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13120057CRTY ®]F CUPERUNG BUI LMN G ]FERM 7 BUILDING ADDRESS: 3 INFINITE LOOP CONTRACTOR: XL CONSTRUCTION PERMIT NO: 13120057 OWNER'S NAME: APPLE COMPUTER INC 851 BUCKEYE CT DA'L'E ISSUED: 12/05/2013 OWNER'S PHONE: 4089961010 MILPITAS, CA 95035 PHONE NO: (408) 240-6000 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 11 License ClassLic: # APPLE- 3RD FLOOR EAST CONVERT T (Z) IEXESTIIj G Cu��,� � ' � � �� CONFERENCE ROOMS TO (4) PRIVATE OFFICES Convactor ate 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: $50000 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 APN Number: 31602107.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is ]PjE][g)yUT EXPOS IF WORK IS NOT STARTED correct. I agree to comply with all.city and county ordinances and state laws relating �� Ili® �� OF PERMIT ISSUANCE OR building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 IIDA=T CALLED IMPI[ 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 1 granting of this permit. ition lly, the applicant understands and will comply Issued by: Date: with all noxi -point sourc re ulati ns per the Cupertino Municipal Code, Section RE -ROOFS: 9.18. j Signature Date ,Z All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, l agree to remove all new materials for inspection. 13\ O ER -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 oroffered 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 b the Bay r Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with he. Cup i Municipal Code, Chapter 9.112 and I have and will maintain Worker's Compensation Insurance, as provided for by the health & Safety Code, Sectr ns 255 , 2 533, and 25534. 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, I CONSTRUC$ N 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION �v 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 ^ FAX (408) 777-3333 > buildincl(1cupertino.or4 ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS, , f1 M ('� 5 J ,,,�PP l -/E-MAIL (� APN/�# /d „ /"'1 OWNER NAME • /�'!/ /�� PHONE,%/y yl i ® STREET ADDRESS �' CITY, STATE, ZIP CONTACT NAME PHONE /� j/ - STREET ADDRESS ,^,/�-- CITY, STATE, ZIP l n r Ary �❑UENNGGIINEER FAXd`'n4th ❑ OWNER ❑ OWNER -BUILDER ❑ ONViNERAGENN-rc ONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT"t DEVELOPER ❑ TENANT CONTRACTOR NAME 1 trj Ctf MW LICENSE NUMBER � ul LICENSE TYPE G BUS. LIC # COMPANY NAMEu�j ^ , , �� 1 U��1 E-MAIL r p o 'n1 �l G rn irtt FAX p STREET .ADDRESS V D� 1 " G�yt CITY, STATE, ZIP p`1 l .n` S G o y �� l PHONE IGNCU ARCHiTECT/ENGINEER NAME (! Rn �� APG -0 /�� LICENSE NUMBER BUS. LICA#`tel COMPANY NAME STV Dt 1 E-MAIL ! _ B �j %C) S . �✓v�. ` lr FAX STREET ADDRESS '" ! V� �f� CITY, STA(T,EE,,(ZIIP '1 �J6anJ N L� 1 �7 C 1J� 1 V PHONE DESCRIPTION OF WORK w EXISTING USE PROPOSED USE CONSTR. TYPE # STO S USE TYPE OCC. SQ.FT. VALUATION (S) FRTG AREA NEW FLOOR AR EA2 TA �^R BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCII AREA DECK AREA TOTAL DECK/PORCH ARE4 GARAGE AREA: DETACH E] ATTACH #DWELLING UNITS: ISA SECOND UNIT E] YES SECOND STORY E] YES BEING ADDED? ❑NO ADDITION? E] NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HONIE? ❑ NO RECE[V- _ TO&kL VALUAT ON: g: I a the property owner or authorized agent to act on the property owner's behalf. I have read this By my signature below, I certify to eacMed application and the information I have ct. Iha a read the Description ofWork and verify it is accurate. I agree to comply withall applicable local ordinances and state laws.relatingtobon. I a thori epresentatives of Cupertino to enter the above-iden Ied p operty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFRMATI N REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for OVER-THE-COUNTER F��BDILDINGPLAN � REVIEW existing building(s). Demolition pennit is required prior to issuance of building permit for new building, ❑ EXPRESS ❑;PLANNI(�l LANREVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIbrvoRks form if any Hazardous Materials are being used as part of this project. p LARGE- _ Copy of Planning Approval Letter or Meeting with Planning prior to _ .•;. A „: e,_.,r - 41A4JOR ice. .r-: . ,- .: SANITARYSENATRDiSrwCT ❑ ' submittal Of Building Permit application. ❑ ENVIRONn1ENTALHEALTH BIdgApp_2011.doc revised 06121111 d"TrrTr W n -V ir1TrTIrD1VTmrrPTTi\TA'T1 OCCUPANCY TYPE: FEE ES'TIMA'TOR \L1lL ll ll \LPI' V., lU iC H:Jllb ll ill N kLy - BUILDING DI`YISIGN PC �IFEEDSPC ADDRESS: 3 infinite loop DATE: 92/05/2013 REVIEWED BY: Mendez BP FEE IIID APN: 1143,111-W ;V -B 18P#:— -- ��p��j✓C 6 -VALUATION: 1$50,000 %PERMIT TYPE: Building Permit $571.00 PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building:TPERMIT $0.00 PIENTAMATION 1 B TI USE: Permit Fee: $571.00 Suppl. Insp. Fee -0 Reg. OT TYPE: hrs $0.00 WORK apple- convert 2 existincl conference rooms to 4private offices SCOPE PME Permit Feer $0.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC �IFEEDSPC IFEE IIID �WP IFIEIES BP FEE IIID B (Tenant Improvements) 1143,111-W ;V -B 250 $2,036.00 IBTIPLNCK $571.00 IBTIINSP Glee, 1nsp..Fae: $0.00 Permit Fee: $571.00 Suppl. Insp. Fee -0 Reg. OT O,p hrs $0.00 PME Unit Fee: $0.00 PME Permit Feer $0.00 TOTALS: 250 $2,036.00 $571.00 MECH,.I4OURLY 0 Yes, Q No PLUMB, HOURLY 0 Yes Q No EIEC, HOURLY 0 Yes C) No :Vech. Plan Check Plremb. Plan Check Elec. Plan Check �1i>cb. Pennil Fe . PGrmb. Penni/ Fee; GLec. Permit Fee: Other rtlech. Insp. Other Plumb Insp. P77�:j Other Elco. Insp. ilech. hasp, Fee; Plumb. Insp. Fec: Glee, 1nsp..Fae: NOTE: This estimate does not include fees due to other Departments (i.e Planning, Public Works, Eire, Sanitary Sewer District, School District, etc). Theseees are based on the Prelimina information available and are onl an estimate: Contact the Dept for a'l in o. FEE ITEMS (Fee Resolution 11-053 Eff.' 711/13) FEE QTY/FEE MISC ff EMS Plan Check Fee: $2,036.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $571.00 Suppl. Insp. Fee -0 Reg. OT O,p hrs $0.00 PME Unit Fee: $0.00 PME Permit Feer $0.00 Cvnstr:�tction .Tc�x: �l.drr2irristrative .Fee: Work Without Permit? 0 Yes O No $0.00 Advanced Plannin Fee: $0.00 Select a Non -Residential Building or Structure a 7 ravel Docr.rtnentation Fees: Strong Motion Fee: iBSEISMICO $10.50 0 # $0.00 Revisions IREVCOMTI I Tenant Improvement 1314, Stds Commission Fee: 1BCBSC $2.00 SUJITOTALS: $2,619.50 L$0.00 TOTAL FEES $2,619.50 Revised: 10/0112613 CONTRACTOR / SUBCONTRACTOR LEST Building Department City Of Cupertino 1.0300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: } " i " — ' .t a: ' PERMIT # I 2,k_00 OWNER'S NAME: p PHONE 4 -90 I GENERAL CONTRACTOR: { ��j ,�- z{� BUSINESS .LICENSE 4 ADDRESS: �1�1L i � 4L�t1' CITY/ZIPCODE: Att, ? "� '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 IEEE SCHEDULED UNTIL THE ; ENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CU PIERTINO BUSINESS LICENSE. E am not using any subcontractors: Signature Fiease check applicable subcontractors and complete the following information: Date ti 12- 1 --, wne ,/_C/®ntractor Signature i Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing -------a-- -- -- — Electric al✓'uL�' Excavation Fencing — -- - w -- -� Flooring / Carpeting - Linoleum / Wood — - -- Glass / Glazing ---- Heating Insulations Landscaping - -- --- Lathing-- Masonry -- Painting / Wallpapers ya`� C,,- Pav ing — --. ---- Plastering --- -----� - Plumbing Roofing Septic Tank ----- Sheet Metal Sheet Rock I) C7- i f f �i�-4 C,�--S Tile j - -- ti 12- 1 --, wne ,/_C/®ntractor Signature i Date