11040222CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRE SS: 10131 BUBB RD CONTRACTOR: DPR CONSTRUCTION INC PERMIT NO: 11040222
OWNER'S NAME: APPLE INC 1450 VE TERANS BLVD DATE ISSUED: 04/28/2011
OWNER'S PHONE: 4089744876 REDWOOD CITY, CA 94063 PHONE NO: (650)474-1450
El LICENSED CONTRACTOR'S DECLARATION
License Class Lie. # 1.517 ?4!i
Contractor 'DPe_ Date 4 ).,�> Y4,11
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 &ereby 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.
A .
APPLICANT CERTIFICATION
ify 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
F1 OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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)
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 al I 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 ELECT r PLUMB
MECH Y_ RE, SIDENTIAL r— COMMERCIAL r
JOB DESCRIPTION: COMMERCIAL DEMOLITION(5,OOOSQFT) OFFICE SPACE,
NON-STRUCTURAL, INTERIOR ONLY; PHASE ONE
Sq. Ft Floor Area: I Valuation: $60000
APN Number: 35720004.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by�� Date:
REA -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 COVE RINGS TO BE CLASS "A" OR BE, TTER
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. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and tile 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 Code, Sections 25505,25533, and 25534.
Ow er� 111r. * c d
,or, �ut6" .1
pc � 7, t �It Date:
CONSTRUCTION LENDING AGE, NCY
I hereby affirm that there is a construction lending agency for the performance of NNorws
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.
Licensed Professional
CUPERT)NO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - buildinig(Qcuperflno.org
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ONEW CONSTRUCTION 0 ADDITION [-] ALTERATION / Ti El REVISION / DEFERRED ORIGINAL PERMIT #
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LICENSENUMBER
LICENSE TYPE
BUS. LIC #
CONVANYNAME
STREET ADDRESP_ LLY PL -PA k I S
CITY, STATE, ZIP
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ARCHITECT/ENGINEER NAME
LIC E NUMBER
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DESCRIPTION OF WORK
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AREA
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REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
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TOTAL DECKTORCH AREA
GARAGE AREA:0 DETACH
ATTACH
9 DWELLINO UNITS:
IS A SECOND UNIT EI'm
SECONDSTORY YES
3111
HE]Tir NO
.ADDED?
ADDMOK? NO
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PRE -APPLICATION El YES
IF YES. PROVIDE COPY 0
FLANNER'3NAIVIE
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PLANNING APPL NO
FLANNINO APPROVAL LETTER
By my signature below, I certify to each of the following: I am the property owner or auth rized ag;nt to'act on the property owner's behalf. I ha4iead this
application and the infonna . I ha I di ct' I ha ad the Descri0iion of Work andVerify it is accurate. I agree to comply with all applicable local
t'on' ve pro '
r - r�
ordinances and state laws lati.g to buil2'eco=... I a,'�o'rZe of Cupertino to enter the above-identiped p op for inspection purposes.
�r�/ttatives
Signature ofApplicandAgent:__..��16 Date: 2A L
SUPPLEI�IENTAL INFORMA`1710N REQUIRED
New SFD or Multifamily dwellings: Apply for demolition permit for
-jx1sting
""A-7
building(s). Demolition permit is required prior to issuance of building
permit for new building.
Commercial Bldgs:
t
Provide a completed Hazardous Materials Disclosure
�Orm if any Hazardous Materials are being used as part of this project.
Copy of Planning Approval Letter or Meeting with Planning prior to
Zbinittal of Building Permit application.
I .
. . . . . .
. . . . . . . . . .
BidgApp_2011.doc revised 03116111
/)I
Building Department
City Of Cupertino
103 00 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
I... ..........
JOB ADDRESS: It) / 31 2099
PERMIT #
OWNER'S NAME:
PHONE#
GENERAL CONTRACTOR:' "Opp
BUSINESS LICENSE #
ADDRESS: d(4)IL11-11 'R[
CITY/ZIPCODE: �14g t)
*Our municipal code requires all businessesworking in the eity 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 CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
Owner / Contractor Signature
Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cem.ent Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner / Contractor Signature
Date
DEMOLITION
CITY OF CUPERTINO
W -W FEE ESTIMATOR - BUILDING DIVISION
19 ADDRESS: 10131 bubb rd.
FEE
DATE: 04/28/2011
REVIEWED BY: bobs.
APN:
I BP#:
Fee':
"VALUATION: 1$60,000
'PERMIT TYPE: Demolition Permit
HECK
PRIMARY Commercial Building
USE:
PENTAMATION ICOMMLDEM
PERA41T TYPE: Id
WORK
comm office space, non structural, interior only, phase one.
F-0---Ol
SCOPE
�mo
FEE ID FLR AREA
(s.f.)
1DEMOCOM 5,000
NOTE. These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l info,
FEE ITEMS .(Fee Resohifion 09-051 M 711110)
FEE
QTY/FEE
MISC ITEMS
Fee':
PC
F71
F-1
plan
NOTE. These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l info,
FEE ITEMS .(Fee Resohifion 09-051 M 711110)
FEE
QTY/FEE
MISC ITEMS
PC
F71
plan
Permit Fee:
$760.00
Suppl. Insp. Fee :G) Reg. 0 OT
F-0---Ol
hrs
$0.00
F1
7 TVC "'1 '1/1, N;? I I N P! I I t i o 1 FC
Strong Motion Fee; IBSEISAffCO
$12.60
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$3.00.
SUBTOTALS:
$775.601
$0.00 TOTAL FEE:
$775.60
Revised: 04/01/2011