13060050 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20525 MARIAN] AVE CONTRACTOR:XL CONSTRUCTION PERMIT NO: 13060050
OWNER'S NAME: CAMPUS HOLDING INC 851 BUCKEYE CT DATE ISSUED:07/03/2013
OWNER'S PHONE: 408996 10 10 MILPITAS,CA 95035 PHONE NO:(408)240-6000
❑ LICENSED CONTRACTOR'S DECLARATION r r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.4 rp %Q r r
MECH RESIDENTIAL COMMERCIAL
Contractor XL 4]115r��ho� Date JOB DESCRIPTION:EAST WING OFFICE TEN ANT IMPROVEMENT(4694 SQ FT).
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 whichthis permit is issued. Sq.Ft Floor Area: Valuation:$476000
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:32656001.001 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 DAYS IT ISSUANCE OR
to building construction,and hereby authorizc representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FR CALLED INSPECTION.
indemnifyand keep less the City of Cupertino against liabilities,judgments,
costs,and expenses h may accrue against said City in consequence of the /
granting of this pe it. dditionally,the applicant understands and will comply Issued ate:
with all non-point ourc regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date 7NAll roofs shall be inspected prior to any roofing material being installed.I f a roof is
installed without first obtaining an inspection,1 agree to remove all new materials For
inspection.
❑ OWNER-BUILDER DECLARATION
1 hereby affirm that 1 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
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)
I,as owner of the property,am exclusivcly 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 Cupert' o Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 2553 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/thupe
eq 'pment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined byay rea Air Quality Management District 1
performance of the work for which this permit is issued. will maintain compliance with tino Municipal Code,Chapter 9.12 and
[have and will maintain Worker's Compensation Insurance,as provided For by the health&Safety Code,Sec55 5,2551"4.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Owner or authorized agent: Date: 3 1
I certify that in the performance of the work For which this permit is issued,I shall
not employ any person inany 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,1 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(See.3097,Civ C.)
Lender's Name
APPLICANT CERTIFICATION Lender's Address
1 certify that 1 have read this application and state that the above in Formation 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 oFthis 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 ]BUILDING PERMIT
BUILDING ADDRESS: 20525 MARIAM AVE CONTRACTOR:XL CONSTRUCTION PERMIT NO: 13060050
OWNER'S NAME: APPLE INC 851 BUCKEYE CT DATE ISSUED:07/03/2013
OWNER'S PHONE: 4089961010 MILPITAS,CA 95035 PHONE NO:(408)240-6000
9/ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
ff-
License Class '0 Lia# g4'1q" EAST WING OFFICE TENANT IMPROVEMENT(4694 SQ
FT).
Contractor YL (`arstuc�ion Date �1�2"�13 REV# 1 - REMOVE INSTALLATION OF STORAGE RACKS
1 hereby affirm that 1 am licensed under the provisions of Chapter 9 nFROM SCOPE OF WORK- ISSUED 11/20/13
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect.
1 hereby affirm under penalty of perjury one of the following two declarations:
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
n performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$476000
' 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:32656001.001 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 DABS®� 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 ' AS ALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and xp ses which may accrue against said City in consequence of the ed b e /1 ZO 3
granting of this rmit. Additionally,the applicant understands and will comply
with all n n-pom source rel s per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date r o 3 All roofs shall be inspccted 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
1 hereby affirm that 1 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
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)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). 1 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,sIto �Ib a 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 ay Area Air Quality Management District 1
performance of the work for which this permit is issued. will maintain compliance w h the C pertin Municipal Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation insurance,as provided for by the Health&Safety Code, ,tions 2 505, 533,an 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Owner or authorized agent: Date: t 2u 13
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(Scc.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.1 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
OI'L'Y OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20525 MARIANI AVE CONTRACTOR:XL CONSTRUCTION PERMIT NO: 13060050
OWNER'S NAME: APPLE INC 851 BUCKEYE CT DATE ISSUED:07/03/2013
OWNER'S PHONE: 4089961010 MILPITAS,CA 95035 PHONE NO:(408)240-6000
13 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class_ Lic.4 Gq- i{$O EAST WING OFFICE TENANT IMPROVEMENT(4694 SQ
1 FT).
Contractor.�anA c.' 4 Date1o�So��� DEF# 1 -STRUCTURAL ANCHORING FOR STORAGE
I hereby affirm that I am licensed under the provisions of Chapter 9 RACKS,
(commencing with Section 7000)of Division 3 of the Business&Professions
Code and that my license is in full force and effect. DEF#l-STRUCTURAL ANCHORING FOR STORAGE RACKS,PL
I hereby affirm under penalty of perjury one of the following two declarations: FOR(N)TEST CHAMBER&ARCH:LAYOUT CHANGES-ISSD OTC
1 have and will maintain a certificate of consent to self-insure for Worker's 10/30/2013
pr Compensation,as provided for by Section 3700 of the Labor Code,for the
U performance of the work for which this permit is issued. Sq.Ft Floor Valuation:$476000
I
1 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 w APN Number:32 6001.001 Occupancy Type:
permit is issued. ��rt���
APPLICANT CERTIFICATION 11��.•��
I certify that I have read this application and state that the above i�tio PERMIT EXPIRES IF WORK IS NOT STARTED
correct.i agree to comply with all city and county ordinances aws relating WIT�11N 18 DAB'S®F PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives o this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 110DAT (LAST CALLED INSPECTI N.
indemnify and keep harmless the City of Cupertino against liabilitics,judgments,
costs,and crises which may accrue against said City in consequence of the
granting o thi permit. Additionally,the applicant understands and will comply Issued by: Date:
with all n - o t s
pource re ulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date T 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
inspcction.
❑ 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
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 M&TERIALS 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 25 (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 f se equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as def ned by he y Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with he C pertino Vunicipal Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sc tions 505,2 3,an 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent Date: 3a lJ
permit is issued.
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,l 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_
C41 '%(06 KufQ�j XL Con A'iov�
(LAOt'Ca2.1_ G2C F
CRTY OF CUP ERTINO
W-PERMIT
spy]F]EIE lESTIIV1I,�TOR— BUI]LIDING IDIVISION
DDRESS: 20525 MARIANI AVE DATE: 06/06/2013 REVIEWED BY: MELISSA
PN: 326 56 001 BP#: ���� VALUATION: $476,000
PE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building PENTAMATION 1 B TI
USE: PERMIT TYPE: d
WORK RECONFIGURE E OFFICE SPACE BY REMOVING & REPLACE NON LOAD BEARING PARTITION
SCOPE WALLS. MODIFY ELECTRICAL & HVAC FOR (N) LAYOUT
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
B (Tenant Improvements) II-A,111-AN-A 4,694 $2,835.40 IBTIPLNCK $4,657.93 IBTIINSP
TOTALS: 4,694 $2,835.40 $4,657.93
MECH,HOURLY Q Yes 0 No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes Q No
Wec h. flan Check Plumb, Plan Check Elec. Plan Cheek
Mech. Permit Fees: Plumb.Permil Fee: Elec.Permit Fee:
Other Afech.Insp. Li Other Plumb Insp. LLJ Other Elec.Insy
4lech.Insp. Fee plumb.lrtsp.Fee! Elec.Insp.Fisc:
NOTE: This estimate does not include fees due to other Departments(Le. Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). 77iese ees are based on the grelimina information available and are onl an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,835.40 Select a Misc Bldg/Structure
Suppl. PC Fee: E) Reg. Q OT Q.Q hes $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $4,657.93
Suppl. Insp. Fee-0 Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
COna•lrztetion Tax:
Administrative Fee: Q
Work Without Permit? Q Yes No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential Q
Building or Structure Q
7`i�cn,rl Dc�crrrnentatinn Fees: a
Strong Motion Fee: IBSEISMICO $99.96 Select an Administrative Item
BldpStds Commission Fee: iBCBSC $20.00
SUBTOTALS: $7,613.29F $0.00 TOTAL FEE: $7,613.29
Revised: 6412912013
CITY OF CU PIERTINO
FEE ESTIMATOR— BUILDING DIVISION
72 ADDRESS: 20525 MARY NI AVE DATE: 10/21/2013 REVIEWED BY: MELISSA
APN: 32656001.001 BP#: i 3 '`VALUATION: Iso
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant improvement
PRIMARY Commercial Building PENTAMATION 1GENCOM
USE: PERMIT TYPE:
WORK DEF# 1 - STRUCTURAL ANCHORING FOR STORAGE RACKS PL FOR N TEST CHAMBER &
SCOPE ARCH. LAYOUT CHANGES
llcch. Plan Check Plumb, Plum Check Elea.Plan Check
F,,_:l, Pc,rmi1 Fre: Plcmh. Permi!Pyre: Elec.Permit Fee:
othey-.!tech. lns'p. Other Plumb Insp. Li Other Elec.Insp, Li I
Mock Insp. Fmc: Phunh. Insp. Fee: Yee.Insp. Fee:
NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or adds 7 info.
FEE ITEMS (Fee Resolution 11-053 Eff, 7/1/131 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 Select a Misc Bldg/Structure
Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 or Element of a Building
PME Plan Check: $0.00 1 # Deferred Submittal
Permit Fee: $0.00 $278.00 IDEFSUeM
Suppl. Insp. Fee Reg. Q OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Consirurtiun T ox:
Adininistralive Fee: Q
Work Without Permit? Q Yes (E) No $0.00 E)
Advanced Plannine Fee: $0.00 Select a Non-Residential Q
Travel Documentation Fees: Building or Structure Q
A
Strong Motion Fee: $0.00 Select an Administrative Item
Bldg Stds Commission Fee: $0.00
1
SUBTOTALS: $0.00 $278.00 TOTAL FEE: $278.00
Revised: 10/01/2013