14090088CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: I INFINITE LOOP
CONTRACTOR: ICOM MECHANICAL INC
PERNIIT NO: 14090088
ONA'NER'S NAME: APPLE COMPUTER INC
477 BURKE ST
DATE ISSUED: 09/15/2014
OWNER'S PHONE: 4089961010
SAN JOSE, CA 95112
PHONE NO: (408)792-2292
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
/101 P2NDL
CIA -40 -C& -40-C& 06 Lic.#
FLOOR; INSTAL A/C UNIT IN LED ROOM
Contractor ( (,a. M AC.--r—d- [tiC Date
I hereby affirm that 1 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: $30000
performance of the work for which this permit is issued.
1 have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
APN Number: 31602105.00
Occupancy Type:
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 D YS 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 DAY LAST 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
granting of this p it. Addit e applicant understands and will comply
Issued by: Date:
with all non --p n ource ulations er the Cupertino Municipal Code, Section
9.18.
r
RE -ROOFS:
Signature Date���4
�
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 ne%v 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. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance wJitlfthe Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Seehon 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
equipmen devices which emit hazardous
material. Additionally, s/,v.
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as definay A Air uality Management District I
performance of the work for which this permit is issued.
will maintain complianceupe ino M iicipal Code, Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code550 25 and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized age Da
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
Compensation laws of California. If, after making this certificate of exemption, I
CONSTRUCTION LEN'DIN'G AGENCY
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 1 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
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
imADDRESS:
1 inflinte loop
DATE: 10/15/2014
REVIEWED BY: Mendez
UNITS
] APN:
7BP#:
*VALUATION: 1$30,000
*PERMIT TYPE: Mechanical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY Commercial BuildingPENTAMATION
USE:
#
PERMIT TYPE: FURN/AC
WORK I
—01v) lil sia & A-11, 11
SCOPEzel
S'vpp/
APPLIANCE / EQUIP TYPE
FEE ID
QTY/FEE
QTY
UNITS
BP FEES
A/C Units (<=10K cfm) A
1BCAIRHA
Lj
1
#
$143
Absorption Unit
1 MCRAA
S'vpp/
1
#
-12— Ob
PME Unit Fee:
PME Permit Fee;
$48.00
Administrative Fee: JADMIN
$45.00
Work Without Permit? 0 Yes 0 No
$0.00
TOTALS:
A
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee: IBSEISMICO
NOTE: This estimate does not include fees due to other Departments (4e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addnl info.
FEE ITEMS (Fee Resolution 11-053 Eff 711113)
Mech. Plan Check 0.0 hrs $0.00
QTY/FEE
MISC ITEMS
Mech. Permit Fee: IMPERMIT
F
Other Mech. Insp.Ej�hrs$48.00
El
Lj
PME Plan Check:
$0.00
NOTE: This estimate does not include fees due to other Departments (4e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addnl info.
FEE ITEMS (Fee Resolution 11-053 Eff 711113)
FEE
QTY/FEE
MISC ITEMS
PME Plan Check:
$0.00
Pel'o'lit I cg""
S'vpp/
PME Unit Fee:
PME Permit Fee;
$48.00
Administrative Fee: JADMIN
$45.00
Work Without Permit? 0 Yes 0 No
$0.00
A
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee: IBSEISMICO
$8.40
Select an Administrative Item
BW Stds Commission Fee:. IBCBSC
$2.00
SUBTOTALS:
)1
$0,00 TOTAL FEE,7,3&&,
Revised: 08/20/2014