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B-2016-3306 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3306 10450 BUBB RD CUPERTINO,CA 95014(357 20 037) PLANT CONSTRUCTION COMPANY L P SAN FRANCISCO,CA 94124 OWNER'S NAME: M WEST PROPCO XIII LLC DATE ISSUED:04/19/2017 OWNER'S PHONE:925-683-7039 PHONE NO:(415)285-0500 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class j3 Lic.#995375 Contractor PLANT CONSTRUCTION COMPANY L P Date 08/31/2018 JX BLDG _ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH—RESIDENTIAL X COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: APPLE-GENERAL RESEARCH FACILITY TENANT IMPROVEMENT I hereby affirm under penalty of perjury one of the following two declarations: (4752 SQ FT). i. I have and will maintain a certificate of consent to self-insure for Worker's REV#1-TI-ADA RESTROOM UPGRADE-ISSUED 10-12-2017 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 1 lc.-rmit is issued. Sq.Ft Floor Area: Valuation:$1203343.00 APPLICANTCERTIFICATION I certi • at 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 buildirig construction,and hereby authorize 357 20 037 A(Tenant Improvements),B(Tenant Improvements) representatives of this city to enter upon the above mentioned property for inspection purposes. (We)'lagree 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 Cupe .i o Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. i. Signatu ,` .. r Date 10-12-2017 Issued by:Kim Dunbar Date:04/19/2017 r 0 J '-BUILDER DECLARATION 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 i. I,as owner of the roperty or my employees with wages as their sole installed without fust 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,Bukiness,"&Professions Code) 2. I,as owner of the property am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:10-12-2017 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER Compensation,as provided for by Section 3700 of the Labor Code,for the performance of thei'work'for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Workers 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. I 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, 55 3,and 25534. Labor Code,I must forthwith`coinply with such provisions or this permit shall � �� be deemed revoked. Owner or authorized agen '71-:&( s REPLICANT CERTIFICATION Date:10-12-2017 I certify that I have read this;application and state that the above information is CONS %UCTION 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 keepiharmless the City of Cupertino against liabilities, costs,and ex enses which mayaccrue against said CityLender's Address judgments, P , 9 � 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 ARCHITECT'S DECLARATION Code,Section 9.18. I understand my plans shall be used as public records. Signature Date 10-12-2017 Licensed • CONSTRUCTION PERMIT APPLICATION `ril0 / COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 / 4. ,..s4, (408) 777-3228 • building@cupertino.org PEMIT#B-�l`Q �'(i CUPERTINO I REV II1..-, DEFE ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.1. ❑MEP ❑RE-ROOF El SWIMMINfa)G POOL/SPA PROJECT ADDRESS i©�3 D 471.`03 deo a APN v 3� q „....„ ,20 ^ 3 .... ., !f OWNER NAME AIL 300 6 vV1 00 ✓ P N�JJ6E33_7037 Ea-PoUDo 0A f.c •coe-c STREET ADD&' CITY STATE ZIP D4 /UAIGlE &DO ^ WS /�fIo eTI 1,57//(-( , xCONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER I LICENSE TYPE P�.cfm 4oy 01 1 153 S ,tU IST. 05 ADDRESS � r CITY,STATE, tio C) , CI- 19/Z 1 E-MAILPHON � BUS.LIC I aiAAvcctoPo� co-CaM �ivis, 3 ~`7._,32... ❑ARCHITECT ❑OWNER ❑OWNER AGENT 0 CONTRACTOR AGENT ENGINEER 0 DEVELOPER 0 TENANT CONTACT NAMbto itemi 0140 E MA�jWa y c e Poffi Q` CO STREETREE.ill'l6e LL ✓. P/!00_C0 ` cqq)F36 ,?,43 DECRIPTON ' 116/1241 ' t. ---- r" A--D — -- --p pt - ❑SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL E 'C-OMME�CIAL ; I EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO 5F STORIES n TOTAL NET SF USE 'TYPE OCC SQ.FT. , VALUATION($) REMODEL REMODEL KITCHEN REMODELOTHR GARAGE 0 ATTACHED BATHROOM SF , SF . SF SF 0 DETACHED EXISING ! ❑YES :EICHLER^❑�YES SECOND STORY ADDITION DYES FIRE SPRINKLERS R.NO ,0Q NO ONO ' - DWELLING SECOND DWELLING; ❑YES ❑ATTACHED DETACHED OTHER - ' UNITSI UNITADDITON: : {YO SF IPOOLS' •i❑FIBERGLASS ❑VINYL-LINED 0 GUNITE 0 PREFABRICATED POOL-SF SPA-SF' 'I SPA ATTACHED❑YES 0 NO I TOTAL-SF 0,..e...e....19 RECE TOTAL VALUATION: Commercial or Multi-Family Buildings with Public Swimming Pools requires Department of Environmental Heath approval l'j RE-ROOFI EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑ 000 INGLES❑TILE OTHER(SPECIFY) REMOVE/REPLACE I]NO IF NO PLYWOOD El 1/2" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS El YES': #OF LAYERS THICKNESS❑5/8" OTHER ❑OSB ❑CDX I OTHER :12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER *Provide a signed copy,of the Cupertino's Tear-Off Policy 1 SF not SQUARES ' 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 ordinan es and state law relating to building construction.I I authorize representatives of Cupertino.to enter the above-identified property for ins, ti'.n purp s s. acknowledge and authorize all information contained on this application form to be made available for public record. 0, /bf/G/ 2 0 / Signature of Applican/Agent: Date: l !! l SUPPLEMENTAL INFORMATION REQUIRED *New SFD/Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. *HOA-Provide a letter of approval from the Home Owner's Association BldgApp_2017.doc revised 08/01/17 '' . CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-3306 10450 BUBB RD CUPERTINO, CA 95014 (357 20 037) PLANT CONSTRUCTION COMPANY L P SAN FRANCISCO, CA 94124 OWNER'S NAME: M WEST PROPCO XIII LLC DATE ISSUED: 04/19/2017 OWNER'S PHONE: 408-450-3820 PHONE NO: (415) 285-0500 LICENSED CONTRACTOR'S DECLARATION License Class B Lic. #995375 Contractor PLANT CONSTRUCTION COMPANY L P Date 08/31/2018. 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. 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. q��• I have and will maintain Worker's Compensation Insurance, as provided for by r Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION 1 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 nd will comply with all non -point source regulations per the Cupertino un ipal Code, Section 9.18. Signature Date 04/19/2017 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 (Sec.7044, Business & Professions Code) 2. 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. 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. 2. 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 04/19/2017 PERMIT INFO: BLDG —ELECT —PLUMB MECH _ RESIDENTIAL X COMMERCIAL JOB DESCRIPTION: APPLE - GENERAL RESEARCH FACILITY TENANT IMPROVEMENT (4752 SQ FT). Sq. Ft Floor Area: (Valuation: $1203343.00 APN Number: Occupancy Type: 357 20 037 1 A (Tenant Improvements),B (Tenant Improvements) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar 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: 04/19/2017 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 agen� ` I __,S_ J Date: 04/19/2017 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 • CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228 -FAX (408)777--3338- building0cupertino.org DNEW CONSTRUCTION [] ADDITION r;'I.ALTERATION I TF F-1 RFvl.11In-IJ/nr.T.ERQrn riVTr-.mtAT prnxAv­ PROJECT ADDRESS I k' R) 14 (G �11 KO APN # 1 7 ,U1' � OWNME r—' s7N()0 �q I i7� -)A E-MAIL S?�T RESS STATE. IP i Y FAX CONTACT NAMEj'yj ATI� e PRON STREET AD_ TY, ST FE, ZIP IWAAA"Pl' &u tlmg(S.V_0 C4 9 !tl *14� 13 OWNER 0 OWNER -BUILDER 11 oWNERAGFNT ❑ CONTRACTORLONTRAC 'TOR AGENT — r .011TECT 0 ENGINEER 0 DEVELOPER; ❑ TENANT CONTRACTOR LICENSE'ENSE"IYPE BUS, LIC NIJMBEReI-S) S �?J 7f-/ 3 COMPANY N -I_" FAX k IcE-hCo. C r"."A '/ L ^C1 STREETADDR�&' CITI, STATE ZIP L) C MIE0 2-S'Y -,L) lso(3 ARMTEMENGINEERNAMEC C' C LICENSE NUMBER I BUS. LIC 9 ......... .. _ ' COMPANY NAMEC,_,, W,8w1Vj K _ E-MAJI-C, t_A FAX STREETADDRESS &,:l C I I TY.§TATEZIP PHO (4p) (02—_S— q (141 G DESCRIPTIONOF W'ORK .EXISTINGUSE; PROPOSEDUSE USE TYPE OCC. SQ.FT' VALUATION EXISTG AREA NrWFLOOR• AREA AREAL �A�j'4,t, TOTAL NETAREA BATHROOMKITCRFN REMODELAREA REMODEL I � .T. . REXIODFL AREA PORCH AREA \�' I DtCK AREA TOTAL .KWPORCHAREA I GARAGE AREA: LIDETACH 'P�ATTACIT A DWEtLTNG UNITS: ISA SECOND UNIT] DYES, 0 BEING ADDED? 'qN SECOND STORY []YES ADDITION? 0 PRE-APPLIbATION ElYES IF YES, PROVU )E COPY OF PLANNrNGAPPLN NNO PLANNING APPROVAL LETTER IS THE BLDG AN 0 YES EICHLERNOME? PNO RECEIVED BY.• TOTAL VALUATION: I 'j 10 k (A `43. U J3y my Signature below, I certify toeach ofthe following: I am the property owner or authorized agent to act on the property oxNmer's behalf. 1 have read this application land the information) have provided is correct. I have read the Description of\Vork and verify it is accurate. I agree to comply with all applicable local ordinances and State laws relating to building iomtYlIctipm Lautygrize representatives of Cupertino to enter the abov7;'d fified property for inspection purposes. Signature ofApplicant/Agent: Date: I J 7 SUPPLEMENTALINPORMATIOVJRFOUIRED PLANCHECKTYIIE ROUTING SLIP 0 OVER-THE-COUNTERBUILDING )9 PLAN REVIEW N6w SFD or Multifamily dwellings: Apply for demolition pennit for existing building(s). Demolition permit is required prior to issuance of building - permit for new building. 11 EXPRESSEl PLAWN11 NG PLAN REVJEw Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTANDARD El PUBLIC 'WORKS form if any, Hazardous Materials; are being used as part of this project, — Copy of Planning Approval Letter or Meeting With Planning prior to LARGEFIREDEPT Cl I'l A 7- D SANUTARYSMYERDISTRICT submittal of Building Permit application. -TOR 'NVJRONME.NTAj,)HFAj:J`H B1dgApp_201 1. doc revised 06121111