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09010098�Op .eW =Z 3F'Lit 1gj Dw 9 96 Z. is y F Ay c acp� k m ft y^fir. –ZY EFC 0Z Z C Lr� UC wF Or- >. O �v U2 CITY OF CUPERTINO BUILDING DIVISION PERMIT �+��+��� .::.... BUILDING ADDRESS: PERMIT NO. 2 INFINITE LOOP DPR CONSTRUCTION OWNER'S NAME: PERMIT ISSUE DATE °r LONE: sXNrtAAU.2CONTROL NO. (650)474-1450 ARCHiTECTlENGiNEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and e%—, —f ADD 1 HANDWASH SINK, 10 SQ License lass Lic. iv Date Jia _Contractor ON ARCshalHITECTS DECLARATIO 1 understand my plans l be used as public records Licensed Professional OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure prior to is issuance, also requires the applicant for such permit to file a signed statement Sq. Ft. Floor Area Valuation that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or $5000 that he is exempt therefrom and the basis for the alleged exemption. Any violation of APN Number Occupancy Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than fire hundred dollars ($500). 31602106 .00 ❑ 1, as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work. and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of q P property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. if, however, the building or improvement is sold within one year of completion, the owner - builder will have the burden of proving that he did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:) The Contractor's Li. cense Law docs not apply to an owner of property who builds or improves thereon, and , who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law. E]I am exempt under Sec B & P C for this reason OwnerDate WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compen- .ion, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain Workers Compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Worker', Compensa 'on insurance carrier and Policy number are: Cartier. A .—A �/ �/1�DJ1 rpoirry No.: L j�I L CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (ibis section need not be completed if the permit is for one hundred dollars ($100) or less.) 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 Workers' Compensation Laws of California. Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lender's Name Lender's Address I certify that i have read this application and state that the above information is cores 1 agree to comply with all city and county ordinances and state laws relating to building construction. and hereby authodre 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 j liabilities, judgments, costs and expenses which may in any way accrue against said City of this permit.DS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date MdR�� Re -roofs S' u for arc Pelican HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant or future building occupant store or handle havardous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Code, Section 25532(a)? All roofs shall be inspected prior to any roofing material being installed. ❑ Yes Wo If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment or devices which til hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. Strict? ❑ Yes �Nu 1 have read the hazardous materials requirements underChaptcr 6.95 of the Califor- nia Health & Safety Code, Sections 25505, 25533 and 25534.1 understand that if the building does o urmntly have a tenant, that it is my responsibility to notify the occupant of the requi inert which must met prior to issuance of a Certifies of Oc ancy. Signature of Applicant Date All roof coverings to be Class'n" or better Owner or t agent Date CITY OF CUPERTINO 5 ITEMS OF 5 PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 31602106.00 DATE ISSUED.......: 01/22/2009 RECEIPT #.........: BS000007020 REFERENCE ID # ...: 09010098 SITE ADDRESS .....: 2 INFINITE LOOP SUBDIVISION ...... CITY .............. CUPERTINO IMPACT AREA ...... OWNER ............: APPLE COMPUTER ADDRESS ..........: 1 INFINITE LOOP CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: patg COPY # : 1 RECEIVED FROM ....: DEREK JENSEN CONTRACTOR .......: NOSLER, PETER C LIC # 13302 COMPANY ..........: DPR CONSTRUCTION INC ADDRESS ..........: 1450 VETERANS BLVD CITY/STATE/ZIP ...: REDWOOD CITY, CA 94063 TELEPHONE ........: (650)474-1450 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ----------------------- 1BCBSC VALUATION ---------- 5,000.00 -------------------- 1.00 0.00 ---------- 1.00 ---------- 0.00 1BPFIXTURE NO OF FIXTURE 1.00 8.16 0.00 8.16 0.00 1BSEISMICO VALUATION 5,000.00 1.05 0.00 1.05 0.00 1PPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 1TRAVDOC FLAT RATE 1.00 40.79 0.00 40.79 0.00 TOTAL PERMIT ---------- ---------- 91.79 0.00 ---------- 91.79 ---------- 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- CREDIT CARD 91.79 -------------------- MC --------------- TOTAL RECEIPT 91.79 CITY OF ''UPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRE,,5,S: 24-,(A � ,z" I---- PERMIT # ?c/2 OWNER'S NAME: PHONE # GENERAL CONTRACTOR: FAX # I am not using any subcontractors: Signature Please check annlicable subcontractors and comvlete the following information: Date er ntractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile er ntractor Signature Date k it CITY OF CUPEkTINO CITY OF CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM APN !-�iD 0 0 Date: � I,ZZ 10ri Building Address: f N Flll%'jZ;- LO [i Op C 0 YL72- T1 rV v &A Mailing Address (if different from building address): Owner's Name: �L — :,�-- Phone #: u®43 Lc i Contractor: Phone: . ©`� � �Z `� �? P k C00s'C (--0LTI0 � `moi L- � Fax: (04� 3; I'O-��(Z� Contractor License #: �; 61cij ja Lf/0 Cupertino Business License #: Contact:_ Phone: z;7-07>� �-(/ Z Residential ❑ Commercial Job Description: Building Permit Info: Bldg ❑ Elect ❑ Plumb Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B L3 II/III/V-A ❑ II/III B, IV -HT, V -B ❑ Valuation: Square Footage: rd Project Size: Express Standard la Large ❑ Major ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it to the application or if applicable, include in plan set & the sheet index. Points Achieved: For help, contact Build it Green at www.buflditgreen.org Revised 01/07/09 al"N" CITY OF CUPEkTINO CITY OF CUPERTINO GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Group Permit Type 1GENRES or 1GENCOM 1STUCOAP Stucco Applications (up to 400 sf) additional stucco application B 1 WINREP Replacement windows/sliding glass door (ea 8 windows) B 1 WINMEWSTR New Window -structural shear wall/masonry (includes plan ck fee) B 1 EPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M 1 PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min when not over counter) Standard Plan Check (when no E/M/P) hourly -stand alone B 1BCBSC Cal Bldg Standards Commission Fee B ALL PERMIT TYPES 1BSEISMICR Seismic Residential B / 1BSEISMICO Seismic Commercial B 1 TRAVDOC Travel & Documentation B 1BUSLIC Business License B pr Thd- f 5 of 1. Use Lo*WVOC PArd 2. Use Low VOC, Water -Based Wood Finishes 3. Use Low/No VOC A&Wves 4. Use Salvaged Materials for Interior Finishes 5. Use Engineered Sheet Goods with no added Urea Formaldehyde 6. Use Exterior Grade Plywood for Interior Uses 7. Seal all Exposed PArWeboand,or.MDF 8. Use FSC Certified Materials for Interior Finish 9. Use Finger -Jointed or Recycled -Content Trim 10. Install Whole House Vacuum System N. Flooring 1. Select FSC Certified Wood Flooring 2. Use Rapidly Renewable Flooring Materials 3. Use Recycled Content Ceramic Tiles 4. Install Natural Linoleum in Place of Vinyl 5. Use Exposed Concrete as Finished Floor 6. Install Recycled Content Carpet with Low VOCs Total Points Available: Total Points Pro'ect Received: 1 IAQ/Health pts y --yes 21AQ/Health pts y=yes 31AQ/Health pts y=yes 3 Resource pts y --yes; 61AQ/Health pts y=yes 1 IAQ/Health pts y=yes 41AQ/Health. pts y=yes 4 Resource pts y=yes 1 Resource pts y --yes 3 IAQ/Health pts y=yes 8 Resource pts y=yes 4 Resource pts y=yes 4 Resource pts y=yes 5 IAQ/Health pts y=yes 4 Resource pts y=yes 4 Resource pts y=yes 1401 130 57 01 01 0 i 1 2-10" G:datalpropslgreenbuildngguidelineslremodelerslgreenpointsfina12.12.04protected.xis