14090004 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10355 N DE ANZA BLVD CONTRACTOR:DEVCON PERMIT NO: 14090004
CONSTRUCTION INC
OWNER'S NAME: VIDOVICH-CUPERTINO LIMITED PARTNERS 690 GIBRALTAR DR DATE ISSUED:09/02/2014
OWNER'S PHONE: 4087384444 MILPITAS,CA 95035 PHONE NO:(408)942-8200
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
APPLE-T.I.-INSTALL 3(N)UNISEX RESTROOMS
License Class___ ,� Lic.# 349/63
Contractor&✓Loh CaVJ<wc✓v 'r4 0 Date—q A
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
operformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$98500
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this APN Number:32633113.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 1811$�CY�OF RMIT 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 {1 DAYS F T CALLED INSPEC 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 /
granting of this permit. Additionally,the applicant understands and will comply >s ued by: Date:
with all non-point s gulations per the Cupertino Municipal Code,Section
9.18.
�
j RE-ROOFS:
Signature ` J'— Date / L 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
I,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). 1 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 9.12 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 I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation hnsurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this c
Owner or authorized agent: Date: / G
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 1 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.
Signature Date
CONSTRUCTION PERMIT APPLICATION �D
is COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION o�O
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �P
CUPERTINO (408)777-3228• FAX(408)777-3333•building(a)cupertino.org \
❑NEW CONSTRUCTION ❑ ADDITION ® ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS 10355 N. De Anza Blvd APN#326-33-113
OWNER NAME V/0_10 Vi • Pli E E-MAIL
De Anza Propertie v �►�a G� 0 738-4444
STREET ADDRESS 960 N. San Antonio RD#114 CITY, STATE,ZIP Los Altos CA 94022 FAX
CONTACT NAME Sylvester Ramirez 408-519-8372 PHONE E-MAILsramireZ p@devcon-const.com
_7STREET ADDRESS 690 Gibraltar Drive CITY,STATE,ZIP Milpitas, CA, 95035 FAx408-946-5513
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT Iq CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENAN-1
CONTRACTOR NAME DEVCCIN Construction LICENSE NUMBER
3991 63 LICENSE TYPE BUS.LIC#
COMPANY NAME DEVCCIN Construction E-MAIL sramireZ devcon-const.com FAX408-946-7713
STREETADDRESS690 Gibraltar Drive CITY,STATE,ZIP Milpitas, CA, 95035 PHONE 408-519-8372
ARCHITECT/ENGINEER NAME Brent Downing LICENSE NIJMBERC-32444 BUS.LIC#
COMPANY NAME E-MAIL l' L FAX
DEVCCIN Construction bdownin devcon-const.com 408-942-7713
STREETADDRESS690 Gibraltar Drive CITY,STATE.ZIP Milpitas, CA, 95035 PHONE 408-942-8200
DESCRIPTION OF woRK Add 3 unisex restrooms, with Elect, Mech & Plumbing
EXISTING USE PROPOSED USE B CONSTR.TYPE #STORIES
B B V-a 1 USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA 98,500.00
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
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 BLDG AN ❑YES
PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO v SO D
By my signature below,I certify to each of the following: I am the prop wn of agent t ct on th erty owner's behalf. I have read this
application and the information I have provi is correct. I have read 'cription of Work and verccurate. I agree to comply with all applicable local
ordinances and state laws relating ing constr ction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: 8/27/14
SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUPINGSLIP
New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PumcwoRKs
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 HEALTH
BldgApp 2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
WPERMIT
DDRESS: 10355 n de anza blvd DATE: 09/02/2014 REVIEWED BY: melissa
PN: 326 33 113 BP#: �ejD 'VALUATION: $98,500
PE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY PENTAMATION
USE: Commercial Building PERMIT TYPE: 1 B TA
WORK APPLE - T.I. - INSTALL 3 N UNISEX RESTROOMS
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE 1D BP FEES BP FEE ID
CONSTR. s.L
B (Tenant Improvements) II-B,III-B,IV,V-B 270 $2,097.00 IBTIPLNCK $588.00 1BTIINSP
TOTALS: 270 $2,097.00 $588.00
MECH,HOURLY 0 Yes 0 No PLUMB,HOURLY 0 Yes 0 No ELEC,HOURLY 0 Yes r)No
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 on an estimate. Contact the Dept/or addn'l in o.
FEE ITEMS (Fee Rcsolution II-05.3 Ell,' ?II 'L3/ FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,097.00 Select a Misc Bldg/Structure
Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $588.00
Suppl. hasp. Fee:Q Reg. 0 OT0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
0
Work Without Permit? 0 Yes 0 No $0.00 0
Advanced Plannin- Fee: $0.00 Select a Non-Residential 0
Building or Structure 0
i
Strom Motion Fee: IBSEISMICO $27.58 Select an Administrative Item
Bldg, Stds Commission Fee: IBCBSC $4.00
SUBTOTALS: $2,716.58 $0.00 TOTAL FEE: $2,716.58
Revised: 08120/2014
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rocbnn Inc,o0 Kevin Irwin emai=kininCdevcon-onst.com,c=US 10/22/2014
Dale.2014 10 22 11 13:50-07'00'
5)ail
Subject: Commercial Remodel/Addition-Approved
Name: Apple Inc—DA 06
Address: 10355 North De Anza Blvd, Cupertino
APN: 326-33-113
Permit No. N/A
Storm water from surface or roof drains, other general surface runoff water shall not be discharged to
the sanitary sewer.
All conditions, requirements and recommendations are to be completed at the
(owner/developer)'s expense.
Yours very truly,
MARK THOMAS &COMPANY, INC.
District Manager-Engineer
AforRichard . Tanaka
If you have any questions or need additional information,please call Thanh Nguyen at 408-
253-7071.
U:'Administration('on-espondence-General Letlers'%2014'Letter#14-334 C'upcitino Building Depaitmmnl_Permil No N A Apple Inc DA
0610355 North De An/.a Blvd Cupeitino-08-28-2014.doc
SUPPLYING SANITARY SEWERAGE SERVICES FOR:CITY OF CUPERTINO,PORTIONS OF THE CITIES OF SARATOGA,SUNNYVALE,LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS