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13070078 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 3 INFINITE LOOP CONTRACTOR:XL CONSTRUCTION PERMIT NO:13070078 OWNER'S NAME: APPLE COMPUTER INC 851 BUCKEYE CT DATE ISSUED:08/22/2013 OWNER'S PHONE: 4089961010 MILPITAS,CA 95035 PHONE NO:(408)240-6000 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALS License Class .t� Lie.# GU� `t5� INTERIOR DEMO OF NON LOAD BEARING WALLS, t g@ CASEWORK Contractor ` �� CSTI UC,:t i pd� Dated 2 &FIXTURES.RENOVATION TO INCLUDE NEW INTERIOR I hereby affirm that I am licensed under the provisions of Chapter 9 WALLS,CONFERENCE ROOM AND REFRESH OFFICE (commencing with Section 7000)of Division 3 of the Business&Professions SPACE. 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:$175000 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:31602107.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I 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 ERA/HT 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 FROM T CALLED INSPECTION. indemnify k p harmless the City of Cupertino against liabilities,judgments, costs,and e: ens which may accrue against said City in consequence of the . granting of this pe it. Additionally,the applicant understands and will comply 14 -01 with all no�-point s urce regulati per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature- 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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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 Iu uipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by t e Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with a Cup rtino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se 'ons 25 O5,255 ,and 2534. Section 3700 of the Labor Code,for the performance of the work for which this / 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 IF ADDRESS: 3 INFINITE LOOP DATE: 07/10/2013 REVIEWED BY: MELISSA APN: 316 02 107 BP#: "VALUATION: $175,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Buildin PEN TAMATION 1 B TI USE: g PERMIT TYPE: WORK APPLE T.I. REMOVE INTERIOR PARTITION WALLS CASEWORK& FIXTURES TO CHANGE SCOPE FROM OFFICES TO 2 CONFERENCE ROOMS, ENLARGE SEPARATE OFFICE SPACE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B (Tenant Improvements) I-A,1-B 2,289 $3,314.48 1BTIPLNCK $2,986.60 IBTIINSP TOTALS: 2,289 $3,314.48 1 $2,986.60 MECH,HOURLY 0 Yes No PLUMB,HOURLY 0 Yes F) No ELEC,HOURLY © Yes Q No 'Ian ,A cd: °(rrran, Plan Chem ee.Plan C.'hack 1<ec/;. 1'cr'nai?r"c>c, Plurzh. Permit r'�ze: Efec. Pernii Fee: ether?tec . lr p. orher Plumb lnsp, E3_L_ oliwi'Elec.lnsp, E3__L_ llech.lnsp.Fae: Phunb.Ins)).Fee: Glec.Insp.Foe: NOTE.This estimate does not include fees due to other Departments(Le.Planninb Public Works,Fire,Sanitary Sewer District,School District,etc). Theseees are based on the relimina information available and are on1 an estimate Contact the De t or addn'l in o: FEE ITEMS (Fee Resolution 11-053 Eff.' 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,314.48 Select a Misc Bldg/Structure Suppl.PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $2,986.60 Suppl. Insp.Fee-0 Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 "ansmuc%ion' Tax: F_FeO: 0 Work Without Permit? C) Yes No $0.00 L 0 Advanced Planning Fee: $0.00 Select a Non-Residential G 1 -1 Building or Structure 0 �rlvnt`tdfi0l'P Fees: � Strong Motion Fee: IBSEISMICO $36.75 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $7.00 SUBTOTALS: $6,344.83 $0.00 TOTAL FEE: $6,344.83 Revised: 07101/2013