13090076k
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10450 RIDGEVIEW CT
CONTRACTOR: NCM DEMOLITION &
PERMIT NO: 13090076
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 11 COMMERCIAL
9 1'�%-
INTERIOR DEMO TO PREPARE FOR FUTURE BUILDING
License Class Lic. #
N(M �)1-y(6 1 010- P
PNDate
DEMO
Contractor Doatl't�h�`n
�
(253,044 S.F) BLDG RC 09
1 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.
Sq. Ft Floor Area:
Valuation: $50000
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 31606046.10450
Occupancy Type:
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
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
to building construction, and hereby authorize representatives of this city to enter
180 DAYS FROM LAST CALLED INSPECTION.
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
Issued by: Date:
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the C mo Municipal Code, Section
9.18.
RE -ROOFS:
Signature Date (�
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
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
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 , and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized ag Date:2r[.IU�
4
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
CONSTRUCTION PERMIT APPLICATION
Is COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 V
CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildingtcDcupertino.org
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS RC 09- 10450 Ridgeview Ct
"PN" 31 Off, - o _ 104P
OWNER NAME Apple Inc.
PHONE (408)783-4613 E-MAIL esandoval@apple.com
mol. ,�
STREETADDRESS 1 Infinite Loop
CITY, STATE, ZIP Cupertino, Ca. 95014
FAX
CONTACT NAME Edith Sandoval
PHONE (408)783-4613
E-11AILesandoval@apple.com
STREET ADDRESS 1 Infinite Loop, MS- 21-1AC2
CITY, STATE, ZIP Cupertino, Ca. 9501;-T
AX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Scott Williams
LICENSENUMBER 34469
LICENSE TYPE Buslne5
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
LICENSENUMBER C27550
BUS. LIC#
COMPANYNAMEFoSter & Partners
E-MAIL wolfgang_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
# STORIES
I
USE TYPE
OCC.
SQ.FT.
VALUATION (S)
AXRIESATG
NEW FLOOR
AREA
TOTAL
-253,0
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECKAREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
I
ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑YES
BEING ADDED? ❑NO
ADDITION? ❑NO
R ED 'OTAL VALUATION:
PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF
IS THE BLDG AN E3 YES
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
Vre /ad
By my signature below, I certify to eac a following: I m the roperty owne or authorize agent to act roperty owner's behalf I have this
application and the information I have provi d is correct. I ave re the Description of Work and veriaccurate. I agree to comply with all applicable local
ordinances and state laws relating to Iding nstruction. I autho a representatives of Cupertino to enter the abo e -identified property for inspection purposes.
Signature of Applicant/Agent: Date:
TION UIRED
SUPPLEMENT INF7Apply
PLAN CHECK TYPE
ROUTING SLIP
❑OVER-THE-COUNTER
1:1BUILDING PLAN REVIEW
_ New SFD or Multifamily dwe 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
ElSTANDARD
❑ 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_2011.doc revised 06/21/11
�,�� CITY OF CUPERTINO
NOME FEE ESTIMATOR - BUILDING DIVISION
191
ADDRESS: 10450 RIDGEVIEW CT
DATE: 08/27/2013
REVIEWED BY: MELISSA
jfech. Permit Fee:
APN: 316 06 046 , t 0 t{ 50
1BP#: 130
`VALUATION:
1$50,000 -�
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
f�1eC:. Iflsp. Fee.
PENTAMATION 1TIPREP
PERMIT TYPE:
WORK I
INTERIOR DEMO TO PREPARE FOR FUTURE BUILDING DEMO (253,044 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
nictrict etc_ h Thece fees are hased an the nreliminary information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/12)
;frer:
CUPERTINO
,, A'. M CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: 1v#3T P-M&4F),7 v cr. PERMIT # I 3Q GU
OWNER'S NAME:PHONE # M-7'
GENERAL CONTRACTOR: �/ry�,' &#-rr BUSINESS LICENSE #
ADDRESS: W1 p-,*- CITY/ZIPCODE: c Z
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) 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
V
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
Owne f!�eontractor Signature
e74v/3
/3
Date