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12060091CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 2 INFINITE LOOP CONTRACTOR: XL CONSTRUCTION PERMIT NO: 12060091 OWNER'S NAME: APPLE COMPUTER INC 851 BUCKEYE CT DATE ISSUED: 07/09/2012 OWNER'S PHONE: 4089961010 MILPITAS, CA 95035 PHONE NO: (408) 240-600(;. ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALO License Class Lic. 9 b H77 4 $0 REMOVAL OF PARTITION AND INSTALLATION OF 3 RF Contractor XL CO' -6 �r-1 a 41 01-1 Date I -?— CHAMBERS 1200 SQFT 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: 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 Sq. Ft Floor Area: Valuation: $350000 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 APN Number: 31602106.00 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 building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECUON. 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: 7. Issued by: ��N 4%./�°7 ate: 1 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. K Lq '2 RE -ROOFS: Signature42Date All roofs shall be inspected prior to any roofing material being installed. If a roof is Le VV 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 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 25 33, 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 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 [ 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 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 CUPERTIIN® I I I NEW CONSTRTT('TTnN C_� P'0' i --i� 1-Z C, �0 o J �l 1 COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION 10300 TORRE AVENUE a CUPERTINO, CA 95014-3255 (408) 777-3228 < FAX (408) 777-3333 ^ build�iinnlg(a"cupertino.org F7 AT)1)TT10w IRI AL-FF.RA-rMN / Ti I I RFVTSTnN / DF.FF.RRFD I)RTGTNAI. PF.RMTT # PROJECT ADDRESS J \ `�� Lvo� APN# "_�J ( 0':� t O OWNERNAME Apple Inc PHONE 408.996.1010 STREETADDRESS 1 Infinite Loop CITY, STATE, ZIP Cupertino, CA 95014 FAX CONTACT NAW L �I®n_®�I6.t41{\ PHONE 408.240.6000 _A6%r,F lCONJP STREETADDRESS 851 Buckeye Court CITY,STATE, ZIP 'Milpitas, CA 95035 FAX 408.240.6001 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT M CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAMET..,,� I.f 1O,,.,pp� LICENSE NUMBER 647480 LICENSE TYPE B Bus.Llc# ' 21836 COMPANYNAME XL Construction E-MAIL jcreese@xlconst.com FAX 408.240.6001 STREETADDRESS 851 Buckeye, Court CITY,STATE,zIP Milpitas, CA 95035 PHGNE408 .240. 6000 ARCHITECT/ENGINEER�I y► 'Gl d� ` e�tl`�`�e LICENSENUMBE' C a J BUS. LTC# COMPANYNAME �� E-MAIL r FAX I w�� STREET ADDRESS %� L pp�� CITY, STATFF 7TD V./�/ �C6tl1C� 0"a��Q1� �^ e✓t1Jv� r`�@C�S.\v�.� �� P Ota3Y�� 6 DESCRIPTION OF WORK ®`'(e) EXISTING USE PROPOSED SE CONSIT� E #STORIES USE TYPE $Q.FT. VALUATION ($) EXISTG AREA NEW AREA AREA O �I� DEMO AREA GV,�\ TOTAL TAREA bF 3 a' ,Oy�CC. t� BATHROOM N/A REMODEL AREA KITCHEN REMODELAREAN/A OTHER NA REMODEL AREA / PORCH AREA N/A DECK AREA TOTAL DECK/PORCH AREA N/A N/A GARAG AREA: DETACH N%A ❑ATTACH # DWELLING UNITS' N/A IS A SECOND UNIT ❑YES BEING ADDED? ®NO SECONDSTORY ❑YES ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # [XNO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOIVIE? W NO RECEIVED BY �/ TOTAL VALUATION: ,$ -By my signatlue below, I certify to each of the following: `I"am th'e property of tier or'authorized agent to act ori the property -owner'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 accurate_ I agree to comply with all applicable local ordinances and state laws relating build"ng construction. uthorize representatives of Cupertino to enter the above -id tifie property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTtWMiRMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER BUILDING 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 -Ed STANDARD ❑ 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 ❑ MMOR ❑ 'SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BidgApp_2011.doc revised 06/21/11 4p% MY OF cCUPIERUN® OCCUPANCY TYPE: ADDRESS: 2 infinite Loop DATE: 06/1512012 REVIEWED BY: Sean PC ]FEE ID APN: 1BP#: *VALUATION: 1$350,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building 1BTIPLNCK PENTAMATI ON PERMIT TYPE: 1 B TA WORK Removal of partition and installation of 3 RF chambers 1200 sq ft SCOPE 1'hrnrh. Insp. Fee: OCCUPANCY TYPE: TYPE OF CONSTR. 1F1LR AREA s.f. PC ]FEES PC ]FEE ID BP ]FEES BP FEE IID B (Tenant Improvements) II-B,111-B,IV,V-B 1,200 $1,955.20 1BTIPLNCK $1,096.88 1BTIINSP Other tile(. Insp. Hoch. Insp. Fete: 1'hrnrh. Insp. Fee: Eley. Imp. Fcc. Permit Fee: $1,096.88 Suppl. Insp. Fee -.0 Reg. Q OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 1,200 $1,955.20 $1,096.88 M1ECH, HOURLY Q Yes Q No PLUMB, HOURLY Q Yes Q No 1E1L1EC, HOURLY Q Yes Q No rLfech. Plon Check Plnnrh. Plan Cheek � Elet'. Plan ChFie, IVlecll. Permit Fee:Plumb. 1'ermil Fee: u:rmit l"ee.- Orher• Tech. Imp. Insp. C E] 0.0 1)1her Plumb Other tile(. Insp. Hoch. Insp. Fete: 1'hrnrh. Insp. Fee: Eley. Imp. Fcc. NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the preliminary information available and are only an estimate. Contact the Dent for addn'l info. lF1ElE ITEMS (Fee Resolution 11-053 E f 7/1/11) ]FEE QTY/FEE M1ISC ITEMS Plan Check Fee: $1,955.20 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,096.88 Suppl. Insp. Fee -.0 Reg. Q OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consoi.iciion .Tax: Administrative .Fee: 0 Work Without Permit? Q Yes Q No $0.00 Advanced Planning Fee: $0.00 # $0.00 Modular Structures 1 Q ®4 Tratool Doc.•t.rinentation Fres. Strong Motion Fee: 1BSEISMICO $73.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $14.00 SUBTOTALS: $3,139.58 $0.00 TOTAL FEL.] $3,139.58 Revised: 06/05/2012 'cu�E kr o CONTRACTOR / SUBCONTRACTOR LEST Building IlDepUtnnnent City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 405-777-3225 Fax: 405-777-3333 JOB ADDRESS: 7 j st e, PERMIT # 406 OWNER'S NAME: PHONE # q 0 q3 GENERAL CONTRACTOR: YL BUSINESS LICENSt # ADDRESS: 706W V,, 1k, e— CITY/ZIPCODE: *Our municipal code requires ad businesses working in the city to have a Cagy of CupertGo business ncense. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED DULED UNTAC THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY DIE CUP ERTIN® BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR Cabinets & Millwork BUSINESS NAME BUSINESS LICENSE # 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 7/gl1Z- caner / Untractor Signature Date Low {' -�-LZ0(" o(:�)9 1 CONSTRUCTION 13 - Apple Subcontractor License Subcontractor Cupertino Business License # Bayside Interiors 25898 Broughton Fire Protection 25167 Canterbury Contractors 25647 Cupertino Electric 697 United Mechanical 27361 XL Construction 21836 Testhg Engheers9 hie. Quality Assurance Services Materials Consulting Since 1954 Ml�ar Concrete Con�l.�ressicin Test Rel•�ort Project No.: 56626 Client: APP337 Sample No.: 240807 Project Name: Report Date : 10/30/12 Apple IL 2.4, 4th Floor, Rm N460 3 Chambers Sample Date :10/02/12 2 Infinite Loop Q Time Sampled: 0715AM Cupertino, CA BY: Date Received : 10/03/12 Permit # 12060091 Inspector: M. Ardizzone, TEI Supplier: A-1 Concrete Mix: Al 603000 Ticket No.: 1337 Location: Mechanical slab at #2 Infinite Loop at parking garage. Specimens Cast (ASTM C-31) : 5 Air Temperature (ASTM C-1064) : 56 deg F Mixture Temperature (ASTM C-1064) : 74 deg F Slump (ASTM C-143) : 4 inches Date Tested 10/09/12 10/30/12 10/30/12 10/30/12 HOLD ID Number 1A 1 B 1C 1D 1 E Mark Sample Dimension, Inches Diameter 4 4 4 4 Length 8 8 8 8 Area, sq. inches 12.57 12.57 12.57 12.57 Ultimate Load, lbs 45000 70000 71000 71000 Ultimate Str., Psi 3580 5570 5650 5650 Average, Str., psi 5620 Age Tested, Days 7 28 28 28 HOLD Fracture Type 1 1 1 1 Dry Unit Weight, pcf Specified Stren th, psi 3000 3000 3000 SPECIMENS NOT SCHEDULED FOR TESTING WILL BE DISCARDED AFTER 28 DAYS OLD The Material %(, WAS WAS NOT The Material Tested K MET DID NOT MEET THE SAMPLED AND TESTED IN ACCORDANCE WITH THE REQUIREMENTS OF THE BLDG. DEPT. OR DSA APPROVED DOCUMENTS. REQUIREMENTS OF THE BLDG. DEPT. OR DSA APPROVED DOCUMENTS. Remarks: Samples Tested in General Conformance with ASTM C-39 1 cc. City of Cupertino 1 cc. Apple Computer Inc. Reviewed By: Robert Green ) 2 l Concrete Lab Supervisor Corporate Office - 2811 Teagar/den Street, San Leandro, California 94577 - (510) 835-3142 - Fax (510) 834-3777 TESTING ENGINEERS, INC. iAi ,� 2811 Teagarden St. 510-835-3142 J 11510-834-3777 fax San Leandro, CA 94577 800-660-3142 b l San Leandro o San Jose - II INSPECTION REPOKT- Week Ending: 7/13/12 PROJECT # 56626 PROJECT: Apple IL 2.4, 41h Floor, Rm N460, 3 Chambers 2 Infinite Loop Cupertino, CA DATE HOURS Permit # 12060091 7/13/12 4 INSPECTOR M. Ardizzone Reported to Juan of XL Construction at the jobsite as requested. TYPE OF INSPECTION: Expansion Anchors PLACE OF INSPECTION: Jobsite Witnessed the drilling and inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and witnessed the proper insertion of one hundred eight (108) 3/s' diameter Hilti KB -TZ expansion anchors, 3-3/4' in length, embedded 2" into floor for three (3) chambers in room N460 on 41h floor. The preceding work was, to the best of my knowledge, in compliance with approved plans and specifications, including revisions by engineer. Reviewed by: vi ippero Special Inspection Division Manager 1cc: Apple Computer Inc./T. Hernandez City of Cupertino/BIdg. Inspection Dept. This report can be reproduced only in its entirety unless written permission from TEI is obtained. Page 1 of 1