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12100063CffTY OF CU? ERTIN® BU LIlDNG ? ERMffT BUILDING ADDRESS: 20823 STEVENS CREEK BLVD CONTRACTOR: NOVO CONSTRUCTIO Ell MT NO: 12100063 OWNER'S NAME: STEVENS CREEK OFFICE CENTER ASSOC 1460 O'BRIEN DR DATE ISSUED: 10/30/2012 OWNER'S PHONE: 4082527988 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 ❑ LICENSED CONTRACTOR'S DECLARATION License Classes Lic. # -75 10 2 2 Contractor Date i 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. 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18.' Signature Date (21� ❑ 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) 1, 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 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 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 BUILDING PERMIT INFO: BLDG T_ ELECT F PLUMB F IMIECH r— RESIDENTIAL r7 COMMERCIAL JOTB DESCRIPTION: SUITE 10 APPLE -COMMERICAL T.I OFFICE SPACE 3,277 SQ FT NON-STRUCTURAL 11/13/12-REV#1 - INSTALLATION OF NEW 3 -TON ROOF TOP UNIT FOR IDF ROOM COOLING -I2/1 1/12 REV41 ISS'D Sq. Ft Floor Area: Valuation: $600000 APN Number: 32632053.20823 Occupancy Type: P ERMffT IEXPffR ES IDF WORK ffS NOT STARTED EIlD WRT HRN 1180 DAYS OF ? ERMffT ffSSUANC E OR 180 DAYS FROM LAST CALLED RNS? ECTRONo A Issued by: Date: -Z- //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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BET'T'ER 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 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owne h Wa Date•/ /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 ARCHI'TECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF C'UP ERTINO BUILDING PERM1 Ic BUILDING ADDRESS: 20823 STEVENS CREEK BLVD CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 12100063 OWNER'S NAME: STEVENS CREEK OFFICE CENTER ASSOC 4025 BOHANNON DR DATE ISSUED: 10/30/2012 OWNER'S PHONE: 4082527988 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class Lic. # 7� SUITE 10 APPLE -COMMERICAL T.1 OFFICE SPACE 3,277 S� FT NON-STRUCTURAL �{{ hY> t)y �1STcY� of Date 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 Sq. Ft Floor Area: Valuation: $600000 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 APN Number: 32632053.20823 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is Ei D PERMIT EXPIRES S 1i WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating �� �� 180 ���� ®� PERMIT ISSUANCE ®� WITHIN to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 )IDA ®ISI LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the C Date: granting of this permit. Additionally, the applicant understands and will comply Issued by: with all non -point source regulations er the Cupertino Municipal Code, Section 9.18. 29i4� RE -ROOFS: Signature Date �O (Z 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 the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 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. 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: 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 ➢ 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, 2553 , 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 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 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 shal I 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 APPLICATI®KII B COMMUNITY DEVELOPMENT DEPARTMENT e BUILDING Me10300 TORRE AVENUE • CUPERTINO, CA 95014-3255- (408) 777-3228 ^ FAX (408) 777-3333 - buildingQcupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/T1 F)d REVISION /DEFERRED ORIGINAL PERMIT # J9J0Cb& S PROJECT ADDRESS � � ' V APN # J J OWNER NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME y PHONEA 5d-� • e® E-MAIL��bur STREET ADDRESS I O ©pg/ CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME A LICENSE NUMBER ` 1 ! ® Z. Z_LICENSE TYPE � BUS. LIC # � � COMPANY N AMEE-MAIL FAX � 0R STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK �7 3 !� EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES ,i l/ fj A i USE TYPE OCC. SQ.FT. VALUATION (5) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UMTS: ORY [I YOB SENtT ING ADDD'.NO ADDITION? 2[.F !❑ PRE -APPLICATION ❑ IF YES, PROVIDE COPY OF PLANNING APPL # NO PLANNING APPROVAL LETTER IS THE BLDG AN EICHLER HONEE? ONO RECEIVE BY *,{,�--'. T TAL VALUATION: 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. 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 to building constructio-ar I thorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED ❑ OVER COUNTER tiTIIE ❑° EIPRESSz „❑ La]GE + 3 x ❑ !\4AJOR' ' e� UILDINGPLAN REVIENY PLAIVIQIIvGPLAi\ REN IENV a S ❑ FIRE DEPT t,&', 'Ig ❑+SANITARY SENN ER DISTRICT. .� EIVVIROIvriENTALIiEALTH . 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. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal Of Building Permit application. B1dgApp_2011.doc revised 06/21/11 Stapr n;� ,1- 101,0101 COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 n (408) 777-3228 ^ FAX (408) 777-3333 ^ building(ckupertino.org 6�! ❑ NEW CONSTRUCTION ❑ ADDITION 4 ALTERATION / Ti ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS2— ©,sz � APN #� s „ ( � �� OWNER NAME ,� E-MAIL t� STREET ADDRESS CITY, STATE, ZiP%%��� w /� / v FAX CONTACT NAME PHONE E-MAIL AT llt>�y 0050. C 0 • IC;fco � �F V@ STREET ADDRESS I (A0 CITY, STATE, ZIP110�� FAX 6 J ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPG� BUS. LIC 9 , j� S 49 1 COMPANYNAME E-MAIL FAX slim Ph A&46r STREET ADDRESS �►v1i11� CITY STATE ZIP PHONE � I�UV� ARCHITECT/ENGINEER NAME �IL� LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX 5r� 5 STREET ADDRESS q05 CITY, STATE, ZIP PHONE 0A -�, % S Yto DESCRIPTION OF WORK 4% 7>4275-F EXISTING USE PROPOSED USE CONSTR, TYPE R STORIES I USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH , ATTACH 9DWELLING UNITS:ISA SECOND UNIT ❑YES SECONDSTORY E] YES BEING ADDED? F.WO ADDITION? /— X10 ''.............. PRE -APPLICATION ❑ 1 IF YES, PROVIDE COPY OF APPL # PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? RECEIVED Y s ie a n •y, TQTAL VALUATION: ffh /• PLANNING 0'90 eIJO Sti ff � �� .�. ;. « f ^� �®a By my signature below, I certify to each of the following: 1 am the property owner or authorized agent to act on 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 to b ing co ct,1:7 e representatives of Cupertino to enter the above -identified property for inspection purposes. Simature of App] icant/A-cent: �,, Date: ho I SUPPLEMENTAL INFORMATION REQUIRED siTP '_ a` ,r>x cxECKTYPE ,,' , .iopTic p ovER LOPI New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building TaE cbuxTERe UEDING Ri vJEW AM 4 z is Y P ermitfornewbuilding. 'I�'E�PREss is �kPLANNINGPLANItJIEW ix' Provide Hazardous Materials Disclosure { PUBLICwORhS Bldgs: a completed sTANl)ARD <t _Commercial form if any Hazardous Materials are being used as part of this project. ❑ LARGE I FIRE DEI a}k f t «' Copy of Planning Approval Letter or Meeting with Planning prior to D NL4JOR c3 �L , ri SER ER DPS'�'RICT submittal of Building Permit application. �`-"~SANITARY BldgApp_2011.doc revised 06/21/11 7 /rh. . rt^ITrrmm -rtll'f -T? APPLIANCE / EQUIP TYPE �+g+ 1 -L -RA n U.U1P tl U1CJC�1LFtlllllV�lL7�}� FEE ESTIMATOR - BUILDING Dff VffSffO Y Plumb. 111un Check ADDRESS: 20823 Stevens Creek Blvd DATE: 11/13/2012 REVIEWED BY: Sean -UNITS APN- RP#: ax *VALUATION: 1$30,000 *PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building # PENTAMATION FURN/AC USE:PERMIT Permit .F'ee: TYPE: woRIC Revision #1: Installation of new 3 -ton roof top unit for OF room cooling. SCOPE APPLIANCE / EQUIP TYPE FEE IID Plumb. 111un Check QTY -UNITS BP FEES Flee. Permit Fee: A/C Units (<=10K cfm) 1BCAIRHA Other F.Iec. Insp. EJ I 1 # $133 Permit .F'ee: Supp!InsFeep PME Unit Fee: $133.00 PME Permit Fee: $45.00 Consltwction :Tent: Administrative Fee: IADMIN $42.00 Work Without Permit? Yes 0 No $0.00 TOTALS: G Travel Documentation Fee: ITRA VDOC $133.00 Strong Motion Fee: IBSEISMICO - I i Mech. Plan Check 0.0 hrs $0.00 Plumb. 111un Check Elect. Pian Mech. Permit Fee: IMPERAffT Plumb. Permit Fee: Flee. Permit Fee: L�,Other0.0 Mech. Insp. hrs $45.00 (then Plumb Insp. Other F.Iec. Insp. EJ I h. Insp. Fee: PilliIa hasp. fa: Elec. Insp, 1,w: NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etG). These fees are haced an the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Elf. 711112) FEE (UTY/I+EE MISC ]ITEMS Plan Check Fee: ,5uppl. PC Fee PME Plan Check: $0.00 Permit .F'ee: Supp!InsFeep PME Unit Fee: $133.00 PME Permit Fee: $45.00 Consltwction :Tent: Administrative Fee: IADMIN $42.00 Work Without Permit? Yes 0 No $0.00 Advanced Plannins; Fees: G Travel Documentation Fee: ITRA VDOC $45.00 Strong Motion Fee: IBSEISMICO $6.30 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $273.30 $0.00 TOTAL FEE: $273.30 Revised: 1010112012 AlirRflR7 AT7r1 Alii rifle ill 7rh rnl 7 M, TAT OCCUPANCY TYPE: x.11 ll 11 Ali' \U U 1F 1 ` in ll ll117 %ky EEE ESTIMATOR - BUILDING DffVff SON FIR AREA s.ff. ADDRESS: 20823 Stevens Creek DATE: 90/09/2092 REVIEWED BY: Sean PC FEE IID APN: DP#: l _�b00(0 'YALUATIION: 1$600,000 *PERMIT TYPE: Building Permit PIAN CIIIECK TYPIE: Tenant Improvement PRIMARY Commercial Building 1BTIPLNCK PIENTAMATION 1 B TI USE: Permit Fee: PERMIT TYPE: WORK Office Tenant improvement 3277 sq ft). SCOPE $0.00 OCCUPANCY TYPE: TYPE OF CONSTR. FIR AREA s.ff. PC FEES PC FEE IID ]BP (FEES BP FEE ID B (Tenant Improvements) II-B,111-B,IV,V-B 3,277 $2,221.08 1BTIPLNCK $2,658.69 1BTIINSP Permit Fee: $2,658.69 Suppl. Insp. Feer Reg. COT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consrt-uction Tax: F] Administrative Fee: Work Without Permit? ( Yes 0 No $0.00 TOTALS: 3,277 $2,221.08 Travel Documentation Foes: $2,658.69 Strong Motion Fee: IBSEISMICO 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 nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E,(f. 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,221.08 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,658.69 Suppl. Insp. Feer Reg. COT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consrt-uction Tax: F] Administrative Fee: Work Without Permit? ( Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 4 Travel Documentation Foes: Strong Motion Fee: IBSEISMICO $126.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $24.00 SUBTOTALS: $5,029.77 $0.00 TOTAL FEE: $5,029.77 Revised: 10/0112012 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 ,t Telephone: 408-777-3228 C U P (E RTO N O Tax: 408-777-3333 CONTRACTOR SUBCONTRACTOR LEST JOB ADDRESS:20823 Stevens Creek, Suite 100 PERMIT # 12100063 OWNER'S NAME:Apple Inc. pHONr, #650-690-1660 GENERAL CONTRACTOR:Novo Construction BUSINESS LICENSE #23891 ADDRESS:1460Obrien Drive CITY/ZIPCODE: Menlo Park, 94025 '`Our municipal code requires all businesses worlaing in the city to have a City of Cupertino business liceme. NO Bt7><a<.,TDINC, 'FINAL OR FINAL OCCUPANCV INSPECTION(S) WILL BE SCEP-EDQl-L E.1(D UNTIL THIE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS RACTORS HAVE Old IrAllNE D A Cl')<Y OF CU?ERUNO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: ]Gate V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # x Cabinets & Millwork Commercial Casework Cement. Finishing x Electrical Redwood Electric Group 21108 Excavation Fencing x flooring / Carpeting Welker Brothers 25264 Linoleum / Wood Glass / Glazing x Heating United Mechanical —731p Insulation Landscaping Lathing Masonry x Pointing/ Wallpaper Canterbury 6 Paving Plastering Plumbing United Mechanical Roofing Septic Tank Sheet Metal x Sheet Rock California Drywall Tile Owner / Contractor Signature Date N