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13040045 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 5 INFINITE LOOP CONTRACTOR:BARRON BUILDERS INC PERMIT NO: 13040045 OWNER'S NAME: APPLE COMPUTER INC 415 CLYDE AVE STE 104 DATE ISSUED:04/04/2013 OWNER'S PHONE: 408996 1010 MOUNTAIN VIEW,CA 94043 PHONE NO:(650)269-7061 El LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG J_ ELECT J_ PLUMB r License Class �\5_ Lic.#_ r— r— r Contractor N)Q\\&`,DateMECH . RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:FAN ROOM RENOVATION ROOMS I &2,REPLACE (commencing with Section 7000)of Division 3 of the Business&Professions EXISTING Code and that my license is in full force and effect. FANS AND FAN COILS WITH NEW IN-GARAGE SHEETROCK AND FRAMING 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:$500000 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:31602109.00 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 WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point urce re ul ons per the Cupertino Municipal Code,SectionTA 9,18, 180 DIVS FROM.4012(9T C4LLED INSPECTION, Signature Date Issued by: Date: El 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. 1 will maintain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& 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 00 ter or t tze ent: Date-�� forthwith comply with such provisions or this permit shall be deemed revoked. -NZ2 APPLICANT_CERTIFICATION CO UCTION 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 for which this permit is issued(See.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 te I understand my plans shall be used as public records. Signature. Da Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 5 infinate loop DATE: 04/04/2013 REVIEWED BY: tarry s APN: BP#: } i' (, � VALUATION: 1$500,000 __j *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1S TI USE: I PERMIT TYPE: WORK fan room renovation rooms 1 and 2. replace existing fans and fan coils with new. in garage. sheetrock SCOPE I and framing. OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. S{Tenant Improvements} 11-B,111-B,IV,V-B 1,500 $3,656.95 1STIPLNCK $1,273.13 1STUNSP TOTALS: 1,500 $3,656.95 ' $1,273.13 +l►1CIRI X S' s lE'L >I � YY04'' Nti ` L C i©I,n 'i�'es leo A�Arck f'fari „heck F'lwr 7b. flan Check ilec., !an C.,1t�ck 11 L1czr,h.1'rr,wil Fe f'tran<h,A-"rmil7°"€tt. F-Iec' F'c:F azir t`<zc:: €'her r1"c:ch, /rasp' Oih r Plumb Trtsp. Other Elec,Insp, NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta . These ees are based on the relimina information available and are onl an estimate. Contact the De t or addn'l in o. FEE ITEMS(Fee Resolution 11-053 Eff 71112t FEE QTYIFEE MISC ITEMS Plan Check Fee: $3,656.95 Select a Misc Bldg/Structure Suppl.PC Feer Reg. 0 OT 0 0 hrs $0,00 or Element of a Building PME Pian Check.: $0.00 Permit Fee: $1,273.13 Suppl. Insp.Feer Reg. 0 OT LZhrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0,00 Const sic tion Tax Work Without Permit? 0 Yes (j) No $0.00 G Advanced Planning Fee: $0.00 Select a Non-Residential 7ica�r�.l'�€c:�tan,ntuticr Ise: Building or Structure 0 Strom Motion Fee: IBSEISWCO $105.00 Select an Administrative Item BldgStds _Commission:Fee: IBCBSC $20.00 �A4LL $5,055.08 $0.00 3 ` L $5,055.08 Revised: 04/0112013 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO,CA 950143255 CUPERTINO (408)777-3228-FAX(408)777-3333-buildin-gecuoertino.om ❑NEW CONSTRUCTION El ADDITION [] ALTERATION/TI n REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 5 tAFIMITE LOOP OWNER NAME to f PHONE 4m E-MAIL - &-t(3110 1 1 CITY,ITA&,W*T1tj(-3 I FAX CONTACT NAME PHONE(tSo 'ST EiriNEM<2%AMM%01 LOMS 00M STREET ADDRESS . AVS CLILM Me ., 51t 10S IWO C A q4-0+3 & 64 -4Aq ®OWNER 0 OWNER-BUILDER 0 OWNERAGENT 2�-�ONTRACTDR OCONTRACTOR AGENT 1:1 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT RAOR NA LI NUMBER LICENSE TYPE fS BUS.LTC# awximo ► COMPANY NAME 6AMA E-MAIL sr FAX ET 115 DDG LS C�ZTE6l "go' !(� .hVt ; St-e (OS- 1 e11,ga� , . a -464-444443 ARCHITECT/ENGINEER NAMe.,L (0"MAA. I LICENSE NUMBER BUS.LIC# COMPANYNAME � IDWA wt.-J� e FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK r<fA: r->VKq0o3 OF &)cts-rit,36 FAt,3 P,(*KS -f-;2 FAM A140 MO ObILS W rrA mew. Li� PA&r-[Aj& EXISTING USE PROPOSED USE I I CONSTR. TYPE I "TORIES USE TYPE OCC- SQ-FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA I AREA JNFryg,,,,, BATHROOM KITCHEN OTHER -0 S1 DETACH REMODELAREA REMODELAREA REMODELAREA RE :EA PORCHAREA DECKAREA TOTALDECKIPORCH GARAGEAREA. DETACH OATTACH YES#DWELLING UNITS: IS A SECOND UNIT YES SECOND STORY OYES IN ADDITION? BEING ADDED? 0 ]NO ADDMON? ONO PRE-APPLICATION OYES IF YES,PROVIDE COPY OF IS THE BLDG AN El YESL VALUATION: PLANNING APPL# ONO PLANNING APPROVAL LETTER I EICHLER HOME? 0 NO I :�� By my signature below,I certify to each of the following: I am the property owner or authorized agent to aft on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction, authorize representatives of Cupertino to enter the above-id t1fi d property for inspection purposes. Signature of Applicant/Agent: Date:—4 4 1 SUPPLEMENTAL INFORMATION REQUIRED 1XLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for {?VER-THE-COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. 11 EXPRESS El PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD 0 PUBLIC WORKS farm El STANDARD if any Hazardous Materials are being used as part of this project. El LARGE El FIRE DEPT —Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application, El MAJOR 13 SANITARY SEWER DISTRICT LEIL-E-,NVI-RONMENTAL H EALTH BldgApp__201 1.doc revised 0612X/11