09090088CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19333 V ALLCO PARKW AY BLDG A
OWNER'S NAME: APPLE, INC
OWNER'S PHONE: 6503027846
0 LICENSED CONTRACTOR'S DECLARATION
License Class n Lie. # 5q1f$'{~
Contractor 1?f\S.. Date !Q<.( 8131/~{O
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.
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
performance ofthe 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
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 pUl1Joses. (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. Q
DateSignature ~F a,hlf!et;
0 OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, 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 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 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 pUl1Joses. (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.
Signature Date
CONTRACTOR: DPR CONSTRUCTION INC
1450 VETERANS BLVD
REDWOOD CITY, CA 94063
PERMIT NO: 09090088
DATE ISSUED: 09/1412009
PHONE NO: (650)474-1450
BUILDING PERMIT INFO:
r
BLDG r ELECT r PLUMB r
MECH RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION:TEMPORARY PERMIT FOR INTERIOR ONLY
(RENEW AL)ORIG
TEMP PERMIT #09080052 & ORIG PERMIT #09060070;
THIS PERMIT GOOD THRU 10114/2009 & NO INSPECTIONS
Valuation: $1000000 Sq. Ft Floor Area:
Occupancy Type: APN Number: 3 I620075.BLDGA
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
?--If? .c-,.
~_.~.~Issue~~ Date:
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
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.
ownL;Z~~ent: Date: 9/tdt'7
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
CITY OF CUPERTINO BUILDING PERMITi
I BUILDING ADDRESS: 19333 VALLCO PARKWAY BLDG A CONTRACTOR: DPR CONSTRUCTION INC PERMIT NO: 09080052
OWNER'S NAME: APPLE, INC 1450 VETERANS BLVD DATE ISSUED: 08110/2009
PHONE NO: (650)474-1450 , OWNER'S PHONE: 4089745951 REDWOOD CITY, CA 94063
~ LICENSED CONTRACTOR'S DEC~~RATION
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License ClasS----.J:3--_ Lic #l\5191 t.f to l
r MECH RESIDENTIAL r COMMERCIAL r
Contractom Gbf"\~~)~~ ih Date &! 10 /1),.1Jt'J7
JOB DESCRIPTION:TEMP PERMIT GOOD THRU 9/10/09; NOI hereby affirm that I am licensed under the provisions of Chapter 9
INSPECTIONS(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
AFTER 9/10109; ORIG #09060066
I hereby affirm under penalty of perjury one of the following two declarations:
1 have a:ld 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 'Nhich this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Valuation: $1000000
Section 3700 of the Labor Code, for the performance of the work for which this
penn it is issued.
APN Number: 31620075.BLDGA
Sq. Ft Floor Area: \ 00) DD'D
Occupancy Type:
APPLICANT CERTIFICATION
1 cenify that I have read this application and state that the above JIlformation is
correct. ! agree to comply with all city and county ordinances a.,d state laws relating
to building construction, a'ld hereby authorize representatives of this city to enter
PERMIT EXPIRES IF WORK IS NOT STARTEDupon the above mentioned property for inspection purposes. (We) agree to save
IIldemnify and keep halmkss the City of Cupertino against liabilities, judgments,
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs, and expenses which may accrue against s:\id City in consequence of the
granting of this permit Additionally, the applicant understands and will comply
180 DAYS FR~T ~LLED INSPEC~I~~.
with all non-point source regulations per the Cupertino Municipal Code, Section
Issued by: Q ~ Date: ~ (0 't:,:&'" -$4' D,"~L~/z<(lD7t
RE-ROOFS:
All roofs shall be inspected prior to any roofing materia'! being installed. If a roof is
I hereb)' affirm that I am exempt from the Contractor's License Law for one of
0 OWNER-BUILDER DECLARATION
installed without tirst obtaining an inspection, I agree to remove all new materials for
the following two reasons: i'lSpection.11, 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,
Busines, & Professions C'Jde)
I, asowner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Busmess & Professions Code).
I hereby affirm under peilalty of perjury one of the following three
declarations:!I have and will maintain a Certificate of Consent to self-insure for Worker's
I Compensation, a5 provided for by Section 3700 of the Labor Code, for theiperformance of the WOlk !(or which this pennit is issued.
I I have and will maintain Worker's Compensation Insurance, as provided for byiSection 3700 of the Labor Code, for the performance of the work for which this
pemlit is issued. .II certifj that in the perf::mnance of the work for which this permit is issued, 1shall
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 su,~ 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 relatingIto building constructio:l, and hereby authorize representatives of this city to enter
!upon the above mentionec property for inspection purposes. (We) agree to save
I indemlllfy and keep harmkss the City of Cupertino against liabilities, judgments, Icosts, a"d expenses which may accrue against said City in consequence of the
. granting of this permit. Additionally, the applicant understands and will comply
Signature of Applicant: ~~/ D'" f}(ZOd9
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, shot~ld I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
m~intain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, alld 25534.
ownero~
Date: K/;cI~rJJ 1
! I/
CONSTRUCTION LENDING AGENCY
J hereby affirm that there is a construction lending agency for the performance of work's
for which this pemued (Sec. 3097, Civ C)
Lender's Name
Lender's Address P4
/
ARCHITECT'S DECLARA TION
, with all non-point source regulations per the Cupertlllo Municipal Code, Section I understand my plans shall be used as public records.
918.
Licensed Professional
SignJtu;c Date
"
CITY OF CUPERTINO
,t,n.,v.-.'..' ~l,w .~ TEMPORARY PERMIT
CITY OF
CUPEIQ"INO PERMIT APPLICATION FORM
6 Date:APN# ~31 ~Z-66 7-~ , LD<e-A
Original Pennit # 7(joqO\Q OO~
Building Address:
lq 33~~~(~()) JJ(Uk.w~ 6t4-It
U 0Owner's Name: Phone #: J..+ '"'i Cj 7-1 5'1 S ,
I \¥+5) '3 D 7"711A'PP)~
Contractor: Phone #' . &J/' D 074 l~S()(6(15f(()Gt/~n ,J;'YlG.D PlZ Fax#: ~r;v i(~~)Y))
Phone #:Contact:
J (~JV '3 o'Z--7 6'1 (;Br (cAn {)JkQ.([1
Contractor License #: :J rC) fL! t
Cupertino Business License #:
Job Description: / ~ -".-+-, of GY1511~ 77J}t/~ g/jy,
Valuation (cost of project): Type of Construction:I 1)L)t.) 000 / I
Project Size: Over the Counter
Quantity FeeID Fee Description Fee Group Permit Type
I
lTEMPPMT
(Flat Fee)
Temporary Pennit Good
for 30 days -Commercial
only.
B ITEMPPMT
-
( lBCBSC Cal Bldg Standards
Commission Fee
B ALL PERMIT
TYPES
01/07/09
/'''~''CITY OF CUPERTINO
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,§', "" ';;:.,,:,.,
I .~ •. _ ,.,.;_ r"'. TEMPORARY PERMIT
CITY OF
CUPERJINO PERMIT APPLICATION FORM
Date:
APN#
'3 \(P d-Oo'~ ,'&.:P&A
q (1'1 /oi
Original Permit #
01 0 <g 0(95'd.-rtevv-(" 010bOO1v (OrT9<Jlf~')I
'-' ./Building Address:
('gLDG-k)lC1s'3? \lAtuo~i
Owner's Name: Phone #:
4rJ%;-q 1-L.{-Stt5 JAf'fL-e-
Phone #: ~o·-~'8--5q~2Contractor:
L)f'R CGN~~\..\l C'.Y'J Fax#: ~ -2~Lf -d-.31Lf
Contact: Phone #:
'b~\tfN oc tc--e-c..L'I
0$'0 -'3D2 -1-8'tb
Contractor License #: 5qq"bL.f~
Cupertino Business License #: 1330'~
Job Description:
'\~Y' ~l\ ~f2 1=N'\E..«l oR C3NV'1
(~r\~')
Valuation (cost of project): Type of Construction: ~r \IOf)O~ODO ~ef"lO~
Project Size: Over the Counter ~e-f
Quantity Fee ID Fee Description Fee Group Permit Type
I ITEMPPMT
(Flat Fee)
Temporary Pennit Good
for 30 days -Commercial
only.
B ITEMPPMT
-
I lBCBSC Cal Bldg Standards
Conunission Fee
B ALL PERMIT
TYPES
01/07/09