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12040048CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10475 BANDLEY DR CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 12040048 INC OWNER'S NAME: DEAN & PING TSAO FMLY LTD ET AL 690 GIBRALTAR DR DATE ISSUED: 08/29/2012 OWNER'S PHONE: 4089745662 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION License Class _-11 Lic.# Contractor Y'C:JQ r ML&S�— Date 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 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. 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 acc against said City in consequence of the granting of this permit. Additio y, the applicant understands and will comply with all non -point source re ' ations per the Cupertino Municipal Code, Section 9.18. Signature Dat ❑ -"' 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) 1, 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. Signature Date BUILDING PERMIT INFO: BLDG r ELECT F PLUMB r MECH r— RESIDENTIAL r— COMMERCIAL I JOB DESCRIP'T'ION: APPLE -TENANT IMPROVEMENT(]2,143SQFT) OFFICE/LABS INCLUDES STRUCTURAL,MECHANICAL,ELECTRICAL & PLUMBING ADD (3) AIRHANDLING UNITS AT EXISTING Sq. Ft Floor Area: A Valuation: $1250000 APN Number: 32633111.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued �� Date4�Z4---/ I- RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove al I 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, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) 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 de, Sections 25505, 25533, and 25534. Own Date CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPUCATION L01 COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 ^ FAX (408) 777-3333 ^ buildinc0cupertino.oro ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROTECT ADDRESS Qq OWNER E PH E-MAIL STREETADDRESS CITY, STATE, ZIP FAX CONTACT NAME ® PHONE E-MAIL /IL ^ ~ l a STREET 6,DDRESS „ . _ _ CITY, STATE, ZIP I FAX R ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAM LICENSE ER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX n) 1/ : M ) T 111lx%� IA4t4- ta..v n 41.,:. t --,n I 'sir STREET ADDRESS (411 IS A SECOND UNIT []YES CITY, STATE, ZIP r PH E ARCHITECT/ENGINEER NAME � LICENSE NUMBER •� BUS. LIC # COMPANY NAME V E- FAX s STREET ADDRESS CITY, STATE, ZIP PHO G DESCRIPTION OF WORK C P r^ r Z_ EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES I n / A.,?171-A fl i 1 USE TYPE OCC. SQ.FT. VALUATION (S) EXIS'rG NEW FLOOR DEMO TOTAL AREA AREA NET AREA BA HR CHE OTHER REMO...L AREA REMODEL AREA I REMODEL AREA TTACH # DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY ❑ YES BEING ADDED? ❑NO ADDITION? [:]NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? NO RECEIVED BY: TfTAL VALUATION: []NO ❑ - By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's beha . I have ead this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buil ' constructi . authorize representatives of Cupertino to enter the above -i enti£ prope for inspection purposes. Signature of Applicant/Agent: f / � � SUPPLEMENTAL ATION RE - - ____ -Date: PLAN CHECK TYPE ROUTING SLIP 9—DwInn PLAN REVIEW New SFD or Multifamily d ings: Apply for demolition permit for ❑ OVER-THE-COUNTER existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0 EXPRESS-- PLAZNG PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STL�I' ANnARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE Lt_'_; E nEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR 0 SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10475 bandley dr. DATE: 04/09/2012 REVIEWED BY: bobs. APN: &3111 BP#: C� Q a� (' *VALUATION: 51,250 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION USE: PERMIT TYPE: WORK Ul comm. office/labs include structural and M E Ps. Add 3 airhandling units at existing roofto SCOPE chiller at rear pad. 000 113 TI New OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,111-B,IV,V-B 12,143 $2,572.28 1BTIPLNCK $6,736.10 IBTIINSP $6,736.10 Suppl. Insp. Fee:Q Reg. Q OT bil hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $44.00 TOTALS: 12,143 $2,572.28 $6,736.10 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.. Thesefees are based on the prelimina information available and are on an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/11) FEE (QTY/FEE I DISC ITEMS Plan Check Fee: $2,572.281= # Mechanical $130.00 IMCRAA Cooling Unit Suppl. PC Fee: Q Reg. Q OT 0.0 �s $0.00 PME Plan Check: $0.00 7T # Mechanical $390.00 /BCAIRHA Air -Handling (<=10K cfm) Permit Fee: $6,736.10 Suppl. Insp. Fee:Q Reg. Q OT bil hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $44.00 Couswuction 1 tiv. Adininistrative Fee: 0 Work Without Permit? Q Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential 0 Building or Structure p G Travel Documentation Fee: ITRAVDOC $44.00 Strong Motion Fee: IBSEISMICO $262.50 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $50.00 SUBTOTALS: $9,708.88 $520.00 TOTAL FEE: $10,228.88 Revised: 04/01/2012 Building Department City Of Cupertino 10300 Tone Avenue Cupertino, CA.95014-3255 P �� I ® Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST TOB ADDRESS: 10475 Bandley Drive PERMIT # 12040048 OWNER'S NAME: Apple Inc. PHONE #408-942-8200 GENERAL CONTRACTOR: Devcon Construction, Inc. BUSINESS LICENSE #399163 ADDRESS: 690 Gibraltar Drive CITY/ZIPCODE: Milpitas, CA 95035 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTIINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please cheelc applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Redwood Electric Group Excavation Fencing Flooring/ Carpeting Preston -Holmes Linoleizm / Wood Glass / Glazing Walters & Wolf Glass Heating . Thermal hisulation Landscaping Lathing Masomy Painting,/ Wallpaper C&O Painting Paving Plastering Plumbing Therma Roofing Statewide Roofing Septic Tank Sheet Meta] Sheet Rock Magnum Drywall Tile ner / Cori ®ate CUPERTONG CONTR lMOR / SUBC®NTRACT®R LHS7 Building Department City Of Cupertino 10300 Tone Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: /dc(r PERMIT # qQO r OWNER'S NAME: 01 " PHONE # '@t'd f- /-7-05q L GENERAL CONTRACTOR: / " BUSINESS LICENSE # 37 ADDRESS:�.,�� CITY/ZIPCODE: 9- 3 S *Our municipal Coale requires all businesses working in the city to have a Cady c;l Cupertino business Ricense. NO BUILDING FINAL OR (FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL `ICHIE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CI'T'Y OF C>(P ERI'IINO BUSINESS LICENSE. I am not using any subcontractors: Signature PRease check apppiicabl.e subcontractors and complete the ffoplowiing iinffornmtiion: (Date d SUBCONTRACTOR BUSI<N ESS NAME BUSI<N ESS LRCENSE # Cabinets & Millwork Cement Finishing Electrical/D Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heatingy�— 0' f Insulation Landscaping Lathing Masonry Painting / Wallpaper t jam' Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock v Tile ner / Contra tnr Signature V&11�-- - 'Date Building Department City Of Cupertino 10300 Tone Avenue Cupertino, CA.95014-3255 P �� I ® Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST TOB ADDRESS: 10475 Bandley Drive PERMIT # 12040048 OWNER'S NAME: Apple Inc. PHONE #408-942-8200 GENERAL CONTRACTOR: Devcon Construction, Inc. BUSINESS LICENSE #399163 ADDRESS: 690 Gibraltar Drive CITY/ZIPCODE: Milpitas, CA 95035 *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTIINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please cheelc applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Redwood Electric Group Excavation Fencing Flooring/ Carpeting Preston -Holmes Linoleizm / Wood Glass / Glazing Walters & Wolf Glass Heating . Thermal hisulation Landscaping Lathing Masomy Painting,/ Wallpaper C&O Painting Paving Plastering Plumbing Therma Roofing Statewide Roofing Septic Tank Sheet Meta] Sheet Rock Magnum Drywall Tile ner / Cori ®ate CUPERTONG CONTR lMOR / SUBC®NTRACT®R LHS7 Building Department City Of Cupertino 10300 Tone Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: /dc(r PERMIT # qQO r OWNER'S NAME: 01 " PHONE # '@t'd f- /-7-05q L GENERAL CONTRACTOR: / " BUSINESS LICENSE # 37 ADDRESS:�.,�� CITY/ZIPCODE: 9- 3 S *Our municipal Coale requires all businesses working in the city to have a Cady c;l Cupertino business Ricense. NO BUILDING FINAL OR (FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL `ICHIE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CI'T'Y OF C>(P ERI'IINO BUSINESS LICENSE. I am not using any subcontractors: Signature PRease check apppiicabl.e subcontractors and complete the ffoplowiing iinffornmtiion: (Date d SUBCONTRACTOR BUSI<N ESS NAME BUSI<N ESS LRCENSE # Cabinets & Millwork Cement Finishing Electrical/D Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heatingy�— 0' f Insulation Landscaping Lathing Masonry Painting / Wallpaper t jam' Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock v Tile ner / Contra tnr Signature V&11�-- - 'Date