11030106CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 6 INFINITE LOOP
OWNER'S NAME: APPLE INC
OWNER'S PHONE: 4083793256
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. 4 3 J 2 (c) '? 7!ff`
Contractor '�4% 9 -A-V CO-A.� Date-4—
I
ate`?^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 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
❑ 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).
CONTRACTOR: SOUTH BAY
CONSTRUCTION CO INC
170 KNOWLES DR
LOS GATOS, CA 95032
PERMIT NO: 11030106
DATE ISSUED: 04/11/2011
PHONE NO: (408)379-5500
BUILDING PERMIT INFO: BLDG I— ELECT r— PLUMB r
MECH r RESIDENTIAL r— COMMERCIAL
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 pen -nit 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
JOB DESCRIPTION: 1 ST FLOOR- MODIFICATIONS TO (E) HARDWARE
STORAGE
& DISTRIBUTION ROOM MODIFICATION TO INCLUDE
REMOVAL OF POCKET DOOR & SHELVING, ADDITION OF NEW
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.
Sq. Ft Floor Area: I Valuation: $20000
APN Number: 31602110.00 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued 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 Appl
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 Code, Sections 25505, 25533, and 25534.
r ora horized agent:
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.
Signature Date
Licensed Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 6 INFINITE LOOP
OWNER'S NAME: APPLE INC
OWNER'S PHONE: 4083793256
❑ LIICENSED CONTRACTOR'S DECLARATION
License Class 6 Lic. # 3 3 (o '? 7q
Contractor �j, %jam Date 4-11
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 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 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
❑ 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.
CONTRACTOR: SOUTH BAY
CONSTRUCTION CO INC
170 KNOWLES DR
LOS GATOS, CA 95032
PERMIT NO: 11030106
DATE ISSUED: 04/11/2011
PHONE NO: (408)379-5500
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
MECH RESIDENTIAL - COMMERCIAL r
JOB DESCRIPTION: I ST FLOOR- MODIFICATIONS TO (E) HARDWARE
STORAGE
& DISTRIBUTION ROOM MODIFICATION TO INCLUDE
REMOVAL OF POCKET DOOR & SHELVING, ADDITION OF NEW
Sq. Ft Floor Area: I Valuation: $20000
APN Number: 31602110.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued bg `y�'!� 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 Appl
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 Code, Sections 25505, 25533, and 25534.
u r or a thorized agent: /
Date:
Cs— CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of Nwrk's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
Date
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
RESS: 6 infinite loop 1st floor
FN:
DATE: 03/22 220 17
REVIEWED BY: bobs.
BP#:
"VALUATION:
1$20,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial BuildingPENTAMATION
USE:
1GENCOM
PERMIT TYPE:
WORK
install new securitydoor, add new walls new switch.
SCOPE
Elec. Plan Check 0.0 hrs $0.00
F'iv
Elec. Permit Fee: lEPERMIT
si, t'i.r:zr; ;`,;;t;.
Other Elec. Insp. 0.0 hrs $42.00
'.nrc. htFw. Fee:
wnTF.! These fees are haled on the nreliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resohrtion 09-05.1 Ef. 711/10)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
0 #
$253.00
New Door Opening
IDOORNONST Non -Structural
Suppl. PC Fee: 0 Reg. 0 OT
F07f
his
$0.00
PME Plan Check:
$0.00
18 l.f. Interior Partitions
$443.00 IPARTICOMM
Permit Fee:
$0.00
Suppl. Insp. Fee:G Reg. 0 OT
0.0
hrs
$0.00
0 Electrical
$42.00 IBREMRECEP Recep/Switch/Outlets
PME Unit Fee:
$0.00
PME Permit Fee:
$42.00
Acoustical Fee: C) Yes 0 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
Travel Documentation Fee: 1TRAVDOC
$42.00
Strong Motion Fee: IBSEISMICO
$4.20
Select an Administrative Item
Bldg=, Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$89.20
$738.001
TOTAL FEE:
$827.20
Revised: 01/15/2011