12040012-EXPIREDCITY OF CUPERTINO BUILDING PERMIT
I BUILDING ADDRESS: 6 RESULTS WAY I CONTRACTOR: XL CONSTRUCTION I PERMIT NO: 12040012
OWNER'S NAME: ECI TWO RESULTS LLC 1 851 BUCKEYE CT I DATE ISSUED: 04/10/2012
OWNER'S PHONE: 4089961010
❑ LICENSED CONTRACTOR'S DECLARATION
License Class__ Lic. # (Plt 7 y a
Contractor )CL Date
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.
I hereby affirm under penalty of perjury one of the following two declarations:
1 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.
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.
APPLICANT CERTIFICATION
I certify that 1 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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date Ytv/1.2,o.
FE
I hereby affirm that I am exemr&Vom the Contractor's License Law for one of
the following two reasons:
I, 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)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
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.
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.
I certify that in the performance of the work for which this permit is issued, I shal I
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
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
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,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
MILPITAS, CA 95035
PHONE NO: (408) 240-6000
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: APPLE - MECHANICAL & ELECTRICAL SCOPE OF WORK
INCLUDING NEW HVAC UNITS
Sq. Ft Floor Area: I Valuation: $100000
APN Number: 35720041.6 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Date:
RE -ROOFS:
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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should 1 store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Date:
I hereby affi94tatthere is Oonstruction lending agency for the performance of work's
for which thi permit is is ed (Sec. 3097, Civ C.)
Lender's Na
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature_ Date I Licensed Professional
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(ftupertino.org
<< �y 001
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
:I
PROJECT' ADDRESS 6 Results Way
APN 11 O I
OWNER NAME Apple Inc
PHONE 4 08 . 996 .1010
E-MAIL
STREETADDRESS 6 Infinite Loop
CITY, STATE, ZIP Cupertino, CA 95014
FAX
CONTACT NAME Marco Innocenti
PHONE 408.240.6000
E-MAIL
minnocenti@xlconst.com
STREETADDRESS 851 Buckeye Court
CITY,STATE,ZIP Milpitas, CA 95035
FAx 408.240.6001
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT M CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCIHECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Marco Innocenti
LICENSE NUMBER 647480
LICENSE TYPE B
BUS. LIC # 21836
COMPANYNAME XL Construction
E-MAIL minnocenti@xlconst.com
FAX 408.240.6001
STREETADDRESS 8551 Buckeye Court
CITY,STATE,ZIPMilpitas, CA 95035
PHONE408.240.6000
ARCHITECT/ENGINEER NAME David S ab a l V a ro
LICENSE NUMBER C- 015 9 2 5
BUS. LIC #
COMPANYNAME Studios Arch
E-m"crossman@studiosarch.com
Tcrossman@studiosarch.co
415.398 .3829
STREET ADDRESS 4 05 Howard St Suite 588
CITY, STE, ZIP
gan Francisco, CA 94105
PHONE 415 . 398 . 7575
DESCRIPTION OF WORK
-- `
M D worki
Le4lt c
EXISTING USE
Business Group B
PROPOSED USE CONSTR.
Business Group B 'Type
TYPE
lA
# STORIES
4
USE
TYPE
OCC.
SQ.FT.
VALUATIONS)
EXISTG
FL
EW 400sfAA
T
O
2400f
TA
2400sf
p
EARAAREA2400sf
BATHROOM N/A
KITCHEN
OTHER
N/A
REMODEL AREA
REMODEL AREAN/A
REMODEL AREA
PORCH AREAE
N/A
AREA
N/A
TOTAL DECK/PORCH AREA
N/A
GARAG AREAS DETACH
N A []ATTACH#DWELLING
UNITS'
N/A
IS ASECOND UNIT DYES
BEING ADDED?
SECONDSTORY YES
ADDITION? NO
In
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECEIVED BY:
TOTAL VALUATION:
PLANNING APPL # MNO PLANNING APP AL LETTEh
EICHLER OME? W NO
$ -D 530
�/
By my signature below, I certify to h the follo inUly owner or authorize agent to act on the property owner's behalf I have read this
application and the information I h v p vided is co eescription of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relatin o ding constru desentatives of Cupertino to enter the above-ide ified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMEN AL INFORMA' N RE RED
PLAN CHECK TYPE
ROUTING SUP
❑ OVER-THE-COUNTER
❑ BUILDING PLAN REVIEW
_ New SFD or Multifamil dwellings: App y for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
El EXPRESS
❑ PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
µ_" STANDARD
❑ PUBLIC 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 DISTRIcr
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06/21/11