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CITY OF CUPERTINO-*PSs*'
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BUILDING DIVISION PERMIT
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BUILDINCADDRESS:
CONSTRUCTION GROUP
1jeMITND06080096
10200 S DE ANZA BLV 3RDFLR
R'S NAME:
PERMIT [SUE DATE
SYMANTEC CORPORATION
645 RIVER OAKS PKWY
09/28/2006
E;
SANITARY NO. CONTROL NO.
(408)321-6450
ARCHITEC IENOINEER:
BUILDING PERMIT INFO
• BLDG ELECT PLUMB MECH
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LICENSED CONTRACTOR'S DECLARATION
Job Description
I hermy affirm that 1 am Idem and under provinces of Chapter 9 (Commencing
.
with Section 7IXIU)ofOiNdon7a(dk Hudnessmd rafesions Code andmylkertseis
In full form err
T.I. INTERIOR ONLY OFFICE SPACE -3RD FLOOR
LICn1eC
ROOF TOP EQUIP MUST BE SCREENED FROM VIEW
Did Comncur
com
ARCHITECTS DECLARATION
I understand my pus,lull be used u public records
Licensed Profession
OWNER -BUILDER DECLARATION
I Immby Affirm that I em eacmpt from the ConlranoYs License Law for the
following neon. (Sada. 713 I.S. Business and Profesions Cade: My city or County
which requires a Permit m Construct, Aller, improve, demallah, or mpWr my smrmturn
prior m lin Issuance. suit reubw the applicant forwch permit to file a signed sutammt
dothe is licensed pursmmtothc prvisionsofthe Conuocmre Lkmrve Law(Chapler9
3q. FI. Floor Area
Va 8.9000
(commencing with Sectia.70M) of Division 3 of the Bushmse and Profeaslo.a Cade) ler
thus he is exempt rheefrom and Alk basis (e the al4•gud redemption. My violation of
e �T 7Q',��r
Occupancy Type
Section 7031.5 by stry applicant for a permit subjects the applicant m a civil penalty of
not mom than five hundred dollars (SSM).
9D 16
3 0 7 V 0 0
❑ 1, as owner of the Property, or my employees with wages as their sale compensation,
R��gpppequlrC tions
will do the wark. and the sauctuto is antinuMad or.firmed farsa oonc.7044,BudM,•
and Cade The Ca.ueclaen Limnu Law doe net apply ro an came, of
Property be ro
property who builds arimprowstiurmn, and whadaea suehwahhim,d(artMu{h his
[f1 ®
ownempbymuiprovided aotinun for Cale IL
fc mpledo.
however. the building or improvement le said within one yet of completion, the awmo-
Improvement
1v��CWltUytj��ss
builder will have tis burden.f proving that M did not build a improve for pogo¢ of
uta.I.
❑ 1. u war of the property am exclusively mntraming with immed Conoamom b
2oaa
Constnkt the project (Sec. 7014. Business and Profealans Code) The Conuacura U.
NrD�
cense law does not apply b an Owner of property who builds or improves memon, and,
who for such projects MNarontractO(s)Bmnud purwaebthe Conuaetots
y
A. Lacu
Licence Law.
❑ 1 stn eaempr ands Sec. . B & P C rar dru.awn
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I Dau
WORKERS COMPENSATION DECLARATION
I hereby dorm under penalty of perjury ane of thr following declaratiae:
IIN+e and will maintain. CeNfrcm, of Consent re self-insum for Workers Compen-
. a provided (oro by Section 370. of the Labor Cade, for the performance of the
for which this permit ie issued.
aw and will malnui. WOkees Compnwdan Insurance, ss required by SeNon
of the Latlar Code,,frdm perimmance ofdm work far which thio Permit 41Yned.orks
Pe d n 1. CartimandPolitynumberr:
i Policy No.: ly/11•-1�
TE OF EMPITON FROM W ERS'
COMPENSATION INSURANCE
'
rf his section need stat he com plcuid if de permit Is far enc hundmA dollars (SIM)
or less.)
I certify that in the perfarmaae or Ilk work far which this pnmit 4 issued, l ,hall not
employ any person in any manner so As m human subject to the workers' Compensation
Laws of California. Data
Applicant
NOTICE TO APPLICANT: If. After making this Certificate of Exemption, you should
become subject m the Workmen Compensation provision, of Alk labor Cadc, you main
Comply with such provisions or this Permit shall ns deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby affirm dot Nem 4 a construction lending agency for the performance of
the wart fur which this permit 4 issued (Sec. 3077. Civ. C.)
,
Lender's Name
r
Landers Add.
I terrify that I have mad this applleusion and sue, Nat Ne show mraonstlun is
'
COMOCL I agree m comply with all city and county pNinarea s and sue laws totaling to
building convection, and he yauthorim topmumatiws of this miry to enter upon the
abovomendoncd r n
property for purposes.
( m saw, i mainly an armless the City of Cupertino against
4 ilidc udg nts.costs adexpc hich ay in any wry amma agdnstsaid City
a at AgCris
S siis WIL COMPLY WITH LLN -POINT
Issued by: Date
SOURC EGULAT fS. p1
U
Re -roofs G
Type of Roof
Sigw o ppli An au
HA ARD ,MATERIALS DISCLOSURE
wi sire aP li ar rule Ilding aaupantstoro or haMlc havvdons maledal
de by dle eman M n' p I Code. Chapter 9.11. and the Health and Safety
Sac, 25533(x)?Yu
All roofs shall be inspected prior to any roofing material being installed.
❑ o
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building madam use equipment or devices which
h hazardous air emuminmu As defined by the Bay AMA Air Quality Management
all new materials for inspection.
uict7
Ye /
I heewv.. arks ateria4toqu' menu n icror pur6.950fthecalifor.
nl a& 79N5,2553 md25 Atexicrs and ll(the dding
Jam Aly haw a w n I up Ility k notify amup t of the
mquheaven ic am be pda i, me c dfkataar pan .&
Signature of Applicant Date
All roof coverings to be Class 'B" or better
Owner
or u rized age