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13100215Y -r CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19333 VALLCO PKWY CONTRACTOR: DEVCON PERMITNO: 13100215 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 10/31/2013 OWNER'S PHONE: 4089961010 MILPITAS, CA 95035 PHONE NO: (408)942-8200 la LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL License Class (A Lic. � ��GI1� � APPLE- COMM T.1 BLDG C- COMM. T.I OF EXISTING Contractor 11vccp, IV' C, Date SPACE Zq iP 2 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: 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: $600000 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: 31620076.00 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 18 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, 180 DAYS LAST CALLED INSPECTION. costs, and expenses which may accrue against said City in consequence of the / granting of this permit. Additionally, the cant understands and will comply Issued by: Date: (U with all non -point sour Cupertino Municipal Code, Section RE -ROOFS: �egulations 9.18. Signature Date �' t 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 1 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, Sect' s WSO5; 2 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,l CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, 1 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 G ' ' I (408f \ 7-3228 • FAX (408) 777-3333 • buildingCc-cupertino.orq UPERTINQ /3)002/s ­ LJ CONSTRUCTION ❑ A DITION 0KJ ALTERATION/T1 ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS^',' 0i` �y] �/�� C _ APNH31 C -2-0 d OWNER NAME ' l n� • PHONE (� E-MAIL STREET ADDRESS 'I �N g.1 „ 1 CITY, STATE, ZIP �4, 8.; 1 p . FAX CONTACT NAME % ,, ✓qz PHONE y„4 q( E-MAIL V a4 1_ STREET ADDRESS ' CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT El ARCHITECT El ENGINEER El DEVELOPER TENANT CONTRACTOR NAME ''� LICENSE NUMBER LICENSE TYPE „ BUS. LIC H @ .. t COMPANYNAME (004 E-MAIL I(f_VC1CA �rwt "$',V'i7a1�W:^Ptd@ FAX VC STREET ADDRESS �o �Y CITY, STATE, ZIP PHONE . ARCHITECr/ENGWEERNAME LICENSENUMBER /1 BUS. LIC 4 � el COMPANY NAME 't-ut>iC,, -c'-rL,P-le'Se-IK)(terAxL1, E-MAIL m5'C"vr)t FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK 4 EXISTING USE PROPOSED USE CONSTR. TYPE N STORIES 2_5USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA '� NEW FLOOR AREA t,,� DEMO 4, AREA 0 TOTAL NET AREA e%j 2_ BATHROOM .....KITCHEN.. _... OTHER REMODEL AREA REMODEL AREA Q REMODEL AREA PORCH AREA DECKAREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH O O 0 ❑ ATTACH # DWELLING UMTS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES 4,7 BEING ADDED? &NO ADDITION? JNO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF ')JZNO IS THE BLDG AN ❑ YES - i'rf rpfirN/ if�v' / 1�� y r1/ %�rrn% r TOTAL VALUATION: PLANNING APPL H PLANNING APPROVAL LETTER EICHLER HOME? RLNO By my signature below, I certify to each of the following: I am the property owner or autVrizgtagent 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 nstructioueJ71uthorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED f f,'//l, »,�o Ml New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit Is required prior toissuance ofbuilding permit for new building. /yf/” ✓r+cfl .Ifir7k/; -. ; ��rf//i'✓)'y' rr/F /v://, r „Jr,/F%'/rJ"r ;'lr�fii% /Alifi fl// ` kir i / ,° %i Commercial Bldgs: Provide a completed Hazardous Materials Disclosure � form if any Hazardous Materials are being used as part of this project. � / / 1 i ✓ /����flr%/ /J, �" �, � 'l"�rr>��( �,Y ff '?rr'/�i I�� � "I /°i���r Copy of Planning Approval Letter or Meeting with Planning Prior to submittal ofBuilding Permit application. r�9��jr�„,/�i�j4 �r///n /r heir's'%/^°�h�t��r���l,,�,' el /,r✓�a��f, 0 �%�//�Y B1dgApp_201 Ldoc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION 1AADDRESS: 19333 VALLCO PKWY DATE: 10/31/2013 REVIEWED BY: MELISSA PC FEE ID APN: 369 33 028 BP#: `VALUATION: 1$600,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial BuildingT USE: IBTIPLNCK PENTAMATION 1 B TI PERMIT TYPE: WORK APPLE COMM .1-12962 SQ FT SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 2,962 $2,308.60 IBTIPLNCK $2,537.55 IBTIINSP 1,11vuh. bly. Y'c'' il7o. Insp /`cc $0.00 Permit Fee: $2,537.55 SuppL Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 2,962 $2,308.60 '� r,, � $2,537.55 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the vreliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eft' 7/1/13) FEE pB� , �E+� )1•Tf�►�RI.r3�= p, Yes 110 Plan Check Fee: $2,308.60 Pb lnh /1"")Y7FIP F"(L I:11c(' /nE`771XC1 JY'C': ��afCt€I➢' �iC'C'C'1. Imp �,)1 �Ft'T t�l't/i V!('7 %v'L4�). i�!'�7��i' 11''( .�Y7.5O, h OE7'�°J, l't't" 1,11vuh. bly. Y'c'' il7o. Insp /`cc NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the vreliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eft' 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,308.60 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. () OT 0.0 hr's $0.00 PME Plan Check: $0.00 Permit Fee: $2,537.55 SuppL Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C `on.so'llclion Ten: 11�'on nistrafive /"ec: 0 Work Without Permit? © Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure Q 0 i 1'mcrb>Q.' dr���a�ed�rral� ?tr�r� 1°`0� Strong Motion Fee. IBSEISMICO $126.00 Select an Administrative Item Bldjz Stds Commission Fee: IBCBSC $24.00 $4,996.15 $0.00 <Tt' A F1EE $4,996.15 Revised: 10/01/2013 Building Department City Of Cupertino 10300 Torre iNvei-im Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-33'33 CON rrRACTOR / SUBCON r FRACTOR LIS'l i 1 PERMIT1,1131100215 .)(,)fi,A,1,)I)RESS:19333VallcoPkwy . ..... -------- - ----- .............. . . ..... 0WNJ`1WS NAM[�':Apple, Inc PHONE i 408-942-8200 (`-0, OF 1V AC Construction, Inc. BUSINEss LIC17"'NSE �� 11068 — - -- — ------------ - - ---- . ....... A J) 1� [ SS 690 Gibraltar Dr. ("ITY0 PCODE: Milpitas, CA *()III- Allunicipall code ro(Itdres all businesses working in the city to have a Chy of ('upert;iio business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE (4].NERAL CONTRNCTOR AND ALL SURCONTRACT011S HAVE OBTAINED A CITY OF CUPERTINO BUSINESS 1ACENSE. I am not using any su bcon ts- actors: Signature Date Pleasc, cheelcapplicable subcontractors and complete the following itiformatiow SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE, # .. . ....... ... Cabinets & Millwork Cernent Finishing x Llectrical Redwood Electric Group Excavation l"encing X Flooring l Carpeting RE Cuddie Linoleum / Wood Glass /I Glazing x Heating ACCO Engineered Systems insulation Landscaping ----------- --------- --- --- Lathing Masonry x Painting 11 Wallpaper C&O Painting, Inc. Paving x Plumbing United Mechanical, Inc. . ....... ... lZoofing Septic Tank x SheetMetalMagnum Drywall, Inc. Sheet Rock Digitally signed by Kevin Irwin DN: m=Kevin Irwin, o=Devcon Const—fion, Inc.. ou, Kevin Irwin e�il=k,�in@de—n-wnst.com, �US Date: 2013.12 1 1 WD5,43 -08'W . .. ...... .. . ... Owner I Contractor Signature Date