00080001 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
If UILDING ADDRESS. PHRMnNO.
15111 PRUNERIDGE AV ADACON CORP 00060001.
OWNER'S NAME APPI.ICAI'ION Still DAIn
HEWLETT PACKARD CO 2048 A CORPORATE CT 08/01/2000
I'IIONE: SANITARY NO. CONTROL NO.
(408) 321.-8700
not A RCHITECTICNGIN1717 R: BUILD(NO PERNGIF I NFO
n00
BLDG ELECT' PLUMB MRCII
Ha�
F y p
LICENSED COMRA S DECLARATION
r 1 M1crtby aliirmhan I ren licensed tootle,prvv>ionsof Chat
J Iconvncncing Job Description
OyFp with Semina 7lXXp of Division 3nf the Rosiness vnd l'mfcxsions Ccda,and nsy licenx
—_ in full force and elf
�s�a i:henre Lin.x 650720 ADDENDUM. TO LIGHT STANDARDS FOR LOT ON
xo F Da.°-�—t=c2
I'S DECLARATION PERNLT, REQUIRES PLANNING PI_ANCHECKnRculrecNQNCClJ
g undemtand my plans shall W used as public records
ce rep o U,,ca,ul Profession:)
co.a o OWNER-BUILDER DECLARATION
1 hereby i ffmnbm I um esnnpr from the Cnnwclor's License U.for the
3< following reason(Section 7031.5.Business and Professions Code:Any city or county
R a which requires a anvil u+conswm,alter,improve,demolish,or repair any srumum
pa prim to its issuance.also requires the applicant for such permit to a signed statement
�—
that he is Licensed too,oanuo the lavasn m—fthc¢ommctors license Law Chapter 9 Sq. Ft. Floor Area Valuation
(commencing with Section 70X8 of Division 3 of me Business and I'ndesslons Collet
or soul he in eaempl Ihercfrnnl and the hail Inn the ullegcd cxentaion.Any violation
orSectior 7031,5 by any upplicum Iia a all nor nahie",one upplinnn u,n civil pcmdly
Ill tat:mom than five hundredollart($500). APN Number Occgpaa)Lq@fte
❑1.as owner of dw pmpen,m my nnpNyres with wages as bell sale umnlara,m un. I .
will Jo the work,and the nmnum is not intended or offered for sae(Sec.7813, IIIrCd Inspections
euanets and Lhnfessmns Code:The Contrartnr.Liccn.e Law does not appy m an 31507043. @01 P
,wase,of property Who Wilds or improves thereon, ad.Im does such work himself
.oirthrough his own employees,provided that such improvementt art not intended or
offered for sale.If,however,the baiid:og or mmrovemeal is sold with,one year or 04 — ROUGH ELECTRICAL
nnplminn.:he owner budder will have the harden lot'provins that he did nal nulla ?
or r
„pro', o"urp"`eorx:d"), _901 ' — FINAL ELECTRICAL ENERGY '
❑L. owner of be properly,am exclusively coavatlthg with heca.wdcoarmclor.In 505 — FINAL 'ELECTRICAL
msmict the project(Sec.7044,Business and Professions Carle:)The Contmnor's
License Law does not apply to an owner of pmpeny who builds or improves thereon,
and who contracts for such projects with a commclor(s)licensed moment to the
Contractors Liceme Law.
01 am exempt under Sec. .B k P C for this mason
Ownm Dare
WORKHR'S COMITNSATION DECLARNI ION
. 1 herchy milr n under penalty of Pcdury one A the following declarations
1 have
❑ ve and will n tonin a Com mate of Consenl to .self-insum for W'orker's O
Compensation, as provided for by Section 3710 of the Lathes, Cock, for be
pet have an %the work for which this watimems ti issued.
01 have and will nm...le, oWorker h 'e Compensation inn ,work F as ayuireJ by Section
%sem of the Worker
Curna for parllatmmcc nl et work for which this permit is
ssuttl.MA�Y Wp,�rtkc,r�'n Cutnpcnsation Inetrunce can let;mJ Policy nutnbcr arc: "
Carrier:= I policy Na.:
CIiRTIPICAf1ON EN NITON INSURANCE RWORKGRS
COMPENSATIONON
('(Lis senior need not W completed if the prm,it is for one hundred dollars
IS 100)or less.(
I certify:Nn In thin Pero n Glace of it,work[or i
�wh
ch this Penh is issuc4l
shall nal eminynw�l IF f elrsovijnrn.y) "'',jncr s^nB �ohvUsuM1lect m the Wndcn
rcC
Comnsmiu J o /
Applmam
N(sioCE'IOAIn'heW k:IL aloe(necking(his Cenin,of 1Excmpuod gnu should
Q QWrome su omptotesuch rsnmpcnsvtion provisionsof the Lull mock You most
hmhwit comply with such prori.inn.wr this prrmil shall W dcnncJ rcvnkcJ.
Z —
F = CONSTRUCT ION LENDING AGENCY
ai } 1 hereby:ill!rm that them is a constmclin I lending agency fnr to performance
W of the work for which this pemnit is issued(Sec:.30817,Civ.C,)
0
OI Lender's d
;Dz Lrndcr's Address
V 1 certify thin l hme read his npplicainn and sw:e that the aWve information is
coram.I agree w 0)IN%lib all City and county ordinances and%late laws relating
V u,Wilding construction.and hereby authorize representatives or this city to enter upon
the abovc-mentioned properly for inspection putraws.
h L (Wel agree to save,indemnify and keep harndess the City of Cupertino against
rn City inie.,j oag erice I f he and mining
I Ic i which may in any way aucme against said / D
(,J z City in ANTU D R the Framing D tis No CO
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NONPOINT IssDedb Date
SOURCE R"GU TI 1S. 1''
sgt more ornpr:r:nm/Commen,r Dae Re-roofs
HA%ARDOUS MATERIALS DISCLOSURE
willlhe applicant or failure Wilding occupant smmorhandle hmedouv mamntil Type of Roof
a defined by the Cupertino Municipal Col Chap cr 9.12.and the Health and Safety
Cade.Section 25532(a)^ yyy
G Ye. dYNo All roofs shall be inspected prior to any rooting material being installed.
Will denplgientnmmmmb,albngoeolnat;;.e eq"ipmemor devices w iich If it roof is installed without first obtaining an inspection, 1 agree to remove
mil hvJa.00s air snuouninnms a.JuGncd 1,the It,,Am.Air Gaudily Munagmnem
•Digdc,I - all new materials for inspection. Applicant understands and will comply with
❑Yca c(Na all non-point source regulations.
1 have read the hvardoml�materials requirements under Chapter 6.95 of the
California Heart&Safety Code,Sections 25505.25533 and 25534.1 understand that
if the Wilding does not currently have a major,that it is my mspnnsibility n,notify the
occupant of the acquirements which most he met prior u,issuance or it Cenilane of
°e` a"e�( ooa�).--'�r�or . Signature of Applicant Date
O neruru thorisAngen Dam All roof coverings to be Class "B" or better
OFFICE