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15080018CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10201 N DE ANZA BLVD CONTRACTOR: T. MARSHALL PERMIT NO: 15080018 ASSOCIATES, LTD. OWNER'S NAME: NMSBPCSLDHB 7042-B COMMERCE CIR DATE ISSUED: 08/04/2015 OWNER'S PHONE: 5103316719 PLEASANTON, CA 94588 PHONE NO: (925) 734-9999 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class �` 1 O Lic. #�� t { Z INSTALLATION OF (12) DUAL HEADED EV CHARGING STATIONS ON TOP FLOOR OF PARKING GARAGE; Contractor ..(Lin utS</vlq 75-0Z Date g— !S _ INSTALL (2) SINGLE HEADED EV CHARGING STATIONS ON I hereby affirm that I am licensed under the provisions of Chapter 9 LOWER (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: $125000 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. APN Number: 32634070.10201 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 0 granting of this permit. Additionally, the applicant understands and will comply Issued by: � } �� Date: m with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. "� Date � � Signature_ � ROOFS: any r All roofs shall be inspected prior to y 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: 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 I 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 permit is issued. agent: Owner or authorized a __` l5� g Z �� Date: 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 ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT a BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 f� CUPERTINO (408) 777-3228 -FAX (408) 777-3333 -build in9(C�cupertino.org 1 J oU Dof PROJECT ADDRESS 10201 N. DeAnza Blvd., Cupertino, CA 95104 APN# ��/' 3�, (n � OWNER NAME Apple I-1PT-}f3 PHONE (510) 331-6719 E-MAIL favery@apple.com STREET ADDRESS I •e CITY. STATE, ZIP � CA +5. 50 9� m C/ FAX None CONTACT NAME Fred Avery PHONE (510) 331-6719 E-MAIL favery@apple.com STREET ADDRESS I Infinite Loop CITY, STATE, ZIP Cupertino, CA 95014 T;AX None Q OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ,4717/j�y LICENSENUMsB."/t t LILICENSE�CE%TYPE BUSLIC�Cc# Z COMPANY NAMF^, ��`AfT`��,CT�e�4Cr E. /1•,t�rS>`A CC`iC7 LLI X 7 G•9 q 4, STREET ADDRESS70 � 5 �^. ytlark cj CITY, STATE, ZIP /9, _ , ,, _ fd J�t � �5 � PHONE ARCHITECT/ENGINEERNAME Bill Beaman LICENSENUMBER 53/9✓330 BUS. LIC# N/A COMPANY NAME AECOM E-MAIL bill.beaman@aecom.com FAX (510) 874-3268 STREET ADDRESS 1333 Broadway, Suite 800 CITY. STATE, ZIP Oakland, CA 94612 PHONE (510) 874-3164 USE OF ❑ SFD or Duplex ❑ Multi -Family STRUCTURE: Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes No PROJECT IN FLOOD ZONE ❑ Yes (Z]No ❑ SOLAR PANELS ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATERHEATING ❑ OTHER: FOR SOLAR PANELS. NUMBER OFPANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: f/ 75 �Q0 DESCRIPTION OF WORK Provide 12 Dual Headed EV Charging Stations for 24 Regular Spaces on top floor of garage Provide 2 single headed EV Charging Stations for 1 Accessible and 1 Regular Space Total No. of EV Charges equals 14. RECEIVED BY: 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. 1 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 buil in ns Tuction. I autho ze presentatives of Cupertino to enter the above -identified roperty fo pection purposes. f� Signature of Applicant/Agent: r' �y _ i ' e %� Date: e� SUPPLEMENTAL INFORMATION REQUIRED N/A OFFICE USE ONLY w r E OVER -THE COUNTER EXPRESS x U x ❑ STANDARD U ❑ LARGE a ❑ MAJOR PVApp 2011.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR — RTTTT.DTN( T)TVTCTON lial ADDRESS: 10201 N De Anza Blvd DATE: 08/04/2015 REVIEWED BY: Sean Plan Check Fee: APN: BP#: 150eool "VALUATION: 1$125,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Buildin USE: g Civil /Religious activities in BQ zone? O Yes �, No PENTAMATION PERMIT TYPE• SOLAR -COMM WORK Installation of 12 dual headed EV charging stations on top floor of parking garaqe; install 2 single SCOPE headed EV Charging Stations on lower level for accessible stall; install (2) transformers; install (2) new© .Uech. Plan Check Plumb. flan Check Elec. Plan Check 0.0 hrs $0.00 ,1•leclz. Permit Fee: Plum/... 1'enli t f ee: Elec. Permit Fee: IEPERMIT Odier 11e�:h..h�.s1;. Other -Plumb Insp. Other Elec. Insp. El hrs $48.00 rllech. InsP. Fire: Plumb. Insp. Fee: Elea Insp. Fee. NULL': 1 his estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School D/striet. etrA TI/Q.CQ tQe.0 ary handl nH 1ho n1•nHH1IHOnf isf fn�sHnfinH nunilnh/n nHd Own nH/v nH nnl:H•..�n /'n..*..n� Il.., T.,..f w ..dd.. �l :..•F FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 14 # Alternative Energy System $1,526.001 1 CHRGSTA EV Charging Station Suppl. PC Fee: (j) Reg. 0 OT F0.0 hrs $0.00 PME Plan Check: $0.00 2 Electrical $215.00 1 IBREMPOWER Transformers Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT0 0 hrs $0.00 1,000 amps Electrical $72.00 1BELEC1000 Services PME Unit Fee: $0.00 PME Permit Fee: $48.00 = amps Electrical $72.00 1BELEC1000 Services Construction Tax: IBCONSTAXC $0.00 Administrative Fee: (ADMIN $45.00 0 E) Work Without Permit? O Yes (E) No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential G Building or Structure O i Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee: IBSEISMICO $35.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $5.00 SUBTOTALS $181.00 $1,885. 00 = TOS AL FEE ;11 $2,066,00 Revised: 07/02/2015 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: �✓, — ,%j�/.Zi� PERMIT # IJGG/ OWNER'S NAME: �/ �� jJp�t PHONE # GENERAL CONTRACTOR: % rl%iq 1t BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date Owner / Contractor Signature Date 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 Owner / Contractor Signature Date