15040160CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: J 0900 N TANTAU AVE
CONTRACTOR: DEVCON
PERMIT NO: 15040160
CONSTRUCTION INC
OWNER'S NAME: CUPERTINO TANTAU LLC
690 GIBRALTAR DR
DATE ISSUED: 04/22/2015
OWNER'S PHONE: 4087384444
MILPITAS, CA 95035
PHONE NO: (408)942-8200
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
APPLE - T.I TO MODIFY (E) CHAMBER, 1ST FLR (240
License Class Lia # 9916 `3/
S.F.)
Contractor 0e V Cl el C-10 n S% Date t, / Z dl -j
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:
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: $21500
erformance 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: 31609029.00
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 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 DAYS FROM LAST C SPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
"
costs, and expenses which may accrue against said City in consequence of the
l
granting of this permit. Additionally, the applicant understands and will comply
Issued Date:
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
u .—
RE -ROOFS:
Signature Date /
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.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1, 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 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 1
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 5505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
y/Z�jJ--
permit is issued.
Owner or authorized agent: Date:
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 LENDING 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 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,
ARCHITECT'S DECLARATION
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
\ �D
CONSTRUCTION PERMIT APPLICATION V
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 O
(408) 777-3228 • FAX (408) 777-3333 • build inq(abcupertino.orq `
CUPERTINO
❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS 10900 Tantau N
APN4 446iiii6fr946 -31 (7— Z
OWNERN/VVE Apple Inc ��"" PHONE 408-738-4444
E-MAIL
STREET ADDRESS 1 Infinite Loop
CITY, STATE, ZIP Cupertino CA 95032
FAX
CONTACT NAME Terry Fullerton
PHONE 408-519-8383
E-MAIL tfullerton@devcon-const.com
STREET ADDRESS
690 Gibraltar Drive
CITY, STATE, ZIP Milpitas, CA , 95035
FAX
408-946-5513
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❑ OWNER ❑ ONT'ER-BUILDER ❑ OWNER AGENT ycl CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSENUMBER399163
LICENSE TYPES
BUS. LIC#
DEVCON Construction
COMPANYNAMEDEVCON Construction
E-MAIL tfullerton@devcon-const.com
FAX408-946-7713
STREET ADDRESS690 Gibraltar D rive
CITY, STATE, ZIP
Milpitas, CA 95035
PHONE408-519-8372
ARCHITECT/ENGINEERNAMEDavid Sabalvaro
LICENSENUMBERC-15925
BUS. LIC#
COMPANYNAMEStudio's Arch.
E-MAIL
FAA15-398-7575
STREETADDREss405 Howard St
CITY,STATE,ZIP an ranclsco CA 941 Ob
PHONE415-3987575
DESCRIPTION OF WORK Modification to an existing Chamber added wall and door to Chamber, with
associated Electrical, mechanical.
EXISTING USE
PROPOSED USE
CONS IR. TYPE
k STORIES
S
S
Ilb
USE TYPE
3($)
OCC
SQ.FT.
VALUATION
EXISTG
AREA
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA Office
B
240
21,500,00
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA GARAGE AREA: DETACH
[]ATTACH
R DWELLING UNITS:
IS ASECOND UNIT ❑YES
SECONDSTORY ❑YES
BEING ADDED? [-]NO
ADDITION? ❑NO
PRE -APPLICATION []YES IF YES, PROVIDE COPY OF
IS THE BLDG AN S�'ri i�
't ' �" ��
'
' ��
TOTAL VALUATION:
PLANNINGAPPLd []NO PLANTING APPROVAL LETTER
EICHLER HOME?
�t 5-00
iii
By my signature below, I certify to each of the following: I am the property owner or ithorized agent to he property owner's behalf. I have read this
application and the information I have provided i rrect. 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 bu construe a re esentatives of Cupertino to enter the above -identified property for inspection purposes.
4/20/15
Signature of Applicant/Agent:� Date:
SUPPLEMENTAL INFORMATION REQUIRED
!
New SFD or Multifamily dwellings: Apply for demolition permit forii'I
Axr�
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
O' CP b
AN
Commercial completed Provide a Bldgs: Hazardous Materials Disclosure'
ai3i 7#trcV
i
i
form if any Hazardous Materials are being used as part of this project.
' �i 777, '
Copy of Planning Approval Letter or Meeting with Planning prior to
',
°
dCl Etttat1i
submittal of Building Permit application.R
BldgApp_201 1. doc revised 06/21/11
CITY OF CUPERTINO
,+I FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 10900 N TANTAU AVE
DATE: 04122/2015
REVIEWED BY: MELISSA
PC FEE ID
APN: 316 09 029
BP#:
'VALUATION: 1$21,500
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
IBTIPLNCK
PENTAMATION 1 B TI
PERMIT TYPE:
WORK
APPLE - T.I TO MODIFY E CHAMBER 1ST FLR
SCOPE
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
240
$2,097.00
IBTIPLNCK
$588.00
IBTIINSP
$0.00
PME Plan Check:
$0.00
Permit Fee:
$588.00
Suppl. Insp. Fee O Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
Permit Fee:
$0.00
TOTALS:
240
$2,097.00
//PME
$588.00
MECH, HOURLY 0 Yes 0 No
PLUMB, HOURLY 0 Yes (F) Nq
ELEC, HOURLY 01 Yes O No
MISC ITEMS
W < :i
Plan Check Fee:
Ph,7iL.
P,acro l .
Of/h IMP
ELL-]
19
Suppl. PC Fee: Q Reg. () OT
0.0
hrs
$0.00
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, eta). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 Erf 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,097.00
Select a Misc Bldg/Structure
or Element of a Building
19
Suppl. PC Fee: Q Reg. () OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$588.00
Suppl. Insp. Fee O Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
Permit Fee:
$0.00
//PME
IA1/1arn xrw`t1,c:c°
Work Without Permit? C) Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
i
ha< ,,/ /)c,(_ w)_n/Ua / CC:e :
Strong, Motion Fee: IBSEISMICO
$6.02
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTc)ALS;
$2,692.02
$0.00
$2,692.02
Revised: 04/01/2015
E
CONTRACTOR / SUBCONTRACTOR LIST
Building Departrnenl
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: V
PERMIT #
OWNER'S NAME.
PHONE# r) C.
GENERAL CONTRACTOR:
BUSINESS LICENSE #
ADDRESS:
/""I ) P 1 0- t111 -/il-
CITY/ZIPCODE: /-,/jjj fc.
*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 U1'mi, -mE
CEI" ERAL CONTRACTOR AND ALL SUIBCONTRACTORS HAVE OBTAINED A CITY OF CI VER`11'1r,1�11-
BUSINESS LICENSE.
I am not using any subcontractors:
Signature
Please check applicable subcontractors and complete the following information:
-Date
V
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICI NSE #
Cabinets & Millwork
Cement Finishing
vz
E lectrical
0
Excavation
Fencing
Flooring / Carpeting
'Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
In
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner /I(ontractor Signature
�
Date