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Home My WebLink AboutB-2018-0840CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-0840 19333 VALLCO PKWY CUPERTINO, CA 95014-2506 (316 20 075) MILROY CONSTRUCTION INC MOUNTAIN VIEW, CA 94043 OWNER'S NAME: APPLE INC DATE ISSUED: 05/22/2018 OWNER'S PHONE: 408-780-6489 PHONE NO: (650) 625-0300 LICENSED CON'TRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class @ Lic. #579832 Contractor MILROY CONSTRUCTION INC Date 10/31/2019 X BLDG —ELECT _PLUMB MECH RESIDENTIAL X COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter (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 VP2A - T. I. PROVIDE SEISMIC BRACKETS FOR TOOL, 1 hereby affirm under penalty of pw•Jury one of the following two declarations: INSTALL CONDENSATE PUMP, INSTALL (2) VAV'S t. I have and will maintain a certificate of consent to self -insure far Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the wok for which this permit is issued. z. I have and will maintain Worker's Compensatien Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Arca: Valuation: $80000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 31620 75 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 City in consequence of the granting of this permit, WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non -point source regulon s per the Cupertino Municipal Co ection 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatur Date 5-22-2018 Issued by: Kim Dunbar Data: 05/22/2018 OWNER -BUILDER DECLARATION 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 s roof is r. I, as owner of the property, o my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (See .7044, Business & Professions Code) x. 1, as owner ofdne properlyam exclusively contracting with licensed Signature o'ApplicanC contractors to construct the project (Sec.7044, Business & Professions Code), Date: 5-22-2018 1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS'1'O BE CLASS "A" OR BETTER u 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 ofthe work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 or the Section 3700 of the Labor Code, fo the perforrance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will permit is issued, maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the a. I certify that in the performance of the work for which this permit is issued, l 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 1 use equipment or devices which emit hazardous Worker's Compensation laws of California. If, after making this certificate of contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and exemption, l become subject to the Worker's Compensation provisions of the the Health & Safety Cade, Sections 25505, 25533, and 25134. Labor Code, I most forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized age APPLICANT CERTIFICATION _ Date: 5-22-2018 1 certify that I have read this application and state that the above Information Is CONSTRIIC'PION LENDING AGENCY larformance 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 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 be used as public records. Signature Date 5-22-2018 Licensed Professional