13030081CITY OF `1 U]PlEuiTINO BUILDING PERMIT
BUILDING ADDRESS; 19191 VALLCO PKWY
CON'T'RACTOR: NOVO CONS'I'RUC'TION
PERMITNO: 13030081
OWNER'S NAME: APPLE INC
1460 O'BRIEiN DR
DATE ISSUED: 03115/2013
OWNER'S PHONE: 6505205483
MENLO PARK, CA 94025
PHONE. NO: (650)701-1500
❑ LICENSED CONTRACTOR'S DECLARATIONr-L
BUILDING PERMIT INFO; BLDG ELECT PLUMB
License Class Lic.4 4-1 1 UZZ
f— r f
MECH RESIDENTIAL COMMERCIAL
ContractorIA,yO �Ait�Lj7Qt)C??�J Date
1 hereby affirm that I am licensed under the provisions n Chapter 9
JOB DESCRIPTION: NORTH WING, 1 S'l FLR "F. 1. FOR REMODEL (I) LAB INTO
(commencing with Section 7000) of Division 3 of the Business & Professions
(N) MUSIC STUDIO & (N) SERVER RM WITH ASSOCIATED
Code and that my license is in full force and effect.
MECH & F.1.ECTRICAL
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
performance of the work for which this permit is issued.
1 have and will maintain Worker's Compensation Insurance, as provided for by
Sq. Ft Floor Arca:
Valuation: $440000
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APN Number: 31620074.00
Occupancy Type:
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 ofthis city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
WITHIN 180 OAFS OF PERMIT ISSUANCE OR
granting of this permit. Additionally, the applicant understands and will comply
180 DAYS FROM (LAST CALLED INSPECTION.
ECTI[ON.
with all non-point source regu ins per the Cupertino Municipal Code, Section
/
����a'y/
Signature Date 3 l3
^-
Issued by: C/ Date: j •�� -/ -3
❑ OWNER-BUILDER DECLARATION
RF.-ROOFS:
1 hereby affirm that I am exempt from the Contractor's License Law for one of
All roofs shall be inspected prior to any roofing material being installed. If a roof is
the following two reasons:
installed without first obtaining an inspection, I agree to remove all new materials for
1, as owner of the property, or my employees with wages as their sole compensation,
inspection.
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
Signature of Applicant: Date:
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sce.7044, Business & Professions Code).
ALL ROOF COVERINGSTO BE CLASS "A" OR BETTER
1 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
HAZARDOUS MATERIALS DISCLOSURE
Compensation, as provided for by Section 3700 of the Labor Code, for the
1 have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued.
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
I have and will maintain Worker's Compensation Insurance, as provided for by
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Section 3700 of the Labor Code, for the performance of the work for which this
Safety Code, Section 25532(x) should 1 store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
permit is issued.
contaminants as defined by the Bay Area Air Quality Management District 1 will
I certify that in the performance ofthe work for which this permit is issued, I shall
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's
Health & Safety Code, Sections 25505, 25533, and 25534.
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
Ow r A�®r`agent:
forthwith comply with such provisions or this permit shall be deemed revoked.
Date: 3 S'
CONSTRUCITON LENllING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
1 hereby affirm that there is a construction lending agency for the performance of work's
correct. 1 agree to comply with all city and county ordinances and state laws relating
for which this permit is issued (Sec. 3097, Civ C.)
to building construction, and hereby authorize representatives of this city to enter
Lender's Name
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
Lender's Address
costs, and expenses which may accrue against said City in consequence Of the
granting of this permit. Additionally, the applicant understands and will comply
ARCIIITECh'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code, Section
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
M1
CITY (OF CUP ElEB" INO BUILDING PERMIT
IT
BUILDING ADDRESS: 19191 VALLCO PKWY
CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 13030081
OWNER'S NAME: APPLE INC
1460 O'BRIEN DR DATE ISSUED: 03/15/2013
OWNER'S PHONE: 6505205483
MENLO PARK, CA 94025 PHONE NO: (650)701-1500
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL. ❑ COMMERCIAL
License Class 1 Lic. L 7 9 /o X?,
NORTH WE G, IST 1FILlR T. ff. FOR REMODEL (E) ]LAIC UNTO
(ISI) MUSIC STUDIO & (N) SERVER RM WRTH ASSOCIATED
Contractor �a! i� Date d /�
MECIH[ & ELECTRICAL
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
8/19/2013- REVISION #1- ADDITION OF STRUCTURAL ]PLANS,
Code and that my license is in full force and effect.
FRAMING DETAILS-IISSID 9/3/2013
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 1 ,
Compensation, as provided for by Section 3700 of the Labor Code, for the
. Ft Floor Area:
Valuation: 5440000
performance of the work for which this permit is issued. 0 (�
have and will maintain Worker's Compensation Insurance, as for b}�
Section 3700 of the Labor Code, for the performance of th orhic s
APN Number: 31620074.00
Occupancy 'Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
P Ej[gryjj T EXPIRES IDF WORK ES NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
���,�� 180 ���� OF ����Il, ISSUANCE ®�
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 DAPI lF OI�[i LAST CALLED INSP T N.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Issued by: (Date: -
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.
c�
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 I 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)
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 25538. 1 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 I
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 25505, 25 33, and 25538.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent.Date:
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, 1
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
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
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
a
CUPERTINO
CONSTRUCTM PERMIT APPUCAT� ON]
COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION
10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 ^ building aacupertino.org
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/Tl R REVISION /DEFERRED ORIGINAL PERMIT # /3C>54>08
PROJECT ADDRESS
=APN
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ACONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
NUMBER
LICENSE TYPE
BUS. LIC #
.1LICENSE
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TOTAL DECK/PORCH AREA
GARAGE AREA: ODETACH
❑ ATTACH
M DWELLING UMTS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? ONO
ADDITION? ONO
PRE APPLICATION [IVES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
TOTAL VALUATION:
PLANNING APPL N 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 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 const I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: c Date: s
SUPPLEMENTAL INFORMATION REQUIRED
PLAN fHECK TYPE ROUTING SLIP
❑ BUILDINCPLANREVIEW
New SFD or Multifamily dwellings: Apply for demolition permit forOVER-THE-COUNTER
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS ❑ PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
' ❑ ,STANDARD ❑ PUBLIC WORKS
_
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
El MAJOR I� SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06/2111/
CUPERTINO
V
CONSTRUCTION PERMIT APPLICAT( I1®N
COMMUNITY DEVELOPMENT DEPARTMENT -BUILDING DIVISION A ()
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 ^ FAX (4{08) 777-3333 a build ingCcDcupertino.org `
❑ NEW CONSTRUCTION [:1 ADDITION IJSJ ALTERATION i Ti ❑ REVISION I DEFERRED ORIGINAL PERMIT #
13
PROJECT ADDRESS 91 `i I VAS -_C0 FAY A
APN # 22 /'1 — 0 3- c �j
OWNERNAME APpLL �(-
h1 F
PHONE
E-MAIL 5-170Rp�Pp pPn�
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e�SD GC�'CUL.��
STREET ADDRESS
CITY, STATE, ZIP
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CONTACT NAME
PHONE
E-MAIL
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STREETADDRESS
CITY, STATE, ZIP
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❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT 91coNTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
1071
COMPANY NAME
E-MAIL
FAX
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STREETADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
Aw 5vri
COMPANY NAME
E-MAIL
FAX
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CITY, STATE, ZIP
PHONE
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DESCRIPTION OF WORK
OSL mootfi o Lb w to O @f ip1
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EXISTING USE
PROPOSED USE CONSTR.
TYPE
# STORIES
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EXISTG
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PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: UDErACH
[]ATTACH
# DWELLING UNITS:
ISA SECOND UNIT . []YES
BEING ADDED?
SECOND STORY [IYES
ADDITION? t�.NO
`�W,_W
PRE -APPLICATION ❑ YFS ff YES, PROV CDE COPY OF
IS THE BLDG AN ❑YES
IVED BY: TOTAL VALUATION:
PC.ANMNGAPPL# 0 PLANNING APPROVAL LETTER
EICHLER HOME? WO
By my signature below, I certify to each of the following: I am the property owner or auth ' e agent to act on the pr erty 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 acc I agree to comply with all applicable local
ordinances and state laws relating to buildiinconstruction. I authorize representatives of Cupertino to enter the ve4d tified property for inspection purposes.
Signature of Applicant/Agent: �/ Date:
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
(�
dp OVER-THE-COUNTER
❑ BUILDING PLAN REVIEW
_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS
❑ PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
ElSTANDARD
❑ PUBLIC WORKS
_
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
❑ MAJOR
❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_201 Ldoc revised 06/21/11
__T CITY Y O F CUP ER'I WO
FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 19191 VALLCO PKWY
DATE: 03/15/2013
REVIEWED BY: MELISSA
PC ]FEE IID
APN: 316 20 074
16P#: ���
*VALUATION: $440,000
*PERMITTYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
1BTIPLNCK
PENTAIO'1IATIION 16 TI
I PERMIT TYPE:
WORK
NORTH WING 1ST FLR T. I. FOR REMODEL E LAB INTO N MUSIC STUDIO & N SERVER RM
SCOPE I
WITH ASSOCIATED MECH & ELECTRICAL
OCCUPANCY TYPE:
TYPE OF
CONSTR.
1FL]R AREA
s.f
PC ]FEES
PC ]FEE IID
]BP ]FEES
]BP FEE IID
B (Tenant Improvements)
II-B,III-B,IV,V-B
1,600
$2,022.45
1BTIPLNCK
$1,384.68
1BTIINSP
Permit Fee:
�ldcch. Insp. fi-ee:
Phimb. hasp. Fee:
Elec. Insp. Fee:
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction .Tax:
Adininistrat i ve .h ee:
Work Without Permit? C) Yes E) No
$0.00
Advanced Planning Fee.
$0.00
TOTALS:
1,600
$2,022.45
Strong Motion Fee: 1BSEISMICO
$1,384.68
Select an Administrative Item
ME.CH, HOURLY 0 Yes_ 0 No
PLUMB, HOURLY Q Yes (F) No
ELEC, HOURLY Q Yes E) No
tbfech. Pian Check
Plumb, Piun Check
Elec. Plan Check
,L,111h. Permit Fee.
Plumb. Permit Fee:
lslec. Permit l=ee:
Other Vech. Insp.
Other Plumb Insp.
Other Etec. Asp.
$0.00
Permit Fee:
�ldcch. Insp. fi-ee:
Phimb. hasp. Fee:
Elec. Insp. Fee:
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info.
]FEE RTiEMS (Fee Resolution 11-053 Eff 7/1112)
FEE
QTY/FEE
PV RSC RTEIO'liS
Plan Check Fee:
$2,022.45
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (j) Reg. C OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,384.68
Suppl. Insp. Feer Reg. OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction .Tax:
Adininistrat i ve .h ee:
Work Without Permit? C) Yes E) No
$0.00
Advanced Planning Fee.
$0.00
Select a Non -Residential 0
Building or Structure 0
Travel Docurnentatior.7 1,ees:
Strong Motion Fee: 1BSEISMICO
$92.40
Select an Administrative Item
Bldg Stds Commission .Fee: IBCBSC
$18.00
SUBTOTALS:
$3,517.53
$0.00
TOTAL FEE:
$3,517.53
Revised: 01/01/2013
CITY OF fCUPE, rfN0
FEE ESTIMATOR - BUILDING DIVISION
imADDRESS:
19191 Vallco Pkwy
DATE: 08/19/2013
REVIEWED BY: Mendez
APN:
DP#: f
-VALUATION: 1$20,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY
Commercial Building
USE:PERIHIIT
row I
PENTAMATIION
1GEIVCOM
TYPE: d.
WORK
revision #1- addition of structural plans, framing details
SCOPE
I ri ee& Plan Check
Nfech. Permit Fee:
Other Nfech. Insp.
Phunb. Plcrn Chee4.
plumb. Permit Fee:
Other Plumb Insp.
Elec. Plan (heck
Ffec. Permit Fee:
O7her Elec. Insp.
Rech. Insp, Fee: Phunb. Irrsp. Fee: I� Elec. Insp. Fee:
NOTE: This estimate does not include tees due to other Denartments (i.e. Planning. Puhlie Works. Fire. Sanitary Sewer District. School
District_ etc ) Thoce fooc nro hncod an tho nroliminary infnrmntinn availahlo and aro nnhr an octimato_ t'antart tho Dont fnr addn'I infn
.FEE ITEMS (Fee Resolution 11-053 Eff 7/1/12)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes (j) No
$0.00
hours
$278.00
Plan Check, Hourly
ISTPLNCK
Suppl. PC Fee: 0 Reg. () OT
row I
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? 0 Yes Q No
$0.00
Suppl. Insp. Fee:Q Reg. 0 OT Q Q hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Goi swuCtion Tax:
fldlnlnlsivalive Fee:
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Plannin Fee:
$0.00
Select a Non -Residential
Building or Structure
d
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICO
$4.20
3.0 hrs
$417.00
Inspections
isnNSP Inspection, Hourly
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$5.20
$695.00
TOTAL FEE: 1
$700.20
Revised: 07101/2013
C UPERTORI®
CONTRACTOR / SUBCONTRACTOR LEST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: Icticl I VALIZ
PERMIT # 0300$1
OWNER'S NAME: AppLE -tUL .
PHONE # (,-10 R6369
GENERAL CONTRACTOR: pj6VO GCj
BUSINESS LICENSE #
ADDRESS: jOf6p4ejj O&V#:
CITY/ZIPCODE: NW&D ?
*our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING ]FINAL OR ]FILIAL OCCUPANCY ffNSPIECTION(S) WILL BE SCHEDULED UNTIL TATE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUP ERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following nnfformafn®n:
d
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
96byzop a- L
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
LWOW
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
3 /6
caner / Contractor Signature Date