conmminams as defined by the Buy.AL,!&iir Quality Management District' r' 1 have read the mor1us.matertuls recian,mems order Chance 6.95 of the California Health & Safety Code; Sections 25505:25537 and 25574. I understand that if the building does not currently have a tenant; that it is my responsibility to notify the .,.,an, of the requlremems which must be at, rW m issuance of u Cc,t 1,mr of Occupancy.. -' Ow r or authorized agent _ Dmc 511 DIVISION STREET (408)379-0400 kTION SUB DATE 06/21/2002 BLDG ELECT PLUMB MECH Job Description REVISION W-BMITT'ED.,-_,NO NEW PERMIT ISSUED. ORIGINA ( 02050176. [/^C 102 - PIERS Required Inspections ” PI'1 y ...............103 _-..LIFER------'-----_..._...--= ------ ___._.....-------.-.._.._... ---- 104 - REBAR 105 - ANCHOR BOLTS -. .. __... —. __. 106 - SEWER & WATER - "'" •'" 202 UNDERFLOOR BING 203- UNDERFLOOR'MECMHANICAL ' ._..._._L_....__.__ 204 - UNDERFLOOR .FRAMEII;I• 205 - UNDERFLOOR INSULATION 301 - ROUGH PLUMBING 302 - TUB & OR SHOWER 303 - ROUGH MECHANICAL 304 - ROUGH ELECTRICAL 305 - FRAME 306 - HOLDOWNS _ "307.,_� . INSULATION;nr : 309' -' EXTERIOR LATH 310 - INTERIOR LATH _ -3I1 - SCRATCH 'COAT.. NI s : , - - 313 - ROOF NAIL' 501--- FINAL -ELECTRICAL rENERGY­-- -;;-,.,;,;:- 502 - FINAL PLUMBING ENERGY 503--- F,INAL MECHANICAL-ENERGYr; ';::--:-.', . „1.„ 504 - FINAL BUILDING ENERGY'. - __ .. _505...-.. FINAL ELECTRICAL.. _..... __ ......._ _ _..._- . __.. 506 - GAS TESTr).:..:- ,,;t,; 507 - FINAL PLUMBING 508 - FINAL MECHANICAL 509 - FINAL GRADE 510 - FINAL NG / Issued%�.4 C WORKS Date C/v Re -roofs ...Type.of.Roof... ...._.. .-w...... ,. ,...._,... _.. 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. Applicant_ understands and will comply with all hon -point source .regulations:, ..,, ,._.Signature of Applicant -.. Date All roof coverings to be Class "B” or'better OFFICE ... .. . .... .. .. ...