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11040139-EXPIREDCITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20230 STEVENS CREEK BLVD CONTRACTOR: DPR CONSTRUCTION INC PERMIT NO: 11040139 OWNER'S NAME: APPLE, INC 1450 VETERANS BLVD DATE ISSUED: 04/19/2011 OWNER'S PHONE: 4089744876 REDWOOD C1TV, CA 94063 PHONE NO: (650)474-1450 ❑ I ICFNSFD CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT f— PLUMB License Class Lirc. ft,, Contractor.Lp ��r Date r l I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions 'odea and that my license is in full force and effect. hereby affirm under penalty of perjury one of the following two declarations: 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 ermit 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 pemtit.ditionally, the applicant understands and will comply with all non -point sourc regulations per the Cupertino Municipal Code, Section 9.18. SignatureDato r '— ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that 1 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 (Scc.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: 1 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 mi 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. MECH f- RESIDENTIAL I- COMMERCIAL JOB DESCRIPTION: DEMO COMM'L OFFICE SPACE, NON-STRUCTURAL, 14512SQFT Sq. Ft Floor Area: I Valuation: $30000 APN Number: 36902031.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued b ��— — --� �._�--� .-._._..---- Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material berg 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 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safely Code, Sections 25505, 25533, and 25534. 1 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 & SWety Code, Sections 25505, 25533, and 25534. CONSTRUCTION LENDING AGENCY I hereby affimi 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date I Licensed Professional_ CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20230 STEVENS CREEK BLVD CONTRACTOR:DPR CONSTRUCTION INC PERMIT NO: 11040139 OWNER'S NAME: APPLE,INC 1450 VETERANS BLVD DATE ISSUED:04/19/2011 OWNER'S PHONE: 4089744876 REDWOOD CITY,CA 94063 PHONE NO:(650)474-1450 i ❑ LICENSED CONTRACTOR'S DECLARATION F BUILDING PERMIT INFO: BLDG' ELECT PLUMB License Class___ Lic.# MECH RESIDENTIAL COMMERCIAL Contractor iy 'l��"P✓ r1�Date _d !Z I hereby affirm that I am licensed nder the provisions of Chapter 9 JOB DESCRIPTION:DEMO COMM'L OFFICE SPACE, (commencing with Section 7000)of Division 3 of the Business&Professions NON-STRUCTURAL,14512SQFT ode and that my license is in full force and effect. It affirm under penalty of perjury one of the following two declarations: 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 Sq.Ft Floor Area: Valuation:$30000 ermit is issued. APPLICANT CERTIFICATION APN Number:36902031.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. A ditionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point soure regulations per the Cupertino Municipal Code,Section 9.18. e Issued by,.; Date: . Signature Date ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&SIO ty Code,Sections 25505,25533,and 25534. 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 On ne uthorized agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of vnork's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional i 12 DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE -CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228 - FAX(408)777-3333 •building(cDcupertino.org PROJECT ADDRESS6� 7APN 9 11'1 44- 4, OWNER NAME PHONE E-MAIL 1Ai Z 44'- . �� ZAA/Ck- STREET ADDRESS CITY,STATE,ZIP 1�0 I FAX CONTACT NAME PHONE CE-MAH, le� L Ph, STREET ADDRESS CITY,STATE,ZIP FAX R 11 OWNER-BUILDER El OWNER AGENT 0�CONTRACTOR El CONTRACTOR AGENT 11 ARCHITECT C3 ENGINEER 0 DEVELOPER El TENANT CONTRACTORNAME LICENSE NUMBER pp LICENSE TYPE BUS.LIC 9 f 11 COMPANY NAMEE-MAIL, FAX v o/ %s STREET ADDRESS CITY,STATE,ZIP I PHONE Z-5, DESCRIPTION OF WORK �iFiC�E� � RESIDENTIAL 9 DWELLING USj FLOOR AREA UNITS usL COMMERCIAL A FLOOR AREA TYPE OF CONSTRUCTION #STORIES Z AQMD JOB NUMBER TOTAL VALUATION By my signature below,I certify to each of the folio g. I a-the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is o.ct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local o truction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. ordinances and state laws relating to buildin6 Signature ofApplicant/Agent: �Z_ Date: SUPPLEMENTAL INFORMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT Provide-Job Number from Bay Area Air Quality Management District NvAw.baagmd.org @ 415-749-4762. ELK - T -YP> !N Prbvide three copies of a site plan showing protection for any trees 10"in diameter or more at 3'above grade. 7 m�_,g Provide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected. Provide a letter of inspection,tests,and abatement of any Hazardous Materials.Letter to be initiated by person(s) certified in asbestos,mercury and/or hazardous material examination. aoxPf Planning Dept clearance to verify building is not considered an historical landmark,Allow 10 business days. T Provide letter of clearance of all vermin from a licensed pest control contractor. Applicant shall call the Public Works Department at 408-777-3104 and schedule a"habitable dwelling"inspection- -------- Provide signed Debris Bin and Recyclable Materials form. Commercial Buildings Only: Provide Fire Dept clearance for fire suppression alarm system review. DenioApp_201 Ldoe revised 03116111 i Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E IST i N O Fax: 408-777-3333 CONTRACTOR SUBCONTRACTOR LIST JOB ADDRESS: PERMIT# > OWNER'S NAME: PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: /: �o ZCITY/ZIPCODE: '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 CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical '7-/3 0 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 Za x Owner/Contractor Signature Date i DEMOLITION CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION WAPN: DRESS: 20230 stvns srk blvd 1st floor DATE: 04/19/2011 REVIEWED BY: bobs. j BP#: *VALUATION: $30,000 PE: Demolition Permit PRIMARY Commercial Building PENTAMATION 1COMMLDEM USE: PERMIT TYPE: WORK demo comm. offices ace non structural SCOPE FEE ID FLR AREA s.f. 1 DEMOCOM 14,512 I,�F't;dr, r. rti.'t��tt: ?a+-. 1't Fi#'`r;e: �s't•., r c r'trt he,;r r"�11P :ISd't:'it.aPr'ij;, J�'T1e'l F'T:r;r:1;Tti,1J. )rrfrzr r ... It7sn, i},.}p'1''., NOTE.These ees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 09-051 L'tf. 7/1/10) FEE QTY/FEE MISC ITEMS �. p3 Permit Fee: $1,519.00 Suppl.Insp.Fee:O Reg. 0 OT FO.OThrs $0.00 /'}E,'r nilI`ec: ti's"ave I Strong Motion Fee: IBSEISMICO $6.30 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 r SUBTOTALS: $1,527.30 $0.00 TOTAL FEE:' $1,527.30 Revised: 01/15/2011