14010102 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 6 INFINITE LOOP CONTRACTOR:NOVO CONSTRUCTION PERMIT NO: 14010102
OWNER'S NAME: APPLE COMPUTER INC 1460 O'BRIEN DR DATE ISSUED:01/16/2014
OWNER'S PHONE: 6508478912 MENLO PARK,CA 94025 PHONE NO:(650)701-1500
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL
License Class 19 Lic.# 717/p-zAPPLE-2ND FLOOR NEW FINISHES MATERIALS AND
l / ELECTRICAL UPGRADES AT NEW LAB
Contractor/Nn Vo CA"1
7y,.-C-VOW Date j 11641
I hereby affirm that I am licensed under the provisions of hapter 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:$20000
1 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 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 LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
��-jj
costs,and expenses which may accrue against said City in consequence of the Issued b /�i11191��granting of this permit. Additionally,the applicant understands and will comply Y• Date:
with all non-point source regulations per the Cupeloo Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date 1 O I 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
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
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). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
1 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 Municipal Code, hapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,2 3, 5534
Section 3700 of the Labor Code,for the performance of the work for which this 1 /b
permit is issued. Owner or authorized agen Date:
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 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 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 �rJ�
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ` O
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildina(c�cuoertino.ora \ �/
CUPERTINO
❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS7�
/ AP\
OWNER NAME PHONE E-MAIL
GC n✓G
STREET ADDRESS C] STATE,ZIP FAX
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CONTACT NAME ONE E-MAIL l 1
A GATS' N /T 6 5n rs'�7- 6111-2- 'wk- v�ovo Co•^s �+ b� ce
STREET ADDRESS C1T 7ATE IIP FAX
121(0 0 D /g2/Er! LCn/Go A�t� GJ4 L5
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR -III(CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC�
Al/00, JoLZ 27S411
COMPANY N E-MAIL FAX
,&/&V& /dS ti(fit 0 ^/
STREET kDDRESS ��/�� CITY,STATE,ZIP PHONE
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ARCMT4CTIENGEER NAMEllCENSE NUMBER BUS.LIC R
662 o M
COMPANY AME E-MAIL FAX
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STRWr ADDRESS C STATE,ZIP PHONE
'Ne, 1y1ee7?,) Gr^/ m V-15- q^I m sI l
DESCRIPTION OF WORK Akio 4r -letv
LA-3 dn/ 2�o iZ E�1 cT win/ oP T);�E
ExISTLNG USE PROPOSED USE CONSTR TYPE STORIES
USE TYPE OCC. SQ.FT. VALUATION(S)
149 1A
EXISTG NEW FLOOR DEMO TOTAL
AREA jq0 AREA 7,q O AREA 2 V NET AREA n O (5
BATHROOM KITCHEN t OTHER (/ J 114
7/1l 13
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREATOTAL DECK/PORCH AREA GARAGE AREA: DETACH
ATTACH
DWELLING UNITS: .IAS ONDUNIT ❑YES SECOND STORY ❑YES
A
DDED? []NO ADDITION? []NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY,: TOT VALUATION:
PLAN;\'LNG ADPL# ❑NO PLAMdING APPROVAL LETTER EICHLER HOME? ❑NO
?� poo
By my signature below,t certify to each of the following: I am the property owner or authorized agent to act on the property owner's beha - I haY read this
application and the information I have provided is cone 1 have read the Des 'ption of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to lding CO n. o re tatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent. Date: �G
SUPPLE INFORMATION REQUIRED PLAN CBECK TYPE RotrllNcsLiP
_New SFD or Mul " IIy 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. ❑ ExPREss ❑ 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. ❑ L.ARGE ❑ FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning prior to MAJOR SANITARY SEWER DISTRICT
submittal of Building Permit application.
[a.'EI\'VIROR'IVIENTAL HEALTH
BIdgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 6 infinite loop DATE: 01/16/2014 REVIEWED BY: Mendez
APN: BP#: `VALUATION: 1$20,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY PENTAMATION
USE: Commercial Building PERMIT TYPE: 1 B T�
WORK apple- 2nd floor new finishes materials and electrical upgrades at new lab
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
B (Tenant Improvements) II-B,III-B,IV,V-B 0 $0.00 $0.00
TOTALS: 0 $0.00 $0.00
MECH,HOURLY 0 Yes (F) No PLUMB,HOURLY 0 Yes Q No ELEC,HOURLY 0 Yes Q No
in Check Llec. Plan C'hec'k
JIfech. PermitFees Plumb. Permit 1" Flee. Pertnit Fee.
Other Xfech,Insp. OJ her Plumb Insp. Lj Other Elee,Insp Li
Vech.Insp, FNe: Plumb. Insp. Fee: Elec.Insp.Fec.
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 prelimina information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Eff 7/1113) FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 2 hours Plan Check,Hourly
Suppl.PC Fee: (E) Reg. 0 OT 0.0 Thrs $0.00 $278.00 ISTPLNCK
PME Plan Check: $0.00
Permit Fee: Hourly Only? 0 Yes (D No $0.00
Suppl. Insp. Fee-0 Reg. 0 OT 0,0 1 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Consmuction Tax:
Administrative Fee: 0
Work Without Permit? 0 Yes C) No $0.00 E)
Advanced Plannig.Fee: $0.00 Select a Non-Residential 0
T rctvel Documentation Fee Building or Structure 0
Strong Motion Fee: IBSEISMICO $4.20 4.0 hrs Inspections
Blda Stds Commission Fee: IBCBSC $1.00 $556.00 ISTINSP 7 Inspection,Hourly
SUBTOTALS: $5.20 $834.00 TOTAL FEE: 1 $839.20
Revised: 01/15/2014
HAZARDOUS MATERIALS CHECKLIST
12 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408) 777-3228• FAX(408)777-3333• building(dcupertino.org
PURPOSE
To minimize possible delays that would result for the Fire Department plan review, please complete the
following checklist to determine if an additional level of Hazardous Materials plan review will be
required.
MARK `YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING?
PLEASE MARK YOUR ANSWER WITH AN `X' IN THE YES OR NO BOX ON THE SIDE YES NO
BELOW.
1. Use, dispensing, mixing or storage of flammable or combustible liquids or gases, /
hazardous materials, etc. J�
2. Battery back-up rooms or racks.
3. Propane tanks.
4. Gasoline stations with underground tanks.
5. Installation or replacement above ground or underground storage of liquid petroleum
products, liquefied petroleum gases, compressed natural gas, explosives or other
regulated hazardous materials.
6. Gas rooms for dentist, doctors or veterinarians.
7. Generators with back-up diesel or other fuels.
8. Large refrigeration systems. X
9. Fuel cell systems. x
10. Commercial pool systems. k
11. Chemical Storage areas. X
12. Flammable liquid storage.
13. Compressed Gases. k
14. Dry cleaners. x
15. Print Shops.
16. Auto Repair and Auto Body Shops.
17. Research and Development.
For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa
Clara County Fire Department, at (408) 378-4010.
Has Mat 2011.doc revised 03/07/11