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11050074CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10131 BUBB RD OWNER'S NAME: APPLE INC OWNER'S PHONE: 4089744876 El LICENSED CONTRACTOR'S DECLARATION License Class Lic. # Contractor 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 declarattons: I have and will maintain a certificate of consent to self -insure for Worker'sZ 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 —4/ OIVNER-BUIAER 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 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. Date CONTRACTOR: DPR CONSTRUCTION INC PERMIT NO: 11050074 1450 VETERANS BLVD DATE ISSUED: 06/16/2011 RE DWOOD CITY, CA 94063 1 PHONE NO: (650)474-1450 BUILDING PERMIT INFO: BLDG ELECT r PLUMB' r MECH' RE SIDENTIAL r COMMERCIAL J_ JOB DESCRIPTION: COMM'L TENANT IMPROVEMENT(7000SQFT)REMOVE NON -LOAD BEARING WALLS, T -BAR CEILING, MODIFY EXISTING MECHANICAL, ELECTRICAL, PLUMBING Sq. Ft Floor Area: I Valuation: $1500000 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 Dat&�16�� 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 Applicant: Date: ALL ROOF COVE, RINGS TO BE CLASS "A" OR BETTE R 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 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. 0am- � _/_/ 4 / 14 - 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 (See. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO WIN FEE ESTIMATOR - BUILDING DIVISION 19ADDRESS: 10131 bubb rd. DATE: 05/11/2011 REVIEWED BY: bobs. N APN: BP#: *VALUATION: 1$1,500,000 PERMIT TYPE: Building Permit PLAN HECK TYPE: Tenant Improvement PRIMARY Commercial Building : — —FP—ENTAMATION I 1BTI I PER IT TYPE: LVU WORK' [electrical, t.i. comm. office space, remove non load bearing walls, t -bar ceiling, modify existnq mechanical , SICOPE plumbing. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA (S.I.) PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) 11-B,111-B,1V,V-B 7,000 $2,248.00 IBTIPLNCK $4,820.60 1BTUNSP Fee: PME Plan Check: $0.00 Permit Fee: $4,820.60 Suppl. Insp. Fee:G Reg. 0 OT ro—.01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 7,000 $2,248.00 1 $4,820.601 MECH,HOURLY 0Yes-(D-No PLUM[B,HOURLY C)Yes-(F)No ELEC,HOURLY ()Yes (E)No 11",n C'hct k 11� mih. Plli/'; 0 Plan Check Fee: ch, �(��m ij I F F F-1 I (0)SP. El Suppl. PC Fee: G Reg. 0 OT 1A h. h�.'p, 1 hr, Fee: IVOTE. These fees are based on the nrelitninary infnrinatinn availahlp and arp nnhi 17n,,vfi"iaYp i-nwartthon i r"fidsPly"f. FEE ITEMS (Tee Resohition L U) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,248.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: G Reg. 0 OT 1 0.0 1 hr, $0.00 PME Plan Check: $0.00 Permit Fee: $4,820.60 Suppl. Insp. Fee:G Reg. 0 OT ro—.01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Col?-S,hwctiw'� Tax Acoustical Fee: 0 Yes (D No $0.00 0 (@ Work Without Permit? 0 Yes G No $0.00 Plaanjqg_Eg�� $0.00 Select a Non -Residential Building or Structure 0 Strong Motion Fee: IBSEISMICO $315.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $60.00 -SUBTOTALS: $7,443.60 $0.00 -1 TOTAL FEE: 1 $7,443.60 Revised: 04/29/2011