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B-2016-1284CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1284 6INFINITE LOOP CUPERTINO, CA 95014-2090 (316 02 110) (NOVO CONSTRUCTION INC) MENLO PARK, CA 94025 OWNER'S NAME: APPLE COMPUTER INC DATE ISSUED: 02/0212016 O'WNER'S PHONE: 650-421-1832 PHONE NO: 650.785-1617 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lie. #791022_BLDG Contractor( NOVO CONSTRUCTION INC) Date 02/02/2016 _ELECT _PLUMB MECH -- RESIDENTIAL X COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing — with Section 7000) of Division 3 of the Business & Professions Cade and that my license is 1n full force and effect. JOB DESCRIPTION: APPLE - 1ST FLR, EAST WING - RECONFIGURE OF (E) MAIL ROOM I hereby affirm under penalty of perjury one of the following two declarations: & TOOL STORAGE ROOM (380 S.R) z. I have and will maintain a certificate of consent to solf-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. z. I have and will maintain Worker's Compensation Insurance, as provided for VK by Section 3700 of the Labor Code, for the performance of the work for which Sq. Ft Floor Area: Valuation; $65000.00 this permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above APN Number: Occupancy Type; information is correct. i agree to comply with all city and county 31602 110 316 A{Tenant Improvements),B (Tenant Improvements} 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 PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said City In consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal 180 DAYS FROM LAST CA SPECTION. Code, Section 9.18. Issued by: MELISS Signature Date p2102/20 f6 Date: 0210272 0 1 6 OWNER-BIIII ER DECLARATION RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is I hereby affirm that I ant exempt from the Contractor's License Law for one of the installed without first obtaining an inspection, I agree to remove all new materials for following two reasons: inspection.inspection 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 (See.7044, Business & Professions Code) Signature of Applicant; 2. I, as owner of the property, am exclusively contracting with licensed Date: 0 210 2 /20 1'6 contractors to construct the project (See.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: L 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 HAZARDOUS MATIERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the California health & Safety Code, Sections 25505, 25533, and 25534. I will z. I have and will maintain Worker's Compensation Insurance, as provided for maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the by Section 3700 of the Labor Code, for the performance of the work for which Health & Safety Code, Section 25532(a) should I store or handle hazardous ' this permit is issued. material. Additionally, should I use equipment or devices which emit hazardous a. I certify that in the performance of the work for which this permit is issued, I t air contaminants as defined by the Bay Area Air Quality Management District I shall not emtiany person in any manner so as to become subject to the will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and Worker's Compensation laws of California. If, after making this certificate of the Health & Safety Code, Sections 25505, 25533, and 25534. 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 owner or authorized agent- be deemed revoked. Date: 02111=016 APPLICANT ERTIFICATION CONSTRUCTIONLENDINGAGENCX I hereby affirm that there is a construction lending agency for the performance 1 certify that I have read this application and state that the above information Is of work's for which this permit Is issued (Sec. 3097, Civ C.) correct. I agree to comply with all city and county ordinances and state laws Lender's Name relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for Inspection purposes. (We) agree Lender's Address to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in ARCHITECT'S DECLARATION consequence of the granting of this permit. Additionally, the applicant I understand my plans shall be used as public records. understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Licensed Professional Signature Date 02/02/2016 CONSTRUCTION PERMIT APPLICATION 0 COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 90300 TORRE AVENUE , CUPERTINO, UA 06014=3255 CUPERTINO (400) 777-3223 - FAX (408) 777-3333 , building(acupertino.om T3- Z rl 16 — (2- F4 NEW CONS'!'Rt.JCTIONADDITION % ALT>;RATION I TI 0 REVISION / DuERRMD ORIGINAL PERMIT # SS APN 0 a� / � GJ.V tT Ln L+� .7 L FOWNERNAMBPRONEAPPLE V 650®itzt • 13z & . i -c Ak +QAW . cS A CITY, S'TATE,ZIP FAX I rm 4Gie p 4WzLT1.J0 r!A �k CONTACT NAME ;7 JFofrl�iZ /� e7pAj4 PHONE 30Z�j' E-tvIAIL STREET ADDRESS CIl'Y,STATF., VP FAX r! 3C�VGiwVtTE L.ov C+4W .cis 0 OWNER CI OWNER•BUIL)OR 13 OWNERACiENT 151 CONTRACTOR 13CONTRA (]TORARENT C ARCI•ItTrcr RNGINRER uIlVii-LoPER TENANT CONTRACTORNANIR LICINSENUIVII311K 7/ay 1-1CENSETYPO t3UN.LAC 'z COMPANY NAMER j1,lbVq CONST? t' -I" MAIL 9410" Wd)Vd(vW5rW&-n0A1. FAX S77tEL"t' ARRIiCISS lybv a`A+et� ill✓+. CITY, STATE., ZIP M.IIu r+)zjc CSA��$�•Ibl� PtIONIr ARCtI1TECT/F.N0INRRRNANIH LICENSENUMAER / � O Z BUS.Llcil COMPANY NAME idAY C, oIsP Pttzcylti c G•NIMI. Asumw�`r-W IIyV �t�RuuP/ccan FAX SrR PT'ADDROSS Zb5}, Q�I.t1Cr i : CITY, STATE,ZIP �6 jot Lr C}! 111,06-3 PI]aNii�j��/�'£ �ry q�ORK " 1Csr TIlO�AICAIL.. a0 !� }r�L 5roFAb'EfacollA. RXLSTING U'G CD SE P/� r:ONSTR-TYPE R S•I'OIirES y_d USE TYPE OCC. SQ,FT. VALUATION($) �/ CROPOS1;D 40 -0 �"� ARMCg -0 iI AREiSTO ARLOOIQ � J CS ARHO � AIIEA Qj('i � TOTAL NI T AREA �� n a � 1P I � � v -- /� � BATHROOM KITCIIEN OTHER REMODFLAREA RENIODELAREA REMODEL AREA PORCH AREA DEC' RISA TOTAL-DECKIPORCHARRA GARAGEA[iSA: 13 I'ACH ATI'ACI l li YELl.INGUNICR:� UNIT YESSt.ONDS'r'ORY Y�Y6SGADDRD? F[SrASECOND E3NO ADDITION? L]NO PRE•APPUCATION dYRS IF YES, PROVIDE COPY OF ISTHI:DLDOAN ❑S`. PLANNINGAPPLY ©NO PLANNINOAPPROVALLETTER GICHLGRHOMC? Tay illy signature below, l certify to each ofthe following: I nnr ilia property owner or authorize a on the property owner's behalf. l have read this application and the inronnation I have provided is correc . I have read lI Description of'Work and verify it is accurate. I agree to comply with all applicable loeal ordinances and state laws relating to building cons ' Ion. I nutho z representatives oFCupertino to enter the above- dri hied property for inspection purposes. signatureorApplicturt/Agent: Tate: SUPPLEMENTAL INFORMA`f REQU[RED PLANCHECKTYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ ON, ER-TtIGCOUNTER ❑ BUILDING PLAN REVIEW existing building(s). Detuolition permit is regtiired prior to issuance of building - permit for new building. ❑ EXPRESS _ ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS fonts ifany Hazardous Materials are being used as part ofthis project. ❑ LARGE ❑ FIRE DErr _ Copy of Planning Approval Letter or Meeting Kiilll Planting prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ENV[RONArENTAL1rEALTII 81dg t pp_20I Woc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 6 INFINITE LOOP DATE: 0210112016 REVIEWED BY: MELISSA PC FEE ID APN: 31602110 BP#: *VALUATION: $65,000 "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: IBTIPLNCK PENTAMATION PERMIT TYPE: 113 TI WORD APPLE - 1ST FLR EAST WING - RECONFIGURE OF E MAIL ROOM & TOOL STORAGE ROOM SCOPE (380 S.F.) OCCUPANCY TYPE: TYPE OF CONSTR. FL.R. AREA 01) PC FEES PC FEE ID BP PEES BP FEE Ill B (Tenant Improvements) 1-A,I-B 380 $3,153.91 IBTIPLNCK $984.53 IBTIINSP Fee: PME Plan Check: $0.00 Permit Fee: $984.53 Suppl. Insp. Fee -.(j) Reg. Q OT 0 0 hrs $0.00 PMP Unit I'ee: $0.00 PME Permit Fee: $0.00 TOTALS: 380 $3,153.91 "-- = -= - $984.53 N1E.GPI= HOIFI2LY::....:. ;YNo..PLUMB, ,.__.. _.. H0U.RLY';r Iwo ELE. .T®URLY 1fk-h Plan Che I'lw{ "b Nan Cf.wck .i lel' "I'm F_1,,,4,1'elww i`eo; P1ifitill. Pe"wiid Fee. .F.,IL'S-..1iP1'3ilil 3d1�t?i' .f'C'JF. II?3(%• ��?�c'F' Dlllii713?Mt1;,ED Oihe �: r. . Imp. E3 0.0 I'1umb. Inslo. Fess' Fee: NOTE., This estimate does not include fees due to outer Departments (le, Planning, Public Works, Fire, Sanitary Sewer District, School District. e1c.). These fees are based on the Dreliminary information available and dre nniv an estimate. Contact the Devt for addi:'L info. FEE ITEMS ,1& -solution .11-053 _h . 711113, FEE QTY/FEE IVIISC ITEMS Plan Check Fee: $3,153.91 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: G) Rel;. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $984.53 Suppl. Insp. Fee -.(j) Reg. Q OT 0 0 hrs $0.00 PMP Unit I'ee: $0.00 PME Permit Fee: $0.00 �-`t�rt,�1r-r�ctitatt Tzx�: <• ekninisfrr€lige( Fee: 0 0 Work Without Permit? 0 Yes (B No $0.00 Advanced Plamnit_ �g _pe:$p,{}Q Select a Non -Residential or Structure G 0 A ;'xx :?.cat;x€tta��rat�xfl<rt F'ees'-Building SjEQn? IylotiojFee: 113STISMIC0 $18.20 Select an Administrative Item Bldg Stds Commission Fee- IBCBSC $3.00 °:°:::'_:;; ;< $4,159.64F $0.00:...TOTAL=Flwt; $4,15 Revised: 01/0112016 HAZARDOUS MATERIALS CHECKLIST COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildirta@cupertino.orQ PURPOSE To minimize possible delays that would result for the Fire Department plan review, please complete the following checklist to determine if an additional level of Hazardous Materials plan review will be required. MARK `YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING? PLEASE MARK YOUR ANSWER WITH AN 'X' IN THE YES OR NO BOX ON THE SIDE BELOW. YES NO 1. Use, dispensing, mixing or storage of flammable or combustible liquids or gases, hazardous materials, etc. 2. Battery backup rooms or racks. 3. Propane tanks. X 4. Gasoline stations with underground tanks. }� 5. Installation or replacement above ground or underground storage of liquid petroleum products, liquefied petroleum gases, compressed natural gas, explosives or other regulated hazardous materials. X 6. Gas rooms for dentist, doctors or veterinarians. 7. Generators with back-up diesel or other fuels. X 8. Large refrigeration systems. 9. Fuel cell systems. X 10. Commercial pool systems. 11. Chemical Storage areas. X 12. Flammable liquid storage. X 13. Compressed Gases. X 14. Dry cleaners. x 15. Print Shops. 16. Auto Repair and Auto Body Shops. X 17. Research and Development. For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa Clara County Fire Department, at (408) 378-4010. HasMat 2011.dac revised 03107111 VTESTING ENGINEERS, INC. RECEIVED I APR 0 5 2016 2811 Teagarden St. 510-835-3142. 510-834-3777 fax San Leandro, CA 94577 800-660-3142 ; San Leandro • San Jose • Martinez INSPECTION REPORT Week Ending. 3/25/16 PROJECT # 62824 PROJECT: Apple IL.6.1E X -Ray LabL_ 6 Infinite Loop ti Permit # B-2016-1284 DATE 3/25/16 HOURS 4 INSPECTOR T. Clair Reported to Allen of Novo Construction at the Jobsite as requested. TYPE OF INSPECTION: Proof Loading PLACE OF INSPECTION: Jobsite Applied a torque load of 60 foot lbs. to 5/8" diameter Hilti expansion anchors, located in the floor for x-ray machine at x-ray lab. Ten (10) anchors of a total of 10 installed were tested representing 100% without visually apparent distress or failure. The preceding work was, to the best of my knowledge, in compliance with approved job plans and specifications, including revisions by engineer, and proof loading values and rate of testing were supplied by manufacturer's specifications. Reviewed by: tee__ Davi&Chippero Special Inspection Division Manager 1cc: Apple Computer Inc./R. Anchartechahar City of Cupertino/Bldg. Inspection Dept. The results presented in this report relate only to the item(s) tested/ inspected and may be reproduced only in its entirety unless written permission from TEI is obtained. Page 1 of 1