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15020137CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6 INFINITE LOOP CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 15020137 OWNER'S NAME: APPLE COMPUTER INC 1460 O'BRIEN DR DATE ISSUED: 03/09/2015 OWNER'S PHONE: 4084380968 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ LICENSED CONTRACTOR'S DECLARATION APPLE - T.I. TO RECONFIGURE 15,220 S.F. ON WEST Lie. # `-7 q (U 1 -_;I_ License Classrt SIDE OF 1 ST & 2ND FLOORS, INCLUDING M.E.P.'S , Contractor �' CJDOO Date I hereby Affirm that I am licensed under the provisions of Chapter 9 REVISION 91- SHOW PHASING OF CONSTRUCTION (PHASE 1; 2ND (commencing with Section 7000) of Division 3 of the Business & Professions FLOOR; PHASE 2; IST FLOOR) ISSD OTC 3/18/2015 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 Valuation: $525000 performance of the work for which this permit is issued. Sq. Ft Floor Area: 1 have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 31602110 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. 1 agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAY F PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter 180 DAYS FR 'ST CALLED INSPECTION. 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 Date• 15 �UL Issued by: 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 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -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 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 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 1 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 ------Owner or authorized agent: �� �" Date: 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, 1 become subject to the Worker's Compensation provisions of the Labor Code, 1 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 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 Profc55ional 9 18. Signature Date 1 CUPERTINO n NEW coNSTRUc' CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • buildinora)cuoertino.org ❑ . ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGMAL PERMIT n J f U L 0 (3 7 PROJECT ADD S S A?N - �n OWNER NAA4E�I V .53 ^ (_yi E-MAIL / PHO1 G G U STREET ADDRESS y CITY, SSATE, ZIP, Ian L) L'f 10 CONTACT NAME I PHONEU G,�, E-h14IL I 1/ STREET ADDR' Sf' rr ( CITY, STATE, ZIP FAX 1. ��....LGo '❑-OWNER'- ❑ OWrI,.MR-BUILDER:" VAINERAGENT ❑ CONTRACTOR - ❑ CONI'RACTOR:AGETT ❑ ,ARCHITECT ❑ENGINEER. ❑ DEVELOPER .❑TENANT COT RACI OR NAME �� GZ C� UTC LICENSE 1 R , L]CENS T1 PE BUS. LIC R C D x d COMPANY NAME /U000 C h - E-MAIL ` FAX cil? . !u c b� % 0 i z c- ,-1 vo n STREET ADDRESS'(,. 1 ^ `7 () �c CITY, STATE, ZIP q cGC ( cZ PHONE CU) G�7 a i � ARCHITECT/ENGI'EER NAME LICENSE NUMBER BUS. LIC 4 Son 2: I _ COMPANY NAME � I E-MA1L FAX 6A n cp 460� AQ 6C STREET ADDRESS q6'I ) n c� �� / V G CITY, STATE, ZIP I PHONE _ � (x� DESCRIPTION OF WORK (i v� � � Lt ��� ✓�.� � n � � E do 44rJ G Ex1STING USE PROPOSED USE CONSTR. TYPE X"STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXIST T� FLOORARE TOTAL AREA AREA I NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTALDECK)PORCHAREA GARAGE7k A: DETACH ❑ ATTACH I 4 DWELLING UI.TIS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES ' BEING.4DDED? ONO ADDITION? E3NO PRE -APPLICATION OYES IF YES; PROVIDE COPY OF 1S THE BLDG AN ❑ YES = IjECEj\/ $ r .-.� ' z �, .. TOTAL PLANNINGAPPL° ONO PL.4TT' IGAPPROVALLETTER I-EICHLER HOME? 0 N � �•�.�. '� , iia a �!�•� 1��.. _ huic.,._. By my signature below, I certify to each of the following: I am the property owner or authorized agent to'arton roperjN o�avler's behalf. I have read this m 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. V'�� Signature of Applicant/Agent: Date: SUPPLEMENTAL INTFO164ATION REQUIRED :y ' x•- _ New SFD or Multifamily dwellings: Apply for demolition permit for `"� � � � � ��* q- 01 E riiE COL ����W� existing building(s). Demolition permit is required prior to issuance ofbuilding ��ER�BLILD GPL43�,RE��\y d permit for new building. n x NT � ' hPLA'TGPLjREVLEIi''�uK �. _Commercial Bldgs: Provide a completed Hazardous Materials DisclosureCi srND �tDE sr r�,�T�Bi rCwoltics 4 form if any Hazardous Materials are being used as part of this project. a ? _ Copy of Planning Approval Letter or Meeting.o with Planning prior to `� submittal of Building Permit application. �� Tb� t'flz stt`$AttYSER�I�SrRicr '�nc,rROr\'hzETr�:iB"E.AI;TRs ... BldkApp_201 1. doc revised 06/21/11 J 2 7 3 CITY OF �, IPV Ve•rll%4 A'rn]P _ RTTTI DING DIVISION ADDRESS: 6 infinite loop DATE: 03/17/2015 REVIEWED BY: Mendez $0 APN: BP#: �� 'VALIDATION: "'0*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building PENTAMATION 1GENCOM PERMIT TYPE: WORK REVISION #1- SHOW PHASING OF CONSTRUCTION PHASE 1; 2ND FLOOR; PHASE 2; 1 ST SCOPE FLOOR) ISSD OTC 3/18/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6 INFINITE LOOP CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 15020137 OWNER'S NAME: APPLE COMPUTER INC 1460 O'BRIEN DR DATE ISSUED: 03/09/2015 OWNER'S PHONE: 4084380968 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E] ❑ LICENSED CONTRACTOR'S DECLARATION APPLE - T.I. TO RECONFIGURE 15,220 S.F. ON WEST 7 q i (] SIDE OF IST & 2ND FLOORS, INCLUDING M.E.P.'S License Class_ Lic. 4 �y� Contractor A)6 Ud 1 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 Valuation: $525000 performance of the work for which this permit is issued. Sq. Ft Floor Area: 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 APN Number: 31602110.00 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. 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 180 DAYS FWP4 LAST CALLED INSPECTION. 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 Issued by: Date: J 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 ��—�e�� 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 Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER the following two reasons: 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) HAZARDOUS MATERIALS DISCLOSURE 1, as owner of the property, am exclusively contracting with licensed contractors to 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 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: for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous should I use equipment or devices which emit hazardous 1 have and will maintain a Certificate of Consent to self -insure material. Additionally, as defined by the Bay Area Air Quality Management District I Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and performance of the work for which this permit is issued. I have will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. and Section 3700 of the Labor Code, for the performance of the work for which this �/ _' Owner or authorized agent: —� ��— Date: � 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I 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 become subject 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 • buildingCc cupertino.orq CUPERTINO I r1 1—I I41 . 1 1--I 0=. Q7n T/ncr=DDEfn WRIT ITJeI PF.'RAAIT@ PROJECT ADDREr O APN 4' —0 ( ( It O OWNER NAME PHONt'q ^' i E-MAIL 5'rRL'ET ryUDI t- , Fj L� CIT SCT} P ,4, 7 hnt (zl v 1– FAX CONTACT NAME cut 0 2� PHO E E-MAIL � ly�,2 �- �.t�i._ ,� amu. � STREET ADDRE$ ['1 CITY, STATE, ZIJ' `1 Ci -,r /l 0 FAX . ❑ OWNER ❑ OWNER -BUILDER OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT NAME/, CONTRACTOR NAME/I ll(�- C�`. LICENSE NUMBER. LICENSE TYPE BUS. LIC f! 2i�j yl i COMPANY NAME vv v C,,�1 E-MAIL �l arcs Cin"o FAX STREET ADDRESSI O I, Z CITY, STATE, ZIPtAv PHO \ 20 3 �" 7b.5-6J �I. S �S YL ARCHITECT/ENGINEER NAME LICENSE NU IBER BUS. LIC t! SrOTT Lot 11-1 COMPANY NAME J� 1 RC4+ IV: a s -A / � h n FAX - STREET ADDRESS 200v CITY, STATE, Z `S5 CA 0 1-) PHONE 86 -08 J CCC n DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE N STORIES l 1 ' O ` Y,� L USE TYPE OCC. SQ.FT. VALUATION (R) EXISTG ARE 5� I 7� NEW FLOOR ' DEMO AREA 7 TOTAL NET AREA v BATHROOM KI .HEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH p DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION EIYES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YE , - ?' TOTAL VALUATION: PLANNING ADPL H ❑NO PLANNING APPROVAL LETTER EICHLER HOME? 0 'I By my signature below, 1 certify to each of the following: I am the property o on tit perry owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and v ccurate. 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: SUPPLEMENTAL INFORMATION .REQUIRED '� ' e ,I�I'i�l PLAN,'CSiECK�T�Yf1E , „ 1 ,MI l 1, «v, ,4 ,. ROU°IIING SLIP`,;,, t ❑� New SFD or Multifamilydwellings: Apply or demolition permit for o pp y fdp or existing building(s). Demolition permit is required prior to issuance of building 10�I OYER THE-COUI�TER`t� BUILDING PLAN REVIEW . er mit for new buildin . P g ❑i EXPRESS ❑s PLANNING PLAN REVIEW `- Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑.j1 STANDARD ?k❑I PUBLIC¢WORItS , : - . form if any Hazardous Materials are being used as part of this project. I ❑ct !✓ARGE F lI. +, r1 s ❑tl FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑-� t .. submittal of Building Permit application. MAJOR ` ❑I SEWERIDISTRICT I]t ,.ENVIRONMFiNTAL HEA''LTH' BldgApp_2011.doc revised 00'2//11 11 CITY OF CUPER'TINO FEE ESTIMATOR — BUILDING DIVISION 6 INFINITE LOOP DATE: 0212312015 REVIEWED BY: MELISSA ADDRESS:*VALUATION: $525,000 APN: 316 02 110 BP#: �V��%Z ,3 IT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement " PERM PENTAMATION 1 B TI PRIMARYPERMIT TYPE: Commercial Building USE: 'CONFIGURE 15 220 S.F. ON WEST SIDE OF 1ST & 2ND FLOORS INCLUDING WORK A PPLE - T.I. TO R SCOPE M.E.P.'S TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID OCCUPANCY TYPE: CONSTR. s.f. � B (Tenant Improvements) I-A,I-B 15,220 $4,474.02 IBTIPLNCK $12,760.98 IBTIINSP $12,760.98 TOTALS: 15,220 t'l7rn1h. Insp. Ve ormation available and are onl an estimate. Contact the De t or addn'! in o. NOTE: This estimate does not in fees due to other Departments (i e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta . These fees are based on the relimina to TY�,EE MISC ITEMS FEE ITEMS (Fee Resolution, Eff 7/1!13) FEE Q Select a Misc Bldg/Structure $4,474.02 Plan Check Fee: or Element of a Building Suppl. PC Fee: Q Reg. Q OT 0.0 hrs PME Plan Check: Permit Fee: Supp! Insp. Fee:Q Reg. Q OT 0.0 hrs PME Unit Fee: PME Permit Fee: Construction Tcrr: k Without Permit? Q Yes 0 $0.00 $0.00 $12,760.98 $0.00 $0.00 $0.00 Wor Advanced Planning Fee: Frarci DUcian0710(ipr( Fees: Strong Motion. Fee: 1 BSEISMICO Bld Stds Commission Fee_.. .1BCBSC Q E) $0.00 ) � Select a Non -Residential $0.00 Building or Structure Select an Administrative Item $147.00 $21.00--------17 `}, TOTALfFEE $ , 403.00 17,403.00 , $0.00 �s Revised: 02/1412015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6 INFINITE LOOP OWNER'S NAME: APPLE COMPUTER INC OWNER'S PHONE: 4084380968 m LICENSED CONTRACTOR'S DECLARATION 11 License Class Lte.9 / v �� Contractor �Ot.IS CD%��ryur�Y� Date 6%17 1 hereby affirm that 1 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. 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 f with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. 918.Signaturee Date Zd- . ox ❑ OWNER -BUILDER DECLARATION CONTRACTOR: NOVO CONSTRUCTION 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). 1460 O'BRIEN DR MENLO PARK, CA 94025 PERMIT NO: 15020137 DATE ISSUED: 03/09/2015 PHONE NO: (650)701-1500 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL APPLE - T.I. TO RECONFIGURE 15,220 S.F. ON WEST SIDE OF IST & 2ND FLOORS, INCLUDING M.E.P.'S REV # 2 - RECONFIGURE 2 (E) ROOMS ON 1ST FLR (ROOMS A148 & A146) - ISSUED 5/21/15 I hereby affirm under penalty of perjury one of the following three declarations: 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 performance 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. 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 time 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, 1 must forthwith comply with such provisions or this permit shall be deemed revoked. Sq. Ft Floor Area: I Valuation: $525000 APN Number: 31602110.00 I Occupancy Type: 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 Willi all non -point source rcgulation5 per the Cupertino Municipal Code, Section 9 18. Signature Date PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FR INSPECTION. Z-1 All roofs shall be inspecm 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 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 2553 , and 25534. Owner or authorized agent • Date: .Z / i 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 ^ FAX (408) 777-3333 - building P-cupertino.org F-1 xipw rnNCTPI trTTnN Fl AnnTTTow n Ai.TERATiON / TI .Nr REVISION /DEFERRED ORIGINAL PERMIT # /'.2b)37 PROJECf ADDRESS 1 1 APN # 73 j� r % _o2- o �iL r c) l OWNER TqAME PHO E-MAIL 4fl? LE ffb2Y STREET ADDRESS 1 4- CITY, STATE, ZIP�O i !}; FAX CS+5C7'G'�%1-IG000O E-MAIL /J'�Dve "��`'ISY•K(JGJYU.+.1.Ca' CONTACT NAME � PHONE i b� Y Fa - STREET ADDRESS CITY, STATE, ZIP FAX �wolo 1,,} rJ �1 ❑ OWNER ❑ OWNER -BUILDER AOWNER AGENT ', CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC H COMPANY NAME E-MAIL 11 FAX o%.10 Y Ahs CrN� STREET ADDRESS�� CITY, STATE, ZI ��,� 9�z PHONE e.154 -C�,,d . y&o ,�eCIJiC ��k ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC H -- CO P ^NY NAMER*NS E-MAIL �m / , aa PAX STR T ADDRESS CITY, STATE, ZIP PHONE 116 N 2 0 N d'vS0P52L20 14W FLA. DESCRIPTION OF WORK V t I , of::� i &T Fua b : s of 0'r—P1 to 1 PE— — KooM EXISTING USE PROPOSED USE CONSTR TYPE Il STORIES may,. _ri cle- 0 CA:—: USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTTER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH _-� []ATTACH # DWELLING UNfTS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? 4�rNo ADDITION? RJO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN YES WO RECEIVED,pTOTAL VALUATION: PLANNINGAPPLd ❑NO PLANNINGAPPROVAL LETTER EICHLER HOME? By my my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the prope wner'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 accurat agree to comply with all applicable local ordinances and state laws relating to building c $8triiCtion. I authorize representatives of Cupertino to enter the above -Identified property for inspection purposes. lS Signature of Applicant/AgenC Date: SUPPLEMENTAL INFORMATION REQUIRED PL'z' y* ceKimEq=}, GEAR`..,isys'ovTuvesirP New SFD or Multifamily dwellings: Apply for demolition permit for OVER T1 COU1\TER ,z b BUM MNG PLAN REVIEW, existing building(s). Demolition permit is required prior to issuance of buildingzgg permit for new bUllding. O ,EXPRESS x i s i ya i f 10?� ANNINGPLAN$REVIEWt } _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTANnARD rr e+rt tS�Tt PUBLIC WORKS #i 3�4i ,� form if any Hazardous Materials are being used as part of this project. F l'„t�z t Yu2"' @b` 3 h09� Copy Approval Letter or Meeting with Planning to a svi �iw �E ofPlarming prior k r itac IVIASOR r- iM ,�'rL-A!zg DIDI STRICT submittal of Building Permit application. x'k'eQ Mr+r� ,sFVVE'R yivYlrio' rI u} << E 9I1nz Nri�IIEAI Ta. B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO TUU V c'rTM A'rnR _ RIIII .nIN(T DIVISION NOTE: This estimate does not include fees due to other Departments tt.e. rlammng, r-uanc rrVrr.D, ��••••••• r -� - •-_, __._ _ _ _. .... o _ _ r __ _� ___ .r_ _ ___r._.:..,_-..:..! �.......�:.,.. n.rniln6lo ntid nro nasty On e.Cl[nt012 Contact the Dent for addn't info. District, e1C . Ines¢ fees are nasea on the reunrsn ur FEE ITEMS (Fee Resolution 11-053 Eff. 7111131 6 INFINITE LOOP DATE: 05/21/2015 REVIEWED BY: MELISSA IlaADDRESS: APN: 316 02 110 BP#: *VALUATION: $0 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? O Yes (F)No PENTAMATION 1 GENCOM PERMIT TYPE: i WORK REV # 2 - RECONFIGURE 2 E ROOMS ON 1ST FLR ROOMS A148 & A146 - ISSUED 5/21/15 SCOPE Suppl. Insp. Fee -0 Reg. Q OT NOTE: This estimate does not include fees due to other Departments tt.e. rlammng, r-uanc rrVrr.D, ��••••••• r -� - •-_, __._ _ _ _. .... o _ _ r __ _� ___ .r_ _ ___r._.:..,_-..:..! �.......�:.,.. n.rniln6lo ntid nro nasty On e.Cl[nt012 Contact the Dent for addn't info. District, e1C . Ines¢ fees are nasea on the reunrsn ur FEE ITEMS (Fee Resolution 11-053 Eff. 7111131 ,k, t Plan i lrcr, 1'lxruh, YJuat f"i, c 6 kier, ! _, C'heC F-(ic,: 1'hopii). Permit L J hours Plan Check, Hourly $286.00 ISTPLNCK (:�rhr.r :bleclr. lits!, 01"Iei Phlnth lrispLi 01her $0.00 Plumb. hisp. 1::';lE: ". IIts;,. Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. Q OT O,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 it.hrt.trtistrcrtita I%`0e: _ -_ I I G Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential G Building or Structure O : F -1 Strong Motion Fee: NOTE: This estimate does not include fees due to other Departments tt.e. rlammng, r-uanc rrVrr.D, ��••••••• r -� - •-_, __._ _ _ _. .... o _ _ r __ _� ___ .r_ _ ___r._.:..,_-..:..! �.......�:.,.. n.rniln6lo ntid nro nasty On e.Cl[nt012 Contact the Dent for addn't info. District, e1C . Ines¢ fees are nasea on the reunrsn ur FEE ITEMS (Fee Resolution 11-053 Eff. 7111131 ,k, t Plan i lrcr, 1'lxruh, YJuat f"i, c 6 kier, ! _, C'heC F-(ic,: 1'hopii). Permit L J hours Plan Check, Hourly $286.00 ISTPLNCK (:�rhr.r :bleclr. lits!, 01"Iei Phlnth lrispLi 01her $0.00 Plumb. hisp. 1::';lE: ". IIts;,. Permit Fee: $0.00 NOTE: This estimate does not include fees due to other Departments tt.e. rlammng, r-uanc rrVrr.D, ��••••••• r -� - •-_, __._ _ _ _. .... o _ _ r __ _� ___ .r_ _ ___r._.:..,_-..:..! �.......�:.,.. n.rniln6lo ntid nro nasty On e.Cl[nt012 Contact the Dent for addn't info. District, e1C . Ines¢ fees are nasea on the reunrsn ur FEE ITEMS (Fee Resolution 11-053 Eff. 7111131 1. FEE -.. - -• - QTY/FEE --•__ ___ ____- _ MISC ITEMS Plan Check Fee: Hourly Only? Q Yes Q No $0.00 L J hours Plan Check, Hourly $286.00 ISTPLNCK Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. Q OT O,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 it.hrt.trtistrcrtita I%`0e: _ -_ I I G Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential G Building or Structure O 7'rui el Doci.rn ew(, lion Fees: Strong Motion Fee: $0.00 Select an Administrative Item $286.00 �`} '' TOTAIr�FE $286.00 Bldg Stds Commission Fee: �f' '�� SUBTOTALS $0,00 $0.00 Revised: 05/01/201b