13080006 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10500 N DE ANZA BLVD CONTRACTOR:DEVCON PERMIT NO: 13080006
CONSTRUCTION INC
OWNER'S NAME: MISSION WEST PROPERTIES LP IV 690 GIBRALTAR DR DATE ISSUED:08/01/2013
OWNE 'S PHONE: 4088624575 MILPITAS,CA 95035 PHONE NO:(408)942-8200
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIALE]
License Class__ Lic.# , �� ,j (APPLE) T.I. FOR HUB OFFICE ADDITION
Contractor A�Q Y[0&4, Date
I hereby affirm that I am licensed under the provisions C pter 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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$40000
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:31622017.00 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.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 FR LED INSPECTI N.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the 3
granting of this permit. Additionally,the applicant understands and will comply mat
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date ! 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
1 hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
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). 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
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2550 55 5534.
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,l 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 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
1 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
o�
CONSTRUCTION PERMIT APPLICATION Od
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
C U P E RTI N O (408)777-3228• FAX(408)777-3333•building a�cupertino.org \
❑NEW CONSTRUCTION ❑ ADDITION LJ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS ' T77-3
`I 6 ' vnL
OWNER NAME ��I t �^G. �I S fl9 A PHO'N-E O SC y EMAIL (Jl
STREET ADDRESS CITY, STATE,ZIP FAX
CONTACT NAME ^ D` PHONE ,1 E-MAIL
o �henr � � le. cam-
STREET ADDRESS ` CTIY,STATE, ZIP
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT VIONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
ONTRACTORNAM ,Q S1`n LICENSE NUMBER LICENSE TYPE BUS.LIC M
V� "
COMPANY NAME FAX
!'fey ccvv Cn,nbk. E-MAIL r to b% ` n ^��yCD� ^ O�S� . `Q 0^
STREET ADDRESS (o -1 d ,lora I� C)r CIN,STATE,- `IP ` ` PHONE ,
12
ARCHITECT/ENGiNEER NAME ` LICENSE NUMBER BUS.LIC 0
COMPANY NAME &MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DFSCOFTION OF ORK
EXISTING PROPOSED USE CONSTR.TYPE p STORIES
USE TYPE OCC. SQ.fl'. VALUATION(S)
R �� NEW FIAO� DEMO AL
AREA AREA AREA
AREA 3 ' ?
BATHROOM KITCHEN OTHER
REM ODELAREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECIUPORCH AREA GARAGE AREA:. DETACH
❑ATTACH
p DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? ONO ADDITION? ❑NO
PRE-APPLICATION [:]YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES REC TOT VALUATION:
PLANNING APPL# []NO PLANNING APPROVAL LEITER EICHLER HOME? []NO .d/4011606
By my signature below,I certify to each of the following: I am the property owner or authorized agent ton the property owner's behalf. I have 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 construction. Lives of Cupertino to enter the above-i7
tified roperty for inspection purposes.
Signature of Applicant/Agent: Date: 1
SUPPLEMENTAL rNFOR IRE PLAN CHECK TYPE ROUTING SLIP
_New SFD or Multifamily dwellings: 1 f olition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for now building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ElSTANDARD ElPUBLIC 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.
❑ ENVIRON<•gNTALHEALTH.
B1dgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 10500 N DE ANZA BLVD DATE: 08/01/2013 REVIEWED BY: MELISSA
APN: 316 22 017 BP#: *VALUATION: 1$40,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial BuildingT PENTAMATION 1B TI
USE: PERMIT TYPE:
WORK APPLE T.I. FOR HUB OFFICE ADDITION
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.t.
B (Tenant Improvements) I-A,I-B 322 $3,061.68 IBTIPLNCK $956.55 IBTIINSP
TOTALS: 322 1 $3,061.68 1 $956.55
MECH,HOURLY Yes Q) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes Q No
1i'ia,n Check
:tech. Permit Fee: Plumb.Pe nit Fee. Elec. Permit Fee:
Other Mech.Insp. E]__L_ Other Plumb Insp Other Elea. Insp,
Mech.Insp.Fete: Plura1b. hup. Fee: Flec.Insp, Fee:
NOTE: This estimate does not include fees due to other Departments(Le.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 De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 fff 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $3,061.68 Select a Misc Bldg/Structure
Suppl. PC Fee: Q Reg. Q OT 0.0 Tfirs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $956.55
Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Cormstruction Tay:
Administrative Fee:
Work Without Permit? Yes Q No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Tien-e1 Documentation Fees: Building or Structure 0
A
Strong Motion Fee: IBSEISMICO $8.40 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $2.00
SUBTOTALS: $4,028.63 $0.00 TOTAL FEE: $4,028.63
Revised: 07/01/2013
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: d 5-v0 (V. ,, /' ,� PERMIT# /3c'8 000c.
OWNER'S NAME: /." 2'�c _ PHONE# C
GENERAL CONTRACT R: c�ttc C,iZ �e BUSINESS LICENSE #
ADDRESS: �� �ib►�F CITY/ZIPCODE: C75�
*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
Cement Finishing
Electrical ,
Excavation
Fencing
Flooring/ Carpeting
Linoleum/Wood
Glass/ Glazing1
Heating ALL.C, E0, +'le�1N ,2
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing A cL v
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile _
;� Owner 9 Contractor Signature Date
July 30, 2013
City of Cupertino
10300 Torre Ave
Cupertino CA. 95014
Re: Apple Inc.
EVCJ:N 10500 DeAnza Blvd
Cupertino CA.
E3EV�
This letter is to serve as authorization for Reel Grobman to use
O
Devcon Construction restroom accessibility related drawings
sheets AT-2.1, AT4.0, AT5.1-5.3, and AT9.1 for use as "Record
only" support documentation at projects located at 10500 DeAnza
DEVCON CONSTRUCTION Blvd, Cupertino CA.
INCORPORATED
General Building Contractors Please feel free to contact me if you have any questions.
Best Regards,
690 Gibraltar Drive Sylvester Ramirez, Asso. AIA
Milpitas, California 95035 Sr. Design Project Manager
Phone(408) 942-8200
Fax (408)262-2342
Lic.#399163
De Anza 03 Apple, Inc.
July 29,2013
RE: DA03 Hub Office and OTA Tooling Area
To whom it may concern,
Kier&Wright Civil Engineers&Surveyors, Inc. authorizes the use of accessibility-related drawings
Sheets C-003 through C-304 for use as"Record Only"support documentation for this project.
Sincerely,
KIER RIGHT
Bryan Carrera, Project Manager
KIER&WRIGHT CIVIL ENGINEERS&SURVEYORS,INC.
3350 Scott Boulevard,Bldg.22 9 Santa Clara,California 95054•408-727-6665.408-727-5641 1 -