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14030038CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20705 VALLEY GREEN DR CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 14030038 OWNER'S NAME: APPLE INC 1460 O'BRIEN DR DATE ISSUED: 03/05/2014 OWNER'S PHONE: 4153105791 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL APPLE- EAST SIDE OF IST FLOOR- REMOVAL OF License Class Lic. # i EXISTING OFFICE SPACE RELOCATE LIGHT FIXTURES ' Contracto�� � /V�%D'�(„��"7�'"""Date �''G� / I herebAa m that I am licensed under the provisions of hapter 9 (com nnfe` cing 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 Sq. Ft Floor Area: Valuation: $20000 performance of the work for which this permit is issued. 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: 32610046.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRISS IF WORK IS NOT STARTED correct I agree to comply with a!I city and county ordinances and state laws relating WITHIN 10 DAY' OF PERMIT ISSUANCE OR Y P ) to nnpectionrpur 180 OM. iz�ST CALLED upon ontthenabovesmentioned property for purposes. (We) agree to saver p p p ry p p p indemnify and keep harmless the City of Cupertino against liabilities, judgments, DAYS F&ON% INSP4TION. a' costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply Issued by:—�Date: with all non -point source regulations per the Cupertino Municipal Code, Section .....m-... RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If roof is . /r �g ��" ,� Date ` � d � Signat _ installed without first obtaining an inspection, I agree to remove all new materials for inspection. ET7 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) 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. 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(x) should I store or handle hazardous [ 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, gpd 25 4. r Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized agent _ f 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, 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 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 ARCHITECT'S DECLARATION' indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building oDcupertino.org CUPERTINO ❑ NEW CONSTRUCTION ❑ ADDITION KIALTERATION / TI ❑ REVISION /DEFERRED PROJECT ADDRESSn O 4 T-- APN 4.�� JC) . OWNER NAME PP PHONE y lz) E-MAIL IL STREET ADDRESS C , STATE, ZIP FAX CONTACT NAME j GOi3 V V ►� l C� ONE (p �t/ ` ' " E-MAIL S4r✓ cw� "A. STREET ADDRESS CITY, STATE, ZIP FAX O b 02r 6✓ ,oE cwt co Z ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHiTECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BU LIC N 0 7 - COMPANY IJAW E-MAIL FAX /IG/ 6n/f Ir r, �mN STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS, LIC N COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EX[STINGUSE PROPOSED USE CONSTR. TYPE 11 STORIES I I -,J USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAqLREq AREA�p l r9 AREA 20 1 5 `� l S _ NET , 14;. 13 111 " 6 BATHROOM KITCHEN KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA AREA GARAGE AREA: DETACH 7TUTECK/PORCH ❑ ATTACH 9 DWELLING UMTS: IS A SECOND UNrr ❑ YES SECOND STORY ❑ YES -- -- •, BEING ADDED? ❑NO ADDrrION? ❑NO -- PRE -APPLICATION OYES IF YES, PROVIDE COPY OF PLANNING APPL0 ❑NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? ❑NO z RgCE�I VEL> 'i'"'(I 1512"',`�"iiGr'f1��10�� i �������"� ,� � �"�y; TOTAL V UATION: c.> By my signature below, I certify to each ofthe following: I am the property owner or authorized agent to act on the property owner's behalf. I )&ve read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construc ' . I a rize resent4obs of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: -?/—S SUPPLE AL INFORMATION REQUIRED _New SFD or Mul6amily dwellings: Apply for demolition permit for building(s). Demolition is required to issuance of building ��4%�d�;�� t m° f �"" IIIS� ( � 0 t / �' `"U i�� y i �' ✓���f � � A �, existing permit prior permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. U _ Copy of Planning Approval Letter or Meeting with.Planning prior to submittal of Building Permit application. BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FM -7 FEE ESTIMATOR - BUILDING DIVISION baADDRESS: 20705 VALLEY GREEN DR DATE: 03/05/2014 REVIEWED BY: MENDEZ APN: BP#: 3 "VALUATION: 1$20,000 PERMIT TYPE: Building PermitP AN CHECK TYPE: Tenant Improvement PRIMARY Commercial BuildingT USE: 0.0 PENTAMATION 1 GENCOM PERMIT TYPE: WORK APPLE- EAST SIDE OF 1ST FLOOR- REMOVAL OF EXISTING OFFICE SPACE RELOCATE LIGHT SCOPE FIXTURES NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School nicirirt air ) Thaco foac nro hncod nn tho nroliminary infnrmnlinn avn//ahlo and aro nnly nn octimato_ ('nntnN tho non/ far nddn'l ;"in - FEE ITEMS (Fee Resolution II -053 Eff 7%1%13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? C) Yes (F) No $0.00 2 hours $278.00 Plan Check, Hourly ISTPLNCK Supp/. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PN/[E Plan Check: $0.00 Permit Fee: Hourly Only? C) Yes 0 No $0.00 Supp/. Insp. Fee:Q Reg. Q OT 1 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? © Yes Q No $0.00 Advanced Planning F'ee: $0.00 Select a Non -Residential E) Building or Structure 0 A Strong Motion Fee: IBSEISMICO $4.20 5.0 hrs $695.00 Inspections ISTINSP Inspection, Hourly Bldg; S'tds Commission Fee: IBCBSC $1.00 SUBTOTALS: $5.20 $973.00 _ TOTAL FEE: 1 $978.20 Revised: 01/15/2014 20705 Valley Green Drive 14030038 Apple, Inc650 -847-8912 j Novo Construction 791022 T' 1460 O'Brien Ave :Menlo Park/94025 ,fo ''I, �p'd rod(" BPS sr, iO c4 ff J.r' '80 (3f - .(pu� kM c oo" I'A' HH' 'O 4 Dak J Cupertino Electric. Inc SD Flooring Magnum Drywall and Paint u n l I���f — - -- — — _ — _ ,I United Mechanical, Inc. Wh"' Jacob White 03/26/2014 DN: cn.=Jamb Wi,t� n. oi. DMe 2014 G3.2h I ?,: l ;19-07'.70'