15060124I CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1 INFINITE LOOP
OWNER'S NAME: APPLE COMPUTER INC
OWNER'S PHONE: 4087806489
V�Jlj LICENSED CONTRACTOR'S DECLARATION
License Class (f2-' C-9* 5 Li,. # L f." 2 --
Contractor 1 L 0 f -k M.�—p Lxt roi\ '!L Bate_ 2--d 1 5�, A
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
have and will maintain Worker's Compensation Insurance, as provided for by
&-ett-on 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 rtino against liabilities, judgme
costs, and expenses whic ac a agai said City in consequen e
granting of this perm' , i ' Wally, t a licant understand ill co
with all non -point rce reg latio er the ertino Municipal Code, Secti
918.
_
Date 1!;�26 / '. A
0 OWNER -BUILDER DECLARATION
I 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).
I hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date
CONTRACTOR: ICOM MECHANICAL INC PERMIT NO: 15060124
477 BURKE ST DATE ISSUED: 06/18/2015
SAN JOSE, CA 95112
PHONE NO: (408)792-2292
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL
APPLE - INSTALL (N) CHILLER IN/ON (E) PAD FROM
PREVIOUS LOCATION
Sq. Ft Floor Area:
Valuation: $56000
I APN Number: 31602105.00 I Occupancy Type: I
PERMIT
NOT STARTED
ISSUANCE OR
) INSPECTION.
Date:
® RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(A should I store or handle hazardous
material. Additionally, should I us ip vices which emit hazardous
air contaminants as defined by t y Arta Air Q ality Management District I
will maintain compliance with upertin I Code, Chapter 9.12 and
the Health & Safety Code, Sec ns 25$05, 3, and 534.
Owner or authorized agentlf_"_ / Date S .
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
-
UI'I' Y OF C UPERTINO
FEE ESTIMATOR - BUILDING DIVISION
unu are
QTY/FEE
ADDRESS: 1 INFINITE LOOP
DATE: 06/18/2015
REVIEWED BY: MELISSA
APN: 316 02 105 BP#: -VALUATION: $56,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMAR
USE: Commercial Building Civil / Religious activities PENTAMATION
in BQ zone? 0 Yes Q No PERMIT TYPE: 1 GENCOM
WORK APPLE - INSTALL N CHILLER IN/ONE PAD FROM PREVIOUS LOCATION
SCOPE
Plan Check, Hourly
ISTPLNCK
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
=#
$143.00
Mechanical
IMCRAA Cooling Unit
Permit Fee: Hourly Only? 0 Yes No
$0.00
Suppl. Insp. Feer Reg. 0 OT
0 0
lus
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
Construction Tax: IBCONSTAXC
$0.00
Administrative Fee:
]ADMIN
$45.00
0
E)
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Plannin Fee
$0.00
Select a Non -Residential Q
Building or Structure 0
i
Travel Documentation Fee: ITRA VDOC
Mech. Plan Check 0.0 1 hrs $0.00
Mech, Permit Fee: IMPERMIT
Other Mech. Insp. 0.0 hrs $48.00
ticc,'z, lns1�. l.'ee:
Phimb. Plan ('11ect I T
Plumb. Permit Fee:
Other Plumb /rup,Li
Phtnlb. Ittsp. Fee.,
11,10c'Plan O..hech
1 Iec. PetriniT Fee:
Other Elec. Insp,
Elec. Alsp. Fee:
---j-- uu « utfs—,-epurtments (ie. rianning, Public Works, Fire, Sanitary Sewer District, School
District. etc).
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13)
... ,,l--.,pft uvuuuutL
FEE
unu are
QTY/FEE
otzt an esnmatc contact the Dept for addn 11 info,
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes (j) No
$0.00
L—'__] hours
$143.00
Plan Check, Hourly
ISTPLNCK
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
=#
$143.00
Mechanical
IMCRAA Cooling Unit
Permit Fee: Hourly Only? 0 Yes No
$0.00
Suppl. Insp. Feer Reg. 0 OT
0 0
lus
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
Construction Tax: IBCONSTAXC
$0.00
Administrative Fee:
]ADMIN
$45.00
0
E)
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Plannin Fee
$0.00
Select a Non -Residential Q
Building or Structure 0
i
Travel Documentation Fee: ITRA VDOC
$48.00
Strong Motion Fee:
IBSEISMICO
$15.68
2.0 hrs
$286.00
Inspections
ISTINSP Inspection, Hourly
Bldg Stds Commission Fee: 1BCBSC
$3.00
777, 77
SL/BTOTALS
$159.68
$572.00
TOTAL FEE,.J
$731.68
Revised: 05/07/2015