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14010129 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 2 INFINITE LOOP CONTRACTOR:XL CONSTRUCTION PERMIT NO: 14010129 OWNER'S NAME: APPLE COMPUTER INC 851 BUCKEYE CT DATE ISSUED:02/05/2014 OWNER'S PHONE: 4089961010 MILPITAS,CA 95035 PHONE NO:(408)240-6000 5- LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL r� INSTALL 2 (N)WATER SOURCED HEAT PUMPS ABOVE T- License Class (/ Lic.# LC+y ` v BAR / Contractor Date ON 3RD FLOOR CEILING,INCLUDING M.E.P.'S � (�- ��s' c,C, � � .� 1 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 fill 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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$115000 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:31602106.00 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. 1 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 LNST- .LED 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 Z r— granting of this permit. Additionally,the applicant understands and will com ssued b —�` . Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. / RF,-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,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant Date: I hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(See.7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will 1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.1.2 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous 1 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 l 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,Sectigr 25505,2553 %?hd 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,1 CON TRUCTION 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 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 indemnit, and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION 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 APPLICATIONIl 1D COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333• buildinaCfcuperlino.ora ❑NEW CONSTRUCTION ❑ ADDmoN ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PRoIECrADDREss 2 Infinite Loop APN# o 2 - ( o-6 OWNER NAME PHONE ( E-MAIL STREET ADDRESS �o r 1 1L) 7 ��C�� CrIY. STATE ZIP / CONTACT NAME Bryan Eisemann PHONE 805-16.74-5877 E-Kubeisemann@xlconstruction.com STREET ADDRESS 1J7 , L• G [ CG v�i CITY,STATE,ZIP r; ti o FAX -) -G� ❑OWNER ❑ OWNER-BUIDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHrrEcT ❑E40MM ❑ DEVELOPER ❑TENANT CONTRACTOR NAME Bryan E i se m a n n LICENSE NUMBER LICENSE TYPE BUS.LIC# 7 COMPANY NAW (`t i�; ri.� cilC^� E-MAIL beisemann@xlconstruction.com FAX ��_ 24-t, - (��G STREET ADDRESS ��, .. l y � v�� CITY,STATE,ZIP �j 5�3S PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK Install (2) new water sourced heat pumps above ceiling grid on the fw1h floor. Includes all MEP's required. p^nppRR� Q ICevsE Vll SE USE T NSTR USE TYPE OCC. SQ.FT. VALUATION(S) DEMO�p 0 AMA 500sf M E P's $115,000 BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA I DBCK AREA TOTAL H A DECK/PORCREA GARAGE AREA: DETACH ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY []YES EI BNG ADDED? ❑NO ADDITION? ❑NO - PRE-APPLICATION OYES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? []NO $115,000 By my signature below,I certify to each of the following: I am the property o or au-&o' agent the property owner's behalf. I have read this application and the information I have rded is correct. I bjye read the Description of Work and fy it is accurate. I agree to comply with all applicable local ordinances and state laws relating ui g constmction8uthorize representatives of Cupertino to enter the abov identifi pro for inspection purposes. Signature of Applicant/Agent: Date: a``a r SUPPLEMb INFORMATION REQUIRED PLAN CEII=TYPE ROUTING SLEP _New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THF-COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN RZMW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ srANDAim ❑ PUBLIC WORMS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJoR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL M"TH BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 2 INFINITE LOOP DATE: 01/22/2014 REVIEWED BY: MELISSA APN: 316 02 106 BP#: *VALUATION: 1$115,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building --7PENTAMATION 1 B TI USE: PERMIT TYPE: WORK INSTALL 2 N WATER SOURCED HEAT PUMPS ABOVE T-BAR ON 3RD FLOOR CEILING SCOPE INCLUDING M.E.P.-S 13 OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B(Tenant Improvements) I-A,1-B 75 $3,054.00 1BTIPLNCK $857.00 1BTIINSP TOTALS: 75 $3,054.00 , ' $857.00 MECH,HOURLY Q Yes Q No PLUMB,HOURLY 0 Yes Q No CC, A rm E3 EL J �<i°cC_lnsp. Fr'c NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These ees are based on the prelimina information available and are only an estimate. Contact the Dept-for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Ef': 7/1%13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,054.00 Select a Misc Bldg/Structure Suppl. PC Fee: 0 Reg. () OTT0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $857.00 Suppl. Insp. Feer Reg. Q OT T0.0Thrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential Ti"Cr`rC'1 OOC"f tli9c'rllO"`%OFi Building or Structure I Strong Motion Fee: 1BSEISMICO $24.15 Select an Administrative Item Bldg,Stds Commission Fee: 1BCBSC $5.00 SUBTOTALS: $3,940.15 $0.00 " ,'TOT 4 FE'V� $3,940.15 Revised: 01/15/2014