11030109CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:20650 VALLEY GREEN DR CONTRACTOR:DEVCON PERMIT NO:11030109
CONSTRUCTION INC
OWNER'S NAME:APPLE INC 690 GlI3RALTAR DR DATE ISSUED:06/10/2011
OWNER'S PIIONE:4089961010 MILPITAS,CA 95035 PHONE NO:(408)942-8200
I~LlCENS[()CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL 0 COMMERCIAL 0
COMM T.I INTERIOR BUILD OUT OF ACOUSTIC LAB TO
License Class ~Lic.#S11/~INCLUDE (M,E)3,018 SQ IT
Contractor Tk;J<CN ODNSfDate .
I herehy affirm that I am licensed under the pruvisions of Chapter 9
(commencing with Section 7000)of Division 3 of Ihe Business &Professions
Code and that my license is in full force and effect.
1 herehy affirm under penalty of perjury one of the following two declarations:Sq.Ft Floor Area:Valoation:$650000
1.I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Seetion 3700 of the Labor Code,for the APN Number:32610053.00 Occupancy Type:
performance of the work for which this permit is issued.
2.1 hewe and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 ofthc Labor Code,for the performance of the work for which this
permit is issued.PERMIT EXPIRES IF WORK IS NOT STARTED
APPLICANT n:RTIFICATlON ~~WITHIN 180 DAYS OF PERMIT ISSUANCE OR
I ccrtify that I have read this application and state that thc above informati is 180 DAYS FROM LAST CALLED INSPECTION.
correct.I agree to comply with all city and county ordinances and slate laws relating
to building eonstruction,and hereby authorilc representatives of this city to enter
Issued bYi',/-~--y C/~Y(upon the above mentioned property for inspection purposes.(We)agree to save Date:
indemnify and keep harmless the City of Cupertino against liabililies,judgments,
costs,and expenses which may ~cruc against said City in consequence of the
granting of th~~,t.f\ddition II ,the applicaJ1l understands and will comply with RE-ROOFS:all non-poi~s e reg lotio s p the Cupertino MuniciPalJde,~ection 9.18.All roofs shall be inspected prior to any rooflllg material being installed.If a roof is
Signature\'Ill.1\_~Date GI\ls \1 installed without first obtaining an inspection,I agree to remove all new materials for
~v~~'\.\inspection.
0 OWN .R-BUILDER DECLAR~TION Signature of Applicant:Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A"OR BETTER
the following two reasons:
1.I,as owner of the property,or my employees with wages as their sole
HAZARDOUS MATERIALS DISCLOSUREcompensation,will do the work,and the structure is not intended or offered for
sale (Sec.7044,Business &Profcssions Code)I have read the hazardous materials requirements under Chapter 6.95 of the
2.L as owner of the property,am exclusively contracting with licensed contractors to California Health &Safety Code,Sections 25505,25533,and 25534.I will maintain
construct the project (Sec 7044,Business &Professions Code).compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health &
Safety Code,Section 25532(a)should I store or handle hazardous material.
I hereby affirm under penalty of perjury one of the following three declarations:Additionally,should I use equipment or devices which emit hazardous air
1 I have and will maintain a Ccrtilicate of Consent to self-insure for Worker's contaminants as defined by the Bay Area Air Quality Management District I will
Compensation,as provided for by Section 3700 of the Labor Code,for the maintain eompliane with the Cupertino Municipal Code,Chapter 9.12 and the
performance of the work for which this permit is Issued.~Safe Co",Sections 25505,25533,and 25534.
2.I have and will maintain Worker's Compensation Insurance,as provided for by wn o\'''lh r;ze .gent:~:~
Section 3700 of the Labor Code,for the performance of the work for which this \IU~I,Date:\
permit is issued.hON;RlJ~N LENDING AGENCY3Icertifythatintheperformanceoftheworkforwhichthispermitisissued,I shall
not employ any person in any manner so as to become subject to the Worker's
I hereby affirm that there is a construction lending agency for the performance of work'sCompcnsa'ion laws ofCalifomia.If,after making this certificate of exemption,I
becomc subject to Il,e Worker's Compensation provisions oflhe Labor Code,I for which this permit is issued (Sec.3097,Civ C.)
Lender's Name
must forthwith comply with such provisions or this permit shall be deemed
revoked.Lender's Address
APPLICANT CERTIFICATION ARCHITECT'S DECLARATION
I certify that I have read this application and state thal the above information is .I understand my plans shall be used as public records.correct.I agree to comply wilh all city and county ordinances and slale laws relating
to building construction,and hereby authorize representatives of this eity to enter Licensed Professionalupontheabovementionedpropertyforinspectionpurposes.(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 Cupcrtino Municipal Code,Scction 9.18.
Signature Date
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20650 VALLEY GREEN DR
O!' I'S NAME: APPLE INC
OWNER'S PHONE: 4089961010
❑ LICENSED CONTRACTOR'S DECLARATION
License Class___.__ Lic. #
Contractor � � rn�J_C*Date I
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 declar
PTI
1 have and will maintain a certificate of consent to self -insure for Worker'.
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 th' permit. Additional) , the applicant understands and will comply
with all non- p t sour1111
egulati per the Cupertino Municipal Code, Section
9.18. �/1l
CONTRACTOR: DEVCON CONSTRUCTION
INC
690 GIBRALTAR DR
PERMIT NO: 11030109
DATE ISSUED: 06/10/2011
MILPITAS, CA 95035 I PHONE NO: (408)942-8200
BUILDING PERMIT INFO: BLDG ELECT r- PLUMB
MECH r RESIDENTIAL I— COMMERCIAL
JOB DESCRIPTION: COMM T.I INTERIOR BUILD OUT OF ACOUSTIC LAB TO
INCLUDE (M,E) 3,018 SQ FT /
* Ilt 4wd - & -0 0
Sq. Ft Floor Area: I Valuation: $650000
APN Number: 32610053.00 I Occupancy Type:
❑ OW ER-BUILVER
1 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).
1 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, 1 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
-on the above mentioned property for inspection purposes. (We) agree to save
emnify 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.
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: ��—`�— f� �` Date: 6f
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, 2.5533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should 1 store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by t Bay Area Air Quality Management District I will
maint ' compliance with th Cupertino Municipal Code, Chapter 9.12 and the
Heal & afety C e, Sec s 25505, 25533, and 25_ 4.
Owner o ut o iz d agen 1 I
Date: /
v
I hereby affir 1 that there is a construction lending agency for the performance of work's
for which thi 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.
gionature Date - I Licensed Professional.
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:20650 VALLEY GREEN DR =-£ONTRACTOR:DEVCON PERMIT NO:11030109
CONSTRUCTION INC
OWNER'S NAME:APPLE INC 690 GIBRALTAR DR DATE ISSUED:06/10/2011
OWNER'S PIIONE:4089961010 MILPITAS,CA 95035 PIIONE NO:(408)942-8200
0 LICENSED CONTMCTOR'S DECLARATlOi\'JOB DESCRIPTION:RESIDEi\'TIAL 0 COMMERCIAL 0
COMM T11NTERIOR BUILD OUT OF ACOUSTIC LAB TO
License Class Lic.#INCLUDE (M,E)3,018 SQ IT
Contractor Date
6/10/1 I DEFERRED SUBMITI AL #I-2 ACOUSTIC CHAMBERS,STRUCTURAL.ISSUED
6/29/11
I hereby affirm that I am licensed under thc provisions of Chapter 9
(commencing with Seelian 7000)of Division J of the Business &Professions
Codc and that my license is in full force and eITect.
I hereby affirm under penalt)'of perjury one of the following two declarations:
1.I have and will maintain a certificate of consent to self-insure for Worker's Sq.Ft Floor Arca:Valuation:$650000
Compensation,as provided for by SecLion 3700 of the Labor Code,for the
pcrfonnancc of the work for which this permit is issued.
2 I have and will maintain Worker's Compensation Insurance,as provided for by APN Numbcr:32610053.00 Occupancy Type:
Section 3700 ofLhe Labor Code,for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION PERMIT EXPIRES IF WORK IS NOT STARTED
I cenify that I have read this applieaLion and state that the above information is WITHIN 180 DAYS OF PERMIT ISSUANCE ORcorrect.I agree to comply with all city and county ordinances and state laws relating
1O building construction,and hereby authorize representatives of this city to enter 180 DAYS FROM LAST CALLED INSPECTION.
upon the above mentioned propeny for inspection purposes.(We)agree to savc
indemniry and keep harmless the CiLy of Cup enina against liabilities,judgments,
costs.und expenses which may accrue against said City in consequence of the Issued by:Date:
granting of this permit.Addition.lly,the applicant understands and will comply with
all non-point source regulations per the Cupenino Municipal Code,Section 9.I8.
Signature Date RE-ROOFS:
All roofs shall be inspected prior La any rooting maLerial being installed.If a roor is.
installed without first obtaining an inspection,I agree to remove all new materials for
0 OWNER-BUILDER DECLAMTION
inspection
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applic.nt:Datc:
the following two reasons:ALL ROOF COVERINGS TO BE CLASS "A"OR BETTER,.I,as owner of the propeny,or my employecs with w.ges as their sale
compensation,will do the work,and the structure is not intended or offered for
sale (Sec.7044,Business &Proressions Code)HAZARDOUS MATERIALS DISCLOSURE
2.I,as owner of the property,am exclusively contracting with licensed contractors LO
consLrucL the project (See.7044,Business &Professions Code).I have read the hazardous materials requirements under Chapter 6.95 of the
California lIealth &Safety Code,Sections 25505,25533,and 25534.I will maintain
I hereby affirm under penalty of pcrjury onc of thc following throe dcclarations:compliance with thc Cupcrtino Municipal Code,Chapter 9.12 and the Hcalth &
1,I have and will maintain a Certificate of Consent to self-insure for Worker's Safcly Codc,Scction 25532(a)shoold I storc or handlc hazardou,material.
Compensation,as provided for by SecLion 3700 ofLhe Labor Code,for the
Additionally,should I use equipment or devices ",,'hich emit hazardous air
contaminanls as defincd by the Day Arca Air Quality Management Ilistrict I will
perfonnance of the work for which this 'permit is issued.m:Jintain compliance with the Cupertino l\'lunicipal Code,Chapter 9.12 and Ihe
2.I have and will maintoin Worker's Compensation Insurance,as provided for by Health &Safcty Code,Scctions 25505, 25533,and 25534.
Section 3700 of the Labor Code,for the'performance of the work for which this
permit is issued,Owner or aUlhorized agenl:
3.I cenify that in the performance of the work for which this permit is issued;I shall Datc:
not employ any person in any manner so as to become SUbject to the Worker's
Compensation laws of California.If,after making this eertilicate of exemption,I CO;,\STIWCTlON LENDING AGEi\'CY
become subject to the Worker's Compensation provisions of the Labor Code,I I hereby affirm that there is a consLruction lending agency for the performance of work's
must fonhwith comply with soeh provisions or Ihis permit shall be deemcd for which this permit is issued (Sec.3097.Civ C.)
revoked.Lender's ~ame
Lender's Address
APPLICANT CERTIFICATION
I certify that I have read this application and stale thalthe above information is
ARClIlTECrS DECLARATIONcorrectIagreetocomplywithallcityondcountyordinancesandstOlelawsrelating
to building construction.and hereby authorize representatives or this city to entcr I undersLand my plans shall be used as public records.
upon the above mentioned propeny for inspeeLion purposes.(We)agree to save
indemnify and keep harmless the City of Cupen ina against liabilities.judgments,Licensed Professional
costs,and expenses which may al.:crue against soid City in conscquence of the
~!LeJcf-'(Y"~granting of this permit.Additionally,the applicant understands and will comply with
all non-poinL source regulations per the Cupenino Municipal Code,Section 9.I8.
Signature Date S!~
T 0CITYOFCUPERINm .,
FEE ESTIMATOR -BUILDING DIVISION
ADDRESS:20650 valley green I.DATE:06/10/2011 REVIEWED BY:bob s.
APN:~~-/I)-os 31 BP#:. ,{J(J ('jv/b'J.'VALUATlON:1$250,000 I
*PERMIT TYPE:Building Permit I PLAN CHECK TYPE:Tenant Improvement
PRIMARY Commercial Building I PENTAMA TION 1GENCOMUSE:PERMIT TYPE:
WORK defer 2 acoustic chambers structural.
SCOPE
i\fe,h Plmr Cht.'L.'k I I PlwJfh Plan Clrec;k I I Elc!('.Pia1/Cru;'d"I I
I ,1,.le::h.!Jermf£Fe/!:I P!umh.Permit Fee:I E!<:.'c.Pe(;7:;z F~:e:
(il;"".11,"';'Insp.D IL-__-I (J11t"r Pl"m!!/,,-,1'.D IL-__-I Oil",,'C/.":l;/.,j).U IL-__-I
~~~il.~~~~1~ll~~.fu':~~~t~:
NOTE:These fees are based on the Dreliminarv information available and are onlv an estimate.Contact the DeDt for addn 'I info.
FEE ITEMS (Fee Resolution 09-051 Eff 7/1//01 FEE QTY/FEE MISC ITEMS
Plan Check Fee:Hourly Only?0 Yes 0 No $0.00 I 4 I hours Plan Check,Hourly
Suppl.PC Fee:o Reg.o OT I 0.0 I hrs $0.00 $504.00 ISTPLNCK I
PME Plan Check:$0.00
Permit Fee:$0.00 I
Suppl.Insp.Fee:€>Reg.o OT I 0.0 I hrs $0.00
PME Unit Fee:$0.00 1
PME Permit Fee:$0.00
C'onstrllctioN Tax I I I
Acoustical Fee:aVes 0No $0.00 a
Work Without Permit?aVes 0No $0.00 I 0
Planning Fee:$0.00 Select a Non-Residential 0
Travd Doell/nenwlio/!Fcc:s:
1
Building or Structure 0
~
Strong Motion Fee:lBSEISMICO $52.50 4.0 I hrs Inspections
Bldg Stds Commission Fee:lBCBSC $10.00 $504.00 llNSPM1S 1 Standard Inspections
SUBTOTALS:$62.50 $1,008.00 TOTAL FEE:I $1,070.50
Revised:04/29/2011
CITY OF CUPERTINOgFEEESTIMATOR-BUILDING DIVISION
ADDRESS:20650 valley green dr DATE:03/24/2011 REVIEWED BY:bobs.
APN:I BP#:·I/O:'D(<J 1.'VALUATlON:1$650,000 1
"PERMIT TYPE:Building Permit !PLAN CHECK TYPE:Tenant Improvement
PRIMARY Commercial Building I
PENT AMA nON 18 TIUSE:PERMIT TYPE:
WORK T.!.interior build out of acoustic lab includes struct.(El,(Pl.
SCOPE
TYPE OF FLRAREA .
OCCUPANCY TYPE:CONSTR.(s.f.)PC FEES PC FEEID BP FEES BPFEEID
8 (Tenant Improvements)II-B,III-B,IV,V-B 3,018 $2,107.20 IBTJPLNCK $2,385.56 IBTIlNSP
TOTALS:3,018 $2,107.20 ,''"$2,385.56 ,,".,
MECH,HOURLY.0 Yes 0 No PLUMB,HOURLY 0 Yes 0 No ELEC,HOURLY.,P:YeS 0No
\}i.·.dl.praJ!('h::.'dc I I Phi/ilb.P/r;r ChecK I I fU(~i:.P!~1!!Ch::;',J I I
r :'j,..!t.';f.;k Pern:;;,1";"'c:IPfund!.Pei77!{t !';(~(~:I E/(,'<..'.P(:rn'z!!r~:'(~:
(}!iii'i'"kelt.1;;,i'.U IL-__-I Or!".:i'u",h !ilSp.U IL--__-I Ol/'e>"!:ic"iii'}).0 IL __---J
NOTE:Tltese tees are hased on tlte preliminary information ami/able and are onlv on estimate.Contact the Dept for addn 'I info.
FEE ITEMS (Fee Resolution 09-051 Eff 7/1/101 FEE QTY/FEE MISC ITEMS
Plan Check Fee:$2,107.20 Select a Misc Bldg/Structure
o Reg.o OT I 0.0 I hrs
,
$0.00 I or Element of a BuildingSupp!.PC Fee:
PME Plan Check:$0.00
Permit Fee:$2,385.56 \
Supp!.Insp.Fee:0 Reg.OOT I 0.0 I hrs $0.00
PME Unit Fee:$0.00 I
PME Permit Fee:$0.00
COllstrucfiun 1"(,":<"I I I
Acoustical Fee:o Yes 0No $0.00 0
Work Without Permit?o Yes 0No $0.00 I 0
Planning Fee:$0.00 Select a Non-Residential 0
Ih'{ve!.!)ocnrnenfatiol1.FCtfs:I Building or Structure 0
A
Strong Motion Fee:1BSEISMlCO $136.50 Select an Administrative Item
Bldg Stds Commission Fee:IBCBSC $26.00 I
SUBTOTALS:$4,655.26 $0.00
....
....~.TOTAL.FEE:I $4,655.26...
Revised:03/0112011