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13100165CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 5 INFINITE LOOP CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 13100165 OWNER'S NAME: APPLE COMPUTER INC 1460 O'BRIEN DR DATE ISSUED: 10/24/2013 OWNER'S PHONE: 4157103063 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL / Z 2 APPLE- 3RD FLOOR- SOUTH EAST- T.I PREP 7,395 SQ FT License Class Lic. # Contractor 0 V Lh yjt Date %0 L S' I hereby affirm that I am licensed under the provisions of Ch pter 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: 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. Sq. Ft Floor Area: Valuation: $50000 have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 31602109.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 80 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter to save 180 DAY, FROM LAST CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree indemnify and keep harmless the City of Cupertino against liabilities, judgments, City in of the � costs, and expenses which may accrue against said consequence 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. ` Signature Date�o z 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. ❑ 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 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 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 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 Section 3700 of the Labor Code, for the performance of the work for which this the Health & Safety Code, Sections 25505, 2 3, a 553 Owner or authorized agent: Date• °�_l 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 CONSTRUCTION LENDING AGENCY 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 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildin4(d)cuaertino.org ❑ NEW CONSTRUCTION ❑ ADDITION kALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS (-` / i _ O� APN # i' t 1 W OZ 0 C>� OWNER NAME PHONE E-MAIL ..0 �1(14/C . 0 — A(P� STREET ADDRE CITY, STATE, ZIP Pio 15" r FAX �, � ,moo CONTACT NAME PLHOGNE E-MAIL ff s 1 STREET ADDRESS ` CIT TATE, ZIPFAX '( / L R. ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ` Vp LICENSE NUMBER I © L LICENSE TYPE (5 BUS. LIC # 3 Q v COMPANY NAME V6116 E-MAIL FAX o%" vUt 0•✓ STREET ADDRESS ,04 &V€ CITY STATE, ZIP ESC C o PHONE o 0 1^ (50. C3 ARCHITECT/ENGINEER NAMELICENSE NUMBER BUS. LIC # / Q� LV4%jiQ COMPANY NAME 7vD! vs �i r 2�G�E E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK ) 2D J 02 S T EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES /\ USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA )315 DEMO AREA 5 1 TOTAL NET AREA 3 zl / (= 11111 A S© f!O D BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH I ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? []NO ADDITION? ANO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RE . IV D EY: TO AL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO CA 14 D 6 D &C, By my signature below, I certify to each of the following: I am the property owner or authorize gent to act on the property owner's behalf. I have read this application and the information I have provided is corre . I have read Descriptio f Work and verify it is accurate. I agree to comply hvith all applicable local ordinances and state laws relating to building cons n. I a orize re of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: 0 2 3 SUPPLE TAL INFORMATION REQUIRED PLAN CHECK YPE ROUTING SLIP ❑' OVER-THE-COUNTER 1:1 BUILDING PLAN REVIEW _ New SFD or Mu tifamily 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 ❑ 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 1:1 submittal of Building Permit application. SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doc revised 06121/11 eo M ��,�-����■��,�,�,��, CITY OF CUPERTINO rw___ l�il FFF ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Pubtic works, Fire, Sanuary Sewer uisrnci, acaoot n.*-.-:. . 1 rL....., f--....., A—d — tl.v nra/imiannr infnrmntinn availahle and are only an estimate. Contact the Dept for addn'1 into. FEE ITEMS (Fee Resolution 11-053 Eff: 7/1/13) ADDRESS: 5 INFINITE LOOP DATE: 10/24/2013 REVIEWED BY: MENDEZ 11??& P, rr:r 1, APN: BP#: zM&"VALUATION: Other Mech. Insp 1$50,000 FPERMIT TYPE: Building Permit fLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: r,le(. Inst)_ Fec: PENTAMATION 1TIPREP PERMIT TYPE: WORK APPLE- T.I PREP 7,395 SQ FT SCOPE $0.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Pubtic works, Fire, Sanuary Sewer uisrnci, acaoot n.*-.-:. . 1 rL....., f--....., A—d — tl.v nra/imiannr infnrmntinn availahle and are only an estimate. Contact the Dept for addn'1 into. FEE ITEMS (Fee Resolution 11-053 Eff: 7/1/13) Mech. Plan Check Phwtb. Plun C'hecl Alec. Plan {:heck 11??& P, rr:r 1, Plumb. Permit Fee: Etec•. Permit Fee Other Mech. Insp Other Plumb Insp. other Elec. Insp, 1rrt=_ Insp. F"',' I'll' -fid" tri°ti, I _'�' r,le(. Inst)_ Fec: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Pubtic works, Fire, Sanuary Sewer uisrnci, acaoot n.*-.-:. . 1 rL....., f--....., A—d — tl.v nra/imiannr infnrmntinn availahle and are only an estimate. Contact the Dept for addn'1 into. FEE ITEMS (Fee Resolution 11-053 Eff: 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 T-1 # $405.00 Tenant Improvement Prep ITIPREP Suppl. PC Fee: Q Reg. OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT O.Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tarr: F71 Administrative Fee: E) Work Without Permit? Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) i 7t tt�zt floc rr,taf:�s�l;rlfz�rr T `t���,: Strong Motion Fee: 1BSEISMICO $10.50 Select an Administrative Item Bldg* Stds Commission Fee: 1BCBSC $2.00 SUBTOTALS: $12.50 $405.00 TOTAL FEE: $417.50 Revised: 10/01/2013