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13100199 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6 INFINITE LOOP CONTRACTOR:NOVO CONSTRUCTION PERMIT NO: 13100199 OWNER'SNAME: APPLE COMPUTER INC 1460 O'BRIEN DR DATE ISSUED: 10/292013 OWNER'S PHONE: 5108613299 MENLO PARK,CA 94025 PHONE NO:(650)701-1500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL License ClassLic.# 7910?.,'li APPLE-2ND FLOOR-T.I PREP NON-STRUCTURAL 796 SQ Jf(�� FT Contractor/YOld �ON/f l�vC�o�✓ Date o Z S I hereby affirm that I am licensed under the provision of Ch ter 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:$15000 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:31602110.00 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 DAVS FROM LAST CALLED 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 O�� granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulation er the C pertin unicipal Code,Section ' 9.18. RE-ROOFS: Signatu 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. El lellz OWNER-BUILDER DECLARATION I 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(See.7044, Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(See.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(x)should I store or handle hazardous I 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 M mcipal ode,C pter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,2 34. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age Date: l� s permit is issued. I certify that in the performance of the work for which this permit is issued,1 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,1 must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions of 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 1 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 \66 u COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(cz)cupertino.org \� NEW CONSTRUCTION ❑ ADDITION 19 ALTERATION 1 TI ❑ REVISION/DEFERRED ORIGINAL PERMTT PROSECT ADDRESS by I Ir �-Vop APN 4 5 f CR 62— OWNERNAME P / I �Z E-MAM i"P 1� STREET ADD JJ__ ,STA;ZIP FAX CONTACT NAME JALos ONE EMAIL �/llN %re �io)�jg7novans'frvc,-I -I STREET ADDRESS CITY,STATE, IIP F I 4 Il f: 6,q(,0 CA q61 2S S6 75-0 — /S e ❑OWNER C3 OWMR-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGII.'T ❑ ARCHITECT ❑ENGWEER ❑ DEVELOPER ❑TENANT COrTRACrORNAhLE 7 91(5�� 9� IiCENSENUb�11t 0��- LICENSETY BUS.LIC 23g-1, COMPANY NAME EMAIL UAX 0140 Sd-R✓vlton/ 50 �Ol ' 15�I STREET ADDRESSCITY,STATE,ZIP ONE 1 p 439-if6-V - t.o A1x lc C„4rl 5c,) -701 - 1500 ARCHITECT/ENGINEER NAME TT LICENSE NUMBER BUS.LIC0 COMPANY NAV,,, E-MAIL FAX STREDRES / CM,STATE,ZIP PHONE DESCRIPTION OF WORK /p, E:r 9 V l 1 T?G7 h! fi pv (,GAP(� i cid r2_ �5 P3 L EXISTING USE PROPOSED USE CONSTR E :STORIES L? /3 — USE TYPE OCC. SQ,FT. VALVATIOh(Y) AREA NEW FLOOR AREA [� !!-- DEMO TOTAL / -C F7q V AREA 7ct � Nrr.RRA BATHROOM KITCHEN OTHER RIZVOORL AREA REMODEL AREA REMODEL AREA PORCH ARaA or-CK AREA TOTAL DE CY/PORCFiAREA GARAGE AREA: DETACH ATTACH Dlt'El,t,tNG UNITS: IS A SECoN'D UNIT ❑Y S S6COhD STORY nrwG ADDED? ❑YES C3 mo wnnrTrON± ❑I'O PRE-APPLICATION YES ¢YES,PRONE COPY OF PLANNING APPL N []NO LS TIM BLDG AN PLAN?�'l1YG APPROVAL L FnERETCH EL R HOIiE? 0 ES RECEI By -. T'OT VALUATTON: By my signature below,I certify to each of the foflowi application and the information I have provided is correct I vchead the T owner ri tion of Work authorized it to act on theproperty Ordinances and state laws relating to building consmlctez , authorize repre tives f Cupert a V1 enter the above-ident ied property have read this Description verify it is accurate. I agree to comply with atl applicable Iota] Signature of ApplicanUAgent: �'� P Ply for inspection Purposes.. Date: /o SUPPLE �� INFO"'I ION REQUIRED New SFD or Mul ' anvil dvveIlin� ; PLAN CK TYPE existing building s). Demolition ellinit: rcpply for demolition permit for _ RouTIxGSLir Permit for new building. `I prier!o iaaunncG of build ng TBECOIINT7 R [�� MING PLAN$EWl W _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ EarxEss form if any Hazardous Materials are being 'rC�r`ivrrG FLAW used as part of this project. s�rAA.v,xb � ill orxres Copy of Planning Approval Letter or Meeting with Planning LaxcE ❑ F>IZE➢>pr submittal of Building permit application. Pfior to 0. MAJOR eo SAIVITARYSE{K/ij2➢ISiRrGT. ❑ EN1 IR0AIVMN-AL HEALTH CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 6 infinite loop DATE: 10/29/2013 REVIEWED BY: Mendez APN: BP#: "VALUATION: 1$15,000 13,10()1919 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1TIPREP USE: PERMIT TYPE: WORK APPLE- 2ND FLOOR-T.1 PREP NON-STRUCTURAL 796 SQ FT SCOPE l "ailn Elec. Plan Check" h t fech. Perani Fee: Plumb, Permit Fee: Flee. Pernrh Fee Other Mech.Insp. Other Piumb Insp. F-1 _L_ Other Elec.Insp. tech. Insp.Fee: Plumb. (lisp. Fee. Elie(.Insp. Fee NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Thesefees are based on the prelimin information available and are onLy an estimate- Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 E.' 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Tenant Improvement Prep Suppl. PC Fee: Q Reg. O OT 0.0 hrs $0.00 $405.007 1TIPREP PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg, Q OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Constntction Tax: Adininistrative Fee: 0 Work Without Permit? © Yes (F) No $0.00 E) Advanced Planning-Fee: $0.00 Select a Non-Residential E) Travel Documentation Fees: Building or Structure 0 i Strong Motion Fee: IBSEISMICO $3.15 Select an Administrative Item Bldg,Stds Commission Fee: IBCBSC $1.001 1 SUBTOTALS: $4.151 $405,001 TOTAL.FEE: 1 $409.15 Revised: 10/01/2013