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14120026CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19333 VALLCO PKWY CONTRACTOR: DEVCON PERMIT NO: 14120026 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 02/13/2015 OWNER' PHONE: 4089749591 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL BLDG A- 2ND FLOOR- LAB; INSTALL FUME MOOD License Class CAG7L Lic. # Contractor I hereby affirm that I am lice-L-bu4cr 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: $25000 performance of the work for which this permit is issued. �4f 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: 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 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 FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non -point sour regulars per the Cupertino Municipal Code, Section 9.18. f /5 RE -ROOFS: Signature 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 - re of ApplTcan �� " Date: I hereby affirm that I am exempt from the Contractor's License Law fo the following two reasons: LL O OVE INGS 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) 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. 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 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 Cupertinounicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 5 533, and Section 3700 of the Labor Code, for the performance of the work for which this t)� Owner or authorized agent: 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 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 �\ CUPERTINO (408) 777-3228 • FAX (408) 777-3333 . build ingC�cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION Q ALTERATION / TI ❑ REVISION / DEFERREDORIGINAL PERMIT # 13120193 PROJECT ADDRESS 19333 Vallco Pkwy APN# �,Icn -Z,0//I�o V-1tv,C-- OWNER NAME Apple, Inc. PHONE 408-974-9591 7E-TLemolloy@apple.com STREET ADDRESS 1 Infinite Loop CITY, STATE, ZIP Cupertino, CA FAX CONTACT NAME Kevin Irwin I PHONE 408-712-9856 E-MAILkINVIII@devcon-const.com STREETADDRESS690 Gibraltar Dr. CITY, STATE,ZIPMilpitas, CA 95035 1 FAx408-262-2342 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT M CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Kevin Irwin LICENSENUMBER399163 I LICENSE TYPE CA GC 1 BUS. LIC #11068 COMPANY NAME Devcon Construction, Inc. E-MAILkirwin@devcon-const.com '408-262-2342 STREETADDRESS690 Gibraltar Dr. $25,000 CITY, STATE, ZIP MiIpitaS, CA 95035 PHONE 408-942-8200 v ARCHITECT/FNGINEER NAME Kate Greenberg LICENSE NUMBER BUS. LIC # COMPANY NAME Studios Architecture ❑ B.11LMNOPLAN REVIEW E-MAIL kgreenberg@studios.com FAX STREETADDRESs405 Howard St, Suite 488 CITY, STATE, ZIP San Francisco, CA PHONE 415-732-5358 DESCRIPTION OF WORK ❑ PLANNING PLAN REVIEW Installation & connection of lab fume hood to existing utilities in existing space (TRU Lab). 2 �I,dC .0 6.4'1 A. DECK AREA TOTAL DECK/PORCH AREA EXISTING USE PROPOSED USE CONS I I- TYPE #STORIES Lab Lab II -B 2 USE TYPE I OCC. SQ.FT. VALUATION($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA Lab A2. H,5 o Q 352. $25,000 BATHROOM KITCHEN OTHER _ New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ B.11LMNOPLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building REMODEL AREA REMODEL AREA REMODEL AREA permit for new building. ❑ EXPREM ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ODETACH ❑LARGE -t`'" nErT _ Copy of Planning Approval Letter or Meeting with Planning prior to MAJOR fI iw El UNITARY SEWER DISTRICT submittal Of Building Permit application.El ❑ ATTACH UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES rDWELLING BEING ADDED? ONO ADDITION? ONO PRE -APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN U YES RECEIVED BY: TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO _ $25,000 By my signature below, l certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. 1 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 buil_din P16ristruction. 1 rite representatives of Cupertino to enter the above -identified roperty for inspection purposes. Signature of Applicant/Agent: Date: I �' ei 114 SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _ New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ B.11LMNOPLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPREM ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure D, STANDARD ❑ PUBLIC WORKS _ form if any Hazardous Materials are being used as part of this project. ❑LARGE -t`'" nErT _ Copy of Planning Approval Letter or Meeting with Planning prior to MAJOR fI iw El UNITARY SEWER DISTRICT submittal Of Building Permit application.El ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 MY OF CUPERUNO FEE IESTMATOR - BUff LDffNG ID)ffVffSffON APPLIANCE / EQUIP TYPE ADDRESS: 19333 vallco pkwy DATE: QTY REVIEWED BY: Mendez DP FEES APN: RP#:/ya 1MCHOOD *VALUATION: 1$25,000 'PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building Strp�>l. Ir�s1, Frre PENTAMATION PERMIT TYPE: 1CMAP5� WORK bid A- 2nd floor- lab; install fume hood PME Unit Fee: $143.00 SCOPE $48.00 APPLIANCE / EQUIP TYPE FEE ID PJru„ b Plon Ch, el, QTY UNITS DP FEES ;'1100i 1'•,' Hood, Mech. Exhaust 1MCHOOD 1 # $143 f'f�r,°rrit I'e: Strp�>l. Ir�s1, Frre PME Unit Fee: $143.00 PME Permit Fee: $48.00 C',n r, i.ctinrr TQV.' 77 TOTALS: Administrative Fee: (ADMIN $45.00 $143.00 J NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef: 7if .1,;13) Mech. Plan Check 0.0 hrs $0.00 PJru„ b Plon Ch, el, 1� ISC )(')<']EMS Mech. Permit Fee: IMPERMIT Pcrtmf Fec: ;'1100i 1'•,' Other Mech. Insp. Eqhrs $48.00 0;her Plumb his,Lj VIC(/? hasp. Fee. Plronl, hasp. Fee: Flrr ht�j%. l r NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef: 7if .1,;13) ]FEE QTY/FEE 1� ISC )(')<']EMS Plan Check f°ae: .tiuppl. PC Fee PME Plan Check: $0.00 f'f�r,°rrit I'e: Strp�>l. Ir�s1, Frre PME Unit Fee: $143.00 PME Permit Fee: $48.00 C',n r, i.ctinrr TQV.' 77 Administrative Fee: (ADMIN $45.00 Work Without Permit? 0 Yes (a No $0.00 Adwac ee/ l'lunrling l'i'es a Travel Documentation Fee: ITRA VDOC $48.00 Strom Motion Fee: IBSEISMICO $7.00 2.0 hrs Inspections $286.00 ISTINSP Inspection, Hourly Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS. -$292.00 $286.00 TOTAL FEE: $578.00 Revised: 10/01/2014 vi C;UP EfRTUNO CONTRACTOR / SUB CONT AcC70R ILRST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-7�7-3333 JOB ADDRESS: 19 13 3 V. 11 co kw PERMIT # 1 H 1 S o o z to OWNER'SNAME: A-ppls-, Inc. Malloy PHONE# 'lob— 01-74-5°5 GENERAL CONTRACTOR: BUSINESS LICENSE # 10(o(b ADDRESS: (D 010 r 1 CITY/ZIPCODE: NA! ` c s c,± q 9o'eS *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 BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITE' OF CU PERTINO BUSINESS ]LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: ]Date d SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing (iyti AlLckah'c0d IKC,. Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature 211-7115 ]Date