B-2018-1007 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1007
19333 VALLCO PKWY CUPERTINO,CA 95014(316 20 076) BARRON BUILDERS
INC
SANTA CLARA,CA
95054
OWNER'S NAME:Apple lne DATE,ISSUED:06/13/2018
OWNER'S PHONE:408-996-1010 PHONE No:(650)964-4493
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class CC=36 Lip.#2111366
Contractor BARRON BUILDERS INC Date 07/31/2019 X BLDG—ELECT_PLUMB
X MECH RESIDENTIAL X COMMERCIAL
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. JOB DESCRIPTION:
APPLE VP02A-(2)NEW ROOF TOP HVAC UPGRADES
I hereby affirm under penalty of perjury one of the following two declarations:
r. 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 Codc,for the
performance of the work for which this permit is issued.
/i ,n z 1 have and will maintain Worker's Compensation Insurance,as provided for by
oLJ'�' Section 3700 ofthe Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$400000.00
APPLICANT CERTIFICATION
I certify that I have read this appllcatlon and state that the above
information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 316 20 076 A(Tenant Improvements)
representatives of this city to enter upon the above mentioned property for
inspection purposes.(We)agree to save Indemnify and keep harmless the
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said ity In consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant nderstands and will comply with all non-point
source regulations per thelcupertino
Mk#cipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 06/13/2018 Issued by:Jasmine Archbold
Date:06/13/2018
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt Brom the Contractor's License Law for one of the RE-ROOFS:
following five reasons: All roofs shall be inspected prior to any raofng material being installed.If a roof is
r. 1,as owner of the property,or my employees with wages as their sale installed without first obtaining an inspection,I agree to remove all new materiels for
.impetration,will do the work,and the structure is not intended or offered for iuspectiou.
sale(See.7044,Business&Professions Cade)
z. 1,as owner of the property,am exclusively contracting with licensed Signature ofApplicant
contactors to construct the project(See.7044,Business&Professions Code). Date:06/13/2018
1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
r. 1 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. HAZARDOUS MATERIALS DISCLOSURE
z. I have and will maintain Worker's Compensation Insurance,as provided£or by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of One work for which this California Health&Safety Code,Sections 25505,25533,and 25534.I will
permit is issued maintain compliance with the Cupertino Municipal Code,Clmpter 9.12 and the
s. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material.Additionally,should I use equipment or devices which emit hazardous
Worker's Compensation Taws of California.If,after making this certificate of contaminants as defined by the Bay Area Air Quality Management District 1
Pe g will maintain compliance with the Carl Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions o£the the Health&Snfety Code,Sectio 25505,25534.
Labor Code,I must Forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Data:06/13/2018
1 certify that I have read this application and slate that the above Information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for Inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit.Additionally,the applicant understands
and will comply with all non-point Source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. 1 understand my plans shall beused as public records.
Licensed
Signature Date 0 6/1 312 01 8 Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
a] 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228• building@cupertino.org PEMIT#B-Zr,t?- 00
CUPERTINO � REV#_ DEF#_
El NEW CONSTRUCTION ❑ADDITION ❑ALTERATION❑T.I. E MEP ❑RE-ROOF ❑SWIMMING POOL/SPA
PROIECTADDRESS I9 1;S(� ' /�f ^ Pk,�y APN1 31 I J� 4Q)
L r
OWNER NAME APP( lN� tiW 0_ PHONE (JCp r—`�In b E-MAIL {'
STREET ADDRESS BNIL 1„?Lrt,L Wk. why CITY,STATE,ZIPb
CONTRACTOR NAME 7❑]OrWNER-BUILDER COMPANY NAMELICENSU'E'NLIMBER LICENSE TYPE
C ILIvf( PO ��bz'z� J�Aa tom``IIWI o8 P.,INS q l r 6 G CS L
STREET ADDRESS CITY,STATE,ZIP C Y°!J" "i� c La�+m
E-MAIL UA1 f&0^ n�n n PHONE ®`10-
0 11 Q-S BUS,LIC I
❑ARCHITECT ❑OWNER El OWNER VAGENT ❑CONTRACTOR AGENT El EN\/GINEER El DEVELOPER El TENANT
CONTACT NAME E-MAIL
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPT'ON � ar/ ,rt�,"`h����n- �� Ni'6,'
o I ��ot�; �-1 UQG f�� � l NST�,t,L,0JoIJ OP
NQ&c O1TS c9 v6t0ar-1 /ass IAr n pll�,,16 &VID fXISTI✓V& 1200f-qd-M
W I I,C M7 PZ M 07/N"l>LO
E]SINGLE-FAMILY/DUPLEX ❑MULTI-FAMILY []INDUSTRIAL ❑COMMERCIAL
EXISTINGUSE I EXISTING" NEW FLOOR SP PORCH SF DECK SP DEMO IF S1'ORIE11TOTALNETSF USE TYPE OCC SQ.FT. VALUATION($1
REMODEL REMODEL KYrCHEN REMODEL Ou IR GARAGE E]ATTACHED
BATHROOM SP SF SF SP ❑DETACHED
FFICHLERYESEXISING ❑yMCONDSTORYA.MUON ❑YES
FIRESPRINKLERS E3 NO El NO
❑NO -
DWELLING JSECONDDWELLING E]YES❑ATrACHEDO DETACHED OTHER
UNITSN UNITADDITON: ElNO SF
POOLS ❑FIBERGLASS El VINYL LINED ❑GUNITE E]PREFABRICATED
POOL-SE SPA-SE SPA ATTACHED AYES ❑NO 'MIAL-8N
JiECENED BY: TQTAL VALUATION:
Cmrnne dd o,MWE-Fnrndi B Td" 'I!P b]'S P ! Dav,I nen(,fEe,irmnnenMI 11,A,nrl,ova) — qt
IZL-.=R-QOF EXISTING ROOF TYPE: ❑BUILT-UPROOF❑ASPHALT SHINGLES[-]WOOD SHAKES E] SHINGLES❑TILE OTHER(SPECIFYI YP
REMOVE/REPLACE NO I IF NO PLYWOOD ❑tY' ❑3/8" PLYWOODTYPE: PITCH: ROOF CLASS
❑YES ®OF LAYERS TIIICKNESS❑5/8" OTHER ❑OSB ❑COX OTHER •12 A
PROPOSED ROOF TYPE:❑BUILT-UP ROOF❑ASPHArr SHINGLES❑WOOD SHAKES❑WOOD SHINGLES El OTHER
*Provide a signed copy of the Cupertino's Tear-Off Policy SF qof SQUARES
By my signature below I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I
have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree
to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to
enter the above-identified property for inspecti4 p, oses�I acknowledge and authorize all information contain9don this application form
to be made available for public record.
Signature of Applicant/Agent: A r Date: I r g
SUPPLEMENTAL INFORMATION REQUIRED
Zew SPD/Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction.
onunerdal Buildings:Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
'Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application.
*HOA-Provide a letter of approval from the Home Owner's Association
Bldg.4pp_2017.doc revised 08101117
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2018-1007
19333 VALLCO PKWY CUPERTINO, CA 95014 (316 20 076)
BARRON BUILDERS
INC
SANTA CLARA, CA
95054
OWNER'S NAME: Apple Inc
DATE ISSUED: 06/13/2018
OWNER'S PHONE:
PHONE NO: (
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C-36 Lic. #916366
Contractor BARRON BUILDERS INC Date 07/31/2019
X BLDG —ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
X MECH _ RESIDENTIAL X COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
APPLE VP02A - (2) NEW ROOF TOP HVAC UPGRADES
1 hereby affirm under penalty of perjury one of the following two declarations:
t. 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.
/1 2. 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
Sq. Ft Floor Area:
Valuation: $400000.00
permit 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 harmless the
City of Cupertino against liabilities, judgments, costs, and expenses which
may accrue against said qity in consequence of the granting of this permit.
Additionally, the applicant Wriderstands and will comply with all non -point
source regulations per the upertino Municipal Code, Section 9.18.
Signature Date 06/13/2018
OWNER -BUILDER DECLARATION
APN Number: Occupancy Type:
316 20 076 A (Tenant Improvements)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Jasmine Archbold
Date: 06/13/2018
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is
t. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, t agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for inspection.
sale (Sec.7044, Business & Professions Code)
2. 1, as owner of the property, am exclusively contracting with licensed Signature of App]
contractors to construct the project (Sec.7044, Business & Professions Code). Date: 06/13/2018
1 hereby affirm under penalty of perjury one of the following three declarations:
t. 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.
z. 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.
3. I certify that in the performance 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 of the
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
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 harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
Code, Section 9.18.
Date 06/13/2018
"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 Cuperti Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sectio
Owner or authorized agent:
Date: 06/13/2018
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit 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