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13030159 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10200 S DE ANZA BLVD CONTRACTOR:VULCAN PERMIT NO:13030159 CONSTRUCTION INC OWNER'S NAME: SEAGATE TECHNOLOGY LLC 346 MATHEW ST DATE ISSUED:03/28/2013 OWNER'S PHONE: 4086581602 SANTA CLARA,CA 95050 PHONE NO:(408)499-6039 'Er_- LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL0 License Class Lie.# - ` FIRST FLOOR SEAGATE TI-LAB MODIFICATIONS- REMOVE SOME WALLS,ADD NEW OFICES AND Contractor V ° Date /7 ADD EXIT DOOR TO EXIT HALLWAY I hereby affirm that I am licensed under the provisions of Chapter 9 ^ REVISION#1-RECONFIGURE(E)BOARDROOM FLOOR (commencing with Section 7000)of Division 3 of the Business&Professions PLAN AND INTERIOR ELEVATIONS-ISSUED 6/26/2013 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:$299374 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:36901035.00 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 180 DA 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 Iss Date: c� with all non-point source regulations per dic cupertino Municipal Code,Section C 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 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 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 I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. 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. It 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: 10200 S DE ANZA BLVD DATE: 06/26/2013 REVIEWED BY: MELISSA APN: 369 01 035 BP#: O ill] I _�:ZVALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY SFD or Duplex PENTAMATION 1 GENRE USE: PERMIT TYPE: WORK REVISION # 1 - RECONFIGURE E BOARDROOM FLOOR PLAN & INTERIOR ELEVATIONS SCOPE Llech.Plan Check Phw7b. Plan Check c"lec.Plan Chock Mech.}'ermit F"ee: Plrn�h.Permit;`ae: Elec.Permit Fee: 011-ler:Wec72_Insp. (Jure.Phinzh b2sp. E171- Ocher Elec.Insp. Jkch./rtsp.Fc:e: phimb. h7sp. Fee: Elec.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.). These ees are based on the prelimina information available and are only an estimate, Contact the Dept./or addn'l info, FEE ITEMS (Fee Resolution 11-053 E . 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes ) No $0.00 0 hours Plan Check,Hourly Suppl.PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 $133.00 1STPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Fee-(F) Reg. 0 OT0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Ii lz -iil/ �,,,,-111 vL 1l e,�. 0 Work Without Permit? 0 Yes Q• No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential E) Travel Docum.en."aifcrr 1 cs: Building or Structure 0 i Stroniz Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: 1 $0.00 $133.00 TOTAL FEE:T $133.00 Revised: 04/29/2013 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10200 S. De Anza Blvd DATE: 03/28/2013 REVIEWED BY: Sean APN: BP#: "VALUATION: 1$299,374 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1 B T® WORK First Floor Seagate Tenant Improvement 5067 sq ft). SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B (Tenant Improvements) II-B,111-B,IV,V-B 5,067 $2,281.56 IBTIPLNCK $4,030.83 IBTIINSP TOTALS: 5,067 $2,281.56 $4,030.83 MECH,HOURLY 0 Yes (F) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY ® Yes .Q No hfech.Plan Check Phrt;tb,Plan Check T Elec..Plan Chock �Llech.Perrrrit I ee: Plumh.Permit Fee: IEec_Perrnir Fee: Orher Alech.Insp. 0--L- Other-Plumb Insp. Oche,Elea.Insp. hlecfi.hasp.FCC-' Plumb. Insp.Tee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.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 Dept_)*addn'l info, FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,281.56 Select a Misc Bldg/Structure Suppl.PC Fee: (j) Reg. OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $4,030.83 Suppl. Insp.Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Feer $0.00 PME Permit Fee: $0.00 Constrzrciion Tax: T-r 'I dministrative Fee: Work Without Permit? 0 Yes (j) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential G Building or Structure 0 Trcnell�ocztnentatie;7 gees: � Strong Motion Fee: IBSEISMICO $62.87 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $12.00 SUBTOTALS: 1 $6,387.261 $0.00 TOTAL FEE: $6,387.26 Revised: 01/01/2013 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10200 S DE ANZA BLVD CONTRACTOR:VULCAN CONSTRUCTION PERMIT NO: 13030159 INC OWNER'S NAME: SEAGATE TECHNOLOGY LLC 346 MATHEW ST DATE ISSUED:03/28/2013 OWNER'S PHONE: 4086581602 SANTA CLARA,CA 95050 PHONE NO:(408)499-6039 L� LICENSED CONTRACTOR'S DECLARATION c BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# / Z [ ✓ 's 7 / MECH RESIDENTIAL COMMERCIAL ContractorVC(LCAIJ C&J�.XK,Date(r 2 7.013 I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:FIRST FLOOR SEAGATE TI-LAB MODIFICATIONS- (commencing with Section 7000)of Division 3 of the Business&Professions REMOVE Code and that my license is in full force and effect. SOME WALLS,ADD NEW OFICES AND ADD EXIT DOOR TO EXIT HALLWAY 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. 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 permit is issued. Sq.Ft Floor Area: Valuation:$299374 - APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:36901035.00 Occupancy Type: 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, PERMIT EXPIRES IF WORD IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the ranting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. � Signature --- / Date 3 Z / Issued by: � s `�' j �/, Date: ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain Section 3700 of the Labor Code,for theerformance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the health& p Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must O forthwith comply with such provisions or this permit shall be deemed revoked. r'.ed ent:j � �Date: L APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's to building construction,and hereby authorize representatives of this city to enter L for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional