B-2016-1359 Permit ApplicationCONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a),cuoertino.org
CUPERTINO I
❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS
10590 N. Tantau
7AP 315-18-035
OWNERNAME Campus Holdings, Inc.
PHONE 408-996-1010
E-MAIL mmills@apple.com
STREET ADDRESS 1 Infinite Loop, MS21-1 AC2
CITY, STATE, ZIP Cupertino, CA 95014
FAX
CONTACT NAME Mike Mills
PHONE 408-593-9597
E-MAIL mmills@apple.com
STREET ADDRESS 1 Infinite Loop, MS21-1AC2
CITY, STATE, ZIP Cupertino, CA 95014
FAX
OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
-7
LICENSE NUMBER 198061
LICENSE TYPE B
BUS. LIC # 5335
K Ili Quinn
COMPANY NAME Rudolph and Sletten, Inc.
E-MAIL kelli_quinn@rsconst.com
FAX -----
STREET ADDRESS 1600 Seaport Blvd, STE 350
CITY, STATE, ZIP Redwood City, CA 94063
PHONE 415-297-0528
ARCHITECT/ENGINEER NAME Scott R. Colson
LICENSE NUMBER C-20117
BUS. LIC #
COMPANY NAME
HGA
E-MAIL
scolson@hga.com
FAX ---
STREET ADDRESS
96 North 2nd Street
CITY, STATE, ZIP
San Jose, CA 95113
PHONE
408-288-7833
DESCRIPTION OF WORK
Tantau 3 N Tenant Improvements to include minor construction of new non load bearing partitions, doors, furniture
and associated finishes.
EXISTING USE
PROPOSED USE CONSTR.
Office
TYPE
11 STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION($)
Office Building
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA 3,000
Office
V-B
B
3,000
$50,000.00
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK PORCH AREA
GARAGE AREA: U DETACH
[]ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑YES
SECOND STORY []YES
BEING ADDED? Q[NO
ADDITION? [INO
PRE -APPLICATION []YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECEIVED BY:
TOTAL VALUATION:
PLANNING APPL # []NO PLANNING APPROVAL LETTER
EICHLER HOME? CXNO
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 building c ction. I authorize representatives of Cupertino to enter the above -identified prpperty for inspection purposes.
Signature of Applicant/Agent: Date: ZI IV 1
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
El OVER-THE-COUNTERElBUILDING
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
❑ PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
El STANDARD
El 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_201 1. doc revised 0612]/]1