01110038 CITY IOFNGUOPERTONPERMIT NO CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
20730 VALLEY GREEN DR SOUTHBAY CONSTRUCTION CO INC 01110038
:HER'S NAME: APPLICATION SPIT DATE
PPLE CUMPUTER 511 DIVISION STREET 11/06/2001
PHONE: (408) 379-0400 SANITARY NO. CONTROL NO.
G ce O ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
a i p�j O I-1 1_""U L7
t as
m= LICENSED CONTRACTOR'S DECLARATION
1 hereby affrtn that 1 am licensed under provisions of chapter 9(commencing Job EpyKOn
'_Co°w, with Section 7M(DofDo,go3orthe BusmessundPml'o
slor,Vc.rm o license TENANT IMPROVEMENT �P ALED
in 11,force and coin 7 7 C
i rc 6 License I Lic.a
Dam Dare Canmc — JUN 1
i 3 u.in ARCHITECT'S DECL 3 2002
E:O 5 1 understand my plans than he used as public rdx
iun
as,
^ Licensed Professional
asza
OWNER BUILDER DECLARATION
I .Rco that I am exempt from the Contractor'sLicense Low for the BUILDING
forson.tsemonTons.Ba.nn,sand mmCooe:An,< rrcounty $350
000
noFo which requires perils r t c bet improve.demolish, repair any suuctum
a 3 tO- Pno t its uu a also n4) the nisions o for Con renrdu BnwI smmmem
thpi he Al hosed pbntu notMp softhe Conuacmrs Licensela IC!Wphrr 9 ValuattOn
—
orth 6 thSemo ]INa fli ails o theallgedt,mkap r. mnsewe) rL'(�"\ ¢t� 9'1 L �Cj4 r',tp'.��,-p^�6,}?�:
or inn nets 3185 b meat riiend me bans for the cts the alma a.Any lviolationnaty
-of Section]OJLS by any appli<am fora permit subjects me applicamton civil penalty
la rnm marc mamrve nanarea douars(ssuo�_._ - . 1 O LAPP I�'pl�*DAT I ON ITN1 Occupancy Type
❑Las owner o,thepropeny,armyemployee,with wages astheir able compenadon. 102 PIERS `
—wdl do-the work.and the structure is not Intended or-offered for sale(sec.7041,,- 103 - UFER Re aired Ins actions""'
Business a id'Promssions Code:The Contractor's License Law does not apply to an q p
owner of property Who builds or improves thereon,and who does such work himself 1.0 4__ _REBAR __ __`_c,-
completion,
___ _
or mrou h his own employees_provided that such improvements are not intended or _...._.__._._ 10 5 ANCHOR BOLTS
offered Er sale.If,-however the buildin — _ it bis sold otthin'ne _ _ f _ ;__
completion,the owner-Wilder will have the burden of proving the,he did not year
or - -- - - - ,` ,'a/•Lt \ ' pa's• •<I
impmvcforporpomm'sale.). 106 - SEWER & WATER
- -
.............
_,_. ... _..
p 1.as owner of the propeny,am exclusively contracting with licensed contractors m _ _ _ _ I..,_.._
_ -
construct the project(sec.70ut4.Business and pmmasmns Code:)The Contractor. 203 - UNDERFLOOR MECHANICAL':F''' ,. .
License Low does not apply to an owner of propsny who builds or improves thereon,
[_:a . and,who.cunt/ets.or.such proje<u.with.a.cammcmhs).licensed.Pursuant.I. he- .___.
204 UNDERFLOOR--FRAME----._-_._-..,._,___..._..----._...___.___.
ern am exempt
Lunde Law,See I'-. ,. I
- - :. ❑Iamcxcmp,undctSec. .BAPCfonhisrtmon 205 - UNDERFLOOR�'INSULATION
" "`'o6e 301 - ROUGH PLUMBING
;kompenwoon
WORKER'SCOMPENSATIONDECLARATION 302 - TUB & OR SHOWER
Iherebyafrm,underPenghyofperjImyoneofmaronewingdeclarations:- 303 - ROUGH MECHANICAL
I nave and will phmdln a Ccnificase of Conttor to self-usure for Worker's 304 - ROUGH ELECTRICAL
, asprovided for by Section 37W-of the Labor Code, for ,he
perfonna"eeof the work for which this permit is issued. 305 - FRAME
❑1 have and will maintain Worker's Compemation Insurance,as required 6y Section 306 - HOLDOWNS
W f the Labor Cud f the Performance f the work'for which this permit s 307 INSULATION
u d MyW kers Cempe�rmarne<arn<r .Palley umber ort - --•-
/L� 308 SHE$TROCK .-
ass
Cert! 'r (_ Pol yNo'O - pp t,
t_If I a r`-
'. t)ICERTIFlCATI NOFhXEMPTIONFROM,WORKERS't .-, 309 =�)dEXTERf2ORrrLATH
COMPENSATION INSURANCE,:_- :�- -
1 f� INTERIOR—LATH---..
'
rsunim 311SCRATCH COAT
(SIM).less.) r-•I'—:.t. -..-s C'—C.-.,-r_'-,1I-1—C7
- I-s-''
--------
�
_._.__..3.1.3..----ROOF NAI,L.___..
1'c rtsfy th i in the perf sin ca of the - k f hteh"is
h pe t' .x' d I „
itiall ort pmpmy apy'Person to any manmr wax m begome mb)ect m,he Wrikem 501 - FINAL EliECTRI CAL [ENERGY `
" _ 502..-_FINAL_..PLUMBING_ ENERGY- -.... ._ _.
pp . . -----------
- ..._ .
Ci pe e n law,of California Da
s NOTICE TO APPLICANT:...after making phisCertificate of ExemyOon.you hmuld- 503 - FINAL MECHANICAL 'ENERGY
., ...o_ oke...- ., .
become subject o the No kers Compensationprovisions of theLaborCade,you must
O p tonniuncomply with achProvisions or,h'spermtxM1nllbed d 504 FINAL BUILDING.. ENERGY_
" + CONSTRUCTION LENDING AGENCY " 505 - FINAL ELECTRICAL,. ,
I lu rcb dfOrm mat the s a'conet ton lending tienc for the rfoimancc
> 6nM1 tom pen, t .sneatS ,097 c.BCiy ° 506 - GAS TEST
y-q Lane Name - _.' , .5.07 -..-...FINAL PLUMBING.. .__
v OLardeen Address
508 - FINAL MECHANICAL'
1 certify that 1 have read this application and state that the above information is
'Ice+=E.1 :ourrac,:I agree to comply with all city and county:ardinu,ca and suer laws reading- -509 --FINAL.-GRADE_
O.V to building constriiction.and hiribi coducia,m;r6sartatives of thl;city to enter upon 510 - FINAL PLANNING
the a orm-o'ntloned pmpcny for inspection purposes.
, (W)ag a so save.mdemdfy and k p bruchlessam Ciiy orC.,'uno against 514 - FINAL PUB C WORKS
y liabilities,judgione is,costs an#_pea, Its ch may n any y gains[ ie
V z City n 9 ricey e g ming of paint t "
APPLIC ? y fi 4 AN WILL COMPLY WlTHALL NON oI -
Sol CV on 'i Issued by: Date
sig at p ,<� , ., : 1 Da 76
Re-roofs .. ..
HAZARUO SMAT R'T'A' DISCLOSURE ) V 6 a
as dWill thcaliplwvno future WiWingcaudwaminhndnhvmdex material . _Type of Roof_ _. . _. .. _ :- -:(=--__ _
' as def dby the CupertinoM Municipal Cod Chapter912;and the Helenand Safety list p r;'f .-f•' ) 1 { Y - 'L. ' ` -
Code Seeuo 25532(4) Ix
"' I `❑Y. - r , ❑Noy - n .''.J- . 'f j t _ .. . _All roofs.shall.be ins ected-poor.to.an -roofin material.bein ,,installed.,_ ,___
---
f Will the applicantim t building rade to use equipment d e: m<n. If a roof is installed'without first obtaining an inspection;fiagree':[o remove
em,hssair
cardousomammants as donned by Ne Bay Area
Air Quality Management'
Dit,d<e "". all new materials for inspection.lacorn. Applicant understandsP.Will comply with
.0yen y , El No
,. ; � all non-point sourceiegaftons,:n'..;; . .I ,_il,,. ;
R� fid' ' 1 It a ad the baiardous materials ie9mrtments under Chapter 695''.of the
'Cali'foinla Ncalm&Safety Code,Sections 25505.25533 and 25534.1,understand that: -
ifinebuildin does �curtcntl have amnam;that it ism ' -bili, ao notif thf -
Tilt. pant of g re is 'fi-b'm it Which prim 1.i ntrimF'fay enifica¢'Ef
--: 1,50°"< _-_Signature of Applicant _._ .. _ ..._ . .-. Date,
owner mEn:a ag c'.' Date roof coverings to be Class,"B" or better
- -OFFICE.