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13120043 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10710 N TANTAU AVE CONTRACTOR:DPR SKANSKA,A JOINT PERMIT NO: 13120043 VENTURE OWNER'S NAME: CAMPUS HOLDINGS INC 1450 VETERANS BLVD DATE ISSUED: 12/06/2013 OWNER'S PHONE: 4089961010 REDWOOD CITY,CA 94063 PHONE NO:(650)474-1450 ❑ LICENSED CONTRACTOR'S DECLARATION r r '— �-�^ BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class_ Lic.# 9 bG)or r r nn MECH RESIDENTIAL COMMERCIAL Contractor 0M Date I Z,/66/13 I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:APPLE-COMM.T.1 TEMPORARY BUILDING TO INCLUDE (commencing with Section 7000)of Division 3 of the Business&Professions M,E,BATHROOM 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 erformance 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 Sq.Ft Floor Area: Valuation:$175000 permit is issued. APPLICANT CERTIFICATION APN Number:31609028.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 77 SignatureQ:21 Date t Z/b 3 Issued by: Date: ❑ OWNER-BUILDER DECLARATION RF.-ROOFS: I hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1,as owner of the property,or my employees with wages as their sole compensation, inspection. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7D44,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under pmalty of perjury one of the following three declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined b the Ba Area Air y y Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534. Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must O`0K 0r�z�tj1 rized agent: / forthwith comply with such provisions or this permit shall be deemed revoked. Date: ZI (G/13 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes.(We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date Licensed Professional i CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 � op �3 J CUPERTINO (408)777-3228• FAX(408)777-3333•building(&cupertino.org 1� EW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS APN N o�l ►o �T�k�A ikv.e X11,'OCl-C OWNER NAME PHONE E-MAIL STREET ADDRESS CI Y, STATE,ZIP n., FAX G� 2'�-;� CA ISDI CONTACT NAME PHONE E-MAIL IiAI L� STREET'ADDROS CITY,STATE, ZIP FAX L L MS - ilC2 _0_rzt,NC C S01 WNER 0 OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT li CONTRACTOR NANEELICENSE NUMBER LICENSE TYPE BUS.LIC d AMPANY NAME E-MAIL FAX STREET ADDRESS CITY, TATE,ZIP PHONE ii Zi elf, �14t3 --,)Cl -- 1,-J ,, ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC k C PAN'NAME Gol IN- E-MAIL FAX �M- ST ITAD ESS CITY,STATE,ZIP P ONE wr DESCRIPTION OF WORK I 114 A N EXISTING USE PROPOSED USE CONSTR.TYPE 9STORIES USE TYPE OCC. SQ.Fr. VALUATION($) EXIS'IG NEW FLOOR DEMO TOTAL AREA AREA io x% AREA NET AREA ya BATHRO KITCHEN V OTHER REMODEL AREA `"'jL REMODEL AREA REMODEL AREA,= PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH 3t []ATTACH dDWELL GUNITS: IS A SECOND UNIT YES SECO DSTORY []YES BEING ADDED? NDf N0 ADDITION? 0 PRE-APPLI ATION ❑YES IF YES,PROVIDE COPY .00F� IS THE BLDG AN ❑YES RECE TOTAL VALUATION: PLANNINGAPPL'A [:]NO PLANNING.APPROVAL LETTER EICHLER HOME? tWO By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the properly owner's behalf. 1 have read this application and the information I have provided is correct, I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and Slate laws relatin�rdllg uction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of AppIkent/Agent,_ Date:V 2-Zm SUPPLEMENTAL INF [ON REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of buildingR-THF.-COUNTER PLAN REVIEW BUILDING permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUR Ic 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_201 Ldoc revised 06/21/1! i CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10710 n tantau DATE: 12/04/2013 REVIEWED BY: Mendez APN: ' a BP#: j/-�, 'VALUATION: 1$175,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1 B TI 1 USE: I PERMIT TYPE: WORK a le- comm. t.i temporary building to include M E bathroom SCOPE .. OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. 8 (Tenant Improvements) II-B,111-B,IV,V-B 10,458 $2,650.70 IBTIPLNCK $6,556.70 IBTIINSP TOTALS: 10,458 $2,650.70 $6,556.70 MECH,HOURLY 0 Yes � No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes (E)No 2r°;a i lsE;-G, . l'lun C'hec�k Flrc�. Plan Check anech. Permit FeePlumb. Permit Fee clef.. Permit Fec. Other Alech.Insp- D--t- Other Plumb Ins/. L,; r Elee.Insp. Li Alech.Imp.Fee: Plumb. hrsp. Fee: Elec.Insp.Free NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works, Fire,Sanitary Sewer District,School District,eta). These ees are based on the relimina in ormation available and are onl an estimate. Contact the Det or addn'I in o. FEE ITEMS (Fee Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,650.70 Select a Misc Bldg/Structure Suppl. PC Fee: (F) Reg. 0 OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $6,556.70 Suppl. Insp.Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: 77 $0.00 Construction Tax: A(ltninistrative Fee Work Without Permit? 0 Yes (F) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential Q Travel/?r!� tutiarr Fees: Building or Structure i Strong Motion Fee: 1BSEISMIC0 $36.75 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $7.00 SUBTOTALS: $9,251.15 $0.00 TOTAL FEE-.T $9,251.15 Revised: 10/01/2013 ..tea. I Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST i JOB ADDRESS: AU o %'qnr— �/ �✓i,= PERMIT# OWNER'S NAME: d PHONE# Dg• to • C,7& 9 GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS:/-V 1/f ,6,ne ,i CITY/ZIPCODE: oo t G.4 *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 LOCENSE. I am not using any subcontractors: j Signature Date i Please check applicable subcontractors and complete the following information: V SUBC NTRACTOR BUSINESS NAME BUSINESS LICENSE # i Cabineis & Millwork i Ceme Finishing J Electri al Excav ition Fencing Floori g/ Carpeting Linole6m/ Wood I Glass /1 Glazing Heating Insulation Landscaping ?' i Lathing Masonry Painting /Wallpapers ,. Paving Plastering Plumbing Roofing t Septic Tank Sheet Metal ; Sheet Rock Tile 1� Owner/Co for Signature Date i i Permit ► ' 4 File Edit Actions Details Links Favorites Help .._.....___ _ __ ------- _____a...... _._ D ��T X A st wa 40 Permit Information - - Location Information Permit Number x 13120043 Address 10� 710 N TANTAU AVE µ Status' City/State/Zip CUPE.RTINO (CA 195014 _ E Master Number `- �� Notes APN 31509028.00 r Project ISI �-��Unit E Apply Date' !12/0412013 Operator !SylviaM Owner Entity Information - Permit Issue Date 1210612013 Operator suety m _ . �0� _ _ _ Ov�mer Name` C4MPUS HOLDINGS INC Certificate Issued 0311012014 Operator ! Use Default El Certificate Type CC CERTIFICATE OF COMPL _ _ Address Business-1 INFINITE LOOP PAS 36-2TX v Certificate Number City/State/Zip CUPERTINO FcAl 9501- 4� PermitProperty Zoning Applicant Contractor i Defined Fields Permit Details _ Purpose/Special Conditions Permit Type 1B TI APPLE- COMM_ T.I TEMPORARY BUILDING TO II4CLUDE M,E, "T TENANT IMPROVEMENT ---'— BATHROOM TIan Usage Class x 111111 111111 B,IV-HT.V B NEW ; T_2 FRfiF 1x110063 Applied Value.' f1750D0 I 41� SQUARE FT. 10458 . Calculated Value 0 US C-404 Type 437 (ALT NON-RES,NON HSKPG Permit Form x AUTOPERM-PERMIT FILE/FLANS IN BOXES IN FLEA ROOM FOR MARCH 2014 Ownership Project Size ICOUNTER -OVER THE COUNTERAdd Default Text Permit.issued 12J0612013 Enter permit status AC- 4LEAF, INC. 2110 Rheem Drive,Suite A ENGINEERING.CONSTP.UCTION IJIANAGENENT Pleasanton,CA 94588 aUILOING INSPECTION.PLAN CME--K Phone(925)462-5959 Fax (925)462-5958 Inspection Report 4LEAF Report No.: AC-Tantau 6-012-- Facility Name and Address Cupertino Permit# DateMme Apple Campus 2 Project 13120043 3/10/2014 3:00 PM 10710 Tantau Ave,Cupertino,CA 95014 Assessors Parcel Number(APN) 4LEAF Project No. 316-09-028 J1848 Contractor Location DPRS Building/Site Sitework Zone Level/Floor Gridline Scope of inspection Project inspector ` CSi 01-General Requirements Signature: Scope Final Building ' Type Name: Chris Fowler Inspection Type: 516-Building Final U Inspection: Reinspection: Inspection Inspections and Observations: Result Pass as Noted Pass Tenant Improvement wotk for interior modifications has been installed as per amended contract documents. Note:This inspection included approval from SCFD for occupancy. 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: 'rr `, / PERMIT# OWNER'S NAME: PHONE # .. GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: CITY./ZIPCODE: ,. '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 # i? Cabinets & Millwork Cement Finishing Electrical C EJ F (-L[�,�{�..b C =}, Excavation Fencing Flooring/Carpeting Linoleum/ Wood Glass/ Glazing Heating -7 y tl Insulation Landscaping Lathing Masonry Painting/Wallpaper (� Paving Plastering Plumbing I Roofing Septic Tank Sheet Metal Sheet Rock Tile la . Owner/Co for Signature Date 4LEAF, INC. 2110 Rheem Drive, Suite A ENGINFVRiING•CONSTRUCTION MANAGEMENT Pleasanton, CA 94588 BUILDING INSPECTION•PLAN CHECK Phone(925) 462-5959 Fax (925) 462-5958 Field Observation Report 4LEAF Report No.: Tantau 6-001 Facility Name and Address Cupertino Permit# Date Apple Campus Project 13120043 F January 9, 2014 10710 North Tantau Application Number 4LEAF Project No. Cupertino, CA 95014 NA Contractor Project Document Status DPRS Addendums submitted Approved ASI's/Bulletins submitted Approved Field Change Dir. Approved RFI's Change Orders submitted Approved Title or Scope of Project Inspector of Record Tantau-6- 305 Frame-Rough/304 Electrical-Rough Christopher Fowler Framing, Drywall, and Rough Electrical in walls only. (925)453-1992 Weather: cfowler@41eafinc.com Inspections and Observations: Inspection Hours: Pass-AS noted: see. A-0.2, A-2.1, A3.1 and D-2 details. rid-line 3 partial height partition including e/f line, F/g line and full height F/g line 2.5 to 3.5 are framed as per contract documents, In wall electrical including MC cable and boxes (metal) are installed as per contract documents. 1/2 inch drywall is installed as per contract documents. Note: Discussed with contractor the need to obtain approval for the hanging walls above ceiling and the need to remove abandoned cables above ceiling. Materials: Visitors: Page_of