B-2017-2049 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-2049
10475 BANDLEY DR CUPERTINO,CA 95014-1912(326 33 111) DEVCON
CONSTRUCTION
INCORPORATED
MILPITAS,CA 95035 - •
OWNER'S NAME: DPT BANDLEY DRIVE LLC DATE ISSUED: 11/30/2017
OWNER'S PHONE:408-942-8200 PHONE NO:(408)942-8200
•
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#399163
Contractor DEVCON CONSTRUCTION INCORPORATED Date 02/28/2019 11/30/2017 BLDG _ELECT _PLUMB
MECH_RESIDENTIAL X COMMERCIAL
• ' I hereby affirm that I am licensed under the provisions of Chapter 9(commencing
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
APPLE INC BANDLEY 5-T.I.PREP;DEMO WALLS,CEILINGS,
I hereby affirm under penalty of perjury one of the following two declarations: MECHANICAL ROOF TOP UNITS,REMOVE HEAT LAB CHAMBER;
4 have and will maintain a certificate of consent to self-insure for Worker's REMOVE&SAFE-OFF ELECTRICAL AND MECHANICAL
Compensation,as provided for by Section 3700 ofthe Labor Code,for the ASSOCIATED WITH DEMO AREA AS NEEDED.
performance of the work for which this permit is issued.
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
permit is issued. Sq.Ft Floor Area: Valuation:$25301.00
APPLICANT CERTIFICATION
(certify that I have read this application and state that the above --- -
information is correct.l agree to comply with all city and county ordinances APN Number: Occupancy Type:
and state laws relating to building.construction,and hereby authorize 326 33 111 A(Tenant Improvements)
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,costs,and expenses which PERMIT EXPIRES IF WORK'.IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
•
source regulations per the Cupertiho Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
c' r
"ii-ature v6142 _ Date Issued by:Jasmine Archbold
$ • Date: 11/30/2017
OWNER-BUILDER DECLARATION
I hereby affirm that L am exempt from the Contractor's License Law for one of the RE-ROOFS:
following tworeasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
i. I I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I'agree to remove all new materials for
' inspection.
coinpensation;will do they work,and the structure is not intended or offered for
•
sale(SeC.7044,Business&Professions Code)
2. I,as owner of the property;am excl'usi'vely contracting with licensed Signature of Applicant:
I contractor's to construct,the project(Sec.7044,Business&Professions Code). Date:
i ..
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. , I have and'will maintain a Certificate of Consent to self-insure for Worker's
i,,
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE.
2. ' I have and will maintain Worker's.Compensation Insurance,as provided for by I have read the hazardous materials requirements under;Chapter 6.95 of the
Section3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
•
3. I'certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall notemploy any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area'Air Quality Management District 1
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the - the Health&Safety Code,Sections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked.. •,y`er or authorized agent: ' ,
APPLICANT CERTIFICATION ur%ate:
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating'to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. I understand my plans shall be used as public records.
•
Signature Date Licensed .
Professional
// DEMOLITION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
44,.51 'ss 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•building@cupertino.org
CUPERTINO
�. 2020`f°
PROJECT ADDRESS 10475 Bandley Dr. APN# 326-33-111
OWNER NAME Apple Inc PHONE E-MAIL
STREET ADDRESS 1 Infinite Loop, (mail stop 119-DDC) CITY, STATE,ZIP Cupertino CA 95014 FAX
CONTACT NAME Terry Fullerton PHONE 408-942-8200 E-MAIL tfullerton@devcon-const.com
STREET ADDRESS 690 Gibraltar DR CITY,STATE,ZIP Milpitas CA 95035 FAX
❑OWNER ❑ OWNER-BUILDER [J OWNER AGENT ® CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER 0 DEVELOPER 0 TENANT
CONTRACTOR NAME Jim Leiboid LICENSE NUMBER 399163 LICENSE TYPE B BUS.LIC#
`tbO`-Cg-
COMPANY NAME Devcon Construction E-MAIL jleibold@devcon-const.com FAX
STREET ADDRESS 690 Gibraltar Dr CITY,STATE,ZIP Milpitas CA 95035 PHONE 408-942-8200
DESCRIPTION OF WORK Interior Demo Only-Walls, Ceilings, Mechanical Roof Top Units, Remove heat lab chamber,
Remove &Safe-off Electrical and Mechanical associated with demo area as needed.
RESIDENTIALNSA #DWELLING N/A OFFICE USE'ONLY ,
FLOOR AREA UNITS USE. OCC..° TYPE SQ.FT. _ VALUATION"
COMMERCIAL
10,767 Office .B °, VB' 10,767 .$25,3019
FLOOR AREA
TYPE OF CONSTRUCTION VB #STORIES 1
AQMD JOB NUMBERRECEIVED BY TOTAL VALUATION:
#: $25,301
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on 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. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date: 11/30/17 '
SUPPLEMENTAL INFORMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT OFFICE USE ONLY
Provide Job Number from Bay Area Air Quality Management District www.baaqmd.org @ 415-749-4762. PLAN CHECK TYPE
Provide three copies of a site plan showing protection for any trees 10"in diameter or more at 3'above grade. 'EXPRESS
1 O STANDARD
Provide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected.
❑ LARGE
Planning Dept clearance to verify building is not considered an historical landmark.Allow 10 business days. MAJOR
Provide letter of clearance of all vermin from a licensed pest control contractor. V
_Applicant shall call the Public Works Department at 408-777-3104 and schedule a"habitable dwelling"inspection.
Provide signed Debris Bin and Recyclable Materials form. - -
Commercial Buildings Only: Provide Fire Dept clearance for fire suppression/alarm system review.
DemoApp_2016.doc revised 03/29/16