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15020137 (3) 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 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL [] COMMERCIAL APPLE-T.I.TO RECONFIGURE 15,220 S.F.ON WEST License Class Lic.lft -711 SIDE OF IST&2ND FLOORS,INCLUDING M.E.P.'S Contractor �ot.� Col��fru`�'^ Date S 6Js REV#2-RECONFIGURE 2(E)ROOMS ON 1ST FLR 1 hereby affirm that I am licensed under the provisions of Chapter 9 (ROOMS A148&A146)-ISSUED 5/21/15 (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 thisAPN Number:31602110.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 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 INSPECTION. upon the above mentioned property for inspection purposes. (We)agree to save 180 D S FR indemnify and keep harmless the City of Cupertino against liabilities,judgments, u costs,and expenses which may accrue against said City in consequence of the y: Date: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 777, 9 18. 11 RE-ROOFS: Signature Date U OK All roofs shall be inspec 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: 1 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) 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. 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 the Health&Safety Code,Sections 25505,2553 ,and 25534. 1 have and will maintain Worker's Compensation Insurance,as provided for by Ko Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent Date: s 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,1 I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code,1 must work's for which this permit is issued(Sec.3097,Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. 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 rcgulation5 per the Cupertino Municipal Code,Section Licensed Professional 9 18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION I;j 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228^ FAX(408)777-3333-building(d-)cu pertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI Jl:!� REVISION/DEFERRED ORIGINAL PERMIT# Z a 3 PROJEC'f ADDRESS APN# `3 r r 1 1 l OWNER TqAME PHO E-MAIL 4fl?LEc� Coda ' Gvffb2Y STREET ADDRESS 1 CITY, STATE,ZIPtVO i ! }; FAX CONTACT NAME 4- PHONE CS+5C7'G'�%1-/��O E-MAIL "��`'ISY•K(JGJYU.+.1.Ca' i' �)'J Y ' Fad- +:=i STREET ADDRESS I CITY,STATE, ZIP { FAX ❑ 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 J1 FAX o%.10 Y Ahs CrN� STREET ADDRESS CITY,STATE,ZI PHONE y�v0 cpa t ,�eCIJK rt to �+zk Cw 95b2 654-le 76- ARCHITECTIENGWEER NAME LICENSE NUMBER BUS.LTC H P.6Lsa - CO PAME S E-MAIL �m FAX STR T ADDRESS CITY,STATE,ZIP /, PHONE 2 NO (9AN %V10sP522t20 DESCRIPTION OF WORK q Ow FLA. i & , o f:;� MT it b -- s Off 0'r-pl6g EXISTING USE PROPOSED USE CONSTR TYPE #STORIES may,._r_ 0 r-1 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: 0 DETACH []ATTACH #DWELLING UNRS: 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 QYES RECEIVED) ,,r "' S,; TOTAL VALUATION: PLANNING APPL N [:]NO PLANNING APPROVAL LETTER EICHLER HOME? 70 �' r t f r�- ..+* — -` AN By 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 ri8trtlrtion. I authorize representatives of Cupertino to enter the above-Identified property for inspection purposes. Signature of Applicant/Agent: Date: ;Vold SUPPLEMENTAL INFORMATION REQUIRED y *PL'z' ceKimEq=},G `. .,isys' ovTuvesirP New SFD or Multifamily dwellings: Apply for demolition permit for , OVER T1COU1\TER ,z b BUILDING PLAN REVIEW, existing building(s). Demolition permit is required prior to issuance of building dw µ}ms E r a ( ' t r permit for new building. � EZP>ztssx ts``�i ya} i f �kPANNINGPLAN$REVIEWt 4(�j�k9fia'irjp{.+c7� r� '" •j.$. ,w�i'��e KS� F��y , _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTANnARD n e �i �Tt PUBLIC WORKS# } +X a s}}i 9 rvl rt ji J r form if any Hazardous Materials are being used as part of this project. ` z sprtib hf� ,hr Tr '- Copy of Planning Approval Letter or Meeting with Planning Prior to r Ji HiQ IVla,roR y--- iN.�'?rtr �� .�'t��sAlvrnAlzx�,�sEw�RDr&rxrcirt,',"��' submittal of Building Permit application. u,' r Vrll „s , 'EtvuiRo'NnNTY7�I3EAI TTI:. ;.�, B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 6 INFINITE LOOP DATE: 05/21/2015 REVIEWED BY: MELISSA APN: 316 02 110 BP#: *VALUATION: $0 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY Civil/Religious activities PENTAMATION 1 GENCOM USE: Commercial Building in BQ zone? O Yes �No PERMIT TYPE: i WORK REV#2 - RECONFIGURE 2 E ROOMS ON 1ST FLR ROOMS A148 &A146 - ISSUED 5/21/15 SCOPE aa pit, 1 %{� � al.4�a L.,.F`;• .x�,A .r t,,,... .e 41;vYx £ fi da a .r d, C�P ayyt a'- I i + Plan1'hrnrh, YJuat f"i,��c'6 1Jer. I' _,C'h��c;; Phoni). Pero?;I lik'c. /'rairiiih'c •. :bleclr. lits/, !)ihei 1'le n h lr: 01her I.7ec'.(Jts/'i. Li ';tri! b. his!. l'ea: 1:;Ie:c. Inv). Ad�:eh. Ili.,p. h�ec: l NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes Q No $0.00L J hours Plan Check,Hourly Suppl.PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $286.00 ISTPLNCK 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 i�.hrt.trtistrcrtit�a I%`O(?: _ -_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 )Oct.rn en1(,lion Fees: Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 'A� SUBTOTALS $0.00 $286.00 TOTAI;�FE $286.00 ZA t ; Revised: 05/07/2015