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15020108CITY OF CUPERTINO BUILDING PERMIT 1I BUILDING ADDRESS: 19191 VALLCO PKWY I CONTRACTOR: NOVO CONSTRUCTION I PERMIT NO: 15020108 I OWNER'S NAME: APPLE INC OWNER'S PHONE: 4084380968 ❑%/GCS LICENSED CONTRACTOR'S DECLARATION License Class 19 Lic. # 1 f 6 Contractor —IyyD P0"n 4fyl F, Date a 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. I hereby affirm under penalty of perjury one of the following two declarations: 1 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. 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 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 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 o?)l ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1 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. 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 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 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 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 1460 O'BRIEN DR I DATE ISSUED: 02/18/2015 MENLO PARK, CA 94025 1 PHONE NO: (650)701 -1500 JOB DESCRIPTION: RESIDENTIAL Ej COMMERCIAL E] APPLE- CONVERSION OF (E) OFFICES INTO (2) LAB SPACE ON (E,M); MODIFY TO (2) (E) CONFERENCE ROOMS COMBINE (2) OFFICES INTO (1) LARGE OFFICE (6,100 Sq. Ft Floor Area: I Valuation: $550000 APN Number: 31620074.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FR CALLED INSPECTION. Issued by: Date: 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: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 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(x) 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, 255 , and 25534. Owner or authorized agent: Date: 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19191 VALLCO PKWY I CONTRACTOR: NOVO CONSTRUCTION I PERMIT NO: 15020108 OWNER'S NAME: APPLE INC 11460 O'BRIEN DR I DATE ISSUED: 02/18/2015 I I OWNER'S PHONE: 4084380968 1 MENLO PARK, CA 94025 I PHONE NO: (650)701 -1500 I ❑ ✓ ` LICENSED CONTRACTOR'S DECLARATION License Class a Lic. # 19 j o a a Contractor J✓O✓2r Q-0,K '4. 1A-.%+ Date 3 201 s 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: 1 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. 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 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 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. Signa Date 711 ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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 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, l 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 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 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. Date JOB DESCRIPTION: RESIDENTIAL Ej COMMERCIAL ❑ APPLE- CONVERSION OF (E) OFFICES INTO (2) LAB SPACE ON (E,M); MODIFY TO (2) (E) CONFERENCE ROOMS COMBINE (2) OFFICES INTO (1) LARGE OFFICE (6,100 DEFERRED #1- HIGH DENSITY STORAGE- ISSD OTC 3/17/2015 Sq. Ft Floor Area: I Valuation: $550000 APN Number: 31620074.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN I80 DAYS OF PERMIT ISSUANCE OR 180 DAYSX110M LAST CALLED INSPECTION. Issued by: Date: 5 f l [57— 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 Appl Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 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: s Date: I 17 CONSTRUCTION LENDING AGENCY 1 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • build ingQcupertino.crg u� l ❑ NEW CONSTRUCTION ❑ ADDITION 19 / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT PROJECT ADDRESS 19191 Vallco Parkway APNh l�, 2 0 , OWNER NAME Apple Inc PHONE 408.438.0968 1 E -MAIL paul_boyer @apple.com STREET ADDRESS 1 Infinite Loop CITY, STATE, ZIP Cupertino, CA 94015 FAX CONTACT NAME Anu Sumanth PHONE 650.365.0600x20 E -MAIL Asumanth @thehayesgroup.com STREET .ADDRESS 2657 Spring Street CITY, STATE. ZIP Redwood City, CA 94063 FAX 650.365.0670 ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Michael DiMonaco LICENSE NUMBER 791 022 LICENSE TYPE B BUS LIC d COMPANY NAME Novo Construction E -MAIL Ndudley @novoconstruction.com FAX STREET ADDRESS 1460 O'Brien Dr CITY, STATE. ZIP Menlo Park, CA 94025 PHONE 650.399.5449 ARCHITECT /ENGINEER NAME Anu Sumanth LICENSE NUMBER BUS. LIC k COMPANY NAME Hayes Group Architects E-M.IILAsumanth@thehayesgroup.com FAX 650.365.0670 STREET ADDRESS 2657 Spring Street CITY,STI�ATE,ZIP Redwood City, CA 94063 PHONE 650.365.0600x20 DESCRIPTION OF WORK F� e Y r(✓� � t 1 �I ,e lI' }�_ � _,5 Gj 1 �� -if n �j�/;� !t� S r.... EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES Offjce Office /Lab VB 1 1 USE TYPE occ. SQ.FT. VALUATION ($) EXISTG AREA- 6,1 00 NEW FLOOR AREA 6 1 00 DEMO 6, 1 00 AREA TOTAL 0 NET AREA Lab V B 6,100 - BATHROOM KITCHEN OTHER REMODEL AREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK /PORCH AREA GARAGE AREA: DETACH ATTACH K DWELLING U NITS I5 .4 SECOND UNIT ❑1'ES SECOND STORY ❑ YES BEING ADDED" ONO ADDITION" ONO PRE- .APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN C] YES RECEIVED BY: TOTAL ' LS PATIO � PLANNING APPL4 ONO PLANNING APPROVAL LETTER EICHLER HOME ". ❑ NO 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 1 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 c nstnlctiot uthorize representatives of Cupertino to enter the above - identified oropert , for inspection purposes. Date: �v �� Signature of Applicant /Agent: SUPPLEMENTAL INFORMATION REQUIRED P HECK TYPE ROUTING SLIP S.FD or Multifamily dwellings: Apply for demolition permit for —New existing building(s). Demolition permit Is required prior to Issuance Of building OVER - THE - COUNTER DING PLAN REVIEW permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC vv' RKs 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 .. ❑ A'1A.IOR ❑ SANITARY SEWER DISTRICT submittal of Building Pet'111tY application. ❑ ENVIRONMENTAL HEALTH B0gApp_201 Woc revised 06 21.11 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • bu ldmg(d-�cupertino org U 1 �� 1 ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION /TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 19191 Vallco Parkway APN 1i j(�> ,V U G % ,CV c OWNER NAME Apple Inc PHONE 408.438.0968 E -MAIL paul_boyer @apple.com STREFT.ADDRESS 1 Infinite Loop CITY, STATE 7IP Cupertino, CA 94015 FAX CONTACT NAME Anu Sumanth PHONE 650.365.0600x20 E -MAD, Asumanth @thehayesgroup.com STREETADDRES` 2657 Spring Street CITY, STATE, 7I1, Redwood City, CA 94063 FAX 650.365.0670 ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Michael DiMonaco LICENSE NUMBER 791 022 LICENSE TYPE B BUS LIC # COMPANY NAME Novo Construction E. MAll- Ndudley @novoconstruction.com TAX STREET ADDRESS 1460 O'Brien Dr CITY, STATE, ZIP Menlo Park, CA 94025 PHONE 650.399.5449 ,ARCHITECT /ENGINEFR NAME Anu Sumanth LICENSE NUMBER BUS LIC k COMPANY NAME Hayes Group Architects E -MAIL Asumanth @thehayesgroup.com FAX 650.365.0670 STREET ADDRESS 2657 Spring Street CI FY. STATE, z1P Redwood City, CA 94063 PHONE 650.365.0600x20 DESCRIPTION OF WORK CONVERSION OF (E) OFFICES INTO 2 (N) LAB SPACE ON FIRST FLOOR WITH ASSOCIATED MINOR ELECTRIC & HVAC WORK. MODIFICATION TO 2 E CONFERENCE ROOMS AND COMBINE (2) OFFICES INTO (1) LARGE OFFICE. EXISTING USE PROPOSED I!SF: CONSTR TYPE # STORIES Office Office /Lab VB 1 USE TYPE OCC, SQ.FT. VALUATION (S) EXISTG AREA 6,199 NEW FLOOR AREA 6,100 DEMO AREA 6,100 TOTAL NFTAREA 0 Office /Lab V B 6,100 $550,000 BATHROOM KITCHEN OI HER REMODEL AREA REMODELARE:.A REMODFLAREA PORCH AREA DECK AREA TOTAL DFCVvTORCH AREA GARAGE AREA DETACH ATTACH µ DW[LIJNC; UNITS IS ASECOND UNIT ❑YES sECONUSTORY OYES BEING ADDED? ❑ NO ADDITION? []NO PRE - APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BY- f TOTAL VALUATION: PLANNING APPL-4 NO PLANNING APPROVAL ITTTFR EICHLER HOME? ❑NO $550,000 By my Signature below, 1 certify to each of the following: 1 am the property owner or authorized agent to act on the property owners 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 t0 building c nstructio uthorize representatives ol'Cupertino to enter the above - Identified property for inspection purposes. Signature of Applicant /Agent, Date: oZ8 aft SUPPI,LMENTAL INFORMATION RE.QUIRLD P HECKTYPE ROUTING SLIP New SFD or Multifamily chvellings: April) for demolition permit far _ existing building(s). Demolition permit is required prior to issuance of building OVER- THE - COUNTER DING PLAN REVIEW permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a Completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC W RKS Ibrm if any Hazardous Materials are being used as part of this project. ❑ LARGE FIRE DEPT' Copy ol'Planning Approval I.,etter or Meeting with Planning prior to ❑ ❑ DISTRICT Submittal of Building Permit application. M11.4.1OR SANITARY SEWER ❑ ENVIRONMENTAL HEALTH RIcIgzIpp 201lJoc rerisecl06 21 /1 FM_]' CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION imlADDRESS: 19191 vallco pkwy DATE: 02/18/2015 REVIEWED BY: Mendez PC FEE ID APN: BP #: 0/69 *VALUATION: 1$550,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: 1BTIPLNCK PENTAMATION 113 TI PERMIT TYPE: WORK apple- conversion of a offices into (2)l b s ace on e m ; modify to 2 e conference rooms combine SCOPE (2) offices into (1) large office (6,100 sq ft). OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II- B,III- B,IV,V -B 6,100 $2,491.42 1BTIPLNCK $5,110.35 1BTIINSP $0.00 PME Plan Check: $0.00 Permit Fee: $5,110.35 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 6,100 $2,491.42 $5,110.35 MECH, HOURLY Yes (F) No PLUMB, HOURLY Q Yes Q No ELEC HOURLY ; (j' Yes C!) No MISC ITEMS Plan Check Fee: .,._ F 1, Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: E) Reg. 0 OT FO.0 hrs $0.00 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution I1 -053 Eff.' 7%1/13) FEE QTY /FEE MISC ITEMS Plan Check Fee: $2,491.42 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: E) Reg. 0 OT FO.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $5,110.35 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? © Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure E) � Strong Motion Fee: IBSEISMICO $154.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $22.00 SUBTOTALS: $7,777.77 $0.00 TOTAL FEE: °1 $7,777.77 Revised: 02/14/2015 CUPERTIN CONTRACTOR / SUBCONTRACTOR LILT Building Dep artment City of,cupertino 10300 Torre Avenue Capertinu, CA 9501 -4 -3255 Telephone. 408-777-3228 Fax. 408- 777 -3133 JOB ADDRESS: PF,R.JXiIT ... 1 _. OWfii.Lai'S NAME;; BUSINIKSS LICRME 4 UENIERr1L C ONTItACTGR: BUSIN�S LICENSE u _. ADDRESS. CITY /ZIPCODE: ::ilia• municipal code requires all businesses working in the city to have is City of'Cupertino business license. NO BUILDING FINAL OR FINAL OC CCJPANCY INSPECTION(S) WILL BE SCHI DI7LrD UNTIL T11E GENERAL CONTIUkCTOR AND ALL SUBCONTRACTORS HAVE OBTA..INFD A. CITY OF CUPERITINO BUSINESS LICENSIJ. i Ana not using any subcontractors: — — Signature Data; Please check applicable subcontractors and complete the following infcarmatio3t: V SUBCONTR.46CTOR BUSINESS NAME BUSINIKSS LICRME 4 Cabinets & Millwork ........... . Cement: Finishing Eloctrical t i ] navatioll I Efl a:a El g I +F,1-1ooring/Carpetffig Linoleum/ Wood � Glass / Glazing � Heating histalatioa Landscaping Lathing Masonry Painting / Wallpaper Au WA P avillg Plasteri.n. i Roofing 3i Septic Tat* Sheet .IVletal LPL Sheet Rock l Tile Owner / Contractor Signature Date CUPERTINO PURPOSE HAZARDOUS MATERIALS CHECKLIST COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • build ing(d-)cupertino.org To minimize possible delays that would result for the Fire Department plan review, please complete the following checklist to determine if an additional level of Hazardous Materials plan review will be required. MARK `YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING? PLEASE MARK YOUR ANSWER WITH AN 'X' IN THE YES OR NO BOX ON THE SIDE BELOW. YES NO 1. Use, dispensing, mixing or storage of flammable or combustibl4aliquids or gases, hazardous materials, etc. 2. Battery back -up rooms or racks. 3. Propane tanks. 4. Gasoline stations with underground tan.. JA Jl- 5. Installation or replacement abov � 'or uNnderground storage of liquid petroleum products, liquefied petroleum ga s, 7 pressed natural gas, explosives or other regulated hazardous materials. 6. Gas rooms for dentist, doctors or veterinarians. 7. Generators with back -up diesel or other fuels. 8. Large refrigeration systems. 9. Fuel cell systems. 10. Commercial pool systems. 11. Chemical Storage areas. 12. Flammable liquid storage. 13. Compressed Gases. 14. Dry cleaners. 15. Print Shops. 16. Auto Repair and Auto Body Shops. 17. Research and Development. 2 For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa Clara County Fire Department, at (408) 378 -4010. HasMat 2011.doc revised 03107111 CUPERTINO PURPOSE: CALGREEN NON - RESIDENTIAL CHECKLIST - MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255 (408) 777 -3228 - FAX (408) 777 -3333 - building(a)cupertino.org The non - residential provisions of the 2013 CalGreen Code outline planning, design and development methods that include environmentally responsible site selection, building design, building siting and development to protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent properties; establishes the means of conserving water used indoors, outdoors and in wastewater conveyance; outlines means of achieving material conservation and resource efficiency; and outlines means of reducing the quantity of air contaminants. Project Name Project Address: Project Description Armle VP 1.1 FN 19191 Vallco Pkwy., Cupel Ino Retrofit An (E) area of offices Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced with the 2013 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Page I of 9 CalGreen Non -Res Checklistdoc revised 01.12314 Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Re uirements CHAPTER 5 — NONRESIDENTIAL MANDATORY MEASURES 5 , i�elrya� �l�if�tis The project meets all the requirements of Divisions 5.101 through 5.508. ❑X ❑ Division PLANNING Planning and 0"Ogft - Site development 5.106.1 Storm water pollution prevention. For projects of one acre or less, develop a Storm Water Pollution Prevention Plan (SWPPP) that has been designed, specific to its site, conforming to the State Storm water NPDES Construction Permit or local ordinance, whichever is stricter, as is required for ❑ ❑ projects over one acre. The plan should cover prevention of soil loss by storm water run -off and /or wind erosion, of sedimentation and /or of dust/particulate matter air pollution. Page I of 9 CalGreen Non -Res Checklistdoc revised 01.12314 5.106.4 Bicycle parking. Comply with Sections 5.106.4.1 and 5.106.4.2; or meet local ordinance, whichever is stricter. ❑ ❑ 5.106.4.1.1 Short-Term bicycle parking. If the qualified project is anticipated to generate visitor traffic, provide permanently anchored bicycle racks within 200 feet of the visitors' entrance, readily visible to passers -by, ❑ ❑ for 5 percent of visitor motorized vehicle parking spaces being added, with a minimum of one two -bike capacity rack. 5.106.4.1.2 Long -Term bicycle parking. For qualified buildings with over ❑ ❑ 10 tenant - occupants, provide secure bicycle parking for 5 percent of tenant vehicle parking spaces being added, with a minimum of one space. 5.106.5.2 Designated parking. Provide designated parking for any combination of tow- emitting, fuel - efficient and carpool/van pool vehicles as ❑ ❑ shown in Table 5.106.5.2. 5.106.8 Light pollution reduction. Outdoor lighting systems shall be ❑ ❑ designed and installed to comply with the following: 1. The minimum requirements in the California Energy Code for lighting zones ❑ ❑ 1 — 4 as defined in Chapter 10 of the California Administrative Code; and 2. Backlight, Uplight and Glare (BUG) ratings as defined in IES TM- 15-11; and ❑ ❑ 3. Allowable BUG rating not exceeding those shown in Table 5.106.8, or ❑ ❑ Comply with a local ordinance lawfully enacted pursuant to Section 101.7, whichever is more stringent. 5.106.10 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how ❑ ❑ site grading or a drainage system will manage all surface water flows. Division 5.2 ENERGY EFFICIENCY 5.201.1 Scope. The California Energy Commission will continue to adopt El building standards. Division • • -� .. 5.303.1 Meters. Separate meters shall be installed for the uses described in Sections 503.1.1 and 503.1.2. 5.303.1.1 New building or additions in excess of 50,000 square feet. ❑ ❑ Separate submeters shall be installed as follows: 1. For each individual leased, rented or other tenant space within the ❑ ❑ building projected to consume more than 100 gal /day. 2. Where separate submeters are unfeasible, for water supplied to the following systems: a. Makeup water for cooling towers where flow through is greater El 13 500 gpm. b. Makeup water for evaporative coolers greater than 6 gpm. c. Steam and hot -water boilers with energy input > 500,000 Btu /h. Page 2 of 9 CalGreen Non -Res Checklist. doc revised 01/23!l4 5.303.1.2 Excess consumption. A separate submeter shall be provided for any tenant within a new building or within an addition that is projected to consume > 1,000 gal /day. 5.303.2 Water reduction. Plumbing fixtures shall meet the maximum flow rate values shown in Table 5.303.2.3. ❑ ❑ Exception: Building that demonstrate 20- percent overall water use reduction. 5.303.2.1 Areas of addition or alteration. For those occupancies within the authority of the California Building Standards Commission, as specified in Section 103, the provisions of Section 5.303.2 and Section 5.303.3 shall apply to new fixtures in additions or areas of alterations to the buildings. 5.303.4 Wastewater reduction. Each building shall reduce by 20 percent wastewater by one of the following methods: 1. The installation of water - conserving fixtures or E 2. Utilizing non - potable water systems. 5.303.6 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code (CPC), and shall meet the applicable standards referenced in CPC Table 1401.1 and CalGreen Chapter 6. 7. 5.304.1 Water budget. A water budget shall be developed for landscape irrigation use. 5.304.2 Outdoor potable water use. For new water service or for addition or alteration requiring upgraded water service for landscaped areas of at least 1,000 sq.ft. but not more than 5,000 sq.ft., separate submeters or metering devices shall be installed for outdoor potable water use. 5.304.3 Irrigation design. In new nonresidential construction or building addition or alteration with at least 1,000 but not more than 2,500 sq.ft. of cumulative landscaped area, install irrigation controllers and sensors which ❑ ❑ include the following criteria, and meet manufacturer's recommendations. 5.304.3.1 Irrigation controllers. Automatic irrigation system controllers installed at the time of final inspection shall comply with the following: 1. Controllers shall be weather- or soil moisture -based controllers that automatically adjust irrigation in response to changes in plants' needs as ❑ weather conditions change. 2. Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicates ❑ ❑ with the controller(s). Soil moisture -based controllers are not required to have rain sensor input. Weathor Rae stance and Moisture Management 5.407.1 Weather protection. Provide a weather - resistant exterior wall and foundation envelope as required by California Building Code Section 1403.2 and California Energy Code Section 150, manufacturer's installation instructions or local ordinance, whichever is more stringent.' Page 3 of 9 CalGreen Non -Res Checklistdoc revised 0//23'/9 5.407.2 Moisture control. Employ moisture control measures by the following methods; 5.407.2.1 Sprinklers. Prevent irrigation spray on structures. 5.407.2.2 Entries and openings. Design exterior entries and /or openings to prevent water intrusion into buildings. 5.407.2.2.1 Exterior door protection. Primary exterior entries shall be covered to prevent water intrusion by using nonabsorbent floor and wall finishes within at least 2 ft around and perpendicular to such openings plus at least one of the following: 1. An installed awning at least 4 ft in depth. 2. The door is protected by a roof overhang at least 4 ft in depth. 3. The door is recessed at least 4 ft. 4. Other methods which provide equivalent protection. 5.407.2.2.2 Flashing. Install flashings integrated with a drainage plane. :., , . 5.408.1 Construction waste management. Recycle and /or salvage for reuse a minimum of 50 percent of the nonhazardous construction and demolition waste in accordance with Section 5.408.1.1, 5.408.1.2, or 5.408.1.3; or meet a ® ❑ local construction and demolition waste management ordinance, whichever is more stringent. 5.408.1.1 Construction waste management plan. Submit plan per this ❑ section to enforcement authority. 5.408.1.2 Waste management company. Utilize a waste management company that can provide verifiable documentation that the percentage of construction and demolition waste material diverted from the landfill complies with CalGreen Section 5.408. 5.408.1.3 Waste stream reduction alternative. The combined weight of new construction disposal that does not exceed two pounds per square ❑ foot of building area may be deemed to meet the 50 percent minimum requirement as approved by the enforcing agency. 5.408.1.4 Documentation. Provide documentation of the waste management plan that meets the requirements listed in Section 5.408.1.1 through 5.408.1.3. 5.408.3 Excavated soil and land clearing debris. 100 percent of trees, stumps, rocks and associated vegetation and soils resulting primarily from land clearing shall be reused or recycled. 0411104 Madntenence and Operation 5.410.1 Recycling by occupants. Provide readily accessible areas that serve the entire building and are identified for the depositing, storage and collection of nonhazardous materials for recycling. 5.410.2 Commissioning. For new buildings 10,000 square feet and over, building commissioning for all building systems covered by T24, Part 6, process systems and renewable energy systems shall be included in the design and construction processes of the building project. Commissioning requirements shall include items listed in Section 5.410.2. Page 4 of 9 Ca /Green Non -Res Checklist.doc revised 01/23%14 5.410.2.1 Owner's Project Requirements (OPR). Documented before the design phase of the project begins the OPR shall include items listed in ❑ ❑ Section 5.410.4. 5.410.2.2 Basis of Design (BOD). A written explanation of how the design of the building systems meets the OPR shall be completed at the design phase of the building project and updated periodically to cover the systems ❑ ❑ listed in Section 5.410.2.2. 5.410.2.3 Commissioning plan. A commissioning plan describing how the project will be commissioned shall be started during the design phase of ❑ ❑ the building project and shall include items listed in Section 5.410.2.3. 5.410.2.4 Functional performance testing. Functional performance testing shall demonstrate the correct installation and operation of each component, system and system - to-system interface in accordance with the ❑ ❑ approved plans and specifications. 5.410.2.5 Documentation and training. A Systems manual and systems operations training are required. ❑ ❑ 5.410.2.5.1 Systems manual. The systems manual shall be delivered to the building owner or representative and facilities operator and shall ❑ ❑ include the items listed in Section 5.410.2.5.1. 5.410.2.5.2 Systems operations training. The training of the appropriate maintenance staff for each equipment type and /or system ❑ ❑ shall include items listed in Section 5.410.2.5.2. 5.410.2.6 Commissioning report. A complete report of commissioning process activities undertaken through the design, construction and ❑ ❑ reporting recommendations for post - construction phases of the building project shall be completed and provided to the owner or representative. 5.410.4 Testing and adjusting. Testing and adjusting of systems shall be required for buildings less than 10,000 square feet or new systems to serve an addition or alteration subject to Section 303.1. 5.410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems. Systems to be included for testing and adjusting shall include, as applicable to the project, the systems listed in Section ® ❑ 5.410.3.2. 5.410.4.3 Procedures. Perform testing and adjusting procedures in accordance with industry best practices and applicable national standards ❑ on each system. 5.410.4.3.1 HVAC balancing. Before a new space- conditioning system serving a building or space is operated for normal use, the system should be balanced in accordance with the procedures defined by ® ❑ national standards listed in Section 5.410.3.3.1. 5.410.4.4 Reporting. After completion of testing, adjusting and balancing, provide a final report of testing signed by the individual responsible for ® ❑ performing these services. 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed operating and maintenance instructions and copies of © ❑ guaranties /warranties for each system prior to final inspection. 5.410.4.5.1 Inspections and reports. Include a copy of all inspection © ❑ verifications and reports required by the enforcing agency. Page 5 of 9 CalGreen Non -Res Checklistdoc revised 011123,14 5.503.1 Install only a direct -vent sealed- combustion gas or sealed wood- burning fireplace or a sealed woodstove and refer to residential requirements in the California Energy Code, Title 24, Part 6, Subchapter 7, Section 150. 5.503.1.1 Woodstoves. Woodstoves shall comply with US EPA Phase II emission limits. 5.504.3 Covering of duct openings and protection of mechanical equipment during construction. At the time of rough installation or during storage on the construction site and until final startup of the heating and cooling equipment, all duct and other related air distribution component openings shall be covered with tape, plastic, sheet metal or other methods acceptable to the enforcing agency to reduce the amount of dust or debris which may collect in the system. 5.504.4 Finish material pollutant control. Finish materials shall comply with Sections 5.504.4.1 through 5.504.4.4. 5.504.4.1 Adhesives, sealants, caulks. Adhesives and sealants used on the project shall meet the requirements of the following standards. 1. Adhesives, adhesive bonding primers, adhesive primers, sealants, sealant primers and caulks shall comply with local or regional air pollution control or air quality management district rules where applicable or SCAQMD Rule 1168 VOC limits, as shown in Tables 5.504.4.1 and 5.504.4.2. 2. Aerosol adhesives and smaller unit sizes of adhesives and sealant or caulking compounds (in units of product, less packaging, which do not weigh more than one pound and do not consist of more than 16 fluid ounces) shall comply with statewide VOC standards and other requirements, including prohibitions on use of certain toxic compounds, of California Code of Regulations, Title 17, commencing with Section 94507. 5.504.4.3 Paints and coatings. Architectural paints and coatings shall comply with Table 5.504.4.3 unless more stringent local limits apply. 5.504.4.3.1 Aerosol paints and coatings. Aerosol paints and coatings shall meet the Product- Weighted MIR Limits for ROC in Section 94522(a)(3) and other requirements, including prohibitions on use of certain toxic compounds and ozone depleting substances (CCR, Title 17, Section 94520 et seq). 5.504.4.3.2 Verification. Verification of compliance with this section shall be provided at the request of the enforcing agency. 5.504.4.4 Carpet systems. All carpet installed in the building interior shall meet the testing and product requirements of at least one of the standards listed in Section 5.504.4.4. 5.504.4.4.1 Carpet cushion. All carpet cushion installed in the building interior shall meet the requirements of the Carpet and Rug Institute Green Label program. 5.504.4.4.2 Carpet adhesive. All carpet adhesive shall meet the requirements of Table 5.504.4.1. DE �� ��EELN ® ❑ ❑iC ❑ rXI Page 6 of 9 CalGreen Non -Res Checklistdoc revised 01'23.74 5.504.4.5 Composite wood products. Hardwood plywood, particleboard and medium density fiberboard composite wood products used on the interior or exterior of the building shall meet the requirements for ❑ formaldehyde as specified in Table 5.504.4.5. 5.504.4.5.3 Documentation. Verification of compliance with this section shall be provided as requested by the enforcing agency. Documentation shall include at least one of the following standards listed in Section 5.504.5.3. 5.504.4.6 Resilient flooring systems. For 80 percent of floor area receiving resilient flooring, installed resilient flooring shall meet at least one ® ❑ of the following standards listed in Section 5.504.4.6. 5.504.5.3 Filters. In mechanically ventilated buildings, provide regularly occupied areas of the building with air filtration media for outside and ® ❑ return air prior to occupancy that provides at least a MERV of 8. 5.504.7 Environmental tobacco smoke (ETS) control. Prohibit smoking within 25 feet of building entries, outdoor air intakes and operable windows where outdoor areas are provided for smoking and in buildings; or as enforced ® ❑ by ordinances, regulations or policies of any city, county, city and county, California Community College, campus of the California State University or campus of the University of California, whichever are more stringent. `� € � . 5.505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of California Building Code, CCR, Title 24, Part 2, Sections 1203 ® ❑ and Chapter 14.1. 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings, meet the minimum requirements of Section 121 of the Califomia ® ❑ Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 8 or the applicable local code, whichever is more stringent.' 5.506.2 Carbon dioxide (CO2) monitoring. For buildings equipped with demand control ventilation, CO2 sensors and ventilation controls shall be ❑ specified and installed in accordance with the requirements of the latest edition of the Califomia Energy Code, CCR, Title 24, Part 6, Section 121(c).' Ett'yi�llit,lrl#°al firtlt��f� 5.507.4 Acoustical control. Employ building assemblies and components ❑ ❑ with STC values determined in accordance with ASTM E 90 and ASTM E 413. 5.507.4.1 Exterior noise transmission. Wall and floor - ceiling assemblies making up the building envelope shall have an STC of at least 50 and exterior windows shall have a minimum STC of 30 for any of the building ❑ ❑ locations listed in Items 1 through 3 in Section 5.507.5.1. 5.507.4.2 Interior sound. Wall and floor - ceiling assemblies separating tenant spaces and tenant spaces and public places shall have an STC of ® ❑ at least 40. Page 7 of 9 C'alGreen Non -Res Checklistdoc revised 0123114 5.508.1 Ozone depletion and greenhouse gas reductions. Installations of HVAC, refrigeration and fire suppression equipment shall comply with Sections 5.508.1.1 and 5.508.1.2. 5.508.1.1 Chlorofluorocarbons (CFCs). Install HVAC and refrigeration equipment that does not contain CFCs. 5.508.1.2 Halons. Install fire suppression equipment that does not contain © ❑ Halons. Page 8 of 9 CalGreen Non -Res Checklistdoc revised O1/23'1d .0 4 CALGREEN SIGNATURE DECLARATIONS Project Name: Apple VP 1.11 Project Address: 1 91 Vallco Pkwy., Cupertino Project Description: Retrofit An (E) area of offices SECTION 1 — DESIGN VERIFICATION Complete all lines of Section 1 — 'Design Verification' and submit the completed checklist (Columns 1 and 2) with the plans and budding permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set forth in the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Owner's Signature Date Paul Boyer 0wgp"6 V* (Please Print) mahr-afs Signature Date _.._a MN NA4f-S . w2ional's Name (Please Print) nr I i—nse Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone 1` MM ' ikPAOS • VQAJAZd A A016 h►" ed_"1e* &0 M . Email Address for License Professional responsibie for CalGreen corApliange SECTION 2 — IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final Inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance (Please Print) Phone 1 Email Address for License Professional responsible for CalGreen compliance Page 9 of 9 CalGreen Non -Res Checkhsl.doc revised 0123 14