13120118`7
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 4 INFINITE LOOP
CONTRACTOR: XL CONSTRUCTION PERMIT NO: 13120118
OWNER'S NAME: APPLE COMPUTER INC
851 BUCKEYE CT DATE ISSUED: 12/16/2013
OWNER'S PHONE: 4089961010
MILPITAS, CA 95035 PHONE NO: (408) 240-6000
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E]
License Class_ Lic. # �7� n!�
Li
apple- comm t.i to include conversion of existing copy room to mothers. room
/ �
Contractor. /\lam ( ..(/N� 11"' ate i 0(, "R
includes new counterop, sink and light fixtures...
I hereby affirm thahl 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 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: $20000
performance of the work for which this permit is issued.
1 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: 31602108.00
Occupancy Type:
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 180 DAYS OF PERMIT ISSUANCE OR
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 DAYS F CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses whichy accrue against said City in consequence of the
granting of this permit, Ad !tionayy, the applicant understands and will comply
Issued by: Date: / d
with all non -point source r gulati& e Cupertino Municipal Code, Section
9.18.
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, 1 agree to remove all new materials for
inspection.
❑ 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
11 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. 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 a ipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by he B y'Are Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with e C pertl Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, S ctins 5, 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
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
1 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
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
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
I-41Tt/ 11TP A-1TTY)UDTiATd-%
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 Preliminary information available and are only an estimate Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E f 7/1/13)
FEE ESTIMATOR
l.11 l kflr %_UiL`A11L.1
— BUILDING DIVISION/
Etec_ .Plan Check
ADDRESS: 4 infinite loop
DATE: 12/16/2013 REVIEWED BY: MENDEZ
F,lec. Permit Fee:
APN:
BP#: 1
*VALUATION: 1$20,000
%PERMIT TYPE: Building Permit
Phinib. hisp. Fee
PLAN CHECK TYPE: Tenant Improvement
PRIMARY
Commercial Building
PME Plan Check:
$0.00
PENTAMATION
1GENCOM
USE:
Permit Fee: Hourly Only? 0 Yes Q No
$0.00
PERMIT TYPE: 14
WORK
a le- comm t.i to include conversion of existing copy room to mothers room includes new countero
SCOPE
sink and light fixtures...
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 Preliminary information available and are only an estimate Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E f 7/1/13)
114ch. Pian Cheek
Phonbi Plan Check
Etec_ .Plan Check
?hlech. Permit Fee:
Plumh. Permit Fee:
F,lec. Permit Fee:
Other bfech. Insp.
Oiher Plumb Inst.
E i
Other I;lec, Insp. Ll I
A1ech. hasp. Fee:
Phinib. hisp. 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 Preliminary information available and are only an estimate Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E f 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? () Yes 0 No
$0.00
2 hours
$278.00
Plan Check, Hourly
ISTPLNCx
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? 0 Yes Q No
$0.00
Suppl. Insp. Fee Reg. Q OT
0,0 1
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Cons(ruction Tax,
Administrative Fee.-
ew •Work
WorkWithout Permit? ®Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure (�
7j-avel Docuinentolion lees � . �
Stroniz Motion Fee: IBSEISMICO
$4.20
4.0 hrs
$556.00
Inspections
ISTINSP Inspection, Hourly
Bldg Stds Commission .Fee: IBCBSC
$1.00
SUBTOTALS:
$5.20
$834.00
TOTAL FEE:
$839.20
Revised: 10/01/2013