13010168CITY OF CUP ERTIINO BUILDING P ERMffT
BUILDING ADDRESS: 2 INFINITE LOOP
CONTRAC'T'OR: BARRON BUILDERS INC
PERMIT NO: 13010168
OWNER'S NAME: APPLE COMPUTER INC
415 CLYDE AVE STE 104
DATE ISSUED: 01(31/2013
OWNER'S PHONE: 4089961010
MOUNTAIN VIEW, CA 94043
PHONE NO: (650) 269-7061
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIP'T'ION: RESIDENTIAL COli MERCIAL 11
License Class Lic. # ot 11036 11'
OOMM ERIIOIIAL T.I. (3600 SF) REPLACE (E) PARKING
fit)
GARAGE (FANS. 3 ]FANS TOTAL, ]FAN RM 1, 2 & 3 @1200SlF
. 1 5! 3
Contractor Date
EACH
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: $750000
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 370.0 of the Labor Code, for the performance of the work for which this
APN Number: 31602106.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
Ei D
?E]E$MIT EXPIRES R ES I WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
TH� Il�®� IF PERMIT ������ ®�
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 DAY ST CAILIL]E➢D 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
granting of this permit. Additionally, the applicant understands and will comply
is U Date:
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
la
1J
RE -ROOFS:
Signature Date 13t
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. E 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(x) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should T 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 E
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, 25533, and 25534.
I
Section 3700 of the Labor Code, for the performance of the work for which this
t I
Owner or authorized agent:
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
CONSTRUCTION ]LENDING AGENCY
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
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 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
CUPERTON®
CONSTRUCTION PERMIT APPLICATION 0
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 0\
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 ^ building(cDcupertino.org
❑ NEW CONSTRUCTION ❑ ADDITION 21�LTERATION/Tl ❑ REVISION /DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS 6 J :=N I_ tf, esy
WI 11 LOOP
j
106
OWNER NAME f o f n L,e
PHO _ I o O
E-MAIL
STREET ADDRESS I � —I
A ( TE LcclO
CITY, STATE, ZIP
FAX
CONTACT NAME �
PHONE ®Q � p� o =yp
�( d !
E-MAIL���� �d4
STREET ADDRESS Sa-1f o
CITY, STATE, ZIP
FAXL_�9
4
❑ OWNER ❑ OWNER-Bua DDER ❑ OWNER AGENT ACONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑TENANT
CO CTOR N ME
LIC' NSE NUMBER
LICE TYPE
BUS. LIC #
E-MAIL ��P'tU{J,�.d�l4ill Il+�1LJ`r
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHI CT/EN EER N E�,
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
p
�� P -00 M 0P&(ZA®eS
9,60 D F ([,2- F,�1 RooMs ,e$ FAJ 01 F -M t2
EXISTING USE
PROPOSED USE
CONSTR TYPE
# STORIES
1
USE TYPE OCC.
SQ.FT.
VALUATION ($)
EXISTGI2�
AREA
NEW FLOOR
AREA
TOTAL
NET AREA
�;W VADEMO
�00
BATHROOM N
REMODEL AREA
KITCHEN OTHER
REMODEL AREA REMODELAREA
1111 II�H 1j'�p1111�-p``�
PORCH AREA
DECK AREA
TOTAL DECKTORCH AREA
GARAGE AREA: DErACH
❑ ATTACH
`! Y
P� qq qq
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? ❑NO
ADDITION? []NO
PRE -APPLICATION []YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑YES
RE
TOTAL VALUATION:
PLANNING ADPL# ❑NO PLANNING APPROVAL LETTER
EICHLER HOME? []NO
-75
By my signature below, I certify to each of the following: I am the property owner or au prized agent to act th erty 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. 1 agree to comply with all applicable local
ordinances and state laws relating to building constructio 1 authorize representatives of Cupertino to enter the a/b�ov -identi ed property for inspection purposes.
Signature of Applicant/Agent: Date: s -
SUPPLEMENTAL INFORMATION REQUIRED
PLANCHECKTYPE ROUTING SLIP
HF COUNTER . El 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
!,VFR_T
permit for new building.
EXPRESS CT PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD ❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
C3 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_201Ldoc revised 06121111
,f"7rrMXAr er'%,Trl .f'ITr TTM7MTrh rMTrr\T�r%
OCCUPANCY TYPE:
FEE ESTIMATOR
k4.,11 ll ll �L1P �. ll 11t 1PllQ ll ll1.�7 W1
— BUMDING IDDEWSION
PC FEES
ADDRESS: 2 INFINITE LOOP
DATE: 01/31/2013 REVIEWED BY: MELISSA
BP FEE RD
APN: 316 02 106
BP#:
-11 AL LUATION: 1$750,000
*PERMIT TYPE: Building Permit
ISTIPLNCK
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
Other Etec, Insp.
Ifech. Insp. I,ee:
PENTAMATRON 1S TI
USE:
hrs
$0.00
PERMIT TYPE:
WORK T.I. 3600 SF
REPLACE E PARKING GARAGE FANS. 3 FANS TOTAL FAN RM 1SCOPE
01MIMERICIAL
3 @1200SF EACH
$0.00
OCCUPANCY TYPE:
TYPE OF
CONSTR.
F1LR AREA
s.f.
PC FEES
PC FEE RD
BP ]FEES
BP FEE RD
S (Tenant Improvements)
II-B,III-B,IV,V-B
3,600
$3,799.76
ISTIPLNCK
$2,344.42
ISTIINSP
Other Etec, Insp.
Ifech. Insp. I,ee:
Plumb. hap. Fee:
Elec. Insp. Fee.-
ee:
hrs
$0.00
PME Unit Fee: _
$0.00
PME Permit Fee:
$0.00
Construction :Tax.
Administrative .Fee:
0
Work Without Permit? 0 Yes E) No
$0.00
TOTALS:
3,600
7$3,799.76
Travel Documentation Fees:
$2,344.42
Strong Motion Fee: IBSBISMICO
MECH, HOURLY ID Yes O No
NOTE:
PLUMB, HOURLY C) Yes G No
ELEC, HOLTRLY 0 Yes (E) No
Xfech. Plan Check
Plrtnrb. Plan Check
Elec. Plan Check
1 ;h. Permit I'BC:
Phamh, Permit Fee:
rke. Permit Fee:
hrs
$0.00
PME Plan Check:
Other hfech. Insp.
Other Plumb Ins/.).
Other Etec, Insp.
Ifech. Insp. I,ee:
Plumb. hap. Fee:
Elec. Insp. Fee.-
ee:
]VOTE: 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 Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 L ..' 711112)
IF]EIE
QTYAFIEF,
MISC ffT EMS
Plan Check Fee:
$3,799.76
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (j) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,344.42
Suppl. Ins p. Fee,0 Reg. C OT
Q,p
hrs
$0.00
PME Unit Fee: _
$0.00
PME Permit Fee:
$0.00
Construction :Tax.
Administrative .Fee:
0
Work Without Permit? 0 Yes E) No
$0.00
Advanced PlaiMing Fee:
$0.00
Select a Non -Residential
Building or Structure
Ly
Travel Documentation Fees:
Strong Motion Fee: IBSBISMICO
$157.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$30.00
SUBTOTALS:
$6,331.68
$0.00
T®TAL FEE:
$6,331.68
J� - Revised: 10/01/2012
CUPIERTOWC
CONTRACTOR / SUBCONTRACTOR OR ILHST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: a- 1 M 14 rM 1�oa
PERMIT #
OWNER'S NAME:
PHONE # oCeP
GENERAL CONTRACTOR: twI LDE)r—S
BUSINESS LICENSE #
ADDRESS:!q l 65-
CITY/ZIPCODE: 0A0OWT-W 80
*Our municipal code requires all ba sinesses working in the city to have a City of Cupertino business license.
NO BUILDING IFI[NA>L, OR (FINAL OCCUPANCY )<NSI? ECTI<®N(S) WILL BE SCHEDULED UNTILL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY CL CUP ERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature
]lDiease check applicable subcontractors and complete the ffbliowing infformationn:
Date
V
SUBCONTRACTOR
BUSINESS NAME
BUSINESS ILI[CENSE #
Cabinets & Millwork
Cement Finishing
Electrical
CSI - ewe-XT'1040 F-LeLi7iZl c
7
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
I (4M L
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
CAM -T & Ufz1( PAIAIT74
L�ZPLi%
Paving
Plastering
Plumbing
t r -o �A AIeAL
02
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner / Contractor Signature
Date