13070024 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1 INFINITE LOOP FLR 3 CONTRACTOR:XL CONSTRUCTION PERMIT NO:13070024
OWNER'S NAME: APPLE COMPUTERS INC 851 BUCKEYE CT DATE ISSUED:07/03/2013
OWNER'S PHONE: 4088768131 MILPITAS,CA 95035 PHONE NO:(408)240-6000
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALO
License Class Li..# -�- 3 APPLE 3RD FLR,NORTH- T.I.PREP,INTERIOR DEMO
Contractor U- (-�''`"�(�-C'��`�Date
l (5,824 S.F.)
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:$25000
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:31602105.FLR3 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
1 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 DAYS T CALLED INSPECTION.
indemnify and keep harmless the City a Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the j
Date:
granting of this pe—i dditionally,the applicant understands and will comply Issu
with all no -point so rce regu tions per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signatu Date 3 '� 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
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 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 Ba rea it Quality Management District I
performance of the work for which this permit is issued. will maintain compliance wit the Cu rtin Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sec'ons 25 05,2 533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this I
permit is issued. Owner or authorized agent: 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 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
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 1 INFINITE LOOP 3RD FLR I DATE: 07/03/2013 REVIEWED BY: MELISSA
APN: 31602105.FLR3 BP#: 130 "VALUATION: $25,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Addition/ Repair
PENTAMATION
USE:
PRIMARY Commercial Building PERMIT TYPE: 1TIPRE;
WORK APPLE 3RD FLR NORTH - T.I. PREP INTERIOR DEMO 5
SCOPE ,824 S.F.)
�Ifech. Plan Check Phiirib.Plan Check Elegy:.PlaP7 Check
tiPech_Pernait Fee: Plr.:nb.Permit Fee: Elec. Permit Fee:
Other-Alech.Insp. Other Plumb Insp. Orbe•Elec.Insp.
kch. It?yp.Fee: Thlenh. b?sp.1-ce: Elea.Irup,Fee:
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). These fiees are based on the preliminary information available and are on1v an estimate. Contact the Dept for addn'l info.
FEE ITEMS(Fee Resolution 11-053 Eff. 711112) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 L_LJ J # Tenant Improvement Prep
Suppl.PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $405.00 1TIPREP
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee:Q Reg. Q OT 0.0 hrs $0.00
PME Unit Fee:- $0.00
PME Permit Fee: $0.00
C"717/7-UCil0n T LY:
Work Without Permit? 0 Yes No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential G
Building or Structure 0
T,-cne/�oeurn��nl:�tio�, Fees: �
Strong Motion Fee: IBSEISMICO $5.25 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: I $6.25 $405.00 TOTAL FEE: $411.25
Revised: 07/01/2013