13090125 CITY OF CUPIERTINO BUILDING PERMIT
BUILDING ADDRESS: 20525 MARIANI Wel CONTRACTOR:DEVCON PERMIT NO: 13090125
CONSTRUCTION INC
OWNER'S NAME: CAMPUS HOLDINGS INC 690 GIBRALTAR DR DATE ISSUED:09/17/2013
OWNER'S PHONE: 4085936303 MILPITAS,CA 95035 PHONE NO:(408)942-8200
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Clascs� Lic.# s (� APPLE-T.I. FOR NEW CONFIGURATION WITH (N)WALL
1 Djrt n &
Contractor ,,.� �t�� Date'31 d CEILING CONSTRUCTION,NLE.P.'S INCLUDED
I hereby affirm that 1 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:$20000
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 which this APN Number:32656001.00 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 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 SPECTION.
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 r
ssued by Date:
with all on-point source qulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date 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 matcrials for
inspection.
❑ OWNER-BUILDER DECLARATION
1 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. 1 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 1 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 1
performance of the work for which this permit is issued. will maintain compliance wit 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,Se ions 505 2 3,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which thisr
permit is issued.
Owner or authorized agen • Dake:S
1 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 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 hercby 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 CUP E1f8TINO
FEE ESTIMATOR—]QUI LIIDRNG DIVISION
ADDRESS: 20525 MARIAM DR DATE: 09/17/2013 REVIEWED BY: MELISSA
APN: 326 56 001 BP#: '30d1�,5 'VALUATION: $20,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building PENTAMATION 1 B TI
USE; PERMIT TYPE:
WORK APPLE -T.I. for new configuration with n wall & ceilinq construction. m.e. .'s included
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.L
B (Tenant Improvements) II-A,111-A,V-A 1,250 $2,608.90 1BTIPLNCK $1,543.60 1BTIINSP
TOTALS: 1,250 $2,608.90 $1,543.60
MECH,HOURLY 0 Yes 0 No PLUMB,HOURLY 0 Yes 0 No ELEC,HOURLY 0 Yes 0 No
,1fvch, Ilan Check pUrnrh. Plan Chec'! Elea Plan Cheek
Afecb. Permit Fee: Fhanh.Permit Fee Floc. Permit Fee:
Other'llech.InspLl Other Plumb Insp. 01her•Eley. Insp.
,Wech.In-%p. Fire: Phi nb. hap. Fee: Elec. Insp, Fee:
NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta . TheseLees are based on the prelimina information available and are onl an estimate. Contact the De t or addn 7 info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/132 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,608.90 Select a Misc Bldg/Structure
Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 or Element of a Building
PME Plan Check: $0,00
Permit Fee: $1,543.60
Suppl. Insp. Feed Reg. 0 OT 0 0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction T us:
Administrative Fey: 0
Work Without Permit? 0 Yes 0 No $0,00 0
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Truvel I)ocrunenturion 11'ees: Building or Structure 0
Strong Motion Fee: IBSEISWCO $4.20 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $4,157.70 $0.00 TOTAL FEE-.T $4,157.70
Revised: 0810112013
CONSTRUCTION PERMIT APPLICAT0ON
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION "
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 V�
CUPERYiNO (408)777-3228• FAX(408)777-3333•build ing0cupertino.org
❑NEW CONSTRUCTION ❑ ADDITION ® ALTERATION/TI ❑ REVISION/DEFERRED\ ORIGINAL PERMIT#
PROJECT ADDRESS 20525 Mariani Drive APNff 326456-0®6
OWNERNAME 20525 Mariani Drive LP PHONE/j IS E-MAIL
°�j9S—c4�di
STREET ADDRESS 2901 Tasman Dr Suite 220 CITY,STATE,ZIP Santa Clara, CA 95051 FAx 408-946-7713
CONTACT NAME Sylvester Ramirez @ Devcon Const. PHONE 408-519-8372 E-MAIL sramirez@devcon-const.com
STREET ADDRESS 690 Gibraltar Dr. CM,STATE,ZIP Milpitas CA. 95035 FAx 408-946-7713
13OWNER ❑ OWNER-BUILDER 13OWNERAGENT 19 CONTRACTOR ❑CONPRACTORAGENr ❑ ARCHrrECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME Devcon Construction LICENSE NUMBER 399163 LICENSETYPE B BUS,LIC N
COMPANY NAME Devcon Construction E-MAIL sramirez@devcon-const,com FAx 408-946-7713
STREET ADDRESS 690 Gibraltar Dr. CITY,STATE,ZIP Milpitas CA 95035 PHONE 408-942-8200
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC ft
COMPANY NAME Devcon Construction E-MAIL FAX 408-946-7713
STREET ADDRESS 690 Gibraltar Dr CITY,STATE,ZIP Milpitas CA 95035 PHONE 408-942-8200
DESCRIPTION OF WORK New wall and ceiling construction, modifications and addition to electrical, lighting and mechanical.
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES
EXISTG
B NEW FLOOR B DEMO IIA TOTAL 3 USE TYPE OCC. SQ.FI'. VALUATION(s)
AREA
ARIA 1250 AREA 1250 AREA 1250 NErARFA 1250
BATHROOM I KITCHEN OTHER
REMODELAREA N/A RFMODELAREA N/A REMODEL AREA NIA
PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH
ATTACH
N DWELLING UNITS: ISA SECOND UNrr ❑YES SECONDSTORY ❑YES
BEINGADDED? ❑NO ADDITION? []NO
PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑Y _ L VALUATION:
PLANNING APPL N []NO PLANNING APPROVAL LETTER EICHLER NOME? []NO
By my signature below,I certify to each of the follow' 1 am the property owner or a orized agent to act o,WKe pr .owner's behal I hav read this
application and the information I have provided is corre I have read the Description of Work and verify it i rate. 1 agree to eomply with all applicable local
ordinances and state laws relating uildin co tructi tatives of Cupertino to enter the above-identified property for inspection purposes.
Signatureof Applicant/Agent: Date: 9/17/13
SUPPLEMENTAL IN RMATI REQ D PLAN CHECK TYPE ROUTING SLIP
_New SFD Or Multifamily dwellings: Apply for demolition permit for
OVER-THE-COUNTER 11 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 ElSTANDARD 11PUBLIC 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
B1dgApp 2011.doc revised 06121111
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR SUBCONTRACTOR LIST
JOB ADDRESS:20525 Mariani Ave PERMIT 413090125
OWNER'S NAME:Apple, Inc. PHONE#408-996-1010
GENERAL CONTRACTOR:Devcon Const, Inc. BUSINESS LICENSE# 11068
ADDRESS: 690 Gibraltar Dr. CITY/ZLPCODE:Milpitas,CA 95035
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
I
NO BUILDING FINAL, OR FINAL OCCUPANCY INSPECTION(S) WILL. BE SCHEDULED UNTIL THE '
GENERAL CONTRACTOR ANIS ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
x Cabinets & Millwork Design Workshops 32803
Cement Finishing N/A N/A
x Electrical Redwood Electric Group 21108
Excavatioi7 N/A N/A
Fencing N/A N/A
x Flooring/Carpeting RE Cuddie 1429
x Linoleum/Wood RE Cuddie 1429
x Glass/Glazing Grand Prix Glass 25611
X Heating United Mechanical, Inc. 27361
Insulation N/A N/A
Landscaping N/A N/A
Lathing N/A N/A
Masonry N/A N/A
x Painting/Wallpaper C&O Painting -49#266--
Paving N/A N/A
Plastering N/A N/A
x Plumbing United Mechanical, Inc. 27361
Roofing N/A N/A
Septic Tank N/A N/A
Shect Metal N/A N/A
x Sheet Rock Magnum Drywall, Inc.
x Tile RE Cuddie 1429
Dlgllally signed by KWn Uwln
Kevin 9 rwi n ema4klm�®� � o C-s le� eY 11/05/2013
Dale:2013.11.05 12:47:54-08'00'
ovruea /Culetractor Signature Date