12080284CITY OF CUPERTINO BUILDING PERMIT '
BUILDING ADDRESS: 6 RESULTS WAY
CONTRACTOR: XL CONSTRUCTION
PERMIT NO: 12080284
OWNER'S NAME: ECI TWO RESULTS LLC
851 BUCKEYE CT
DATE ISSUED: 12/14/2012
OWNER'S PHONE: 4084901641
MILPITAS, CA 95035
PHONE NO: (408) 240-6000
❑ LICENSED CONTRACTOR'S DECLARATION
f— r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class L— ) O Lic. # 3 y 3 ; _
F
/
Contractor �►rJcva �1 fic,T&. . +Date
MECH RESIDENTIAL COMMERCIAL
I lereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: APPLE - COMMERCIAL OFFICE TENANT IMPROVEMENT
(ummencing with Section 7000) of Division 3 of the Business & Professions
(72738 SQFT) NEW INTERIOR PARTITIONS, DOORS,
FINISHES,CEILINGS,LIGHTING AND 12/18/12-REV#1-INSTALLATION OF (4)DUAL
Ode and that my license is in full force and effect.
EV CHARGING STATIONS AT BLDG 6-REV#1 ISS'D 12/18/12
hereby affirm under penalty of perjury one of the following two declarations:
have and will maintain a certificate of consent to self-insure for Worker's
;ompensation, as provided for by Section 3700 of the Labor Code, for the
)erformance 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
Sq. Ft Floor Area:
Valuation: $6227750
permit is issued.
APPLICANT CERTIFICATION
APN Number: 35720041.6
Occupancy Type:
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
PERMIT EXPIRES IF WORK IS NOT STARTED
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature/ .----' Date ! Z led—/Z
Issued by: �,�r�%/1� �% mil Date•/-
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
RE-ROOFS:
the following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1, as owner of the property, or my employees with wages as their sole compensation,
installed without first obtaining an inspection, I agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec. 7044,
inspection.
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construct the project (Sec.7044, Business & Professions Code). -
1 hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's
HAZARDOUS MATERIALS DISCLOSURE
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
permit is issued.
Additionally, should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued, I shall
contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Compensation laws of California. If, after making this certificate of exemption, I
Health & Safety Code, Sections 25505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
PY P P
Owner or auth rued agen ti-
Date: lZ r--7'
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
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
I hereby affirm that there is a construction lending agency for the performance of work's
to building construction, and hereby authorize representatives of this city to enter
for which this permit is issued (Sec. 3097, Civ C.)
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Lender's Address
granting of this permit. Additionally, the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code, Section
ARCHITECT'S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEW FEE ESTIMATOR - BUILDING DIVISION
1AADDRESS:
6 Results Way
DATE: 12/18/2012
REVIEWED BY: Sean
APN:
BP#: 12080284
*VALUATION: 1$45,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY Commercial Building
USE:
Suppl. PC Fee: Q Reg. Q OT
PENTAMATION SOLAR -COMM
PERMIT TYPE:
WORK
Revision #1: Installation of 4 dual EV charging stations at building 6.
SCOPE
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
Aictrirt_ otn )_ Thoco foot aro hacod an tho nroliminary infnrmatinn availahlo and aro nn1v an octimato_ C'antart tho Rent for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 Ef: 711112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
=#
$408.00
Alternative Energy System
ICHRGSTA EV Charging Station
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -.0 Reg. Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction I'Lix:
Adminisiratity Fec:
Q
0
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
i
Tnfr ;cl 1"C(Is.
Strom Motion Fee: IBSEISMICO
$9.45
Select an Administrative Item
Bidg Stds Commission Fee: IBCBSC
$2.00
` SUBTbTALr
$11.45
$408.00TQ'TAL;FEE:,�
$419.45
Revised: 10101/2012
CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 6 RESULTS WAY I CONTRACTOR: XL CONSTRUCTION I PERMIT NO: 12080284 I
OWNER'S NAME: ECI TWO RESULTS LLC
851 BUCKEYE CT I DATE ISSUED: 12/14/2012
OWNER'S PHONE: 4084901641 1 MILPITAS, CA 95035 ! PHONE NO: (408) 240-6000
K_ LICENSED CONTRACTOR'S DECLARATION
License Class_ _:Y� Lic. #
Contractor )CL l ,oh CJ f� Date
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
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
permit is issued.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
granting of this ermit. Ad ition ly, the applicant understands and will comply
with all non -p source r gulag s per the Cupertino Municipal Code, Section
9.18.
Signature Date
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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 or offered for sale (Sec.7044,
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following thrce
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
performance of the work for which this permit is issued.
[ 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
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
BUILDING PERMIT INFO: BLDG ELECT r PLUMB r—
MECH r RESIDENTIAL COMMERCIAL r
JOB DESCRIPTION: APPLE - COMMERCIAL OFFICE TENANT IMPROVEMENT
(72738 SQFT) NEW INTERIOR PARTITIONS, DOORS,
FINISHES, CEILINGS, LIGHTING AND
Sq. Ft Floor Area: I Valuation: $6182750
APN Number: 35720041.6 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by:f'���%` Date: /-I -% T/ -/"
RE -ROOFS:
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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance it the Cupertino Municipal Code, Chapter 9.12 and the
Healt Safety Co e, -to
25505, 25533, and 25534.
Ow or autho g nt: 'j
Date: ,[
//11//2
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Date I Licensed Professiona
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
imADDRESS:
6 Results Way DATE: 08/28/2012
REVIEWED BY: Sean
PC FEES
APN:
BP#: / WaO2 Ll
'VALUATION: $6,182,750
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
$7,688.68
PENTAMATION 16 TI
PERMIT TYPE:
WORK
Office tenant im rovemet 72738 s ft). new interior partitions,doors finishes ceilings, lighting and
SCOPE
M,E,P's
RWkZAA M
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
72,738
$7,688.68
1BTIPLNCK
$27,307.28
IBTIINSP
$27,307.28
Suppl. Insp. Feee. Reg. Q OT 10-07hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
'r
C rJ? /I IIIYi(W7 ! tIX
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
TOTALS:
72,738
$7,688.68
$27,307.28
$1,298.38
NOTE: This estimate does not include fees due to other Departments (Ie. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc ). These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff 7/1/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$7,688.68
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. 0 OT 0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$27,307.28
Suppl. Insp. Feee. Reg. Q OT 10-07hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
'r
C rJ? /I IIIYi(W7 ! tIX
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential Q
Building or Structure 0
A
7i'<r'rt'l 1�rr`t!tTc'r7'ui;il,a l'e'C'i:
Strong Motion Fee: 1BSEISMICo
$1,298.38
Select an Administrative Item
Bldy, Stds Commission Fee: 1BCBSC
$248.00
.BTO`I'AI,S:
36,542.34
$0.00 ;TOTAL FEEi 1-.
$36,542.34
Revised: 07/0112012