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11040008CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20650 VALLEY GREEN DRI CONTRACTOR: DEVCON CONSTRUCTION I PERMIT NO: 11040008 OWNER'S NAME: APPLE INC 1690 GIBRALTAR DR I DATE ISSUED: 05/04/2011 OWNER'S PHONE: 408996 10 10 I MILPITAS, CA 95035 I PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION License Class Liic.. 4 (SA 3 Contractor L_�� 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. 6�_ APPLICANT CERTIFICATION 1 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 soy�gulation per the Cupertino Municipal Code, Section 9.18. / 1 ❑ O*NER-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 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 r PLUMB r MECH r RESIDENTIAL I— COMMERCIAL r JOB DESCRIPTION: PHASE 6 TI, COMMERCIAL SPACE INCLUDES VIBRATION STORAGE ROOMS, 358 SF, THICKEND SLAB, ELCTRICAL, MECHANICAL, CEILINGS, WALLS & DOORS. Sq. Ft Floor Area: I Valuation: $75000 APN Number: 32610053.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued Xw_ I ' 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 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(x) 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 Vo , Sections 25505, 25533, and 25534. Ownerage Date C STRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of vork'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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 GUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building cDcugertino.org 1i• ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT APRESS JJA11r,4 4,9 )J ZzlIK- APN # / n O , 063 OWNER NAMEPHONE JfJ E-MAIL STREET ADIRET ` ` L —[ ^ �o14 FAX CONTACT NAM PH E-MAIL Y� ' v MP STREET ADDRESS C STATE, ZIP up F ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LIC ENS TLICENS�KE BUS. LIC # COMPANY NAME E-MAIL FAX QL r / STREET AD RESSITY, ST TE, IP PH ARCHI CT NG E LICENSE NUMBER BUS. LIC # COMPANY �KgV E-MAIL FAX ST=S DES ON OF WORK EXISTING USE PROPOSED USE CONS TR. TYPE # STORIES L/ a I Y COATION (S) EXISTG NEW FLOOR DEMO TOTAL Tt +r^ AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH - ❑ ATTACH M DWELLING UNITS: IS A SECOND UNI ❑ YES SECOND STORY ❑ YES BEINGADDED4 ❑ NO ADDrr1ONT ❑ NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNER'S NAME RECENEDBY:,.� f TGT V UATION: PLANNING APFL0 ❑ NO PLANNING APPROVAL LETTER /.�f_ �� 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 behalf. I have read this I agree to comply with all applicable local application and the information I pro ided is sect. I have read the Description of Work and verify it is accu atef ordinances and state laws relating to b it g n ction. I autho ' epresentatives of Cupertino to enter the ab G a-intified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL I ORM TION REQ RED PLAN! CIIECX TYPE: ROUTING SLOP ❑ OYER-THF-COLrNTEIR �r LJ BiiLD1NG PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRM © PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure C$�DARD ElPUBLICWORKS form if any Hazardous Materials are being used as part of this project. ❑ LARCE.[��DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to 0 �J submittal of Building Permit application. MAJOR SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 03116111 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 *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 Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR • . -PHONE #!; • Eel 9101 1;1 OLIF.11 WRL91•. Cabinets & Millwork - 1(. *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 Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement 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 A -III Date CITY OF CUPERTINO WE FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20650 valley green dr. DATE: 04/0112011 REVIEWED BY: bobs. PC FEE ID APN: I BP#: l i 46EiE�� "VALUATION: $75,000 -PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: IBTIPLNCK PENTAMATION 1 B TI PERMIT TYPE: 19 WORK phase 6- T.I. comm, space inludes vibration and storage rooms. SCOPE PME Plan Check: 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 358 $1,860.66 IBTIPLNCK $580.51 IBTIINSP fic+r.ln,t� i'��t� $0.00 PME Plan Check: $0.00 Permit Fee: $580.51 Suppl. Insp. Fee.e Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 TOTALS: 358 $1,860.66 1 $580.51 MECH, HOURLY 0 Yes 0 No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY 0 Yes Q No MISC ITEMS Plan Check Fee: $1,860.66 rw"Lj Select a Misc Bldg/Structure or Element of a Building I ifr�l: in.;j•. F�;i>� ,� ;•s.�. fic+r.ln,t� i'��t� NOTE: These fees are based on the oreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 09-051 Eff. 7/1/10) FEE QTYIFEE MISC ITEMS Plan Check Fee: $1,860.66 Select a Misc Bldg/Structure or Element of a Building I Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $580.51 Suppl. Insp. Fee.e Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes 0 No $0.00 0 0 Work Without Permit? 0 Yes 0 No $0.00 Planniniz Fee: $0.00 Select a Non -Residential Building or Structure 0 Travel 1 y,,�c7:��E:�rr�jli�+t T_c, ., Strong Motion Fee: IBSEISAffCO $15.75 Select an Administrative Item i Bldiz Stds Commission Fee: IBCBSC $3.00 SUBTOTALS: $2,459.92 $0.00 TOTAL FEE: 1 $2,459.92 Revised: 01/15/2011