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B-2016-2617
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: , PERMIT NO:B-2016-2617 10,351 BUBB RD CUPERTINO,CA 95014-4149(357 20,009) SILICON VALLEY MECHANICAL INC SAN JOSE,CA 95131 OWNER'S NAME: SI 39 LLC DATE ISSUED:08/31/2016 OWNER'S PHONE:408-9746970 PHONE NO:(408)943-0380 LICENSED CONTRACTOR'S DECLARATION ATION BUILDING PERMIT INFO: License Class C-20 Lic.#992731 X BLDG _ELECT _PLUMB Contractor SILICON VALLEY MECHANICAL INC Date 05/31/2018 X MECH_RESIDENTIAL X COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9(commencing ) fessions Code and that my with Section 7000 of Division 3 of the Business.&Pro licensers in full force and effect. JOB DESCRIPTION:. REPLACE(2)40 TON A/C UNITS&(1)BOILER(ROOF TOP)-APPLE I hereby affirm under penalty of perjury one of the following two declarations: t. 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. 2. I have and will maintain Worker's Compensation Insurance,as provided for by ' �ro p rmance of the work for which this Section 3700 of the Labor Code,for the erfo permit is issued. Sq.Ft Floor Area: Valuation:$150000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type information is correct.I agree to comply with all city and county ordinances 357 20 009 A(Tenant Improvements) and state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above imentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. i �Signature Date 08/31/2016 Issued by:Kim Dunbar Date:08/31/2016 RF-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1. I,as owner of the property,or my employees with wages as their sole inspection. compensation„will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature nfApplicant: contractors to construct the project(Sec.7044;Business&Professions Code). Date:08/31/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance,as provided for by I California Health&Safety Code,Sections 25505,25533,and 25534. 1 will Section 3700 of the Labor Code,for the performance of the work for which this maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous s. I certify that in the performance of the work for which this permit is issued,I material.Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,2553 , d 25534. Labor Code,I must forthwith comply with such provisions or this permit shall ,r; be deemed revoked. "Owner or authorized ages' APPLICANT CERTIFICATION Date:08/31/2016 I certify that I have read this application and state that the above information la s is I hereby affirm that there is a construction lenCON TRUCTIONLE ding agency for the performance correct.I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued(Sec.3097,Civ C.) relating to building construction,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands ARC ffiTECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 08/31/2016 professional MEP--- GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPEF2'i IHOl (408)777-3228 FAX(408)777-3333•building@cuperlino.ora MISC Za 0PLUMBING OMFCHANICAL DELECiRICAL ❑MISCELLANEOUS PROJECT ADDRESS 10351 Bubb Rd. Cupertino, CA 95014 .ArNlt S z-Q Q OWNER NAMEPHONE E-MAIL Apple Inc 3 eq' l—I,C I 4x8.974.6970 paul_avila@apple.com STREET ADDRESS CITY,STATE,ZIP FAX 690 E. Arques Ave Sunnyvale, CA -7 CONTACT NAME PROME-MAIL. Paul Avila 408.373.3278 au1 ila@apple.com -STREffr ADDRESS CITY,STATE,ZIP FAX same as above ❑OWNER 13 OWNER-151I11MElt ❑OWNER AGENT CONtRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPERS ❑TENANT CONTRACTOR NAME LICENS14 NUMBER LICENSE TYPE BUS,LTC 8 SVM Inc 992731 C20 26079 COMPANYNAME - E-MAIL FAX SVM Inc tsecolo@svminc.coi-n STREI{C ADDRESS CITY,STATE,ZIP PHONE 2115 Ringwood Ave San Jose CA 95112 408.943'.0380 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS,LIC COMPANYNAME R-MAIL FAX STREET ADDRESS CITY,STATE;ZIP PHONE USE OF ❑SFDorDUPUX ❑. MULTI-FAMILY PROJECT INWILDLAND ❑ YES PROJEC`rrV ❑YES ISTHRRLDGAN ❑YES BUILDING: [a COMMERCIAL URBAN INTERFACE AREA ❑ NO - FLOOD ZONE ❑NO ETCHLERHOME7 ©NO DESCRIPTION OF WORK Like for like replacement of (2) 40 ton boxcar A/C units and -(I) rooftop boiler. w_.... TOTAL VALUATION: $150,000.00 ,tR:E.C:.£IZ,E..D:B.:r`:�;;_:;etc-;�=i-;�=i_'iso'•;-:=-=-;::_:._�+.�--�-;�r�;�>�>=_"s;:_==. By my signature below,I certify to each of the following: lam the property owner or authorized agent to act on Fire 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 slate taws relating to building construction. uth .Fre • entatives of Cupertino to enter the abbooYe"dentifieZroperty for inspection purposes. Signature of Applicant/A nt Date: 13 �� SUPPLEMEN`]'t1I,INFORMATION REQUIR131) - _:_M�. ......---._ sem- 7 _ _ --- - BIGGS CAROO'SA 16 ASSOCIATES INC to STRUCTURAL ENGINEERS JOB#: 865 The Alameda PagelOf San Jose, GA 95.125-3135 Telephone 408-296-5515 Facsimile 408-296-5114 SPECIAL INSPECTION DAILY REPORT Project Name: f Date. Project Address: Time Arrived: Time Departed: Location of Inspection: IV Inspections made: Samples Taken Items Complete: L — Deficiencies/Items Pending: Comments: To the best of my knowledge,the work completed or in progress for this report was done in general conformance with the intent of the approved design documents and specifications and applicable workmanship provisions of the C.B.C. exce 't as note above. INSPECTOR: MJ4,4 Ai4 BC-SIDR-1/16 BIGGS CAR©®SA ASSOCIATES INC to 61 16 STRUCTURAL ENGINEERS JOB #: BCS The Alameda Page1of San Jose, GA 951 28'3123 Telephone 408-296-5515 Facalmile 4oa-2SS-8114 SPECIAL INSPECTION DAILY REPORT Project Name: Affl f, r Date: Project Address: Time Arrived: � 12 Time Departed.: Location of Inspection: Inspections made: Samples Taken: Items God: Deficiencies/Items Pending: Comments: To the best of my knowledge,the work completed or in progress for this report was done in general conformance with the intent of the approved design documents and specifications and applicable workmanship provisions of:the C.B.C. except as noted above. INSPECTOR: �I'& M,4 BG SIDR-9/f6 F I L7,-7- ASSOCIATES INC �!1 � `4�I 16 STRUCTURAL ENGINEERS JOB #: 8 6 5 The Alameda n tt San Jose. CA 95126-3133 Page t of Telephone 408-296-5515 Facsimile 408-296-8'114 STRUCTURE INSPECTION DAILY REPORT Project Name: At4&& Date: Project Address: Time Arrived: Time Departed: Location of Inspection; r Inspections Made: Samples Taken: Items Complete: - Deficiencies/Items Pending. Comments: r r, - To the best of my knowledge,the work completed or in progress for this report was done in general conformance with the intent of the approved design documents and specifications except as noted above. INSPECTOR: