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14060074 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 2 INFINITE LOOP CONTRACTOR:ICOM MECHANICAL INC PERMIT NO: 14060074 OWNER'S NAME: APPLE COMPUTER INC 477 BURKE ST DATE ISSUED:06/13/2014 OWNER'S PHONE: 4087264479 SAN JOSE,CA 95112 PHONE NO:(408)792-2292 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL E]/ 3RD FLOOR-INSTALL(2)WATER SOURSE A/C UNITS License ClasC?J C3&—6 Lic.# fg hZ Z REPLACE EXISITNG,TIE INTO THE EXISTING Contractor C0ftDat�7. 06. /� CONDESNER PIPING SYSTEMP FOR NEW UNITS. 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$95000 ave and will maintain Worker's Compensation Insurance,as provided for by e tion 3700 of the Labor Code,for the performance of the work for which this APN Number:31602106.00 Occupancy Type: ermit 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 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 F OM LAq CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses whist ace st said City in consequence of the granting of this per dditi ally,t plicant understands and will comply Issued by: Date: with all non-poin o cc regul ion er e upertino Municipal Code,Section 9.18. RE-ROOFS: Signature Dat q=w9Is 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 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) 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. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.I2 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 u uip devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by ay ea uality Management District I performance of the work for which this permit is issued. will maintain compliance wit a Cup ti n ipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code, ons 255 5 33, d 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized age D 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 1 have read this application and state that the above information is correct.1 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 al I non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 1 nd 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 r\� M I S C CUPERTINO (408)777-3228•FAX(408)777-3333•building(acupertino.org O PLUMBING MECHANICAL ELECTRICAL MISCELLANEOUS PROJECT ADDRESS , 4' APN# 0 0 OWNERNAME , r fie- (••iN PH E w A E-M IL '/\7% ^? e I' 40 qq7j STREET ADDRESS ( t +_i✓ `�LWe CIT TA E,ZIP`T C` A O, FAX CONTACT NAME PHO E ) �l IE-MAIL /'7� lCJecS9J v �l Z 2203 en L ZOlw,wt�Caw L STREET ADDRESS '_.G� 4 CI TATE,ZIP ^ Q�" ^ F�t��. ^ q(1 f_Q ❑OWNER ❑ OWNER-BUILDER 9 0 OWNER AGENT CONTRACTOR OCONTRACTOR AGENT�J❑7 AR(CAIIECT(❑--ENGINEER 13 ❑1 TENANT CONTRACTOR NAME LICENSE NUMBER 1-2- -E 1 BUS.IA I r0c> K0COMPANY NAME t W H 0A o E-MAIL �•,,� 0k ?_12- 'N( Zy STREET ADDRESS ,STATE, IP /Y Cj I �Z �1a- ARCHITECT/ENGINEER NAME LICENSE NUMBER (Vp' BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK �- L CZ1504.A#-Lc ftg. GONA►'_ al) (-3cm tw S WLA cAE ONS ) C)AST( Gri . TIE IPTOf a+SS�+�G C SII�''cL 1� u t4 Irr. TOTAL VALUATION: RECEIVED BY: i By my signature below,I certify to each o ollowin the property owner or authorized agent to act on the,I�foperty own ' a . I have read this application and the information I have p d ed is ect. ave ad the Description of Work and verify it is accutale ee to comply with all applicable local ordinances and state laws relating to b tng con ructi . I auth rize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: 6�q16- 06- ( Z S LEME FORMATION REQUIRED OFFICE USE ONLY prW ❑ OVER-THY-COUNTER ❑ EXPRESS U ❑ STANDARD U ❑ LARGE a ❑ MAJOR MEPMiscApp 2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 2 infinite loop DATE: 06/12/2014 REVIEWED BY: Mendez APN: BP#: 'VALUATION: 1$95,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: FURN/A WORK 3rd floor- install 2 water sourse a/c units replace exisitnq, tie into the existing condesner piping SCOPE systemp for new units. Mech.Plan Check 0.0 1 hrs $0.00 Mech.PermitFee: IMPERMIT Other Mech. Insp. 0.0 hrs $47.00 Ll NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School District,etc.). Thesefees are based on the prelimina information available and are only an estimate. Contact tl:e De t or addn'l info. FEE ITEMS (l=ee Resolution II-053 E f 7.'1:73,) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # Mechanical Suppl. PC Fee: Q Reg. © OT Q.Q hrs $0.00 $417.00 A/C Units(>I OK cfm) PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. Q OT Q.Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 Administrative Fee: IADMIN $44.00 Work Without Permit? © Yes E) No $0.00 Advanced Planning;Fee: $0.00 Select a Non-Residential G Travel Documentation Fee: ITPA VDOC $47.00 Building or Structure 0 i Strong Motion Fee: IBSEISMICO $19.95 Select an Administrative Item Bldg,Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $161 .95 $417.00 TOTAL FEE: $578.95 Revised: 04101/2014