Loading...
09090210 I ;lJ3 `u � I I IHS+I I I I I III Idl � u � F x � Q1 O A O v ti O ti Lb d O O 0 U p a LiJ F O LLL 1 U O? o w Z W Lb pq F PG H F O U J P7 [G Q I P4 W W E!] O Lr-I S F S O ti H cn o a Z � ;2;w W U J U a o a LO z W W 'D Q7 ON J U w a O ]L co \ Ql m O LD z O W N Um LO a O N S m - O N O? N O .-I J) W _ W 0 -0 CD 00 O d � LO CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: NW CORNER STEVENS CREEK BLVD @ FINCH CONTRACTOR:TBD-TO BE DETERMINED PERMIT NO:09090210 OWNER'S NAME: 500 FORBS,LLC DATE ISSUED:09/29/2009 OWNER'S PHONE: 6503441500 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT F PLUMB License Class Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:SEASON SAKS PUMPKINS-PERMIT GOOD THRU (commencing with Section 7000)of Division 3 of the Business&Professions 10/2/09 Code and that my license is in full force and effect. THRU 10/31/09;CONTRACTOR ABC TREE FARMS LLC GOOD THRU 12/29/2009 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 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 Sq.Ft Floor Area: Valuation:$2000 permit is issued. APPLICANT CERTIFICATION APN Number:31620085.PMKN Occupancy Type: I certify that I have read this application and state that the above information is correct.1 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature Date Issue y: f ►�n s• Date: Z 115 ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Scc.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent tJ self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should 1 use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall 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 Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,1 must O ner or authorized a forthwith comply with such provisions or this permit shall be deemed revoked. t Date: Ct I lJ 1 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address 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 oint source regulations per th Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18• ^ I understand my plans shall be used as public records. f Signatu ate Licensed Professional E CITY OF CUPERTINO TEMPORARY PERMIT CUPERTINO PERMIT APPLICATION FORM APN # n Date: Original Permit# Building Address: NW Olpi-ncv, Owner's Name: Pho e#: , 00 _cN kis (C,,50\_2YL4 15CO Contractor: 4 9 Phon #: 503 �p U � LL- �5 Fax#: Contact: Phone#: Contractor License #: Cupertino Business License#: ��5� cD w9 Job Description: b kak it vz Valuation (cost of project): Type of Construction: Project Size: Over the Counter Quantity Fee ID Fee Description Fee Group Permit Type 1TEMPPMT Temporary Permit Good B 1TEMPPMT Z. (Flat Fee) for 30 days —Commercial — only. 1BCBSC Cal Bldg Standards B ALL PERMIT Commission Fee TYPES 01/07/09 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: N W CORNER STEVENS CREEK BLU @ FINCH CONTRACTOR:TBD-TO BE DETERMINED PERMIT NO:09090212 OWNER'S NAME: 500 FORBES LLC DATE ISSUED:09/29/2009 OWNER'S PHONE: 6503441500 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELECT I— PLUMB f License Class Lic.# MECH F_ RESIDENTIAL f— COMMERCIAL Contractor Date hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:TEMP PERMIT FOR SEASONAL SAKS OF (commencing with Section 7000)of Division 3 of the Business&Professions CHRISTMAS TREES- Code and that my license is in full force and effect. PERMIT GOOD 11/25 THRU 12/24;CONTRACTOR ABC TREE FARMS LLC GOOD THRU 12/29/2009 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 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 Sq.Ft Floor Area: Valuation:$1000 permit is issued. APPLICANT CERTIFICATION APN Number:31620085.XMAS Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN,180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature Date Issu by: Date: ❑ OWNER-BUILDER DECLARATION ROOFS: I hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to anyy roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&, Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air 1 certify that in the performance of the work for which this permit is issued,1 shall 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 Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,1 become subject to the Worker's Compensation provisions of the Labor Code,1 must O ner or authorized a e t: ( � forthwith comply with such provisions or this permit shall be deemed revoked. Date:_ rj �_ APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address 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 ARCHITECT'S DECLARATION 9.18. 1 I understand my plans shall be used as public records. Signatur Licensed Professional ]IM (:)q D 9 c) CITY OF CUPERTINO TEMPORARY PERMIT CUPEIVTINO PERMIT APPLICATION FORM -aq -0 APN# (D2, 0 08�5, X(rA-5 Date: � �. O9 Original Permit# Building Address: tQw 0 fy\<_y-- NoA t C1 Owner's Name: Phone #: 8W Tv Y bcs Contractor: Phone#: 5a:?) 14 bC-Tre--c`T6U_ryA S_1 Fax#: 5 G k!�:) Contact: Phone#: rVA 0- 503 Contractor is se #: Cupertino Business License #: (� � Job Description: `7 e_cuccs.( ks © o.5 �c_S cD5- peg �1 Valuation (cost of pr t): Type of Construction: QUO ojec X60,00 Project Size: Over the Counter Quantity Fee ID Fee Description Fee Group Permit Type 1TEMPPMT Temporary Permit Good B 1TEMPPMT (Flat Fee) for 30 days —Commercial only. I 1BCBSC Cal Bldg Standards B ALL PERMIT Commission Fee TYPES 01/07/09