15040216CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 3 INFINITE LOOP
CONTRACTOR: SPRIG ELECTRIC
PERMIT NO: 15040216
OWNER'S NAME: APPLE COMPUTER INC
1860 S IOTH ST
DATE ISSUED: 04/29/2015
OWNER'S PHONE: 4089961010
SAN JOSE, CA 95112
PHONE NO: (408)298-3134
LICENSED CONTRACTOR'S DECLARATION
License Class (, (y Liic. #
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
APPLE - 3RD FLR - INSTALL 39 (N) OUTLETS & 9 (N)
BOXES
,(,
MCContractor Vt G►/V 1-G Date I.S S
I hereby affir that I am licensed under the provisions 0 - 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: $35000
performance of the work for which this permit is issued.
4,11ave 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.
APN Number: 31602107.00
Occupancy Type:
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
to building construction, and hereby authorize representatives of this city to enter
WITHIN 180 D RMIT ISSUANCE OR
upon the above mentioned property for inspection purposes. (We) agree to save
O ED 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 permi Additionally, the applicant understands and will comply
with all non -point r egulations per the Cupertino Municipal Code, Section
9.18.
Signat Date S
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
E3OWNER-BUILDER DECLARATION
inspection.
I hereby affirm that I am exempt from the Contractor's License Law for one of
Signature of Applicant: Date:
the following two reasons:
1, as owner of the property, or my employees with wages as their sole compensation,
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
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. 1 will
1 hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Health & Safety Code, Section 25532(a) should l store or handle hazardous
material. Additionally, should 1 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 I
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
will maintain compliance with the C ertino Municipal Code, Chapter 9.12 and
the Health & Safety Code Sectio 05, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
Owner or authorized age Date: Zf s
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
CUPERTINO
GENERAL PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(@cupertino.org
❑PLUMBING ❑ MECHANICAL ELECTRICAL
bti`b MEP
MISC
❑ MISCELLANEOUS
PROJECT ADDRE I
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OWNERNAME�
PHONE Y0��7�/�/�
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP
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FAX
CONTACT NAME
PHONE
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STREET ADDRESS �GLD �- /O'�/�
CITY, STATE, ZIP 0
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT N CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME j' w +`
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LICENSE NUMBER 7 �7
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LICENSE TYPE A
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BUS. LIC N /�
COMPANY NAME , /� y'G
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E-MAIL
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FAX
STREET ADDRESS
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CITY, S TE, ZIPe
PHONE • r/
AR.CFIITECr/ENGINEER NAME
LICENSE NUMBER
BUS. LIC N
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or DUPLEX ❑ MULTI -FAMILY
BUILDING: ❑ COMMERCIAL
PROJECT IN WILDLAND ❑ YES
URBAN INTERFACE AREA ❑ NO
PROJECT IN
FLOOD ZONE
❑ YES
❑ NO
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
DESCRIPTION OF WORK 1 cC
t4
REC
TOTAL VALUATION:00
By my signature below, I certify to each the following: I am the property owner or authorized agen e property owner's behalf. I have read this
application and the information I ha d is correct. I have read the Description of Work and verify it is accurate. Ia ree to comply with all applicable local
ordinances and state laws relati uildi construction. 1 authorize representatives of Cupertino to enter the above -i -e roperty for inspection purposes.
Signature ofApplicandA nt Date: ?�
SUPPLEMENTAL INFORMATION REQUIRED
CJ OVEit-TTiE COUNTER
Aw
%`t/ ,
MEPMiscApp_201I.doc revised 06/21/11
T-�
CITY OF CUPERTINO
FM -7 FEE ESTIMATOR - BUILDING DIVISION
lalADDRESS:
3 INFINITE LOOP
DATE: 04/29/2015
REVIEWED BY: MELISSA
UNITS
APN: 316 02107
BP#:
*VALUATION: 1$35,000
'PERMIT TYPE: Electrical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY Commercial Building
USE:
#
PENTAMATION 10EAP10
PERMIT TYPE:
WORK
APPLE - 3RD FLR - INSTALL 39 (N) OUTLETS & 9 (N) BOXES
SCOPE
1,
APPLIANCE / EQUIP TYPE
FEE ID
QTY/FEE
QTY
UNITS
BP FEES
Elec. Permit Fee: 1EPEkYJT
Recep/Switch/Outlets
1BREMRECEP
Other Elec. Insp. ETrs—[ $48.00
48
#
$188
1,
PME Unit Fee:
$188.00
PME Permit Fee:
$48.00
Con"'I'rircfiof-
F
Administrative Fee: ]ADMIN
$45.00
Work Without Permit? Yes (F) No
$0.00
TOTALS:
A
Travel Documentation Fee: I TRA VDOC
$188,00
Strong Motion Fee: IBSEISMICO
NOTE: This estimate does not include fees due to other Departments (i.e. 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 addn't info.
FEE ITEMS (Fee Resolulion 11-053 Fff 711113)
FEE
QTY/FEE
Elec. Plan Check lo,7 hrs $0.00
J' "j" ;� J':�l 17'a hc�
Elec. Permit Fee: 1EPEkYJT
TP,,p.
Other Elec. Insp. ETrs—[ $48.00
/V .1 1 I'll
I
NOTE: This estimate does not include fees due to other Departments (i.e. 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 addn't info.
FEE ITEMS (Fee Resolulion 11-053 Fff 711113)
FEE
QTY/FEE
MISC ITEMS
PME Plan Check:
$0.00
1,
PME Unit Fee:
$188.00
PME Permit Fee:
$48.00
Con"'I'rircfiof-
F
Administrative Fee: ]ADMIN
$45.00
Work Without Permit? Yes (F) No
$0.00
A
Travel Documentation Fee: I TRA VDOC
$48.00
Strong Motion Fee: IBSEISMICO
$9.80
Select an Administrative Item
Bldg Stds Commission Fee:. IBCBSC
$2.00
SUBTOTALS:
$340.80
$0.00 TOTAL FEE:
$340.80I
Revised: 04/01/2015