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14050110 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19925 STEVENS CREEK BLVD CONTRACTOR:NOVO CONSTRUCTION PERMIT NO: 14050110 OWNER'S NAME: STEVENS CREEK 1NVRS LLC 1460 O'BRIEN DR DATE ISSUED:06/27/2014 OWNER'S PHONE: 4084990223 MENLO PARK,CA 94025 PHONE NO:(650)701-1500 ci LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL APPLE T.I. - RECONFIGURATION TO INCLUDE INTERIOR License Class Lic.# �� JZ Z WALLS,FIXTURES& EQUIPMENT (42,355 S.F.) ContractorAjCVG C0�1SFvv�%��0,1Date �y 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. 1 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:$1300000 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:31621089.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 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 FROM ED 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 / granting of this permit. Additionally,the applicant understands and will comply Y: ate: Z with all non-point source regulation per the Cupertino Municipal Code,Sectio 9.18. �� -ROOFS: Signature Date All roofs shall be inspecte 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 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 I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 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 I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533 4n 25534. Section 3700 of the Labor Code,for the performance of the work for which this Z7 A'I Owner or authorized agent: UV �'�- Date: l 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,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions ofthe 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. Signature Date l � CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTINO �v (408)777-3228• FAX(408)777-3333•buddincy2cupertlno orq \ ❑NEW CONSTRUCTION ❑ ADDITION EeALTERA"I ION TI ❑ REVISION/DEFERRED ORIGINAL PERMIT,' PROJECT ADDRESS 19925 Stevens Creek Blvd. Cupertino CA 95014 APN# - 16 — 4 Q OWNER NAME Apple Inc. `��+`$ HONE 408-499-0223 EntA1L tina@thvec regroup.comq STREET ADDRESS 1 Infinite Loop CITY, STA HE_ZIP Cupertino, CA. 95014 F,AX CONIrACr NAMF Carla Fierros PHONE 650-380-8624 E-MAIL cfierros@novoconstruction.com STREET ADDRESS 1460 O'Brien Dt CITY STATE, ZIP FAX Menlo Park, CA 94025 ❑OWNER ❑ OWNFR-BUILDER ❑ OWNER AGENT C'ONTRAC'TOR ❑C'ONTRAC'TOR AGENT ❑ ARCHITECT ❑ENGINFER ❑ DEVELOPFR ❑-TENANT CONTRACTOR NAME B Carla Fierros 791022 LICENSE NUMBER LICENSE FYPF. BUS LIC U COMPANY NAME .E-MAILFAX Novo Construction cfierros@novoconstruction.com STREET ADDRESS 1460 O'Brien Dr. CITY,STA IE,ZIP Menlo Park, CA 94025 PHONE 650-380-8624 ARCHITECT/ENGINEER NAME Kaileen Yen LICENSE NUMBER C-015925 BLS LIC COMPANY NAME Studios Architecture EMAIL kyen@studios.com FAX STREET ADDRESS 405 Howard St, Suite 488 CITY,STATE.ZIP San Francisco, CA, 94105 PHONE 415-398-7575 DESCRIPTION of WORK Interior demolition work is under a separate permit. Renovation to include new interior wall construction, finishes, equipment and fixtures for offices,conference rooms, restrooms and break room. No exterior work,tree removal, landscape, or roof top equipment is submitted as part of this permit.No change of use or additional office space is submitted as part of this permit. EXISTING USE PROPOSED USE CONSTR TYPE #STORIES Type III-B 2 USE TYPE orc. sQ.Fr. TI I, EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETARE.A42,355 SF III-B 42,355 SF $1,300,000.00 BATHROOM KITCHEN OTHER REMODELARE.A REMODEL.AREA REMODEL AREA PORCH AREADECK AREA TOTAL.DECKIPORCH.AREA GARAGE AREA: DETACH ATTACH F DAVELLING UNITS ISA SECOND UNIT '0YF SECOND STORY OYES BEING ADDED? ONO ADDITION? ONO PRE-APPLI('ATION OYES IF YES.PROVIDE COPY OF IS THE BLDG AN ❑YES E TOTAL VALUATION: PLANNINGAPPL# ONO PLANNING.APPROVAL LETTER EICHLER HOME? $1,300,000.00 By my signature below.I certify to each of the following [am the property owner or authorizedto act on theo y owner's behalf [have read this application and the information I have provided is correct. I have read the Description of Work and verify it is< ur I agree to conlpk With all applicable local ordinances and state laws relating to budding const action. I authorize representatives of Cupertino to enter t Ove-identified property for inspection purposes- SignatureofApplicant/Agent- y Date' �'-� SUPPLEMENTAL.INFOR TION REQUIRED PLAN CHECK TYPE ROUTING SLIP 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. GAXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS 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_20/1.doc revised 06'2/7/ CITY OF CUPERTINO MaAPNFEE ESTIMATOR- BUILDING DIVISION : DDRESS: 19925 STEVENS CREEK BLVD DATE: 05/19/2014 REVIEWED BY: MLEISSA 316 21 089 BP#: 'VALUATION: 1$1,300,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTANIATION 1 B TI USE: PERMIT TYPE: WORK APPLE T.I. - RECONFIGURATION TO INCLUDE INTERIOR WALLS FIXTURES & EQUIPMENT SCOPE (42,355 S.F.) OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B (Tenant Improvements) II-B,111-B,IV,V-B 42,355 $4,675.48 IBTIPLNCK $16,603.84 IBTIINSP TOTALS: 42,355 $4,675.48 $16,603.84 MECH,HOURLY Yes (j) No PLUMB,HOURLY Q Yes (F) No ELEC,HOURLY Q Yes 0 No 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 (Fee Resolution II-053 Ef* ?i1%73) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,675.48 Select a Misc Bldg/Structure Supp/. PC Fee: ) Reg. 0 OT0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $16,603.84 Suppl. Insp. Feer Reg. Q OT 70.0 Fhrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes E) No $0.00 ID Advanced Planning Fee: $0.00 Select a Non-Residential 0 Building or Structure i Strong Motion Fee: IBSEISMICO $273.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $52.00 SUBTOTALS: 21,604.32 $0.00 TOTAL FEE: $21,604.32 Revised: 04/01/2014 COURTESY INSPECTION REQUEST FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISICN ALBERT SALVADOR,P.E.,C.B.O.,BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CLJPERTINO (408)777-3228•FAX(408)777.3333 buildin c(D'.Cuportino.oro SITE ` BUILDING APPLICATION 11: DATES BMITTED: ADDRESS:/p ft.'r j�Q✓!°nS ��'�1� �I'/�" 2� 1� APN TI PREPARATION BUILDING PERMIT 4 14050110 OWNER'S AMF: PHONE#' f ✓e"I r t'JJV f-.( L-L C- FAX#: 410e- tf qq-0 2. 73 MAILING ADDRESS(if different from site address): CONTRACTOR: ./ PHONE#: fp - D 1�'n✓p �►1��ra(L`�ra''` FAX#: CONTACT: PHONE �gv11 rf FAX#: LIMITS OF'WORK REQUESTED FOR COURTESY INSPECTIONS: ( s ►' e.4— rc riK --— P_'qxot 1-6y ec / Ge y— "t`c."J '6P Kg� I request to start construction work in which a building permit has not been completely secured. I have obtained a tenant improvement preparation permit if the scope covers the removal of interior non-structural efernents within the building. I have submitted a building permit application and plans for the tenant improvement project and It is currently in the plan review process. I agree to call for courtesy inspections for the llmited work as noted on this application. I fully understand that I will be responsible to redo the work performed under courtesy inspections if the work d es not fuliy_comply with the aperoved set off�p1plans and all State and local rules and re regulations. OwOwII n Print:....t.1�Pl..,r!(?Q .....................................Date:...41.:.ci.7.:.ALt. ............................................Print....7Fg..✓ f... Date:... AY..... - OFFICE USE ONLY- Ttte Request IS: GRANTEE) DENIED 9 Bld Official/Inspector:......................................................................Date:......................... ...... � � INSPECTION RESULTS INSPECTION TYPE INSP.DATE TIME -RESULTS INSP• CpMMENTS(REASON IF INSPECTION FAILED) SPENT INIT. Cly /54r 47 1 all, lie O "RESULTS: P-Pass,F-Fail,C-Cancel,I-Incomplete,N-Not Required,R-To be Rescheduled Cow•tesylnspForrn-2DI1.doc revised D3114112