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15060138CITY OF CUPERTINO BUILDING PERMIT I I BUILDING ADDRESS: 20705 VALLEY GREEN DR I CONTRACTOR: NOVO CONSTRUCTION I PERMIT NO: 15060138 OWNER'S NAME: APPLE INC 11460 O'BRIEN DR I DATE ISSUED: 07/16/2015 1 OWNER'S PHONE: 4153105791 1 LICENSED CONTRACTOR'S DECLARATION License Class Lic. # 1�41 f 02 Contractor /V0"() COt,/5T0#(,J1 ' Date I 23 / 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. 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 Verformance of the work for which this permit is issued. �: 1 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 1 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 wit all non -point sourcg regulations per the Cupertino Municipal Code, Section 9.18. i Signature Date 2 /� ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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) 2. 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. 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. 2. 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. 3. 1 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 e must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that 1 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 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ APPLE TENANT IMPROVEMENT - LAB EXPANSION (720 SQ FT). DEF # 1 - PLANS FOR EXISTING LOCATIONS FOR ACCESSIBLE RESTROOMS - ISSUED 9/23/15 Sq. Ft Floor Area: I Valuation: $200000 APN Number: 32610046.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DA S OF PERMIT ISSUANCE OR 180 D OM_1A&LED INSPECTION. k.. 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: 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. Owner oyirutWrized agent: 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO I/.II FEE ESTIMATOR -BUILDING DIVISION 1AADDRESS: 20705 VALLEY GREEN DR DATE: 09/23/2015 REVIEWED BY: MELISSA APN: 32610 046 BP#: 15060138 *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? 0 Yes C No PENTAMATION PERMIT TYPE: 1 GENCOM WORK DEF # 1 - PLANS FOR EXISTING LOCATIONS FOR ACCESSIBLE RES-rROOMS - ISSUED 9/23/15 SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School nicirint am i Thoco fooc nro hncod nrr tho nroliminnry hifarmntinn availahlo and aro nnhf an actimnto_ Cnntart tho Dont far addn'i info_ FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/13' FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # $286.00 Deferred Submittal 1DEFSUBM Suppl. PC Fee: (E)Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONSTAXC $0.00 �1ca�ni111at1'�riire Ftic: E) Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure I fs�.rvcl L.>��Grrnr�>� tciiio!t :�',��c�: Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE: $286.00 Revised: 07/02/2015 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISI 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 CUP1rRTINrJ (408) 777-3228 - FAX (408) 777-3333 • building(dcupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI 'R REVISION /DEFERRED ORIGINAL PERMIT 4 15loct t71 3 113 PROJECT ADDRESS APN # OIVNER NAME PH NE E-MAIL o t,� _ e , cor- STREET A.DDRES - CITY, STATE, ZIP I FAX N t�1 �rF L10QJ&` CONTACT NAVE PHONE E-MAIL a t S -r z t -3 .� r^ �,� ktr{vN1�/ocoasrf��ri i STREET ADDRESS CITY, STATE, ZIP FAX IV(�XI 6'Kar-f foj aie- A"0 Q420 -k- / 2 ' OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑"ENGINEER ❑ DEVELOPER ❑ TENANT CONTRA TOR NAME LICENSE NUMBER ` LICENSE TYP BUS. LIC # „ I. (—V- /� % LV EZ l^ k O Z'l.- COMPANY NA),1E E-MAILCON �N &VO FAX STREET ADDRESSCITY, Ltul-o O` 3a-N164i V VLC-0 STATE, ZIP L a ?44AC L PHONE 01l b - S --L% -310 olf�) ARCHITECT/ENGTNEER NAME LICENSE NUMBER BUS. LIC # COMPANTY NAME E-MAIL <-nS11^CY 1 !) (�lcl� eQt{�, lG.r I FAX A S � tip Z04L-R�;'s' STREET ADDRESS CITY, STATE; ZIP PHONE DESCRIPTION OF WORK -7>6���� �2 `" ! 1J -Ln CiBt_A� liz�-S r2-oo--_ EXISTING USE PROPOSED USE CONSTR TYPE # STORIES I USE TYPE UCC. SQ.FT. VALUATION (S) FXISTG NEw FLOOR DEMO TOTAL AREA AREA AREA N'ET AREA BATHROOM KITCHEN OTHER REMODEL AREA TRFMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKiPORCH AREA GARAGE AREA: LJDETACH ❑ Ai TACH #DWELLINIGUNITS: IS A SECOND UNIT' El YES SECONDSTORY (]YES BEING ADDED? []NO ADDITION? []NO , PRE -APPLICATION ❑YES IF YES, PROVIDE COPY of IS THE BLDG AN TOTAL VALUATION: PLA.NMNG .ADPL# []NO PLAN'N'ING APPROVAL LEITER EICHLERHONIE? NO By my signature below, I certify to each of the following: I am the property owner _ nt to,4 property owner's behalf. I have d this application and the information I have provide correct. I have read the Description of'W and It is accurate. I agree to comply with all applic ble local ordinances and state laws relating to bu' g c tructio orize representatives of Cbpertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: /7— n, SUPPLEM AL INFORMATION REQUIRED = t Pral. c>�cx��PE T Wit; z. 3zoII1TI.G`sLIP =, _ New SFD or Multifamily d�-ellings: Apply for demolition permit for. �] ov7 x Ts>rcoirtTSR BIIILDLicPL4NREVIElY existing building s). Demolition permit is required prior to issuance of building permit for new building. ExPREss ❑_ PI A><t.L.GrLah xEVIEw Commercial Bldgs: Provide a completed Hazardous Materials Disclosure I] sTaNnARi� r t form if any Hazardous Materials are being used as part of this project. LARcr �FIxEDIr Copy of Planning Approval Letter or Meeting with Planning prior to '— '�•.� �aSANTTARYSESi'ERDISTRICT submittal of Building Permit application. -©-.MA70R � � � �= :._ -� _._ .� EIfiYIitOIVMEI�T4I,.F[EAI�TFi BIdgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20705 VALLEY GREEN DR CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 15060138 OWNER'S NAME: APPLE INC 1460 O'BR1EN DR DATE ISSUED: 07/16/2015 OWNER'S PHONE: 4153105791 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 ,❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ APPLE TENANT IMPROVEMENT - LAB EXPANSION (720 License Class Lie. # :7q (&')--L SQ Contractor / bio an wcrr Le 7Z46 FT). 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 Sq. Ft Floor Area: Valuation: $200000 erformance of the work for which this permit is issued. 1 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 APN Number: 32610046.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. l agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued by: �� Date: l��1C 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. 7 '----Date RE -ROOFS: Signature—��--- --- 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. ❑ NER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should 1 use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this --� ,�� �//6 Owner or authorized agent_ ---� Date:_ permit is issued. -- �— Jam_ . 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build incl a)cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION .ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS APN # L a VAI G Gran DC �ro c.� S' �(9 _ OW RN E � (✓�- PH1 1 J O E 0 t� t!iV ST ET ADDRESSCITY, STATE, ZIP FAX CO ACT AME 4' PH E ' lorG - 83 E- A �( 0 /l ovreGon.s��Lct:o STREET ADDAES CIT , STATE, Z FAX ) o 0`13r l o ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT P. CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LICENSE NUMBER LICENSE PE BUS. LIC l-71 �� � CO%jANY NAME ,OVG n UG'h"d E-MAIL FAX ��(p� y(,ovvLcYtSd-Nc�s' STR[4 ADDRESSrl` �r, CIT04 Y, ST TE, ZIP Co., ��D �� PH �� ARC c?.%NGINEER E / , N U I' LICENSE NUI,vIB R BUS. LIC # 6k COMPAN E-MAII. FAX /'w 1 a Li STREET AD RESS n� CITY, �I'A'r�EPHONE DESCNETION OF WORK w1 e., ,cc f v cr:. b �: l CG rvi, r s �M o�- e w-LCACtA re_(&c.cA_t EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES cjgi T t(.Z@i�� V :CC_ (N 2•_• 1 ! ' USE TYPE OCC. SQ.FT. VALUATION (S) EXISNEW DETOTAL � AREA AREA --AREA -724 NET AREA C�•I BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA. DETACH ATTACH N DWELLING UNITS: IS A SECOND UNIT YES SECOND STORY []YESvA BEING ADD ED? ❑NO ADDITION? []NO PRE -APPLICATION []YES IF YES. PROVIDE COPY OF PLANNING APPL M ❑ NO PLANNING APPROVAL LETTER I IS THE BLDG AN ❑ YES EICHLER HOME? []NO RECEIVED TOTAL, VALUATION: OV JTS006 I 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 application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: �—� J Date: SUPPLEMENTAL INFORM A LON REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-TH&COUNTER q L7 BUILDING 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."EXPRESS El PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure LLQ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121/11 .f.UH CITY OF CUPERTINO FEW FEE ESTIMATOR — BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20705 Valley Green Dr DATE: 06/22/2015 REVIEWED BY: Sean PC FEE ID APN: BP#: , 'VALUATION: 1$200,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial BuildingT USE: 1BTIPLNCK PENTAMATION 1B TI PERMIT TYPE: WORK A le Tenant Improvement - Lab Expansion 720 sq ft). SCOPE OCCUPANCY TYPE: TYPE OF CONSTIL FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,111-B,IV,V-B 720 $2,123.30 1BTIPLNCK $929.80 1BTIINSP $0.00 PME Plan Check: $0.00 Permit Fee: $929.80 Suppl. Insp. Fee -0 Reg. Q OT 0.01hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 720 $2,123.30 $929.80 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District etc )_ Thew fees are haled on the nreliminary information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff.' 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,123.30 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: E) Reg. Q OT 70.0 Fhrs $0.00 PME Plan Check: $0.00 Permit Fee: $929.80 Suppl. Insp. Fee -0 Reg. Q OT 0.01hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 7 E) Work Without Permit? 0 Yes E) No $0.00 Advanced Planning_Fee: $0.00 Select a Non -Residential Building or Structure 0 A Strong Motion Fee: 1BSEISMICO $56.00 Select an Administrative Item Bldg; Stds Commission Fee: 1BCBSC $8.00 a, SUBTOTALS: $3,117.10 $0.00 TOTAL FEE; $3,117.10 Revised: 05/07/2015 :;2: :E: ZENITH ENGINEERS Engineering during Construction 22320 Foothill Blvd, Suite 322 Hayward, CA 94541 Phone 925 640 4500 Fax — 415 500 9583 Email — s uliyadinzenithengineers.com www.zenithengineers.com PROJECT : Air Compressor Unit Anchorage PROJECT #: 150181 LOCATION: Cupertino, CA. LJ /) '9Q CLIENT: Silicon Valley Mechanical C71630 ;:0 PREPARED BY: Senthil Puliyadi, MS., M.Eng., PE Exp. 12131/15 REV -0 s�q�� C / V � OF C AIF TABLE OF CONTENTS 12 pages 6-18-15 1 `NJ wings / Sketches / Cut Sheets / Photos 2 thru 3 2 Engineering Calculations 4 thru 12 CONTROL PANEL; I WEIGHT ASSUMED = 400 LBS Industry-leading Performance Anchor in each foot UP6-5TAS-125 5 125 115 18.5 0.52 65 UP6-5-125 5 125 18.5 0.52 65 UP6-5TAS-150 5 150 140 16 0.45 65 UP6-5-150 5 150 16 0.45 65 UP6-7TAS-125 7.5 125 115 28 0.79 65 UP6-7-125 7.5 125 28 0.79 65 UP6-7TAS-150 7.5 150 140 25 0.25 65 UP6-7-150 7.5 150 25 0.25 65 UP6-7TAS-210 7.5 210 200 17.5 0.50 65 UP6-7-210 7.5 210 17.5 0.50 65 UP6-IOTAS-125 10 125 115 38 1.08 68 UP6-10-125 10 125 38 1.08 68 UP6-IOTAS-150 10 150 140 34 0.96 68 UP6-10-150 10 150 34 0.96 68 UP6-10TAS-�10 10 210 200 24 0.68 68 UP6-10-210 10 210 24 0.68 68 UP6-15JAS-125 15 125 115 55 1.55 69 UP6-15c-125 15 125 55 1.55 69 UP6-15cTAS-150 15 150 140 50 1.42 69 UP6-15c-150 15 150 50 1.42 69 UP6-15cTAS-210 15 210 200 38 1.08 69 UP6-15c-210 15 210 38 1.08 69 Performance in accordance with I50 1217 1996 annex C ` Measured in accordance with CAGI-pneurop test code PNBNTC2.3 Base Mount 41 1,042 28.9 734 36 914 725 330 650 295 80 Gallon Receiver Tank 53.6 1,361 28.9 734 60.7 1,541 1,000 454 925 419 120 Gallon Receiver Tank 74.7 1,897 28.9 734 60.7 1,541 1,035 470 960 435 272 Liter Receiver Tank 51.6 1,311 28.9 734 60.7 1,541 1,003 455 928 420 500 Liter Receiver Tank 81 2,059 28.9 734 60.7 1,541 1,080 490 1,005 455 UP5-4TAS-8 4 8 7.3 0.55 19.5 65 UP5-4-8 4 8 0.55 19.5 65 UP54TAS-10 4 10 9.3 0.45 16 65 UPS -4-10 4 10 0.45 16 65 UP5-5TAS-8 5.5 8 7.3 0.82 29 65 UP5-5-8 5.5 8 0.82 29 65 UP5-5TAS-10 5.5 10 9.3 0.74 26 65 UP5-5-10 5.5 10 0.74 26 65 UP5-5TAS-14 5.5 14.5 13.8 0.51 18 65 UP5-5-14 5.5 14.5 0.51 18 65 UP5-7TAS-8 7.5 8 7.3 1.08 38 68 UP5-7-8 7.5 8 1.08 38 68 UP5-7TAS-111 7.5 10 9.3 0.96 34 68 UP5-7-10 7.5 10 0.96 34 68 UP5-7TAS-14 7.5 14.5 13.8 0.68 24 68 UP5-7-14 7.5 14.5 0.68 24 68 UP5-1IJAS-8 11 8 7.3 1.60 56.5 69 UP5-11c-8 11 8 1.60 56.5 69 UP5-11cTA$-10 11 10 9.3 1.42 50 69 UP5-11c-10 11 10 1.42 50 69 UP5-11cTAS-14 11 14.5 13.8 1.08 38 69 UP5-11c-14 11 14.5 1.08 38 69 Performance in accordance with I50 1217 1996 annex C ` Measured in accordance with CAGI-pneurop test code PNBNTC2.3 Rotary Compressors 11 Code / Standard - CBC 2013 / ASCE 7-10 Equipment: Air Compressor Unit (see attached sheet; Weight of equipment, WPequipment:=1000 lbf +400 dbf includes the weight of control panel unit) aP := 2.5 (mechanical equipment made of sheet metal RP:= 6.0 framing ) h:= 20 ft (assumed roof height; no need to be exact because of the nature of the equaiton) z:=0 ft (equipment is anchored at ground level) SDS:=1.162 (for the given site) IP:=1.5 (conservative assumption; see section 13.1.3 ASCE 7-10) ap Seismic lateral force coefficient, FP := 0.4 • R • SDS • (1+2. z l �Pi � h J l IP J FP = 0.291 I''Pmin := 0.3 • SDs •IP= 0.523 Fp.x :=1.6 -SDs-I,,=2.789 FPdesign := min (Fp as I max (FP, FPniZn)) = 0.523 Seismic lateral forceF ' •W i pequipment'— —F pdesign pequipment Fpequipment = 0.732 kip Height of center of gravity, hCG:=; 2; • 31 60.7 • in (See attached sheet) l llong := 36 in (See attached sheet, Conservative assumption - distance between anchors in long. direction) M := F h �0.9 • W 0.2 • S W ) i hong 1-1.067 overturningseismiclong '— pequipment • CG pequipment DS • pequzpment � 2 I — Moverturningseismiclong = 12801 Vseismiclong :=Fpequipmment = 732'06 Height of center of gravity, hCG:= `3� • 60.7 in (See attached sheet) Itra,1,,:= 24 in (See attached sheet, Conservative assumption - distance between anchors in trans. direction) M := h �0.9 • W.2 • S ) Itrans 1= 1.534 overtzurningseismictranF pequipment' CG pequipment— 0DS•W pequipment 2 /+ Moverturningseismictran = 18408 Vseismictran •= Fpequipment = 73 2.0 6 (Wind load is not considered because equipment is fixed inside the building) Nlovertvrningseismictran = 18408.348 lbf • 2'12 Nlovertvrningseisrniclon,g = 12800.508 Of • in Vseismiclong= 732.06 lbf Vseismactran= 732.06 Of www.hilti.us Profis Anchor 2.5.3 Company: Page: 1 Specifier: Project: Address: Sub -Project I Pos. No.: Phone I Fax: Date: 6/18/2015 E -Mail: Specifier's comments: 1 Input data Anchor type and diameter: Effective embedment depth: Material: Evaluation Service Report: Issued I Valid: Proof: Stand-off installation: Anchor plate: Profile: Base material: Reinforcement: Seismic loads (cat. C, D, E, or F) Geometry [in.] & Loading [ib, in.lb] base plate is shown to comply with the quirkiness of Hilti program. In reality, here is no base Dlate. s Kwik Boit TZ - SS 316 518 (3 118) het = 3.125 in., hn— = 3.563 in. AISI 316 ESR -1917 5/1/2013 1511/2015 Design method ACI 318 / AC193 eb = 0.000 in. (no stand-off); t = 0.250 in. Ix x ly x t = 30.000 in. x 42.000 in. x 0.250 in.; e no profile cracked concrete, 4000, fc' = 4000 psi; In = 5.000 tension: condition B, shear: condition B; no supp edge reinforcement: none or < No. 4 bar yes (D.3.3.6) Input data and results must be checked for agreement with the existing conditions and for plausibility! PROFIS Anchor (c ) 2003-2009 Hilb AG, FL -9494 Schaan Hilti is a registered Trademark of HIM AG, Schaan plate thickness: not calculated) splitting reinforcement present EVEN THOUGH SST 316 ANCHOR IS CALLED -OUT, IT IS PERFECTLY OK TO USE HDG ACNHORS IF SPECIFICATION ALLOWS IT AND THE INSTALLATION IS INSIDE THE BUILDING. Kwik Boit TZ - SS 316 518 (3 118) het = 3.125 in., hn— = 3.563 in. AISI 316 ESR -1917 5/1/2013 1511/2015 Design method ACI 318 / AC193 eb = 0.000 in. (no stand-off); t = 0.250 in. Ix x ly x t = 30.000 in. x 42.000 in. x 0.250 in.; e no profile cracked concrete, 4000, fc' = 4000 psi; In = 5.000 tension: condition B, shear: condition B; no supp edge reinforcement: none or < No. 4 bar yes (D.3.3.6) Input data and results must be checked for agreement with the existing conditions and for plausibility! PROFIS Anchor (c ) 2003-2009 Hilb AG, FL -9494 Schaan Hilti is a registered Trademark of HIM AG, Schaan plate thickness: not calculated) splitting reinforcement present EVEN THOUGH SST 316 ANCHOR IS CALLED -OUT, IT IS PERFECTLY OK TO USE HDG ACNHORS IF SPECIFICATION ALLOWS IT AND THE INSTALLATION IS INSIDE THE BUILDING. www.hilti.us Company: Specifier: Address: Phone I Fax: E -Mail: 2 Load case/Resulting anchor forces Load case: Design loads Anchor reactions [lb] Tension force: (+Tension, -Compression) Anchor Tension force Shear force Shear force x Shear force 1 346 183 183 0 2 18 183 183 0 3 346 183 183 0 4 18 183 183 0 max. concrete compressive strain: 0.00 [%o] max. concrete compressive stress: 21 [psi] resulting tension force in (x/y)=(-10.792/0.000): 729 [lb] resulting Compression force in (x/y)=(14.448/0.000): 729 [lb] 3 Tension load CZ= Profis Anchor 2.5.3 Page: 2 Project: Sub -Project I Pos. No.: Date: 6/18/2015 Load N„a [lb] Capac�b] Utilization �N Status Steel Strength` 346 13410 3 OK Pullout Strength` Concrete Breakout Strength" N/A N/A N/A N/A 729 1403 52 OK *anchor having the highest loading "anchor group (anchors intension) 3.1 Steel Strength Nsa [ib] Nsa [lb] Nue [ib] 17880 0.750 13410 346 3.2 Concrete Breakout Strength ANc [in .2] ANco [in. 2l Ca,min [in.] cac [in] Wc,N 351.56 87.89 5.000 7.000 1.000 e.1,N [in.] Yecl,N ec2,N [in.] Yecz,N Yed,N lilcp,N kcr 10.792 0.303 0.000 1.000 1.000 1.000 17 Nb [lb] _ seismic y.nonductile �Ncbg [Ib] Ned [lb] 5940 0.650 0.750 0.400 1403 729 Input data and results must be checked for agreement with the existing conditions and for plausibility! PROFIS Anchor (c ) 2003-2009 Hitt AG, FL -9494 Schaan Hilti is a registered Trademark of Hilti AG, Schaan K www.hilti.us Profis Anchor 2.5.3 Company: Page: 3 Specifier: Project: Address: Sub -Project I Pos. No.: Phone I Fax: Date: 6/18/2015 E -Mail: OK 4 Shear load anchor having the highest loading **anchor group (relevant anchors) 4.1 Steel Strength Vsa [lb] �Vsa [lb] Vua [lb] 9350 0.650 6078 183 4.2 Pryout Strength AN. (in.'] ANcO [in. 2l Ca,min fin.l kcp ca. [In.] wc,N 351.56 87.89 5.000 2 7.000 1.000 ec, v [in.] ti�ect v ec2,v [in-] y1ec2,y y/ed,N y/cp,N kcr 0.000 1.000 0.000 1.000 1.000 1.000 17 Nb [lb] b seismic (nonductile �Vcpg [Ib] Vua [lb] 5940 0.700 0.750 0.400 9978 733 4.3 Concrete edge failure in direction x+ le [in.] Load Va, [lb] Capacity Vn [Ib] Utilization p, = Vu./+V. Status Steel Strength* 183 6078 4 OK Steel failure (with lever arm)* N/A N/A N/A N/A Pryout Strength** 733 9978 8 OK Concrete edge failure in direction x+** 733 1389 53 OK anchor having the highest loading **anchor group (relevant anchors) 4.1 Steel Strength Vsa [lb] �Vsa [lb] Vua [lb] 9350 0.650 6078 183 4.2 Pryout Strength AN. (in.'] ANcO [in. 2l Ca,min fin.l kcp ca. [In.] wc,N 351.56 87.89 5.000 2 7.000 1.000 ec, v [in.] ti�ect v ec2,v [in-] y1ec2,y y/ed,N y/cp,N kcr 0.000 1.000 0.000 1.000 1.000 1.000 17 Nb [lb] b seismic (nonductile �Vcpg [Ib] Vua [lb] 5940 0.700 0.750 0.400 9978 733 4.3 Concrete edge failure in direction x+ le [in.] do [in.] ct [in.] Avc (in .21 Avco [in.I 3.125 0.625 5.000 125.00 112.50 Ved,V Wparalleiy ec,y[in•] Wec,V tYc,V lYh,V 0,900 1.000 0.000 1.000 1.000 1.225 Vb [lb] seismic y nonductile �Vcbg [Ib] Vua [lb] 5399 0.700 0.750 0.400 1389 733 5 Combined tension and shear loads Utilization 3N.v [%] Status 0.520 pNv = P� + [3v `:= Input data and results must be checked for agreement with the existing conditions and for plausibility! PROFIS Anchor (c) 2003-2009 Hilti AG, FL -9494 Schaan Hilti is a registered Trademark of RIC AG, Schaan www.hilti.us Profis Anchor 2.5.3 Company: Page: 4 Specifier: Project: Address: Sub -Project I Pos. No.: Phone I Fax: Date: 611812015 E -Mail: 6 Warnings Load re -distributions on the anchors due to elastic deformations of the anchor plate are not considered. The anchor plate is assumed to be sufficiently stiff, in order not to be deformed when subjected to the loading! Input data and results must be checked for agreement with the existing conditions and for plausibility! Condition A applies when supplementary reinforcement is used. The 0 factor is increased for non -steel Design Strengths except Pullout Strength and Pryout strength. Condition B applies when supplementary reinforcement is not used and for Pullout Strength and Pryout Strength. Refer to your local standard. • Refer to the manufacturer's product literature for cleaning and installation instructions. • Checking the transfer of loads into the base material and the shear resistance are required in accordance with ACI 318 or the relevant standard! An anchor design approach for structures assigned to Seismic Design Category C, D, E or F is given in ACI 318-08 Appendix D, Part D.3.3.4 that requires the governing design strength of an anchor or group of anchors be limited by ductile steel failure. If this is NOT the case, Part D.3.3.5 requires that the attachment that the anchor is connecting to the structure shall be designed so that the attachment will undergo ductile yielding at a load level corresponding to anchor forces no greater than the controlling design strength. In lieu of D.3.3.4 and D.3.3.5, the minimum design strength of the anchors shall be multiplied by a reduction factor per D.3.3.6. An alternative anchor design approach to ACI 318-08, Part D.3.3 is given in IBC 2009, Section 1908.1.9. This approach contains "Exceptions" that may be applied in lieu of D.3.3 for applications involving "non-structural components" as defined in ASCE 7, Section 13.4.2. An alternative anchor design approach to ACI 318-08, Part D.3.3 is given in IBC 2009, Section 1908.1.9. This approach contains "Exceptions" that may be applied in lieu of D.3.3 for applications involving "wall out -of -plane forces" as defined in ASCE 7, Equation 12.11-1 or Equation 12.14-10. • It is the responsibility of the user when inputting values for brittle reduction factors (�nonductile) different than those noted in ACI 318-08, Part D.3.3.6 to determine if they are consistent with the design provisions of ACI 318-08, ASCE 7 and the governing building code. Selection of �nonductiie = 1.0 as a means of satisfying ACI 318-08, Part D.3.3.5 assumes the user has designed the attachment that the anchor is connecting to undergo ductile yielding at a force level — the design strengths calculated per ACI 318-08, Part D.3.3.3. Fastening meets the design criteria! Input data and results must be checked for agreement with the existing conditions and for plausibility! PROFIS Anchor ( c ) 2003-2009 Hilti AG, FL -9494 Schaan Hilti is a registered Trademark of Hilti AG, Schaan www.hiiti.us Profis Anchor 2.5.3 Company: Page: 5 Specifier: Project: Address: Sub -Project I Pos. No.: Phone I Fax: Date: 6/18/2015 E -Mail: -18.000 7 Installation data Anchor plate, steel: - Anchor type and diameter: Kwik Bolt TZ - SS 316 5/8 (3 1/8) Profile: no profile; 0.000 x 0.000 x 0.000 in. Installation torque: 720.001 in.lb Hole diameter in the fixture: df = 0.688 in. Hole diameter in the base material: 0.625 in. Plate thickness (input): 0.250 in. Hole depth in the base material: 3.750 in. Recommended plate thickness: not calculated Minimum thickness of the base material: 5.000 in. Cleaning: Manual cleaning of the drilled hole according to instructions for use is required. Coordinates Anchor in. Anchor x y c_x c+x c.y c.y 1 -12.000 -18.000 5.000 29.000 5.000 41.000 2 12.000 -18.000 29.000 5.000 5.000 41.000 3 -12.000 18.000 5.000 29.000 41.000 5.000 4 12.000 18.000 29.000 5.000 41.000 5.000 Input data and results must be checked for agreement with the existing conditions and for plausibility! PROFIS Anchor( c ) 2003-2009 Hilti AG, FL -9494 Schaan Hilti is a registered Trademark of Hilti AG, Schaan www.hilti.us Cn= Profis Anchor 2.5.3 Company: Page: 6 Specifier: Project: Address: Sub -Project I Pos. No.: Phone I Fax: Date: 6/18/2015 E -Mail: 8 Remarks; Your Cooperation Duties • Any and all information and data contained in the Software concern solely the use of Hilti products and are based on the principles, formulas and security regulations in accordance with Hilti's technical directions and operating, mounting and assembly instructions, etc., that must be strictly complied with by the user. All figures contained therein are average figures, and therefore use -specific tests are to be conducted prior to using the relevant Hilti product. The results of the calculations carried out by means of the Software are based essentially on the data you put in. Therefore, you bear the sole responsibility for the absence of errors, the completeness and the relevance of the data to be put in by you. Moreover, you bear sole responsibility for having the results of the calculation checked and cleared by an expert, particularly with regard to compliance with applicable norms and permits, prior to using them for your specific facility. The Software serves only as an aid to interpret norms and permits without any guarantee as to the absence of errors, the correctness and the relevance of the results or suitability for a specific application. • You must take all necessary and reasonable steps to prevent or limit damage caused by the Software. In particular, you must arrange for the regular backup of programs and data and, if applicable, carry out the updates of the Software offered by Hilti on a regular basis. If you do not use the AutoUpdate function of the Software, you must ensure that you are using the current and thus up-to-date version of the Software in each case by carrying out manual updates via the Hilt! Website. Hilti will not be liable for consequences, such as the recovery of lost or damaged data or programs, arising from a culpable breach of duty by you. Input data and results must be checked for agreement with the existing conditions and for plausibility! PROF IS Anchor( c ) 2003-2009 Hilti AG, FL -9494 Schaan Hilti is a registered Trademark of Hilti AG, Schaan STATEMENT OF SPECIAL INSPECTIONS, 2013 CBC COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (406) 777-3228 • FAX (408) 777-3333 • bullding0cuuertino.ora SITE A DRESS 20705 Valley Green Dr APN 3 (, BBP# 1A Owner .................... Ap,ale,Anc................................................................... Contractor..... Ai..... .filo.. fl.Q. m.................................. Address....... ........................................ Address........................................................................................................... City/St......Cupertino, CA........zip............95014.Phonel,0011,5951 City/St............. .................................... Zip ................... Phone ........................ Applicant.„�ileen Mollny............................................I.............. Engineer/Architect., ayes Group. Architects......... Address.... ...Infinite Loop ........ Address .................. Z6.5.7....$Prlua..firKft.t....................... atylst........... .... Zp...... -95.1 .. Phone ..................... RedaJood t:it CA 94063 City/St...................... .....X....Zip........ Phone ........ .................... PROJECT DESCRIPTION: fi P%WO i W4 AN La MlI N11 A MW RA Ni "o—A - This 'STATEMENT OF SPECIAL INSPECTIONS' is submitted In fulfillment of the requirements of CBC Sections 1704 and 1705. This form Is structured after and used by permission from the Structural Engineer Association of Norlhem Callfomia's (SEAONC) mode statement of Special Inspections. Also, included with this form is the following: ❑ 'LIST OF SPECIAL INSPECTION AGENCIES (page 2). A list of testing agencies and other special inspectors that will be retained to conduct the tests and Inspections for this project ❑ "SCHEDULE OF SPECIAL INSPECTION' (page 3 — 6). The Schedule of Special Inspections summarizes the Special Inspections and tests required. Special Inspectors will refer to the approved plans and specifications for detailed special Inspection requirements. Any additional tests and inspections required by the approved plans and specifications shall also be performed. Special Inspections and Testing will be performed in accordance with the approved plans and specifications, this statement and CBC Sections 1704, 1705, 1705. 1707, and 1708. Interim reports will be submitted to the Building Official and the Registered Design Professional in Responsible Charge in accordance with CBC Section 1704.1.2. A Final Report of Special Inspections documenting required Special Inspections, testing and correction of any discrepancies noted in the inspections shall be submitted prior to issuance of a Certificate of Use and Occupancy (Section 1704.1.2). The Final Report will document: • Required special inspections. • Correction of discrepancies noted in inspections. The Owner recognizes his or her obligation to ensure that the construction complies with the approved permit documents and to implement this program of special Inspections. In partial fulfillment of these obligations, the Owner will retain and directly pay for the, Special Inspections as required in CBC Section 1704.1. This plan has been developed with the understanding that the Building Official will: • Review and approve the qualifications of the Special Inspectors who will perform the inspections. • Monitor special Inspection activities on the job site to assure that the Speciallof qualified and are performing their duties as called for in this Statement of Special Inspection. • Review submitted inspection reports. • Perform Inspections as required by the local building code. I have read and aanee to comply with the terms and coedtement Prepared By: Project Q Engtneer 14 Architect Registered Design Professional in Ch a Si natur ..........LA--4�1,1075..........Lic. .. .............. Date: .., 90” / i..... OwnerName:Eileen Molloy Owners Authorization Signature ........................................................................ Date: � ..� ..I I.n�p-�tion,A�envy / Inspector Name* ' ' 7 Sl natu .....2-11ULAZ11"-Dale:.... �.. Builth Ofllcia r des l St nature . . Date: ..1.� SpecialnspecrionForm 2011.doc revised 09106111 SCHEDULE OF SPECIAL INSPECTION SIT E ADDRESS Z O 1 S V141 G.�.i�1J PROJECT DESCRIPTION: EOAIN PMA IP "R%t4 W& �t.�J►t tNL. A n.S MIAM I L t oo M . Notation Used in Table: Column headers: C Indicates continuous inspection is required. P Indicates periodic inspections are required. The notes and/or contract documents should clarify. Box entries: X is placed in the appropriate column to denote either "C" continuous or "P" periodic inspections. Denotes an activity that is either a one-time activity or one whose frequency is defined in some other manner. Additional detail regarding inspections and tests are provided in the project specifications or notes on the drawings. VERIFICATION AND INSPECTIONC p REFERENCED IBC REFERENCE STANDARD INSPECTION OF FABRICATORS 1. ❑ Inspect fabricator's fabrication and quality control 7-1— 1704 3 procedures. INSPECTION OF STEEL 1. Material verification of high-strength bons, nuts and washers. ❑ Identification marking to conform to ASTM stds RISC 360, specified in the approved construction documents. — X Section A3.3 and applicable ASTM material standards ❑ Inspect fabricator's fabrication and quality control — X procedures. 2. Inspection of high-strength bolting: ❑ Snug -tight joints. — X ❑ Pretensioned and slip -critical joints using tum -of -nut with matchmarking, twlst-off bolt or direct tension — X AISC 360, Indicator methods of installation. 1704.3.3 Section M2.5 ❑ Pretensioned and slip -critical joints using tum -of -nut without matchmarking or calibrated wrench methods X of installation. 3. Material verification of structural steel and cold -formed steel deck ❑ For structural steel, identification markings to conform _ X AISC 360, to AISC 360. Section M2.5 ❑ For other steel, identification markings to conform to Applicable ASTM ASTM standards specified In the approved — X material standards construction documents. ❑ Man rladurer's certified test reports. — X SpecfalnspectionForm 2012.doc revised 09/06/12 VERIFICATION AND INSPECTIONC P REFERENCED STANDARD IBC REFERENCE INSPECTION OF CONCRETE 1. ❑ Inspection of reinforcing steel, including prestressing tendons and placement. — X ACI 318: 3.5, 7.1-7.7 1913.4 2. ❑ Inspection of reinforcing steel welding in accordance with Table 1704.3 Item 5b. _ AWS D1.4 ACI 318: 3.5.2 _ 3. ❑ Inspection of bolts to be installed in concrete prior to and during placement of concrete where allowable loads have been increased or where strength design is used. X — ACI 318: 8.1.3, 21.2.8 1911.5, 1912.1 4. ❑ Inspection of anchors installed in hardened concrete. — X ACI 318: 1912.1 5. ❑ Verifying use of required design mix. _ X ACI 318: 1904.2.2,1913.2, 1913.3 6. ❑ At time fresh concrete is sampled to fabricate specimens for strength tests, perform slump and air content tests and determine the temperature of the concrete. X — ASTM C 172 ASTM C 31 AC 318: 5.6, 5.8 1913.10 7. ❑ Inspection of concrete and shotcrete placement for proper application techniques. X — ACI 318: 59510 . 510 1913.6, 1913.7, 1913.8 8. ❑ Inspection for maintenance of specified curing temperature and techniques. _ X ACI 318: 5.11-5.13 1913.9 9. Inspection of prestressed concrete: ❑ Application of prestressing forces. X — ACI 318:18.20 ❑ Grouting of bonded prestressing tendons in the seismic force-resisting system. X — ACI 318:18.18.4 10. ❑ Erection of precast concrete members. — X ACI 318: Ch. 16 — 11. ❑ Verification of in-situ concrete strength, prior to stressing of tendons in posttensioned concrete and prior to removal of shores and fomes from beams and structural slabs. — X ACI 318: 6.2 — 12. ❑ Irrspect formwork for shape, location, and dimensions the concrete member being formed. — X ACI 318: 6.6.1 13. molts Installed in Existing Masonry or Concrete ❑ Direct tension testing of existing anchors. — X See ICC ES Reports form special inspection requirements for proprietary products ❑ tension testing of new bolts. — X testing of new bolts. — X I quail ication test for bolts and other types of attt�hors": — X 14. ❑ Other ,pecialnspectianFann 2012.doc revised 09/06112 SpeckdnspecdonForm 2012.doc revised 09/06/12 REFERENCE FOR CRITERIA VERIFICATION AND INSPECTION C P IBC TARS 402/ACI TMS 4021ACI SECTION 630/ASCE 6 630/ASCE 6 8. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be — X 2105.2.2, — Art. 1.4 observed. 2105.3 INSPECTION OF LEVEL 2 MASONRY 1. ❑ Compliance with required inspection provisions of the construction documents and the approved — X — — Art. 1.5 submittals. 2. ❑ Verification of fmand faac prior to construction and for every 5,000 square feet during -- X — -- Art. 1.413 construction. 3. ❑ Verification of proportions of materials in premixed or preblended mortar and grout as -- X — — Art. 1.513 delivered to the site. 4. ❑ Verification of slump flow and VSI as delivered to X — — -- Art. 1.513.11.3 the site for self consolidating rout. 5. The fo0owing shall be verified to ensure compliance: ❑ Proportions of site -prepared mortar, grout, and — X — --- Art. 2.6A prestressing grout for bonded tendons. ❑ Placement of masonry units and construction of — X — -- Art. 3.313 mortar joints. ❑ Placement of reinforcement, connectors and X — Sec. 1.15 Art. 3.4, 3.6A prestressing tendons and anchorages. ❑ Grout space prior to grouting. X — — — Art. 3.21) ❑ Placement of grout. X — — -- Art. 3.5 ❑ Placement of prestressing grout. X — — — Art. 3.6C ❑ Size and location of structural elements. -- X — — Art. 3.3F ❑ Type, size, and location of anchors, including otter details of anchorage of masonry to X — — Sec.1.2.2(e) — structural members, frames and other construction. ❑ Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and — X — Sec. 1.15 Art. 2.4, 3.4 anchorages. ❑ Welding of reinforcing bars. X — — Sec. 2.1.9.7.2, — 3.3.3.4 (b) ❑ Preparation, construction, and protection of masonry during cold weather (temperature below _ X Sec. 2104.3, — Art. 1.8C, 1.81) 40 degrees F) or hot weather (temperature above 2104.4 90 degrees F). ❑ Application and measurement of prestressing X — — — Art. 3.613 force. 6. ❑ Preparation of any required grout specimens, Sec. mortar specimens, and/or prisms shall be X — 2105.2.2, — Art. 1.4 observed. 2105.3 SpeckdnspecdonForm 2012.doc revised 09/06/12 �— VERIFICATION AND INSPECTION C P REFERENCED IBC STANDARD REFERENCE 7. ❑ For specialty piles, perform additional inspections as determined by the registered design professional in — — — Table 1704.8 responsible charge. REQUIRED VERIFICA'T'ION AND INSPECTION OF CAST -IN-PLACE DEEP FOUNDATION ELEMENTS 1 ❑ Observe drilling operations and maintain complete and X — accurate records for each element. 2. ❑ Verify placement locations and plumbness, confirm element diameters, bell diameters (if applicable), lengths, embedment into bedrock (if applicable), and X -- -- Table 1704.9 adequate end -bearing strata capacity. Record concrete or grout volumes. 3. ❑ For concrete elements, perform additional inspections in accordance with Section 1704.4. _ — HELICAL PILE FOUNDATIONS 1. ❑ Record Installation equipment used, pile dimensions,X — — 1704.10 tip elevations, final depth, final installation torque. SPRAYED FIRE-RESISTANT MATERIALS Physical and visual tests 1. Condition of substrates. ❑ Inspect surface for accordance with the approved fire- rwistance design and the approved manufacturer's — — written instructions. ❑ Verify minimum ambient temperature before and after — X application. — 1704.12.1 ❑ Verify ventilation of area during and after application. — X 2. ❑ Measure average thickness per ASTM E605 and — — Section 1704.12.4. 3. ❑ Verify density of material for conformance with the approved fire-resistant design and ASTM E605. (Ref. — — Section 1704.12.5) 4. ❑ Test cohesiveladhesive bond strength per Section 1704.12.6. — — 5. ❑ Condition of finished application. MISCELLANEOUS 1. Mastic and Intumescent Fire -Resistant Coating. — — -- 1704.13 2. Exterior Insulation and Finish Systems (EIFS). Water - resistive barrier coating when installed over a sheathing — — — 1704.14 substrate. 3. Special Cases — — — 1704.15 4. Smoke Control System — — — 1704.16 5. Seisrnic Resistance ❑ Suspended ceiling systems and their anchorage. — — — 1705.3 [4.3] SpecialnspectionForm 2012.doc revised 09/06112 ❑ Inspection of screw attachments, bolting, anchoring, and other fastening of components within the seismic- — X fore -resisting system including shear walls, braces, diaphragms, collectors (drag struts) and hold-downs. 4. Storage racks and access floors ❑ Anchorage of storage racks 8 feet or greater in height — X 1707.5 and access floors. 5. Architectural components ❑ Inspect erection and fastening of exterior cladding weighing more than 5 psf and higher than 30 feet — X above grade or walking surface. ❑ Inspect erection and fastening of veneer weighing more than 5 psf.and higher than 30 feet above grade -- X or walking surface. — 1707.6 ❑ Inspect erection and fastening of all exterior non- bearing walls higher than 30 feet above grade or — X wailking surface. ❑ Inspect erection and fastening of all interior non- bearing walls weighing more than 15 psf and higher — X than 30 feet above grade or walking surface. 6. Mechanical and Electrical Components ❑ Inspect anchorage of electrical equipment for — X emergency or stand-by power systems. ❑ Inspect anchorage of non -emergency electrical — X equipment. ❑ Inspect installation of piping systems and associated mechanical units carrying flammable, combustible, or — X — 1707.7 highly toxic contents. ❑ Inspect installation of HVAC ductwork that contains — X hazardous materials. ❑ Inspect installation of vibration isolation systems — X where required by Section 1707.7. 7. ❑ Verify that the equipment label and anchorage or mounting conforms to the certificate of compliance — — — 1707.8 when mechanical and electrical equipment must be seismically qualified. 8. ❑ Seismic isolation system: Inspection of isolation — X — 1707.9 system per ASCE 7 – Section 17.2.4.8 9. ❑ Obtain mill certificates for reinforcing steel, verify compliance with approved construction documents, — — — 1708.2 and verify steel supplied corresponds to certificate. 10. ❑ Structural Steel: Invoke the QAP Quality Assurance — — — 1708.3 requirements in AISC 341. 11. ❑ Obtain oertificate that equipment has been seismically — — — 1708.4 qualified. 12. ❑ Obtain system tests as required by ASCE 7 Section — — — 1708.5 17.8. SpeclabupectionFonn 2012.doc revised 09/06/12 Test, Adjust & Balance Report PROJECT: Apple VG6.1 ADDRESS: 20705 Valley Green Drive Cupertino, CA 95014 ARCHITECT: Hayes Group ENGINEER: Silicon Valley Mechanical GENERAL CONTRACTOR: Novo Construction HVAC CONTRACTOR: Silicon Valley Mechanical LEAD BALANCE TECHNICIAN: Scott McClung DATE: 9/16/2015 DATE: 9/16/2015 PROJECT: Apple VG6.1 PAGE: 1 CFM Cubic Feet Per Minute FPM Feet Per Minute RPM Revolutions Per Minute HP Horse Power BHP Brake Horse Power FLA Full Load Amps SF Service Factor " W.G. Inches of Water gauge SP Static Pressure TSP Total Static Pressure ESP External Static Pressure AP Differential Pressure AT Differential Temperature °F Degree Fahrenheit °C Degree Celcius CD Ceiling Diffuser CS Ceiling Supply CR Ceiling Return WS Wall Suppy WR Wall Return CE Ceiling Exhaust WE Wall Exhaust EDS Exposed Duct Supply ODUCT Oen Duct DSOX Duct Sox LSD Linear Slot Diffuser HEPA High Efficiency Particulate Air Filter FP -NEPA Fan Powered -High Efficiency Particulate Air Filter DNA Data Not Available DNL Data Not Listed NA Not Applicable LOA Lack of Access NI Not Installed DATE: 9/16/2015 PROJECT: Apple VG6.1 PAGE: 2 1 Unless otherwise noted, indicated CFM Cubic Feet per Minute is a standard condition. 2 Unless otherwise noted, indicated GPM Gallons per Minute is a standard condition. 3 Unless otherwise noted, all sizes are measured in inches. PROJECT: Apple VG6.1 DATE: 9/16/2015 SYSTEM: ( E ) Supply air PAGE: 3 REMARKS: CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20705 VALLEY GREEN DR CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 15060138 OWNER'S NAME: APPLE INC 1460 O'BRIEN DR DATE ISSUED: 07/16/2015 OWNER'S PHONE: 4153105791 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 le LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ License Class_ Lie. #� 4a►2� APPLE TENANT IMPROVEMENT - LAB EXPANSION (720 SQ FT). ContractorO �i, GD�/S?�(G17t�' Date t 'LZ✓ / DEF # 1 - PLANS FOR EXISTING LOCATIONS FOR ACCESSIBLE RESTROOMS - ISSUED 9/23/15 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: 1. I have and will maintain a certificate of consent to self -insure for Worker's Sq. Ft Floor Area: Valuation: $200000 Compensation, as provided for by Section 3700 of the Labor Code, for the erformance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32610046.00. Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 0 ED INSPECTION. 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 -®m' - h all non -point sourc regulations per the Cupertino Municipal Code, Section 9.18. OOFS Signature Date 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 ❑ OWNER -BUILDER DECLARATION inspection. I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: t. I, as owner of the property, or my employees with wages as their sole ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 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 I hereby affirm under penalty of perjury one of the following three declarations: following r f compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & I. I have and will maintain a Certificate Conto lre for Worker's Safety Code, Section 25532(a) should I store or handle hazardous material. Compensation, as provided for by Section 3700 of the Labor Code, for the Additionally, should I use equipment or devices which emit hazardous air performance of the work for which this permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will 2. I have and will maintain Worker's Compensation Insurance, as provided for by maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Section 3700 of the Labor Code, for the performance of the work for which this Health & Safety Code, Sections 25505, 25533, and 25534. permit is issued. 3. I certify that in the performance of the work for which this permit is issued, I shall Owner o' ut rized agent: 4' Date: 2`� /)'-- 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 CONSTRUCTION LENDING. AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's revoked. for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to •save I understand my plans shall be used as public records. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Licensed Professional 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 t-yqr-.i i -%u "TDV1D'rTT%Tn �fz T . . . . . . . . . . . . . . . . . . . . . . 111-yonb. I'tan Check Fl�mYNI C Cheek I L- I I "--7E 1'erfnif I - 'e e: Efec� jlerinit fee: t tech. Perraii Fee: F Y,,,, , 1, -F ------- Other i.14ech. h7sp. I I Other.Phiwb.-fijspL--J Other Nee. Insp. I." f i% I' — Aiech. Insp. Fee: 111timb. Mat). J`ee: lec'. NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer I District, etc.). These for tion available and are only an estimate. Contact the D e t ces are based on the prelimina -f ma on FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/11 MISC ITEMS FEE QTY/FEE I FEE ESTIMATOR - BUILDING DIVISION $0.00E# Deferred Submittal ADDRESS: 20705 VALLEY GREEN DR DATE: 09/2312015 REVIEWED BY: MELISSA $0.00-i APN: 326 10 046 BP#: 15060138 *VALUATION: I$o *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial al Building USE: PE' Civil / Religious activities PENTAMATION IGENCOM in BQ zone? 0 Yes OZ PERMIT TYPE: 14 WORK DEF # 1 - PLANS FOR EXISTING LOCATIONS FOR ACCESSIBLE RESTROOMS - ISSUED 9/23/15 SCOPE I �fz T . . . . . . . . . . . . . . . . . . . . . . 111-yonb. I'tan Check Fl�mYNI C Cheek I L- I I "--7E 1'erfnif I - 'e e: Efec� jlerinit fee: t tech. Perraii Fee: F Y,,,, , 1, -F ------- Other i.14ech. h7sp. I I Other.Phiwb.-fijspL--J Other Nee. Insp. I." f i% I' — Aiech. Insp. Fee: 111timb. Mat). J`ee: lec'. NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer I District, etc.). These for tion available and are only an estimate. Contact the D e t ces are based on the prelimina -f ma on FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/11 MISC ITEMS FEE QTY/FEE I Plan Check Fee: $0.00E# Deferred Submittal IS OT 0.0 hrs SUPPI. PC Fee: Reg. () F' SUBM $0.00 $286.00 IDEFSU � PME Plan Check: $0.00-i Permit Fee: $0.00 SUPPI. Insp. Fee -.(F) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 Adnihfis,irath,e Fee: wnrl- Without Permit? n Yes (E) No $0.00 School i'l info. Select a Non -Residential Advanced Planning Fee: $0.00 Building or Structure 1),t el Docuirentalion F'ees. - Cn nn Select an Administrative Item #10 Strong Motion -Fee. Bldg Stds Commission Fee: $0.00 A $286.00 $0.001 $286-00 Revised: 07/02/2015 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISI 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408} �l1PERTIhlE7 777-3228 + FAX (408) 777-3333 • building(c cupertino.org NEW CONSTRUCTION ❑ ADDITION . ❑ ALTERATION / TI 'R REVISION /DEFERRED ORIGINAL PERMIT 4J S-bLe_nl 3 g PROJECT ADDRESS APN 9 0 . OWNER NAME PH NE &MAIL ps1' l y (t FE-+r� /✓dot.` D .. �i 5^J oLLO . Lo.p- - �17 STREET ADDRESS Of ?$J %-r E- L o ` CITY, STATE, ZIP I FAX CONTACT N PHONE E-MAIL !L ILr`C-r2 ISlyRt's-s-it-3 JJ -k% - *OILvNt��coavcr� CA STREET ADDRESS CITY, STATE, ZIP FAX ) ��v 6 16 f G� IPO— A'-&0 P� o Z OWNER ❑. OWNER-BUIIAER ❑ oiANERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT II -ENGINEER. ❑ DEVELOPER ❑ TENANT CONTRA TORNANS LICENSENUD4BER LICENSETYPE 5AlL11 �,"� � BUS. LIC 9 COMPANY NAI S Novo &MAIL {) LTjON• to J \k L+i'12�f�iVOGOf�Ili�' FAX STREET ADDRESS �Lwo p`3QA� 64J v VL CITY, STATE, ZIP A Ets L a �C i LA � gt{aZs' PHONE ARCHITECTIENG 'E£RNAME LICENSE NLMER ]BUS. LIC - I COMPANY NAME E-MAIL 1M e lay MLt�. (0 FAX - A�eCAL-R�alsl r STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK 7---b rz- £'1C l 4'4'f JJZn A -u— E` s S t B I L- !2k' S T-112-0 O EXISTINGUSE PROPOSED USE CONSTR. TYPE 1 4 STORIES- USE TYPE I OCC. I SQ.FT. ,VALUATION (S) EXJSTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN - OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ATTACH DR FEEING UMTS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? NO ADDITION? ❑NO �F PRE A❑PPLICATION YES IF YES, PROVIDE COPY OF PLANNING APDL m ❑ NO PLANNA G APPROVAL LETTER I IS THE BLDG AN EICHLER HOME? ❑ NO ±r -;✓I - � N' _ ` � T07AI. VALUATION: By my signature below, I certify to each of the followine: I am the property owner _ent to property owner's behalf. I have d this I to comply with ail applic ble Ioczl application and the information I have provide 'correct. I have read the Description of Werk and .__ ais_accurate. agree ordinances and state laws relating to bu g c tructio Drize representatives'of Cbrperr-Elno to enter the above -identified property for inspection purposes. A Signature of Applicant/Agent: Date b _ Pte. cr cx �e> � orlrLnGSLiP SUPPLE AL R\TFORMATION REQUIREDqgg 0- SFD Multifamily dwellings: Apply for demolition permit for I] -0 R TB��couhrER �BUILDZrtGPL4NREYSE43r Mew or gx - existing building(s). Demolition permit is required prior to issuance of building ME �PT pA�'� permit for new blllldlng. 'xp1?Ess '— (. s'�+" Ty4 �f P�IBY Bldgs: Provide completed Hazardous Materials Disclosures �rnnnxD �� y _ Commercial a NA _ form if any Hazardous Materials are being used as part of this project. n _ Copy of Planning Approval Letter or Meeting With Planning prior to� S s �Is�tl Permit submittal of Building application. Bld.-App 2011.doc revised 06/21111 av- 2 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20705 VALLEY GREEN DR CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 15060138 OWNER'S NAME: APPLE INC 1460 O'BRIEN DR DATE ISSUED: 07/16/2015 OWNER'S PHONE: 4153105791 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 ,0 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL APPLE TENANT IMPROVEMENT - LAB EXPANSION (720 License Class Lic.o 2-2- SQ /� '^bc'�- Contractor J ub) C c-,, ate ¢D FT �. 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 Sq. Ft Floor Area: Valuation: $200000 erformance 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. APN Number: 32610046.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED 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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: Date: �G�ll / !��'l�GfT with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature -��ate (� 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. ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: \ I have and will maintain a Certificate of Consent to self -insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. �/��' _,_ agent �----� Owner or authorized Date: I certify that in the performance of the work for which this permit is issued, I shall lr 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building o)cupertino.org CUPERTINO ❑ NEW CONSTRUCTION ❑ ADDITION R.AL�-7TFRATTnN/TT I I RFVTCTON/TIFFFRPFTI (1RVANAI PFPT`4TTH PROJECT ADDRESS p � /recA Y� r �q p APNg /J OWt1N/5 RN �j - PHOe���'E���� IV E-MAIL STET ADDRESS CITY, STATE ZIP FAX CONN//;;SrACT T,.p7AME - _ Cs� oda A/L S L(—, �� dr� ¢pTEp- ^� PHO€YS �� .A " 9 51 _ g E 8 P.7 �I STREET ADDRESSI CIT , STATE, ZIR FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT Q CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LICENSE NUMBER LICENSE'NE BUS. LIC# COMPANY NAME NO VG Cl) n" nu ct�n E-MAILFAX I Frre resp nous c ��-��� ��t.;I STVT A/DhDRESS �''^� CITY, 4 0 � k , CCL/ -7, G � PHONE ARCPECT/ENGINEER 9'd LICENSE NU/gMB R 9 ��p ay �^ q �,A 9.�y U1 " ® 1 e— YY. _A tf x'_0.9 -m BUS. LIC # �%A, COMPAN NAME' qq� ,pT} '�� s� 0 g9 r E-MAIL FAX STREET ADDRESS CITY, A ZIP PHONE DESCRIPTION OF WORK ' Uf�d l.�°A� °Y e7 d`��®�l ✓ sCh Ci �d 4� iiJ a�a 5 ra L vvv_COLU�q® c-� 9,—aon, EXISTING USE PROPOSED USE CONSpTR TYPE # STORIES q USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA "i 7, yeg AREA � AREA '% NET AREA J T/" p /� .� gy g `� -720 @ ,/ � ' BATHROOM KITCHEN OTHER" REMODEL AREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH I # DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY []YES V&— BEING ADDED? []NO ADDITION? A- []NO PRE -APPLICATION []YES ff YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑YES EICHLER HOME? ❑ NO RECEIVEDTOTAL - /\/ VALUATION: A 6 s 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 application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: — _ Date: 2-11 SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-TH&COUNTER BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building 111 permit for new building.EXPRESS ElPLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to El MAJOR l SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BZdgApp_2011.doc revised 06/21/11 4 O0A,% CITY OF CUPERTINO FM__1 FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20705 Valley Green Dr DATE: 06/22/2015 REVIEWED BY: Sean PC FEE ID APN: BP#: "VALUATION: 1$200,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building $929.80 PENTAMATION PERMIT TYPE: 1 B T� WORK Apple Tenant Improvement - Lab Expansion 720 sq ft). 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,111-B,IV,V-B 720 $2,123.30 IBTIPLNCK $929.80 1BTIINSP Llec. Insp, Pec: $0.00 Permit Fee: $929.80 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction action Tax: TOTALS: 720 $2,123.30 Adininistrative Fee: $929.80 MECH;.FIOURLY . .. Yes ;� No PLUIIZB, HOURLY Yes .-. No .. ELEC, HOURLY ®.Yes No... Mecb. Plan C'he<Ck Numb. Plan i7heek T P'Iec..Plan Check :19ech. Permit Fee: Plumb. Permit Fee: lslec. Permir Fee: Orber Hec•h. Insp. Other Plumb Insp. Other Vec. Insp. P2��j ilech. 1nsp. Lee: I'Izunb. I'nap. /'ec: Llec. Insp, Pec: NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Pire, Sanitary Sewer Utstrict, acnoot nictrirt ,tr- )- noco fool aro hasod an tho nroliminary infor"w ian availahle and are only an estimate. Contact the Dent for addn'1 into. FEE ITEMS (Fee Resolution 11-053 E f 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,123.30 Select a Misc Bldg/Structure or Element of a Building L Suppl. PC Fee: (F) Reg. 0 OT 0.0 Fhrs $0.00 PME Plan Check: $0.00 Permit Fee: $929.80 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction action Tax: Adininistrative Fee: 0 E) Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure I 0 0 i Travel Docivnentalion Fees: Strong Motion Fee: IBSEISMICO $56.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $8.00 SUBTQTALS:„ $3,117.10 $0.00 „r„ TOTAL FEE ' $3,117.10 Revised: 05/07/2015 c>�-7 0 -1Zop Project: le VG6 Platform Lab