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B-2016-3314CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-3314 5 INFINITE LOOP CUPERTINO, CA 95014-2088 (316 02 109) BARRON BUILDERS INC SANTA CLARA, CA 95054 OWNER'S NAME: APPLE COMPUTER INC DATE ISSUED: 12/22/2016 OWNER'S PHONE: 408-996-1010 PHONE NO: (650) 964-4493 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class @ Lic. #916366 Contractor BARRON BUILDERS INC Date 07/31/2017 X BLDG _ELECT _PLUMB MECH RESIDENTIAL X COMMERCIAL 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. JOB DESCRIPTION: INSTALLATION OF A PRECAST MANHOLE AT IL5 TO ACCESS FIRE I hereby affirm under penalty of perjury one of the following two declarations: SPRINKLER WATER TANK. t. I have and will maintain a certificate of consent to self -insure for Worker's REV#1 - CUT INA MAN DOOR OPENING -ISSUED 06-15-2017 Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. z. I 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 Sq. Ft Floor Area: Valuation: $20000.00 permit is issued. APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 316 02 109 A (Tenant Improvements) representatives of this city to enter 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 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. L Signature ~`—� ` Date 06-15-2017 Issued by: SEAN HATCH OWNER -BUILDER DECLARATION Date: 12/22/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is t. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 06-15-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER r. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use equipment or devices which emit hazardous 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, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 06-15-2017 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is issued (Sec. 3097, Civ C.) to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 06-15-2017 Professional CONSTRUCTION PERMIT APPLICAR /ISION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, (A 95014-3255 CUPERTIN© I (408) 777'3228 •FAX (408) 77'-3333 • bullding0cupertino,org D -701(d / ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERA'T'ION / TI REVISION / DEFERRED ORIGINAL PERMIT # 6 PROIBCT ADDRESS 5 1 F I til tTC- LG lie - / (� �C'� /„ -D 9, .-/0 APN # 31& `01 Ow"ANIE A99 t E � y l c- PHONE ���� - 10107 0 EMAI L STREETADDRESS 1viIFIN (� 1 � PAX CITY, STATE Cv�-nu0 04 'e-160 14 CONTACT NAME Ea o ES"- D ?K av�or 1 F'� 1`+ P�v� -R64- 4493 � E-MAIL fSl'D eM&(i.(Mr,1 Sult.flRs. ADDRESS C LCC- DEL QU46 ;� �l /� DSAS &Ae,& L/fi 1505' FAX ❑ OWNER ❑ OWNER-BU11DER ❑ OWNER AGENTCONTRACTOR ❑ CONTRACCTO/R AGENT 11ARCHITECT ❑ ENGINEER. E) DEVELOPER ❑ TENANT ME �q rJ i7 IDENSE FfR�3fon LICHN�CFyTYPE BUS. LIC# C MP �� U1(.�ESS �RtJ�ST' AKKn�$ ct: g-E.40M FAX Wb -Z9 ^% CUM r STREET DREA(.LE �L :,iflldY%Lj CITY, SAfJ STATE, ZIP SVS4 PHONE 6%-b-9644453 ARCFIITEC1IENGINEERNi9TWE WH�r u C ellowCOMPANY LICENSENUMEER BUS, LIC 4 NAS Iv Ew ��� wAL E-MAII FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK CUA f 4 FAN EL v`r�lTE►.1t�►UC f'� -ro ve-oitctE I�Ce�sS b�L P���CT' of "f1tE VV IJ TIANK. EXISTING USE PROPOSED USE CONSTR. TYPE N STORIES I USE TYPE OCC, SQ,FT, VALUATION (�) EKISTG NEW FLOOR DEMO TOTAL AREA .AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH ❑ ATTACH N DWELLING UNITS:1S A SECOND UNIT ❑ YES .SECOND STORY ❑YES 7 BRINGADDED? []NO ADDITION? LINO PRB-APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS TRE BLDG AN [] YES TOTAL VALUATION: PLANNINGAPPL# []NO PLANNING APPROVAL LETTER E1CIU,ER H Nam .__.__... 1 By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the 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 state laws relating to building construction: I authorize representatives of Cupertino to enter the above -identified f7or inspection purposes, 3property '' Signature of Applicant/Agent: r— Date: SUPPLEMENTAL INFORMATION REQUIRED New SFD or Multifamily dwellings: Apply for demolition permit for %] o GEk r couivrEYi Lel. Euu�lHtiFLAr v>EW existing building(s). Demolition permit is required prior to issuance of building permit for new building. OaREss < ❑ PI XNNf1V R 12E G iIT4Y _ Commercial Bldgs! Provide a completed Hazardous Materials Disclosure ❑ STAADARD r- r` ❑ 1 UBLTC WORKS - form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑' 1;IREDEPT - _ Copy of Planning Approval Letter or Meeting with Platmulg prior to submittal of Building Permit application. Q az SANITARYSEWEI2DISTRICTr = AA_>;� :0 FivvlRONaTENTAY HI Aires -- B1dgApp_2011. doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B -2016-3S14 5 INFINITE LOOP CUPERTiNO, CA 95014-2088 (316 02 109) BARRON BUILDERS INC SANTA CLARA, CA 95054 OWNER'S NAME: APPLE COMPUTER INC I I DATE ISSUED: 12/22/2016 PHONE: 408-996-1010 License Class a Lic. #DJ_QM Contractor BARRON BUILDERS INC Date 07/31/2017 hereby affirm that I am licensed under the provisions of Chapter 9 (commencing rith Section 7000) of Division 3 of the Business & Professions Code and that my cense is in full force and effect. . I hereby affirm under penalty of perjury one of the following two declarations: 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 performance of the work for which this permit is issued. D2, I have and will maintain Worker's Compensation Insurance, as provided for by /if%I'►/Jd Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 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 permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature ,��.�------- Date 12.22.1$ I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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 (See.7044, Business & Professions Code) 1 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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 performance of the work for which this permit is issued. z. 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 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18, Signature Date 12.22.16 NO: (650) 9644493 PERMIT INFO: X BLDG _ ELECT —PLUMB _ MECH RESIDENTIAL X COMMERCIAL JOB DESCRIPTION: INSTALLATION OF A PRECAST MANHOLE AT ILS TO ACCESS FIRE SPRINKLER WATER TANK. Ft Floor Area: I Valuation: $20000.00 APN Number: Occupancy Type: 316 02 109 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: SEAN HATCH - 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. Signature of Applicant: Date: 12.22.16 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: 12 22_..116 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address AR HITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO I F-1 w-pw(V1T,TCTATT(`'rTn1,T CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingp_cupertino.org F-1 n BldgApp_2011.doc revised 06121111 xc.vi�1IUIN i 1)h11 ;KKE1) ORIGINAL PERMIT# PROJECT C APN # OW'NERNAME PHONE E-MAIL STREET ADDRESS 1� LL� FAX CONTACT NAME A � �1 PHONE E-MAIL SIRE T DRESS ��J�- CITY, STATE, ZIP - 61 FAX ❑ OwNER ❑ OwNER-BUILDER ❑ OwNTERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ' ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CO OP,j LIC ST VU1�;BER (� LICENSECE BUS. LIC COMP /�r-/I l� 1®I � �� ,9 � a/9'i F V 1 t.r / E-MAIL E4 013AMo�i puIti) S.r�� FAX ,. �� •e164 - 4_31Z STREET_ ADDRESS t' 1 ' n f -A \),J P D C�I^TY, STATE ZIP _ S (ami qsbg � PHONE Gr -+-413 ARCHITEC WEM L) `TO f A �__ LICENSE NUMBER BUS. LIC # COMPANY INTANIE ^ }r�a�6i11�0 E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK q SAFitAKL W kJ'E- 7, EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXIST G AREA NEW FLOOR AREA DEMO AREA TOTAL NETAREA BATHROOM REMODEL AREA KITCHEN REMODEL AREA OTHER REMODEL AREA - PORCH AREAT ECK AREA TOTAL DECKTORCH AREA GARAGE AREA: DETACH - ❑ ATTACH 'DWELLING UNTITS: IS A SECOND UNIT ❑ YES — SECOND STORY ❑ YES ADDED? ONO An ADDITION? ONO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑YES '- EICHLER HOME? ❑ NO RECEED $Y _ TOTAL VALUATION:PLANNING By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the infonnation 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 ction. I authorize representatives of Cupertino to enter the above-identi red pr perry for inspection purposes. ordinances and state laws relating to bu9;;� Signature of Applicant/AgentA Date: 4- � � �Z� t� SUPPLE- SUPPLEMENTAL INFORMATION REQUIRED PL_ AIV CHECK TYPE ROUTING -SI IP _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building r .�y k"OVER TiIE COUNTER Z uH DINS PLAN permit for new building. EXPRESS PLANiSIIVG PLAN RETIES - , Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 01 STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. Cl. LARGE _ Copy Of Planning Approval Letter Or Meeting with Planning prior t0 �pR ❑ S submittal of Building Permit application. , ITARI'SEWERDISTRICI- -- ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 Quality Assurance Services Materials Consulting TESTING ENGINEERS, INC. Since 1954 September 15, 2017 - City of Cupertino TEI Proj .ct No. 65959 Building Inspection Department -rmit No. B2016-3314 10300 Torre Avenue Cupertino, California 95014 Subject: FINAL REPORT Project: 5 Infinite Loop :. . Water Tank Project Cupertino, California Gentlemen: . In accordance with Section 1705 of the California Building Code,we have provided special inspection of: - Placement of concrete. - Sampling and laboratory compression testing for concrete. Installation of epoxied dowels in existing concrete. These inspections were performed by personnel under the general supervision of a Registered Civil Engineer in the State of California. Based upon our inspections performed and our substantiating reports,the inspected work requiring special inspection was,to the best of our knowledge, in conformance with the approved plans and specifications,.the applicable workmanship provisions of this Code, and any changes by the Engineer of Record. Details of our work on this project are contained in our testing and inspection reports that were submitted during . the progress of construction. oFESSlO4/q TESTING ENG EEQ,� ���[. SToc t CZ No.739 0 Exp• Colin Stock, P.E. * CE# 73980, Exp. 6/30` 0p. A c)�\� 1cc: Apple Computer Inc. /R. Anchartechaher RECIE I\72 SEP 21 2017 BY)dizt± Corporate Office—2811 Teagarden Street—San Leandro,California 94577—(510)835-3142—FAX(510)834-3777 www.Testing-Engineers.com