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09070142CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19333 VALLCO PARKWAY BLDG B CONTRACTOR: DPR CONSTRUCTION INC PERMIT NO: 09070142 OWNER'S NAME: APPLE 1450 VETERANS BLVD DATE ISSUED: 11/0912009 OWNER'S PHONE: 4089745951 REDWOOD CITY, CA 94063 PHONE NO: (650)474-1450 LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I 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. fP LicenseClass Lic. #~3?61//5 Contractor JJ?!2-4J»JT~/c714i!/~e 1/?Le?1' r hereby affirm under penalty of perjury one of the following two declarations: r 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 perfonnance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 ofthe Labor Code, for the performance of the work for which this pennit is issued. 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 to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnifY and keep hannless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting ofthis permIt. Additionally, the applicant understands and will comply with all non-p:2Zintsou,regulations per the Cupertino Municipal Code, Section 9.18. -J Signature -c/~ Date /&/7 JOB DESCRIPTION:T.l OF EXISTING BUILDING, INCLUDIGN NEW CAFETERIA, ELEV ATOR I ST AND 2ND FLOOR NON-STRUCTURAL TO INCLUDE RE-ROOF 140 SQUARES BUILDING PERMIT INFO: BLDG r ELECT r PLUMB 1 MECH r RESIDENTIAL r COMMERCIAL r Sq. Ft Floor Area: Valuation: $15000000 Date: //<?'~ Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. .. ~.--7~/~- Issued ~~:'__....:~'--__~__----r,c-'-­//--L:~'--_ APN Number: 31620075.BLDGB t-------------------"--------------I o OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the fonowing two reasons: I, as owner of the property, or my employees with wages as their sole compensation, RE-ROOFS: 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. 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. I 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. I certifY that in the perfonnance of the work for which this pennit is issued, I shall Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Compensation laws ofCalifomia. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this pennit shall be deemed revoked. APPLICANT CERTIFICATION I certifY that I have read this application and state that the above infonnation is 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 upon the above mentioned property for inspection purposes. (We) agree to save indemnifY and keep hannless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this penni!. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date _ Health & Safe~ode, Sections 25505, 25533, and 25534. Owner o~~ed ~~ ? ~~ ;I" l/V'"'/" A&. Date: /r~t?T (/ CONSTRUCTION LENDING AGENCY ) hereby affinn that there is a construction lending agency for the performance of work's for which this pennit is issued (Sec. 3097, Civ C.) Lender's Name _ Lender's Address, _ ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO BUILDING PERMIT REVISION ,~ _ BUILDING ADDRESS: 19333 VALL CO PKWY BLDG B I .1­ CONTRACTOR: DPR CONSTRUCT/OJ' m" ,~. v/v ,vn~ OWNER'S NAME: APPLE INC 1450 VETERANS BLVD DATE ISSUED: 11/09/2009 OWNER'S PHONE: 4089745951 REDWOOD CITY, CA 94063 PHONE NO: (650)474-1450 o Contractor I hereby affirm that I 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. LICENSED CONTRACTOR'S DECLARATION LicenseClass, Lic.# (3307­ ,Off? CoV(7l?Cl?dA6ate VA'fr 0 I 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 perfonnance ofthe work for which this pennit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 ofthe Labor Code, for the perfonnance of the work for which this penn it is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above infonnation is correct. 1 agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives ofthis city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep hannless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this pennit. Additionally, the applicant understands and will comply wIth all non-point source regulations per the Cupertino MUniCipal Code, Section 9.18 . // Signature ~~ Date Wydo BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r­ MECH r RESIDENTIAL r COMMERCIAL 1­ 0:LL~ 6 f) JOB DESCRIPTION: T.I OF EXISTING BUILDING, INCLUDIGN NEW CAFETERIA, ELEVATOR 1ST AND 2ND FLOOR NON-STRUCTURAL TO INCLUDE RE-ROOF 140 SQUARES \'2(( u I 0; ~ \')02 '~4 r c.-\ ..:::>~, ~ Sq. Ft Floor Area: Valuation: $15000000 APN Number: 31 620075.BLDGB Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Date:r;1'--I Lt./t..tf RE-ROOFS: 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, Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS"A" OR BETTER o OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, 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 construct the project (Sec, 7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation, as provided for by Section 3700 ofthe Labor Code, for the perfonnance of the work for which this pennit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the perfonnance of the work for which this pennit is issued. I certify that in the perfonnance of the 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 Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions ofthe Labor Code, I must forthwith comply with such provisions or this pennit shall be deemed revoked, Date ~Wa APPLICANT CERTIFICATION I certify that I have read this application and state that the above infonnation is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives ofthis city to enter upon the above mentioned property for inspection purposes, (We) agree to save indemnify and keep hannless the City of Cupertino against liabilities,judgments, costs, and expenses which may accrue against said City in consequence of the granting of this penn it. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 918. /) ~ Signature "'(f.~-' HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. O~J~~r~_th~~~nt: Date: V;!I'7#b (/ . CONSTRUCTION LENDING AGENCY I hereby affinn that there is a construction lending agency for the performance of work's for which this penn it is issued (Sec. 3097, Civ C.) Lender's Name _ Lender's Address'--­_ ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional