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13090078Iko CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10555 RIDGEVIEW CT CONTRACTOR: NCM DEMOLITION & PERMIT NO: 13090078 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 II License Class__ Li.. # C71 4 6 $ s- — INTERIOR DEMO TO PREPARE FOR FUTURE BUILDING DEMO d I f,e� Contractor lyCM �ttd�if b'r °i�'-f" aYe , c //3e (145,702 S.F) 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. 1 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: 31606048.00 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 upon the above mentioned property for inspection purposes. (We) agree to save 180 DA 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 Date: /3 granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is 9.18. Signature Date installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ ER -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. 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 25505,2 533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this p, Owner or authorized agent: Date: /�/ -S �� 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 i CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION O 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildingO)cupertino.org \ I F1 NF.W CONSTRI ICTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS RC 05- 10555 Ridgeview Ct APN# b , 06 OW NERNAME Apple Inc.Ll M f (408)783-4613 E-MAIL esandoval@apple.com 114 STREET ADDRESS 1 Infinite (oop CITY, STATE, ZIP Cupertino, Ca. 95014 FAX CONTACT NAME Edith Sandoval PHONE (408)783-4613 F -MAIL esandoval@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 ❑ TENANT CONTRACTOR NAME Scott Williams LICENSENUMBER 34469 LICENSE TYPE Bushes BUS. L'C' 34469 COMPANY NAME NCM Demolition and Remediation, LLP E-MAIL swilliams@ncmgroup.com FAX STREETADDRESS 6644 Sierra Lane CITY,STATE,ZIP Dublin, Ca. 94568 PHONE (925)307-1500 ARCHITECT/ENGINEER NAME Wolfgang Wagner LICENSE NUMBER C27550 BUS. LIC# COMPANY NAME. Foster & 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 UOCC. SQ.F"I'. VALUATION ($) ARE' ARE FLOOR AREA TOTAL 145,702 BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH I ri DNW'ELLING UNITS: IS A SECOND UNIT YES SECOND STORY r]YES BEING ADDED? ONO ADDITION? ❑NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF 4STHE LDG AN ❑YES IVE TOTAL VAI,UATI N: PLANNING APPL # ❑NO PLANNING APPROVAL LETTER EICHL HOME? ❑ NO 7V By my signature below, I certify to owin I am t property owner or authorized agent to act roperty owner's behalf. 1 have read this application and the information I hacome I. I have ead the Description of Work and verify it is accurst . I agree to comply with all applicable local ordinances and state laws relating toructi [ au orize representatives of Cupertino to enter the abov ide fled property for inspection purposes. U'Iding Signature of Applicant/Agent: Date: 11 _ SUPPLEMENT INFO TION REQUIRED PLAN CHECK ,'PE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily ellings: Ap y for demolition permit for existing building(s). Demolition rmit is req ired 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 ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ia ADDRESS: 10555 RIDGEVIEW CT DATE: 08/07/2013 REVIEWED BY: MELISSA APN: 316 06 048 BP#: lj *VALUATION: 1$50,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: Suppl. PC Fee: (F) Reg. Q OT PENTAMATION 1TIPREP PERMIT TYPE: WORK INTERIOR DEMO TO PREPARE FOR BUILDING DEMO 145,702 S.F. SCOPE NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). Thesefees are based on the preliminai.w information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution II -053 Eff. 711112) FEE t Ib -t°£ Ofhe! tech, Insp,E�� rwr t i{/.yib Itt.�'jx Fnsp, El Suppl. PC Fee: (F) Reg. Q OT 1 0.0 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). Thesefees are based on the preliminai.w information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution II -053 Eff. 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 # $405.00 Tenant Improvement Prep ITIPREP Suppl. PC Fee: (F) Reg. Q OT 1 0.0 1 hrs $0.00 PME Plan Check: $0.00 Pen -nit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 10701 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Pen -nit? 0 Yes ) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G 0 A Strong Motion Fee: IBSEIS-MICO $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 CUPERTINO ohjg- CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOBADDRESS: JPs -5' Ptt9w"^ve-T, PERMIT# ad ty OWNER'S NAME: X11'1 yvbS I N? . PHONE # q 0-7 rU77 GENERAL CONTRACTOR: N p fA,. S WI,'W4 Pr(VIS BUSINESS LICENSE # ADDRESS: 1a CITY/ZIPCODE: ISI N *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 Signature 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 Signature Date