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14040166 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: I INFINITE LOOP CONTRACTOR:XL CONSTRUCTION PERMIT NO: 14040166 OWNER'S NAME: APPLE COMPUTER INC 851 BUCKEYE CT DATE ISSUED:04/23/2014 OWNER'S PHONE: 4082406340 MILPITAS,CA 95035 PHONE NO:(408)240-6000 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ¢ p APPLE T.I. PREP, INTERIOR DEMO 2,700 S.F. License Class /,(jp(7 Lic.# _ l Contractor CO Klr--f ajcl t o�"S Date 1 1 hereby affirm that I am licensed under the provisions of C pter 9 (commencing with Section 7000)of Division 3 of the Bu iness&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 per ormance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$50000 ave 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:31602105.00 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 FROMINSPEC ION, 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 3 �(� granting of this permit. Additionally,the applicant understands and will comply Date: with all non-poi source reg a i s per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature ✓ Date All roofs shalt 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. 13OWNER-BUILDERDECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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(Sec.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 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 1 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 ItheArea Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with ertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Secti05, 5533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this -2 f Owner or authorized agent: Date: _f 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,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 indemnify 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. T � ��,� . �a CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 V CUPERTINO (408)777-3228• FAX (408)777-3333• building a,cupertino.org ❑NEW CONSTRUCTION ❑ ADDITION .ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESSAPN# 2 t NF-km 11c X01' b — Z 05 OWNER NAMEPHONEE-MAIL o--j z�� e, ° fob-Zoo-C-24U E Tom kP� E,co STREET ADDRESS CITY STATE,ZIP FAX N�tivlZ� �ooP C`UP 'llwC) CONTACT NAME PHONE E-MAIL .� NIS —C�STIQ 4iS-3G1-911Z_ 111 CbS'9f� twtNj STREET ADDRESS _ C J CITK,$jA 1� r�� FAX as 13 OWNER 1:1 OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRA ❑1CTOR (`/ 1CONfRACTOR AGENT �❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYP BUS.LIC# IAC o S`�1_U C_'1 la UJ 6,4? 0 COMPANY NAME O ii S-t YLU C?(O YJ l E-MAIL FAX STREET ADDRE ._11 1� CITY,STATE,ZIP PHONE Ok S 11§D, ARCMTECT/ENGINEE NAME � LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIPw PHONE DESCRIPTION OF WORK ' 1 . 1 '?i Z Od S EXISTING USE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA saw BATHROOM KITCHEN OTHER I !�\ REMODELAREA REMODEL AREA REMODEL AREA S I'l� 70O 060 PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLD AN ❑YES IVE TOTAiy VALUATION: NI PLANNG APPL# [I NO PLANNING APPJN.VAL LEITER E12 1E? ❑ X�5`J5 0� Q V By my signature below,I certify to each ofithe follo m I�the rpperty owner or authorized agent on the property o�nier's behalf. I haveread this application and the information I have pro; ided is ecI. I Y"`e re 'the Description of Work an erify it is accurate. I agree to comply with all appI icab]e local ordinances and state laws relating to bui ding cons tiopl. Ilauthori representatives of Cupertino to enter the above-'dentified property for inspection purposes. Signature of Applicant/Agem. , i mate: SUPPLEMENTAL FORMA 0NQ IRED riAri CHECK TYri ROUTING SLIP, , New SFD or Multifamily dwellings: Apply for demolition permit for ovER TI[EE cootvTEx ❑ BUH DING rvAiv REvtEw existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ ELrREss� ❑ riax>vvmcrLANREviEW x _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑lsTnNDain fi ❑ PUBLIcwoRxs 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 EY MAJOR ' ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTALHEALTH,, B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 1 INFINITE LOOP DATE: 04/23/2014 REVIEWED BY: MELISSA APN: 316 02 105 BP#: 61a "VALUATION: 1$50,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1TIPREP USE: PERMIT TYPE: WORK APPLE T.I. PREP INTERIOR DEMO 2,700 S.F. SCOPE LJ 1- NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc . Theseees are based on the prelimina information available and are only an estimate. Contact the Dept/or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7,-1%13FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Tenant Improvement Prep Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 $405.00 1TIP REP PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feed Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? Yes ( No $0.00 G Advanced Planning Fee: $0.00 Select a Non-Residential Q Building or Structure 0 i Strong Motion Fee: 1BSEISMICO $10.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $2.00 SUBTOTALS: $12.50 $405.00 TOTAL FEE: $417.50 Revised: 04/01/2014 s r 01 [I(;O i e,4 lei;photic: 40X— i-a_'-- R-3 I P C'ONURM SIJ BCONTR_Xil "FOR LIST 51nfiniteLoo p 1'th\4f"1 . 14060186 - - - - - .' \1[,,Apple, Inc. -�� - _1 �'i Itji [, 650-470-1540 ---- -- - �? 1- A(';01i� NOVO Construction, Inc. ls' `>I .I.�i L_!E t '�J ;I� =791022 1!,,i,',,,_,:1460 O'Brien Drive -Menlo Park, CA 94025 . i •.,S ivijwl t'. ,N: 1"4°q1R11-cs 'di i i"6 t. C'!t'. $` h ".t 0` of Qi, l,Dpertim) blosi9@oss j3t".onw. . �, st�'.w; 4�t:�,=�� f� �. ��[�Al, t�6,.-ti,i.4°��,� � 1-��>t;�..41(�.�{;�;) �*�"„it.�, ��; +�i'�-1��t�i�t°;1� 1;:�"➢��a. "tf��•. 0 i f�,�(.,�-/$ ko @$ $f�,s :w � lk. �e m ", d9 �, `. :sR .',IL1,', 'A (.I OF t 6. 111:P ; i nn.% - r 1'a)4IA, �14'aarl .�sa$�1�: t �'{ `' 1'C ACTOR 13t;,�INII'�S NAiN111, i�t)�ill�I_ '�'� t.��`t'.�`�'.-: _�� ch11i��L ;.til lex c�rl�.- � Commercial Casework, Inc. � 201 41 � , �J�� lri�:til Cupertino Electric, Inc. i <11foil ( 'trh:'flil�r Sd Flooring 881 � � Walters & Wolf Interiors 37 2 Le � 'i l ir�zli[l�! �1i-;uI'll iiJn California Drywall Co. 14: 2'0 i - — -- -- i lw� yValle""tpe� City Painting Co. 35 21 =-7 I I P!l 1's orilili t , Silicon Valley Mechanical, Inc. h, Silicon Valley Mechanical, Inc. 99X31 l i I c e,'vrtt.l's)c lo$ S�=�)Eatlse Er li to Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 1 L01. I S -11 N LOD P PERMIT# OWNER'S NAME: &30t)iks—cosiA PHONE# GENERAL CONTRACTOR: C. to NS-TCUC--i l C)0 BUSINESS LICENSE# O ADDRESS: MJ BUC t 7-7 CITY/ZIPCODE:N 1 *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 SUB71kCTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: '91,9—nature Date Please check applicable subcontractors and complete the following information: V 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 Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date