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13090077CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10450 RIDGEVIEW CT CONTRACTOR: NCM DEMOLITION & PERMIT NO: 13090077 REMEDIATION LP OWNER'S NAME: CAMPUS HOLDINGS INC 404 BERRY ST DATE ISSUED: 09/11/2013 OWNER'S PHONE: 4087834613 BREA, CA 92821 PHONE NO: (714) 672-3500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL LJ Lic. # � Lrb� License Class/s��"" INTERIOR DEMO TO PREPARE FOR FUTURE BUILDING _ "VI DEMO NCM Vtl' �tf fl Date�1" Contractor lin qv� � �I _,3 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. (121,078 S.F) BLDG RC 08 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. 1 have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $50000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 31606046.10450 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED 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 hereby of this city to enter WITHIN 1 PERMIT ISSUANCE OR to building construction, and authorize representatives upon the above mentioned property for inspection purposes. (We) agree to save 18 T 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 Issu Date: granting of this permit. Additionally, the applicant understands and will compl with all non -point source regulations per the rtino Municipal Code, Section 9.18. Signature Date 3 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. ❑ 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) 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 1 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, 25533, 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. 1 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 -�T CONSTRUCTION PERMIT APPLICATION C Q 13 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION (1 1 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 �7 U CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION []ALTERATION/ TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS RC 08- 10450 Ridgeview Ct APN11 I 06_ O Lf4 . 1 Dq 5 OWNERNAME Apple Inc. h1`ewir 6NE (408)783-4613 E-MAll, esandoval@apple.com �s STREET ADDRESS 1 Infinite Loop CITY, STATE,ZIPCupertino, Ca. 95014 FAX CONTACT NAME Edith Sandoval PHONE (408)783-4613T-MAILesandoval@apple.com STREET ADDRESS 1 Infinite Loop, MS- 21-1AC2 CITY,STATE, ZIP Cupertino, Ca. 95014 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANI CONTRACTOR NAME Scott Williams LICENSE NUMBER 34469 LICENSE TYPE BUSIneS BUS.LIC# 34469 COMPANY NAME NCM Demolition and Remediation, LLP E-MAIL SWilliams@ncmgroup.com FAX STREET ADDRESS 6644 Sierra Lane CITY,STATE,zIP Dublin, Ca. 94568 PHONE (925)307-1500 ARCHITECT/ENGINEERNAME Wolfgang Wagner LICE NSENUMBER C27550 BUS. LIC# COMPANY NAME Foster & Partners E-MAIL wollfgang_wagner@apple .COM FAX STREET ADDRESS 1 Infinite Loop, MS 21-1AC2 CITY, STATE, ZIP Cupertino, Ca. 95014 PHONE (408)306-6172 DESCRIPTION OF WORK Demolition of furniture office partitions and computer flooring to allow access to preform abatement work. EXISTING USE PROPOSED USE CONSTR. TYPE N STORIES USE TYPE OCC. SQ.FT. VALUATION (5) AREAC ARE FLOOR AREA TOTAL ET AREA 1 21 ,078 BATHROOM KITCHEN OTHER REMODEL AREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA±I.E.NAo.'DED? AL DECK/PORCH AREA GARAGE AREA: DETACH I ATTACH k DWELLING UNITS: ND UNIT ❑YES SECOND STORY []YES []NO ADDITION? ❑NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑YES EIVTOTAL V LLUA;IION: PLANNING APPL # ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, l certify to each of the following: 1 am a property o ner o e gent to e property owner's behalf. I have read this application and the information 1 have provi I hav read the De iptron of Work and v rt is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin con [ aur orize repre ntatives of Cupertino to enter the above -id ntif d property for inspection purposes. �®rred_. Signature of Applicant/Agent: _ Date: a l� SUPPLEMENTAL INFTION REQUIRED PLAN CHECK TYPE ROUTING SLIP 11 OVER-THE-COUNTER El BUILDING PLAN REVIEW New SFD or Multifamily dwellings. 1 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 ❑ 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 ❑ MAJOR ❑ SANITARV SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION r ADDRESS: 10450 RIDGEVIEW CT DATE: 08/27/2013 REVIEWED BY: MELISSA A.fec:i't..Pe inif Fee' APN: 316 06 046, t0450 IBP#: I MOO 2 'VALUATION: 1$50,000 *PERINIIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: Eler:. I,t.�t:. Fee: PENTAMATION 1TIPREP I PERMIT TYPE: WORK INTERIOR DEMO TO PREPARE FOR FUTURE BUILDING DEMO (121,078 S.F. - NO EXTERIOR SCOPE WORK, NO ASBESTOS ABATEMENT, NO ALTERATION OF FIRE SPRINKLER SYSTEM) NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Dictriet etc_ )_ These fees are haled an the nreliminary information available and are only an estimate. Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) I fet:12 QTY/FEE A.fec:i't..Pe inif Fee' .r�111fMb. Permil F c' Elec'. 1.%iJret`.A.feC: ,•'7, 7_ 0/%381 .f�'.7UP%Zt'>FIi_)T%.Li Cit/ic't'.Ll"'., lmv. iic:ch, Fr 1'.'1rtr.•i-. Eler:. I,t.�t:. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Dictriet etc_ )_ These fees are haled an the nreliminary information available and are only an estimate. Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 # $405.00 Tenant Improvement Prep ITIPREP Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. () OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ("onstruction Tax: T ?€/9ilt?77,i't�ftll%t' T L''c:' O G) Work Without Permit? Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 i ' ov l D curn{,ntalion T"I t; Strong Motion Fee: 1BSEISMICO $10.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $12.50 $405.00 TOTAL FEE: $417.50 Revised: 07/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date JOB ADDRESS: p �� P-torenov cr. PERMIT # 3 0!? BUSINESS NAME BUSINESS LICENSE # OWNER'S NAME: F-/t/L PHONE # Cabinets & Millwork GENERAL CONTRACTOR: J1 e&.' eV7T BUSINESS LICENSE # 3 10 Cement Finishing ADDRESS: CITY/ZIPCODE: � /v vt- *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date / Contractor Signature g113/0 Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork 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 / Contractor Signature g113/0 Date