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10110160CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10261 BUBB RD CONTRACTOR: DPR CONSTRUCTION PERMIT NO: 10 110 160 1 INC I -NER'S NAME: APPLE INC 11450 VETERANS BLVD I DATE ISSUED: 03/22/2011 OV*1NER'S PHONE: 4089744876 REDWOOD CITY, CA 94063 PHONE NO: (650)474-1450 0 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL L1 License Class * 0 Lic. #10 BUBB - COMM'L TI- 800SQ OF TENANT Contractor �Z>40 . . IMPROVEMENT, X Date -3- /_?_ r— /ff ONE CONFERENCE ROOM & WOOD FLOORING, I hereby affirm that I am licensed under the provisions JChap r 9 INCLUDES (commencing with Section 7000) of Division 3 of the Business & Professions MECHANICAL,ELECTRIC&PLUMBING DRAWINGS 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 fol'.bry Section 3700 of the Labor Code, for the performance of the work for wh�*y permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information s correct. I agree to comply with all city and county ordinances and state laws lelating 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. -iature Date IN 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) 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 building construction, and hereby authorize representatives of this city to enter n the above mentioned property for inspection purposes. (We) agree to save ...,iemnify 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. Sq. Ft Floor Area: I Valuation: $152000 APN Number: 35720008.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued Date: -5� 2, 1� / 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. 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 Cod:e, Sections 25505, 55 , and 25534 �42553 Owner or authorized agent: Date: CON TRUCTION rENDING 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Profession CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION OCCUPANCY TYPE: 10261 bubb rd. #10 DATE: 11/23/2010 REVIEWED BY: bob s. IlaADDRESS: APN: BP#: *VALUATION: 1$152,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building T07,4L FLOOR ,IRE,1: PENTAMATION PERMIT TYPE: 1B T, WORK T.I. comm offices ace structural include M E P SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 800 $1,879.30 IBTIPLNCK $822.55 1BTIINSP Elec. lay, Fee: PME Plan Check: $0.00 Permit Fee: $822.55 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 800 1 $1,879.30 1 1 $822.55 MECH, HOURLY 0 Yes G No: PLUMB, HOURLY 0 Yes Q No ELEC, HOURLY ® Yes (D No Uech. Plein Chsc1, Plumb, Pluu Check Elea. Plein Check ,,f,,--1,permil Fee: Plumb. POMil FcT: Dec. Permit Oflrer Akc•h, hasp. Other P/umb lnsp.Ll Other Elec, Insp. llkch. Insp. re, Phrmb. lase. Fee: Elec. lay, Fee: NOTE: These fees are based on the nrelindnary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resohttio;i 09-051 E '. 7/1/10, FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,879.30 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $822.55 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Cotr,slr•rrction TnX Acoustical Fee: 0 Yes G No $0.00 Q Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: PLLONGRNGC $0.00 Select a Non -Residential Building or Structure T7 IBuilding G Ti-m�el Docnriler�ltrtiort Fees': Strong Motion Fee: 1BSEISMICO $31.92 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $7.00 SUBTOTALS: $2,740.77 $0.00 TOTAL FEE: 1 $2,740.77 Revised: 11/08/2010