14120067 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19333 VALLCO PKWY CONTRACTOR:DEVCON PERMIT NO: 14120067
CONSTRUCTION INC
OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 12/15/2014
OWNER'S PHONE: 4089745951 MILPITAS,CA 95035 PHONE NO:(408)942-8200
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL F] COMMERCIAL
APPLE T.I. -BLDG A-REPLACE(E)ROOF TOP
License Class 6A f11-Gr C—Lic.# �j��l CD �j CHILLER UNIT WITH(N)UNIT
Contractor
1��VCr.✓t (C-114- Date I'2
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:
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:5100000
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:31620075.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION _
I certify that I have read this application and state that the above information is PERMI (JRK IS NOT STARTED
correct. I agree comply with all city and county ordinances and state laws relating rODA
180 DAYS OFIERMIT ISSUANCE OR
to building construction,
uction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save YS FROM LA/ 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
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with all non-points re I tions per the pertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date t ltq
All roofs shall bei pec prior to any roofing material being installed. If a roof is
installed without 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. 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
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,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Secti 20805 25533,an 534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent: Date:
permit is issued. �Z J
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
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 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
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228• FAX(408)777-3333•bw (c
ldlngilcupertlno.org
�\
[:1 NEW CONSTRUCTION ❑ ADDITION C■] ALTERATION/Tl ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS 19333 Vallco Pkwy AP"# 3(4 — Z0 'O �-
OWNERNAME Apple, Inc. PHGNE408-974-5951 E_MAILemolly@apple.com
STREET ADDRESS 1 Infinite Loop CITY, STATE,ZIP Cupertino, CA FAX
CONTACT NAME Kevin Irwin PHONE408-712-9856 E-MAIDkirwin@devcon-const.com
STREETADDRESs690 Gibraltar Dr. CITY,STATE,"'Milpitas, CA 95035 FAX 408-262-2342
11 OWNER 11OWNER-BUILDER ❑ OWNER AGENT M CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Kevin Irwin LICENSE NUMBER 399163 LICENSE TYPE CA GC BUS.LIC#11068
COMPANY NAME Devcon Construction, Inc. EMAILkirwin@devcon-const.Com FAx408-262-2342
STREETADDRESS690 Gibraltar Dr. CITY,STATE,ZIP Milpitas, CA 95035 PHONE408-942-8200
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS A CITY,STATE,ZIP PHONE
r✓
DESCRIPTION OF WORK 6,p
/ /�
Replacement of (E) chiller with higher capacity chiller. Addition of (1) new sleeper to support
wider chiller.
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES
B B II-B 2 USE TYPE OCC. SQ.FT. VALUATION(S)
EXISTG NEW FLOOR DEMO TOTAL B 00,000
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH
❑ATTACH
#DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY []YES
BEING ADDED? ❑NO ADDITION? []NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES VED BY: TOTAL VALUATION:
PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO
By my signature below,I certify to each of the following: I am the property owner or autho zed a act onwner's behalf. I have read this
application and the information I have provided is correct. I have read_ scription of Work and verify it is ree to fly with all applicable local
ordinances and state laws relating to bui struction. Ia Ize representatives of Cupertino to enter the ab�ate. I
fied property DoT' ection purposes.
Signature of Applicant/Agent: Date: 2
41
SUPPLEMENTAL FORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP
_New SFD or Multifamily 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. ❑ LARGE ❑ FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp 201 Ldoc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 19333 VALLCO PKWY DATE: 12/15/2014 REVIEWED BY: MEI-ISSA
APN: 316 20 075 BP#: t E' `VALUATION: j$100,000
PERMIT TYPE: Mechanical Permit PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY Commercial Building PENTAMATION FURN/AC
USE: PERMIT TYPE:
WORK APPLE T.I. - BLDG A - REPLACE E ROOF TOP CHILLER WITH N UNIT
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Cooling Unit 1MCRAA 1 # $143
TOTALS: $143.00
Mech. Plan Check0,0 hrs $0.00
Mech. Permit Fee: 1MPERMIT
Other Mech. Insp. 0.0 hrs $48.00
NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc.). These ees are based on the prelimina information available and are only an estimate. Contact the Detor addn'1 info.
FEE ITEMS (Fee Rc�solwfion 11-053 E . T l/13l FEE QTY/FEE MISC ITEMS
PME Plan Check: $0.00
PME Unit Fee: $143.00
PME Permit Fee: $48.00
T-T-
Administrative Fee: !ADMIN $45.00
Work Without Permit? ® Yes 0 No $0.00
Travel Documentation Fee: ITRA VDOC $48.00 A
Strong, Motion Fee: IBSEISMICO $28.00 Select an Administrative Item
Bldg,Stds Commission Fee: IBCBSC $4.00
SUBTOTALS: $316.00 $0.00 TOTAL FEE: $316.00
Revised: 08/20/2014