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11010140CITY QF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10500 N DE ANZA BLVD FLR 1 CONTRACTOR.. DEVCON PERMIT NO: 11010140 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 03/09/2011 OWNER'S PHONE: 4088629799 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT F PLUMB F_ License Class B Lic.#11/ � ry r- F ! Mt MECH RESIDENTIAL COMMERCIAL Contractor f tlM 1%/y�✓ d Date 3 JOB DESCRIPTION: TI, 3016 SF, FLOOR 1, INCLUDES FOUR NEW EQUIPMENT I hereby affirm that I am licensed under the provisions of Chapter 9 CHAMBERS, OFFICES, AND MEETING ROOM. NO EXTERIOR (commencing with Section 7000) of Division 3 of the Business.& Professions WORK OR ROOF MOUNTED EQUIPMENT, INCUDES 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 of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $450000 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 tt is APN Number: 31622017.FLRI Occupancy Type: permit is issued.[dI/ APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter 180 DAYS FROM LAST CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, may accrue against said City in consequence of the costs, and expenses which Issued by:`' Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulati ns per the Cupertino Municipal Code, Section 9.18. -- / Signatur Date �1 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the is issued. air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Mu icipal Code, Chapter 9.12 and performance of the work for which this permit 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 the Health & Safety Code, Sections 25505, 2553 , and 25534. / Owner or authorized agentl� _ Date: ✓ ll 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, must work's for which this permit is issued (Sec. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked, Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO BUILDING PE : i ` F `I _- -5-� BUILDING ADDRESS: 10500 N DE ANZA BLVD FLR 1 CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 11010140 OWNER'S NAME: APPLE INC 1690 GIBRALTAR DR I DATE ISSUED: 03/09/2011 OWNER'S PHONE: 4088629799 ! MILPITAS, CA 95035 1 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION License Class ':S� — f Lie. # Contractor Date 1 ' I hereby affirm that I am licensed under the provision 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 declarat 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. 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. ❑ 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 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. BUILDING PERMIT INFO: BLDG~ ELECT' PLUMBN MECH r RESIDENTIAL COMMERCIAL JOB DESCRIPTION: TI, 3016 SF, FLOOR 1, INCLUDES FOUR NEW EQUIPMENT CHAMBERS, OFFICES, AND MEETING ROOM. NO EXTERIOR WORK OR ROOF MOUNTED EQUIPMENT, INCUDES Sq. Ft Floor Area: Valuation: $450000 APN Number: 31622017.FLR1 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 YS OF PERMIT ISSUANCE OR 180 DAYS M LAST CALLED INSPECTION. Issued by: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 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(x) 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. Owner ',% Dater CONSTRUCTION LENDING AGENCY I her y affirm that there is a construction lending agency for the performance of "Nork's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Date ' Licensed P 94 CITY OF CUPERTINO BUILDING PERMI BUILDING ADDRESS: 10500 N DE ANZA BLVD FLR I CONTRACTOR: DEVCON 10140 CONSTRUCTION INC OWNER'S NAME: APPLE 690 GIBRALTAR DR DATE ISSUED: 03/09/2011 OWNER'S PHONE: 4088629799 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION License Class Lic. # 4 `� > BUILDING PERMIT INFO: BLDG ELECT PLUMB (w { / j - ' i f / 0/L/3 Date / � I , MECH RESIDENTIAL COMMERCIAL Contractor -✓ t -i JOB DESCRIPTION: TI, 3016 SF, FLOOR 1, INCLUDES FOUR NEW EQUIPMENT I herebyaffirm that I am licensed under the provisions of Chapter 9 p p CHAMBERS, OFFICES, AND MEETING ROOM. NO EXTERIOR (commencing with Section 7000) of Division 3 of the Business & Professions WORK OR ROOF MOUNTED EQUIPMENT, INCUDES Code and that my license is in full force and effect. 6/1/11-DEF#1 -DEFERRED SUBMITTAL FOR INSTALLATION OF I hereby affirm under penalty of perjury one of the following two declarations: TESTING CHAMBERS AT 1 ST FLOOR LAB-ISSD 8/4/2011 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 Sq. Ft Floor Area: Valuation: $450000 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 APN Number: 31622017.FLR1 Occupancy Type: permit is issued.1 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS, FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, t r t I costs, and expenses which may accrue against said City in consequence of the Issued by: Date. granting of this permit. Additionally, theapplicant understands and will comply with all non -point source reiulations,460lic Cupertino Municipal Code, Section , 9.18. C/ 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. t. ❑ OWNER-BUILDER`DECLARATIbN Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (See.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Muniyipal Code, Chapter 9.12 and 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 the Health & Safety Code, 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date __ ___ _ CITY OF CUPERTINO FFF FSTIMATOR — BUILDING DIVISION ikADDRESS: 10500 n de anza blvd. TYPE OF CONSTR. DATE: 06/01/2011 REVIEWED BY: bobs. -N, APN: BP#: BP FEE ID "VALUATION: 1$3,000 11 "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: iwi .':/{:'C;. iWyp' 0.0 PENTAMATION 1GENCOM PERMIT TYPE: WORK deferred submittal for installation of testing chambers at 1st floor lab. SCOPE $0.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID i>£ $0.00 0 hours Plan Check, Hourly $378.00 STPLNCK I ETo iwi .':/{:'C;. iWyp' 0.0 lirs Deferred Submittal (Not R-3) II-B,111-B,IV,V-B 0 $0.00 $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT Fo.0 firs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 0 $0.00 � `f?Dd4'8'r"IZi%{riser �F7;' $0.00 MECH, HOURLY 0 Yes G) No PLUMB, HOURLY 0 Yes Q No ELEC, HOURLY 0 Yes Q No %E4. fl P', s,fFi.. j- r�t?trs�], t 'r (. fs;:'r,:C £ � .1'1£771 i.r .,, Plan Check Fee: Hourly Only? 0 Yes i>£ $0.00 0 hours Plan Check, Hourly $378.00 STPLNCK I ETo iwi .':/{:'C;. iWyp' 0.0 lirs $0.00 NOIT+ - Thove tooc aro hncod nn tho nrolinjinary information availahle and are Only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 09-051 E '. 711110) FEE QTY/FEE77 MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (D No $0.00 0 hours Plan Check, Hourly $378.00 STPLNCK I Suppl. PC Fee: G Reg. 0 OT 0.0 lirs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT Fo.0 firs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 � `f?Dd4'8'r"IZi%{riser �F7;' Acoustical Fee: 0 Yes 0 No $0.00 0 0 Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: $0.00 Select a Non -Residential 0 Building or Structure 0 i 7 u,:a<:rrrF<srr<r�acsrr 1� c'as Strong Motion Fee: IBSEISMICO $0.63 2.0 firs Inspections $252.00 IINSPMIS Standard Inspections Bldg=, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.63 $630.00 TOTAL FEE: $631.63 Revised: 04/29/2011 CITY OF CUPERTINO (� FEE ESTIMATOR - BUILDING DIVISION' 19 ADDRESS: 10500 n. de anza blvd 1st floor DATE: 03/09/2011 REVIEWED BY: bobs. APN: BP#: 11010140 "VALUATION: 1$2,000 rPERMIT TYPE: Building Permit _717PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: Suppl. PC Fee: 0 Reg. .0 OT0.0 PENTAMATION PERMIT TYPE: WORK revise offices path of travel wheel chair lift fill -n exterior storefront doors. SCOPE NnTF,- These fees are hased on the nreliminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolutioli 09-05I Ef. 7/1/101 c-r.iF F'rz�.rrt t ��eC1f: 11., >;; r wi h" ch MISC ITEMS Plan Check Fee: Plti'i' aPc`jf. x'FhS�t, )r°ir�c'i' t'f{t'tt�7 ]1?.iii. 0 11 A"erc t A"?,p; Ff;i'.; Suppl. PC Fee: 0 Reg. .0 OT0.0 NnTF,- These fees are hased on the nreliminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolutioli 09-05I Ef. 7/1/101 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. .0 OT0.0 his $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Ta Acoustical Fee: 0 Yes (F) No $0.00 0 Work Without Permit? 0 Yes 0 No $0.00) Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 A T -,,,v >I :: t:rrrrat>rtr rPil:�7t I'' e� _ Strong Motion Fee: 1BSEISMICO $0.50 1 # $760.00 Revision IREVCOMTI Tenant Improvement Bldg Stds Connnission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $760.00 TOTAL FEE: 1 $761.50 Revised: 01/15/2011 __ _ _ _ CITY OF CUPERTINO r. � FEE ESTIMATOR — BUILDING DIVISION 19, ADDRESS: 10500 n. de anza blvd. 1st floor DATE: 01/26/2011 REVIEWED BY: bob s. PC FEE ID APN: BP#: *VALUATION: 1$450,000 FPERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARYPENTAMATION Commercial Building IBTIPLNCK 1 B TI USE: Elec, Lisp. F(7c: PERMIT TYPE: WORK office/labs ace structural include M E no plumbing. �Ucpommercial SCOPE Permit Fee: OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) I-A,I-B 3,016 $3,160.80 IBTIPLNCK $3,577.84 IBTIINSP Elec, Lisp. F(7c: PME Plan Check: $0.00 Permit Fee: $3,577.84 Suppl. Insp. Feel@ Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 3,016 $3,160.80 Con.ctruction Tax 1 $3,577.84 MECH, HOURLY 0 Yes (F) No PLUMB, HOURLY 0 Yes Q No ELEC, HOURLY 0 Yes 0 No Lkzch. Pfcua C'hcclr plumb. Pfim OwN, LYec, Plali Chcch 1,&>ch, Permil Fel" PTmrrb. Peron Frc: Lhec, Peouil er Hech. h -up. L Ol1av Phunb Irisp.L] Other Elco. Nish. ch. Lash. f (-:e: Phmnb. Nish. Fe,,: Elec, Lisp. F(7c: T7nTP+. Tl..,a., f — nrn Anand nn foo nrvlis»innry infnrnfnllnn nvnilnhly moil an, nnly an PsthnOiP_. Contact the Deur for addlll'l into. FEE ITEMS (Fee Resolution 09-051 Eff. 711/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,160.80 Select a Misc Bldg/Structure or Element of a Building , Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $3,577.84 Suppl. Insp. Feel@ Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Con.ctruction Tax Acoustical Fee: 0 Yes No $0.00 0 0 Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 i Tr(wel Docro),lerdotion F(res: Strong Motion Fee: IBSEISMICO $94.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $18.00 SUBTOTALS: $6,851.14 $0.00 TOTAL FEE: $6,851.14 Revised: 01/15/2011