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14070109 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10500 N DE ANZA BLVD CONTRACTOR:DEVCON PERMIT NO: 14070109 CONSTRUCTION INC OWNER'S NAME: MISSION WEST PROPERTIES LP IV 690 GIBRALTAR DR DATE ISSUED:07/24/2014 OWNER'S PHONE: 4088624397 MILPITAS,CA 95035 PHONE NO:(408)942-8200 LICENSED CONTRACTOR'S DECLARATIONr BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class CA G-1 G Lic.# 3qq 1 U5 r r r Contractor -7/An/ i,4 n l,-j t MECH RESIDENTIAL COMMERCIAL �V C.GN Cc�s�l IMC, Date 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: APPLE T.T.-RECONFIGURE(E)OFFICE SPACE(9,851 (commencing with Section 7000)of Division 3 of the Business&Professions S.F.) 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. Sq.Ft Floor Area: Valuation:$500000 �Gl 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 tl>is APN Number:31622017.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that 1 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 1 YS OF IT ISSUANCE OR to building construction,and hereby authorize representatives of thus city to enter upon the above mentioned property for inspection purposes. (We)agree to save *180S ALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of thet/granting of this permit. Additionally,the ap licant understands and will comply ate: l /i V with all non-point s ulatio rt e ertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date / 2 1 All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,1 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) 1,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 1 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 Cupertillo Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections ,25- ,am 534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agent: Date: 1 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 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 1 certify that I 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 1 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 Q 1 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION O\ 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 a O CUPERTINO (408) 177-3228 • FAX(408)777-3333• buildina5cuoertino.ora ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINTAL PERMIT 44 PROJECT.ADDRESS (6506 N • '� �� g`V�j APN d' O,ANERNP.MEok.Sz' l G. G �D PHONE ` _ `wj I E-MAIL 1 h.ti Ce�t_ llyit�C W STREET ADDRESS J I r _ a CITY, Lzip [ FAX CONTACT NAVE O ZB_ 2 .�y7�� l�N�►�i� l�r�ra�ll .ieV(' STRPETADDRESS j CITY,STATE,ZIP � ,{/.� F.AX \ YV\Ta ❑ OWNER-BUILDER ❑ ONTzR AGEh((T ❑ Col.-iRACT0R ❑CON.'TRACTOR AGET T ❑ kP-C-- --CT ❑ENciP,-R ❑ DE\.LOPER ❑ TENANT CONTRACTOR N.4A,E J C� / K$� 1 Yl L ' LICENSE NUh43ERq�f 3 I LICENSE T1 L1L I BL'S.LIC +d(o lG M 1 COMPANY N.4I' E-NiAIL I FARC �i� I(w+ `Ci v(r•v��dQJr-GV(-CG.nS� tCTL� STREET ADDRESS J_`96 ��,I r�f f a v �( CITY,STATE,ZIP ,A`I A rN-G s ( �� �� �� PHONE 1106`712--A 135 0 .4RCHITECT/ENGINEEI(RJNA,\ZE 1D r LICENSE Vn-fBER 1V( t( J(J7 BUS.LIC'4 a! ;.k COMPANY NAME 1 /Kih �n E-MAIL , FAX STREET ADDRESS Rb N• •S �� CITY,STATE,ZIP S C ` PHONE 40�__ DESCRIPTION OF WORK GtX,W� O 1 A-V EXISTING USE PROPOSED USE CONSTR.TYPE =STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXLSTG NEW FLOOR DEMO TOTAL AREA AREA AREA Nrel'AREA CJ"F'"TlC.Sl� +'f -1,�5 r $C;C L BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH.AREA GARAGE AREA: LJDETACH []ATTACH 9 DV,ELLING UNITS: ISA SECOND UNIT ❑-I-Es SECOND STORY ❑YES BEING ADDED? ONO ADDITION? 0N0 - -�RE•APPI3C:AT-ION--❑l'ES--1-r-]-tS,3R0].IDEL01`'OF _1S THE BLDG AN Yr REC _ TOTAL VALUATION: PLA.MNG APPLR ❑ .NT NO PLAD\IG APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized aeent t on the property owner's behalf. this application and the information I have provid is rrect. I h ea fN Description of Work and verifj'�rat"agree to comply with all applicable local. ordinances and state laws relating to buil e r tructicn. authorize presentatives of Cupertino to enter the above-ientifi property for inspection purposes. SignatureofApp]icant/Aeent: —�� Date: �y UIRED SUPPLEMENAT -'FORMA _I T RE o- Q . ' PL1 CEIECIZTYPE ROUTZ G::�LIP ,n New SFD or Multifamily cl-wellings: Apply for demolition permit for � g \ER TAECOURTERc - - BTJIIHTi�GPL�'�RELTEPV�`"� existing building(s), Demolition permit is required prior to issuance of buildln- 4 x permit for new building. Ea.-:, _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STA nAxD }ti r s PUBLIc�voRKS,, � form if any Hazardous Materials are being used as part ofthis project. w e _Copy of Planning Approval Letter or Meeting with Planning prior to m d r Y submittal of Building Permit application. © 3 � e k,5 BldgApp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10500 N DE ANZA BLVD DATE: 07/24/2014 REVIEWED BY: MELISSA APN: 316 22 017 BP#: 149', `VALUATION: 1$500,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PENTAMATION PRIMARY USE: Commercial Building PERMIT TYPE: 1 B TA WORK APPLE T.I. - RECONFIGURE E OFFICE SPACE 9851 S.F. SCOPE 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 9,851 $4,045.68 1BTIPLNCK $9,794.17 1BTIINSP TOTALS: 9,851 $4,045.68 $9,794.17 MECH,HOURLY 0 Yes (E) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes Q No Li Ll 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 De t or addn'l info. FEE ITEMS (/-,cc Resolution 11-053 Elf "l"l_l) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,045.68 Select a Misc Bldg/Structure hrs $0.00 or Element of a Building Suppl. PC Fe e: 0 Reg. 0 OTTO.0 PME Plan Check: $0.00 Permit Fee: $9,794.17 Suppl. Insp. Fee:Q Reg. Q OT TO.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes Q No $0.00 Advanced Planninw l=ee.. $0.00 Select a Non-Residential G Building or Structure Stron l Motion Fee: 1BSE1SM/C0 $140.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $20.00 SUBTOTALS: 13,999.85 $0.00 TOTAL FEE: $13,999.85 Revised: 07/10/2014 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: 165o0 t,)• fir A -.j z.A} PERMIT# 144 01 0 i 09 OWNER'S NAME: V>l.a IN G _ PHONE# GENERAL CONTRACTOR: 1�U&0^ CvAs+i (t4G, BUSINESS LICENSE# t 10(08 ADDRESS: (090 C71b1(al}x✓ or. CITY/ZIPCODE: M,,j .frS (,+ 85035 `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 CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork WI,, Cement Finishing N /A- Electrical Nwac Excavation Fencing N Flooring/Carpeting (2-1E C Aj ie Linoleum /Wood r1/A- Glass/ Glazing t f ,4 Heating GCA Insulation VXVM Landscaping of A, Lathing tj Masonry N Painting/Wallpaper C4.0 F'a; Paving til/Ar Plastering Plumbing Roofing N J Septic Tank 1� Sheet Metal Sheet Rock M v %#yri Ur-twr-ll ) 1 mac... Tile nl C 4caner/Cont c r Signature Date HAZARDOUS MATERIALS CHECKLIST 10 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333• building ftupertino.orq PURPOSE To minimize possible delays that would result for the Fire Department plan review, please complete the following checklist to determine if an additional level of Hazardous Materials plan review will be required. MARK 'YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING? PLEASE MARK YOUR ANSWER WITH AN 'X' IN THE YES OR NO BOX ON THE SIDE YES NO BELOW. 1. Use, dispensing, mixing or storage of flammable or combustible liquids or gases, hazardous materials, etc. 2. Battery back-up rooms or racks. 3. Propane tanks. 4. Gasoline stations with underground tanks. 5. Installation or replacement above ground or underground storage of liquid petroleum products, liquefied petroleum gases, compressed natural gas, explosives or other regulated hazardous materials. 6. Gas rooms for dentist, doctors or veterinarians. 7. Generators with back-up diesel or other fuels. 8. Large refrigeration systems. 9. Fuel cell systems. 10. Commercial pool systems. 11. Chemical Storage areas. 12. Flammable liquid storage. 13. Compressed Gases. 14. Dry cleaners. 15. Print Shops. 16, Auto Repair and Auto Body Shops. 17. Research and Development. For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa Clara County Fire Department, at(408)378-4010. HasMat 201T doe revised 03/07/11 DEVCON CONSTRUCTION INCORPORATED 690 Gibraltar Drive Milpitas,CA 95035 ■ 111 Phone:(408)712-9856 License#399163 7/15/14 DA03.2—Comms T.1. 10500 N. De Anza Blvd. Cupertino, CA 95014 To: City of Cupertino Building Department Re: DA03.4 Comms T.I.Accessibility Details To whom it may concern, Our office authorizes the use of accessibility-related drawings sheets At2.1A through AT9.1 for use as "Record Only"to support documentation for this project. Thanks, Kevin Irwin I Project Engineer Devcon Construction,Inc. kirwin@devcon-const.com • APP25-03 Comms T.I. Project Apple, Inc. July 15, 2014 RE: APP25 DA-03 Comms T.I. Project To whom it may concern, Our office authorizes the use of the Site Accessibility related drawings for use as"For Reference Only" support documentation for this project. Sincerely, KIER&WRIG T n Carrera, Project Manager KIER&WRIGHT CIVIL ENGINEERS&SURVEYORS,INC. 3350 Scott Boulevard,Bldg.22•Santa Clara,California 95054.408-727-6665.408-727-5641 1-