01070086 CITY OF CUPERTINO
BUILDING DIVISION PERMIT CONTRACTOR INFORMATION:
BUILDING ADDRESS: PERMIT NO.
10475 BANDLEY DR SOUTHBAY CONSTRUCTION 01070086
OWNER'S NAME: APPLICATION SUB DATE
APPLE CUMPUTER 511 DIVISION STREET 07/19/2001
PHONE: q 1 SANITARY NO. CONTROL NO.
i 1�� — � \�yJ (408,) 379-0400
q 95ARCHITELT/ENCINEER: BUILDING PERMIT INFO
.y- ELECT PLUMB MECH
a i ' *LZ 1_:_I
s»"
LICENSED CONTRACTOR'S
under
DECLARATION Job Description
1 hereby eflirm that I am licensed under provisions of Chapter.a I in irenic
ag
FH-� with Section 7000)of Diviion3ofthe Businessand Pm=scion Code,ny„d m ,ieen:e EXTEND (E) CMU SOUND WALL.
in fan force and el Lie '
E ce ' License Class Lic.a
Dan, Comructor G
3 a CHITECT'g DECLAR ON /�•
k.p.O g 1 undersn d plans shall W used as public records
ty Y
K:e O Licensed professional
OWNER-BUILDER DECLARATION
`-° 1 hereby affirm that 1 am exempt from the Convacmr'a License law for the
t 3 a following recon(Section 70315,Basinesx and Professions CWe Any city m county $30000
s❑ which requims a permit m net
conm .alter improve,demolish,or repair any strucstructureruc
a- -pre rb is uumme Nwmqdtcapplscantforsuchp itt fl gnednatemem- -
NmhgtslccnscdpuFsurectod(-promons of riteContrmtorL'cen Taw(Chapar9 mea F�rr .F,] rop a t Valuation
(comment with Se to 7000)of Division 3 of the Busmecs, d Professions code) �;LZt-d1.32�3"3�1�q°.:V�r�`i.;12€.t`'. i
Dr that be is'eeempt therefmni and the basis for the alleked"emotion.Any violation
of Section 703L5 by any npplicart for n perron snbjena the applicant in a civil penalty
of omonrethnn five hundred dollar,Sulk). 516AYN TrL BUI LDIN j,:e,.- Occupancy Type
❑I,as owner of the property,or my employees with wag"as their sole compeuation,
-will do the aork.-and the structure is not intended it,offered for al -(Sec 7094, ,
CBus n d Prof Code:Th Contractor'sL' a La tl t apply to an Required Inspections `
owner of property Who Wilds improves thereon,and who does such work himself ,
or through his own employees.provided that such improvements are not intended or _
Fofi red for side!If,however,the f undin8 or itenFrovicrient is gold witun one year of
Completion,the owner h ilder will have the burden f moving that he did not build or
improve for purpose of sale) 11
.�Lax owner of the p pe y am -sc-IJ0 W comrxting
- ro n wnh licensed contract n 10 t
construct the prolecs(Sec 7094,Business and Professions Code)The Connector's
l
T'', License Low do"not apply man owner tit property who builds ed poi,mi thereon,
.
and-whoeters Loc¢for such Projects wish..mntmcmrtsl hcenxed pursuant m the
Cunmcm/a License Taw.
- - ' ❑lam exempt under Secy ' :B&PCfonhk frown ...��` i�iS+-:IDu `
owner,•, ".'I: w t Unit, . ..
WORKER'S COMPENSATION DECLARATION �IVgL.ED
1 hereby effum under penalty of pe jury one of Ne following F
de tiarmions: r
❑ I have and will maintain ii C&rtilicid,'ol"Cbn.sent to .self-insure lir Workers 1 6 2001
Compensation, as provided for by Section 3]00 of the labor ale,Cofor the OCT
'- _ performance of the work(or which this permit is issued. la i
❑1 n and ill m5 to W k}s Comperi,zitionlossrunce,as req 'ted by Saco L..
17M mint,Lidul Conn for the Performance of the work for which no,pe'im,is BUILDING
is u d My W rkeex C mpensation Insurance Carrier and Policy be are
R•bl
Policy Na: V _ n ii ys: 7
;'y Ib: ERTIFICATION OF EXEMPTION FROM WORKERS�i .a•.., d _ s.
t "COMPENSATIONINSURANCE• t
_. ...�.,q,..-.. _. . ..-__._. _ -.___-------._._
e" sQThis union need nos Ce cumpined if the Permit is for one hundred dollars ' - '
-----
("I'dr less.) I�
... ., .., _. -.._v...
Icen Certify that tl PC nee ftM1 kfor h hth Prntl s', d,ll it:+ �(
shall us a ploy a non t 9 t n n to c at I Ys the W k rs I` I
�ppKK� JLe sk��.n Appli6mq /JYL_,1 �.
Con mpaosauo�lafsAal.CW fY//� t
%NOTICET( NT n is Certificate ofE puny should , - t'it
rte om bled m ,e W d,e s Cn pen at on p vdns of tit L ho Code;you muse t
00 forthwith comply with such provisions or tits permit shall be deemed roxmked. 1
CONSTRUCTION LENDING AGENCYt r -
I hereby Rum that theric is a constoctloA lending gen y for the performance t -, Ir '
.L 0 1L+emdacrwsoNrk foar _...__ s. ...._. . .t
". _. ..._... ... .. _
Lender's Address
1 cc
tit tln h11 ppl t n nB.mrcth rthe nbo 'ref rmat an int
�Gr:tti tob t 1 co to.4a ply tit-II 1p, I. Y 1 t d a l -e elupon
.J tobuildingmperty onyamhoratnp csentni res al d,is city menterupm
the bo a mem getd property for spec! p be, _ ._
Woe)agree to ntl oily and keep Aerml"s the City of Cuperi oagainst,
liabilities1 dg encs t rt e pense h a Y y 6 in t idt
U z c ty n c s q cc t g g of fn I t
'{kPPLIC 0r UNDF CAN LY W ITN ALL N P I /
sovxcERfi ova • 9 ,p Issued by: Dale
Ssgruni cofAppf,mdcoa r t";. to . '. Re-roofs
;? ( HAZARDOUSM TERIALSDISCLOSURF - a f
Wut
., theappbcantrtn,mWildingComportst 'orodlnoamdsattdal Type of Roof.,
'Cdbi ed,by tit 3200 Mm P'I Cone Coapt 9.12. dth H hit d5 fry. t,, ;rr + t -
c,wesnnzsz3xm - 'x tpl . f C!'., t 14• _ .. ,_ . ' �,(; . ,c_;.*,. .
ov i ` " 't -..All-roofs shall be inspected prior to any roofing.material.being installed-
Will
ed.... .. ._.
W Il the ppltc ret rfumr ilding occupant use equipment ordevick,which If a roof is installed without first obtainingAn inspection,-[ agree to remove
coot hared T cob m I,u cline by she Bay Area A final by Management p g
DI trct 9 - all new materials for inspection.,Applicant understands and-will comply with
ov :� t No 1, all non-point source regulations. :,,
,1s I h ve atl di hazard a "creak req ems under Chapter 6.95.of the
i is
ult
Ow er I f non& he ti C Sec u the net pr sir m red rat and stand that
/ 5 �t of fy titre _... _ ...-. _
Sections 0 255 a
of then IJ gdce not Indy ha a en m!hot in p sblty
a p m of the requ h' � j9of niEcate of '
_ Signature of Applicant Date
„ Date All roof coverings to be Class `B",o'r better
V OFFICE