13070073 CITY OF CUPERTI.NO
FEE;ESTIMATOR—`BLT.I_LDING:D-IVISION
ADDRESS-.,4 INFINITE'LOOP DATE: 0511512013' ;REVIEWED BY MECIS;SA
APN: 31:6'02;1!08 BP#: 13040.0.73 . 'VALUATION: $0
xPERMIT°TY,PE:, ;Building.Permit PLAN CHECK,TYPE: Alteration:/Addition./ Repai=r
PRIIVIA•RY" PENTAMATION
USE': Commercial Building PERMIT TYPE: IGENCOM.
i
woRK. DEFERRED# 1 -PLUMBING PLANS& DIAGRAMS
SCOPE .
ICA 11MM1,
-t � a
"�1 t _ !
Lfeolr. Flan Cilicek l'lurhh..r'?!;r;!:'hZc6, latr;. r.l ir?(.'h uikI 77F
titech. Perr,ril Fee: Plrmrh..P t t ti1'Tee,;` Z ler. 'Permit.l'c$:
C)rliur Atech::Ins'p. Other.PhurnL'irrsn. Clri er L lec;7nsn:,
`�97e�ch.Ins�z. l t;e: P?itntb.n liie/i:fere:: L-'lt c.Insp.F' e:'
NOTE:,.This estimate does not include'fees due kotherDepar`tments(i.e.Planning,Pu61ic'?Works;.Fire,Sanitary,Sewer Disfrict,.School
-
,Dis"tAd etc. . ilhese. ees are based on the. relimind ;information,available'and'are onl an estiina"te.. 'Contact the Dept or addn''1 in o.'
FEE'ITEMS jFee Resolution 71-0i3 E : 7„ZI'!1.2). FEE, QTY/FEE- MISC JTEMS
Plan.Check Feer Hourly.Only.? '0 Ves ( No $0.00 'hours Pl'aa Check,Hourly
Suppl.PCeFee ,� Reg..C)'OT 0 0 lies, $0.00 $133.0'0 1sTPLNck
PME P1an.Check $0;.00
Perin,.ti”
Fee: ... . $0.00
Suppl_-Insp, Fee )',•Reg: "Q OT 0,0 hrs $0.00 :
PME Unit Fee:: $0.00
RMEPerinit Feer $0.001
Cohsli,W-:titin l=ax
Adininistrati,ve„Il eco.: �
Work Adithaut'Perriiii? '0 Yes ,E)°:No $0.00
Advanced,Plannin�Fee:. $0.00 Select•a.Non-Residential
TravelDc�cri�nentctrgtr FtrErs: Building or Structure Q
'Strom Motion:Fee: $0.00 Select an Administrative Item
.Bld'y,-Stds;Cornrnission Feer,
�ruB�TOTAi $0'.00 $1`33.00" T �FsE $1`33.00
Revised: 04/29/2013
CITY OF CUPERTINO BUILDING PERMIT.
BUILDING.ADDRESS 4fINFINITE LQOP CONTRACTOR DEVCON -PERMIT`NO: 130.40073
'CONSTRUCTION INC
OWNER'S NAME:`;APPLE COMPUTER ING 690 GIBRALTAR DR DATE:ISSUED:6/13(2013
'OWNEWS;PHONE: 4089743516' MILPITAS,CA, 9'503,5 PHONE NO:,(408)942=8200
❑ LICENSEDzeONTRACTOR'S•DECLAR,TION'
JOB DESCRIPTION. RESIDENTIAL L COMMERCIAL
L'ioense)Class . ,46_ Lic.# -,� r" INSTALL ONE3 COM'PARMENT SINK&ONE MAT WASH
�/ IN
Contractor, / �( �'h.�fi Date; (E),JANI.TOR'CLOSET•.-
I',hereby affirm,thafl arrr-Iicen'sed under ihe;provis►ons of, `apterv9 -,5/,15/203-DEFERRED SU'BMITTAL4 I: PLUMBING
f-Division 3 ofttie:Busmess:&Rrofessions�
,(comme,ncmg with Section 7000)0 _ PLAN/DIAGRAMS-.ISSUED OVER-THE-COUNTER
Goge!and'that'my license is inlull f6rceiyand,effect.
1 herchyaffirrim`under,penaltyof;perjui•y one.of the Mowing two,declarationsi
['have andwill maintain a.certificate',of'consent to self-insure for.Worker's
Compensation,as provided for by Section 3700 if i e`LaborCode;;for,the
perfo_rmance�of-the;work,for'which,ihis•permit:is-issued. Sq-FfFloorArea:, 'Valuation:$15000_ .-
,I:have and will.rnaintain.Wnrker's Compensation In'surance;;as provided for-'by
-' Section,3790 ofth_e Libor Code;for tfie:performanc_eof the work-foi which'this
A'PN`Number.'31602 602f0&66, Occupancy Type:
•:permif;isrissued.
APPLICANT CERTIFICATION
pr PERMIT EXPIRES IP WORK ISNOT I'certifythat I have read tfik,a lication and'state that the above information,is
correct I a ree toacom I with all ci ces,and,state1aws relating
g p y ty and county ordiiman WITHIN 180;,D IT ISSUANCE OR
to buildmg,construction,and hereby authorize"representatives of this city taenter
upon the above mentioned property formspection purposes (We)-agree to save 180 D CALLED;INSPECTION_.
indemnify'and keep harmlessJhe Cny,of Cupertino against liabilities judgments,
costs and•expenseswhich may accrue agamsi.said City in,consequence,of-the
' rantm of thl-s'ermit."Additional) thea li.7-- nderstands and'will coin I ued: Hate:, S
With
all non poin- source.regulations per'the,CupertinoMunicipal,Code„Section
\ .RE-ROOFS:
Signature Date 3' All roofs shallbe inspecf4prior to any roofing?material being installed.If a_roof is
installed,:without first obtain ing_;an'inspection,1-agree to remove all new materials-46i
inspection.
❑ OWN_ER-BUILDEKDECLA'RATION
SignatureW Applicant:. Date:_
t�hcreby affi�m;that:I•am exempt from:the,Contfictor=s;License;Law°for one o_f
the following two'reasons:, ALL;ROOF'COVERINGS TO BU CLASS"W'OR BETTER
I;as ownenof the,property;or myemployees with^wages as'theirsole compensation,,
Will do the work;andthe Wfwture:is not intended,onoffered for:"sale(Sec'7044,
Business:&,Erofessions Code)
I;as,owner,ofthe ro ert „a
_,p p yin exclusively con[racting witfi,lioensedcontractors to HAZARDOUS-M•ATERIALS'DISCLOSURE .
c_onstruofthe project(Sec.7044„Business&ProfessionsCoBe). Lhave read theshazardous materials requirements under Chapter.6:95'of•the
Calfocnia.HealthBr:Safety.Code;,Sections 35505„25533,and`,25534. Twill
J hereby-rafkrm under penalty oN eirjuryone`of the following three. maintain compliance with the Cupertino Mumcipal'Code,Chapter'9.12 and the
declarations Health&5afety:Code,Section 25 S2(a),should I store_or handle hazardous
m
1 have and;will mainta 'a:Certificate of Consentito�self=irfs6ie,f6tWorker's
material.-Ad ditionally;=should.I use equipment or deviceswhich emit.hazardous
Compensation,as'provided,forby,Section 3700`of the Labor Code,for,the air'cootammanisas dAneil',by-the�Ba'-Area A�r'Quality'ManagementDistrict`1
performance ofthe.work;forwhich,thivpermitgi'_s issued. will mainta[gveomphaoce'with the:Cuperiino;Muniol:ial Code;.ChapteF9.12iand,
I.have:and`will maintain Worker,s!,Compensatibn.Insurance;•as proyided4for 6y” the Health&-Safety'Code,Section ' 5505,25 d 2 4.
Section`3700 of the;-Labbt`Code for,thePerform_ance of;the work for'which this
permit,is issued: _ Owner;orauthorized agent to
I certify that in the performance of the work<.for which this:Permif is,issued;I shall
notemployany persorim any manner so as tobecome subject,fo the Worker's
CONSTRUGTION,LENDING.AGENCV
Compensationrlaws of Califomi& If,;aftei making this certificate of exemption;:)
.,becomeaubjectto•the'Woikec sCompensation provisions of.•,the'L"abor'Code;Lmust 'I hereby^affirm that fhere1s a.construction lendingvageiicyfortfie;performance of
forthwith comply.with,soch provisions+:orthis,pei7ni[shall*e.&emed.revoke_.d. worksToi which this permit is issued(Seo."3097,Civ C.)
LendeVs.Name-
AP,PLICA'NT'CERTIFICATION; Lender's,A`ddress _
certify that-l_have,read-this:applicaiion,,and state thatthe above information%is
correct.•)agree toacomy ti'-
plithall,cit'y and,county ordinances and,state')aws;re-lating,,
to building construction,-and hereby,'authorize representatives of this_city to enter-
upon,theiAnv-b4nentioned;property forlinspectioii purposes (We)agree to saVe,_
indemm 'and kee harmless.the:Ci" of Cu ertino;a ainst liabilities ud rents;, ARCHITECT'S DECLARATION.
f}.' P ty' p g J_.g,
costs and+ezpenses-which,may accrue again"st said City in>consequence:of,the. I,understand my�planstshall,be:used as public records-.
m
granting of this'permit Addifionally;,the applicani.understands Ad:
CITY OF C.UPERTINO BUILDING PERMIT'
BUILDING°ADDRESS': 4 INFINITE C0.OP CONTRACTOR:DEUCON 'PERMIT_NO; 13.040073
CONSTRUCTION'1NC
O'WNER'S NAME' APPLE'ICOMPUT,ER'INC 690 GIBRALTAR'DR• DATE .ISSUED.05/i3720i3
OWNER'S PHONE; 4089,743516. MILPITASiCA.9503`5: PHONE NO:(408)942'8200
D `LICENSED CONTRACTOR'S DECLARATION
JOB'DESCRIPTION: RESIDENTIAL ElCOMMERCIAL"0.
License:Class: Lic:;#f INSTALL ONE 3 COMPAR'MENT'SINK&ONE MAT WASH'
IN
ConfractordJe'V fy1 (�b�f !UeJ Date ` �' (E)JANITOR;CLOSET.
I hefebyaffirm:tlrat I am,licensed;und"er`the provisions;of C apter9
:J, men cing,with;Seetion°7000)of Division 3'of'the:Busiiiess&:Professions
Code and`that mylicens,is in,full foree.and""e'ffcet:
;I`hereby aff_rin under penalty of;perjury°one,of'the;following two;declarations;.
I have and;wiii,inaintain,a certificate of consent---to,self insure`for Worker:'s
Compensation,as+provided.foi by Section 3700.of the Labor Code,for the
performance d the'woik.'for which,this•permit,i's issued;,-. Sq.-Ft Floor.Area Valuation:$45000
J have and will•,maintain Worker's Compensation Insurance„as provided for.'by
Sect�on:37�00 of the;Labor;Code,foi`th&performance of tfie work for which'this
APN Number:3l`602108'_00 Occupancy Type:
;permit isJssued.
APPLICANT CERTIFICATION
• 1`certify thaf I have read`this application and state°that the above inforination;is PERMIT EXPIRES.,IF`W.ORK IS NOT°STARTED
correct;,,I agree to�corriply with,all city and`county ordinances and st_ate;�lawsrelating
to 0gilding,constr9ction,and hereby;authorize represen"tati'ves ofihiscityto enter WITHIN 180�DAY,S,OF PERMIT,ISSUANCE
, 'OR
u onithe ab6V6inentioned:property'for inspectionapurposes ,(We)agree tosave 1gO DE1YS , ' VAST CALLED INS'PECTIQN,
indeinn-ify4fid.keep harmless the,City,of'Cu&rtino against liabilities,judgments,,
costs and expenseswhich may,accrue agamstsaid City in conse4derice'�bf the
graniing,of 6s�permit.4Addiiionally,theapp hcanLundeistinds'and will.comply Date: � � ?� �3
with all non-pointsource regulatrons:per the Cupertino Municipal'Code,Section,
RE'ROOFS:
Signature Dates 5 All,roofs shall be;inspected priortoany<roofing mateiialbeing installed.lf a roof is
installedwithout_-firsvobtaining,an mspection„I agree to remove;alf;new materials for
inspection.
❑ :OWNER=BUILDER'DECLARATION
Signature of.Applicant: Date:
I:herepy affirm thatj din.ezenipt�from.the Contractor's beenseLaw for one of
theifollowirig two-reasons: ALL ROOF CO_VERINGS,TO-BE CLASS"A".OkBE1TER.
I;as Owner of th&property,or my.employeeswith_wagesas•theirsole.compensation,
will_dothe`work;°and theistructure is not�interid'ed or'offered forsafe3(Sec.7044; -
Mi'ness�&Professioris.Code),
a,asoowner'of the property,am e_xclusivel_y-contracting with.'li'cddsed'contractors,to HAZARDOUS°MATERIALS DISCLOSURE
eonstructaheiproject(SecP7044;Busine`ss�&Professions Co.de).. I haveread.the hazardour;materials requirements under Chapter 6195 of4he
= California,Healt6&-Safety Code,�Sections25505,•25533„and 25534.T will
- I,hereby affirm under,peuaityof'perjuryone ofthe following'three maintain compliance withlthe Ggpertino.Mpnicipal Code,Chapter 9.12 and the
declar`atioos: Health,&,Safety Code,Section 25532(al.should I store oe handle hazardous
Lhave,an&W ll maintain`a,Certificate of Consent�toself-insufekfor,Worker:'s material. Additionally,should I use'equlpment or'devices which emit'liazardous
Compensation„as provided'for by,Section 37,Wofihe1Labor Code;for the aircontaminants�as defined by the-Bay Area.A�r Quality Management.District;I
performanceofthe work;forwhichtl5ispermrt isissueil_ will maintain compliance with the�GupertinoMumci,pal Cod e„Chapt_erv9:12"and:
l,have and'will maintain UVorker s &'
:Co.mpensation_Insurance,as by
the Health SafCN Code,Sections:25505,2 nil'; 34.
Secfion.3700 of the Labor Code for the perforniance,of,thetyork for which this �7y�
,. Owner or authorized agent
permit-is : ate
issued
l,certify.[hat m[lie;performancerofthe,work',for'which this permit isrssued;lshall,
not einploy'any'person m anymannerso alto become subject`to the Worker's
CompcnsatibnIaw§of California.;If,,,after making'
this certl_ficateJofexemption;:I
CONSTRUCTION'LENDINGiAGENCY
6ecome;subject to'the'Worker's Compensahon,provision"s'of tfie;La6or,Code,,lrnust ,I hereby,affirm that there=is.a,construchon lending agency for the performance_of
forthwith complywith such_ proyisrons oiahisjpe-r—i it'shalbbe;deemed:revoked. worksj-for which,thisepermit is,issued(Sec'`3697,Civ C.)
:Lender'sJName'
APPLICANT"CERTIFICATION ,Lender's Addf.css -.
I certify-that,I have re.ad'this application+andstate.thatthe,ab-oveiinformation,is
correct: l,agree'to comply with ail_c6,and,courity ordinances and',state lawslrel-afing;
'to building construction;-anil;hereby`,autlio�izeaiepresentatives+of.this:city�io,ente_-
upon.the above mentioned property for msp`ection,purposes (We)agree to sayer _
indemnify and keep hdffilessthe City'of'Cuper-tinolagai'nst liabrlrties�udg"pients;. ARCHITECT'S"DECLARATION.
c6nay,accrue
tyJn
g�anting of th s permR'Add_i[ovally,th eappLcaiitun ' o
derstandS and will.comply
I understand,my plans sfiall'be usedi:as public record's.
wrthvalLnon-point source.regula_tions perthe Cupertmo.Municipal Code,Section Licensed Professional
9.18.
-Signature Date
CITY OF'CUPERTINO
FEE ESTIlVIATOR.— BUILDING DIVISION
..ADDRESS: 4INFINITE LOOP DATE: 04/04/2013REVIEWEp BY:-'MELISSA ,
APN '. 316 02 1`08
BP#;; 3;� ���3 'v"ALUATION: $15,000
PERMIT TV U., Building:Permit P.LANCHECK TYPE: Alteration/'.Addition / Repair
PRIMARY PENTAMATION
C;omme1.rcial`B'uildln9, 1:GENCOM
USE PERMIT TYPE:
wURK INSTALL ONES C:QMRARMENT SINKS&ONE MAT WASH IN PREP.ORATION OF FUTURE
SCORE. AODITION
:.[77
l
.. � ,f a - �S' � _:&" ;'; -",� �...v , a•., zw5 5 ro .mtwa- - .� �C,•.�".. _�:._ u' �
ifec%r Plan C'6ieck Plumb.Plan Check 0.0 hrs $0:00 Iit>c.Plan Chock
Plumb:PermitFee: 1,PPER1UT' !7-c.pekinir Pe�:
l)r1�et iClech.'Iizsr�' Other Plumb Insp. 0.0 hr§- . '$45:00 Oji ct.l..leC.jn,PLi
.
daec'hlnsp.F'e:e: P;iarzla. Ii���a. Tt>e:" I"lc�.Insp.gl'en.
NOTE.ATh'isestiinate,doesno"t'indudefeesdue loother Departments,(i.e.Planning,.Public.Works,,Fire,Sanii Sewer District;School'.
;District,.etc).-'-These ees are>`basedwkthe reli»iiiia information aivailable.and.are onl .,an�estimate. Contact,thefDe t or addh!l,iiz o.
FEE ITEMS';&F Aesol ikh,114 Ef 7/1%1,2: FEE QTY/FEE MISC ITEMS
Plan CtieckFeer Hourly Only? 0 Yes . No, ;$0.00F 1 hours Plan ck,`CheHourly
0.
S.'uppl: PC,Fee Reg: QT- 0:0 hrs $.0.00 $133'.00. STPENCx'
-OME Plan Qheck $0.00 1 # Plumbing
Peiintt Eeec• = '
'Houk :Onl ? Yes No
y y � Q $0,.0.0 $1.0:00 IBPFIXTURE° Fixture set on One Trapp
� ..
Suppl.,Insp Fee;•)Reg,, Q"OT :0;0 .hrs $0.00
RM E Unit Fee: $0.00
P.ME Permii;Fee: $45.00
Oons7r,'z.�ctiun'Tax
AdintnistrattveFee ]ADMIN $
e - 42:00
Work'Without'PerimV. Yes' e No.
Advafice_&Planni'tig_Fee'; $0.00.
_ lours Inspections 0
'Tnkyel'Document.ttori:Fee:, ITRA wDoc W'!,,W ;$266'A0
'IST Inspection,Hourly 0A .
_
Stron`€
Motion.Fee » 1BSEISAIICO `$3_.1;5` S'elect.an Adrriinisfrative Item
5`tds'iComm.ission Fee:, IBC-BSC- $1.00
sUpBTo�ALsF $13:6:15 $409 0.0 b o'rAL,f $545:1`5
I Revised: 04%01/2013 ` .