13110170 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 2 INFINITE LOOP CONTRACTOR:XL CONSTRUCTION PERMIT NO: 13110170
OWNER'S NAME: APPLE COMPUTER INC 851 BUCKEYE CT DATE ISSUED:11/27/2013
OWNER'S PHONE: 4089338836 MILPITAS,CA 95035 PHONE NO:(408)240-6000
0 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 0 COMMERCIAL®
License Class Lic.4 Lt7 "ISO
*B APPLE-SOUTH 4TH FLOOR-T.1 PREP 7100 SQ FT
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Contractor X/_ 54 �
TA , Date_1PARTITION WALLS
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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:$3000
,have an will maintain Worker's Compensation Insurance,as provided for by
/19Section 3700 of the Labor Code,for the performance of the work for which this APN Number:31602106.00 Occupancy Type:
111pp
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 80 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 D3AF r
M LAST 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-point source regulations ppr the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature
Signature —Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
4L / installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
n I,/ 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. 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 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
n,* _4
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio25505I 25533nd 25534.1�1/
Section 3700 of the Labor Code,for the performance of the work for which thisOwner or authorized agent: ,l'1_ /_/_� Date.—,
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 CONSTRUCTION LENDING AGENCY
Compensation laws of California. If,after making this certificate of exemption,I
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: 2 infinite loop DATE: 11127/2013 REVIEWED BY: Mendez
APN: BP#: 3 VALUATION: 1$3,000 � 1
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY commercial Building PENTAMATION 1TIPREP
USE: PERMIT TYPE:
WORK APPLE SOUTH 4TH FLOOR-T.1 PREP 7100 SQ FT PARTITION WALLS
SCOPE
�fech. F kmj Check 1111 "b, F'ir £"�1c;c°k F"lec:. Plan an�:,"h�-c:k
`>cir.1'>rs fz`1 ea>_ I'Latrr E>.I'trarntt t'e e: L�j" 1'crmit Fee:
L
Other I'1ramb Tns;�. £lures ;'ler..Resp,
L1 I
eck/r slv, (a`r:cr: t'Is a,ala lai,r�„Fee: Met-I� p Fee:
NOTE.This estimate Moes not includefees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc . These ees are based on the relimina information available and are and an estimates Contact the De t or addn'l in o.
FEE ITEMS(Fce Resolution 11-053 Eft' 711/13 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 # Tenant Improvement Prep
Suppl.PC Fee: Reg. 0 OT Ej hrs $0.00 $405.00 1TIPREP
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee-.0 Reg. 0 OT p,p hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
(,'onslr uction ax:
.dpninistn,aive.Fee: 0
Work Without Permit? 0 Yes 0 No $0.00 G)
Advanced PlanninZ Fee: $0.00 Select a Non-Residential E)
Building or Structure
Travel Doctunentation Fees:
Strong Motion Fee: 1BSEISMICO $0.63 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
S[IBT(iTAL : $1.63 $405.00 AL
FIE $406.63
Revised: 10/01/2013