11120080 I
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CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20330 STEVENS CREEK BLVD CONTRACTOR:DEVCON CONSTRUCTION PERMIT NO:11120080
INC
OWNER'S NAME: WW DASC OWNER LLC 690 GIBRALTAR DR DATE ISSUED: 12/13/2011
OWNER'S PHONE: 4089961010 MILPITAS,CA 95035 PHONE,NO:(408)942-8200
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# 15C /j- 3 r r
ryry�
�� 1 (.1/ 1 / MECH RESIDENTIAL COMMERCIAL
Contractor A__?y&P t��10n("Mate /O)-8
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:APPLE-4TH FLOOR-COMMERCIAL TENANT
(commencing with Section 7000)of Division 3 of the Business&Professions IMPROVEMENTIND RAL,INCLUDE MECHANICAL&
Code and that my license is in full force and effect. ELECTRICAL;NOO PLUMBING
LU
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 Sq.Ft Floor Area: Valuation:$30000
permit is issued.
APPLICANT CERTIFICATION APN Number:36901020.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
Signature C a" ( - Date ODZ Issued b_: Date: _
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
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 I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
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 Ownearbr author' agent; / lJ
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
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.
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Signature Date Licensed Professional
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CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT^BUILDING DIVISION j
10300 TORRE AVENUE^CUPERTINO, CA 95014-3255 i
(408)777-3228•FAX(408)777-3333•buildinc CeuRg1 ino.arg
CUPERTINO
❑NEW CONSTRUCTION ❑ ADDrrION ❑Q ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDREss 20330 Stevens Creek Blvd. 7APN 369-01-020
OWNERNAME Apple Inc. 1 3 1( F'`ti � _-/k PHONE 408.974.3516 E-MAIL vchow@apple.com
STREET ADDRESS CITY,STATE,ZIP FAX
1 Infinite Loop Cupertino, CA 95014
CONTACT NAME Silvia Lee PHONE 650.365.0600 x 12 E-MAIL sloe@thehayesgroup.com
STREFr ADDRESS 2657 Spring Street CITY,STATE,ZIP Redwood City,CA 94063 FAX 650.365.0670
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONrRACrOR ❑CONrRACrORAGENT 0 ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTORNAME Darcy Narduzzi LIC ENSENUMBER 2A37
LICENSE TYPE An BUS.LIC#
COMPANYNAMEDevoon Construction, Inc E-MAIL dnarduzzi@devcon-const.com /�'��j FAX Og. UZ •t2t1
STREET ADDRESS 690 Gibraltar Drive CITY,STATE,ZIP Milpitas,CA 95035 PHONES 408.519.8321 .TI
ARCHITECT/ENGINEER NAME Ken Hayes LICENSE NUMBER C-1555562 BUS.LIC#
COMPANY NAME Hayes Group Architects,Inc. E-MAIL khayes@thehayesgroup.com FAX 650.365.0670
STREET ADDRESS CITY STATE,ZIP PHONE
2657 Spring St. ,.� Redwood City,CA 94063 650.365.0600
ke
DESCRIPTION OF WORK Tenant Improment for portion of the(Ourth floor of an existing office building consisting of new
offices and finishes.
EXISTING USE PROPOSED USE CONSFR TYPE #STORIES OFFICE USE ONLY
Office Office-No Change (l-A 4 OCC TYPE DESCRIPTION _S0,FT, VALUATION
EX[STG NSR'FLOOR 0 SF DEMO 0 SF TOTAL S F r
AREA SF AREA AREA NET AREA 4--- J 0,6VG✓
BATHROOMKrrCHEN OTHER
REMODEL AREA O SF REMODELAREA 0 SF REMODEL AREA 675 SF
PORCHAREA DECKAREA TOTAL DECK/PORCH AREA I GARAOEAREA:❑ DETACH
NA NA NA NA ❑ATTACH
#DWEI.IINGII. IS A SECOND UNrr ❑YES SECOND STORY ❑YES
BEINGADDED7 ®NO ADDMON7 ®NO
PRE APPLICATION ®YES IFYFS,PROVIDE COPY OF PLANNER'S NAME RECEIVED BY:&--)
PLANNING APDL# NG PLANNINGAPPROVALLIn-m NA !-� AG':� )
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the. 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. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature ofApplicant/Agent _ Date:
SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP
OVER•TJ3E-couNTER El BUILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_ e ❑ STANDARD ❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project. ❑ LARGE FIRE DEPT
to
submittal of Building Permit application. El MAJOR El SANITARY SEWER DISTRICT
❑ ENVIRONMENTAL HEALTH i
B1dgApp 2011.doc revised 03116111
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Building Department
artment
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City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P S RT I nl® Fax: 408-777-3333
CONTRACTOR SUBCONTRACTOR LIST
JOB ADDRESS: 'e PERMIT#
OWNER'S NAME: PHONE#
GENERAL CONTRACT R: BUSINESS LICENSE# `
ADDRESS: ¢ r tt -_ CITY/ZIPCODE: i
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND 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:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/ Carpeting
Linoleum/Wood
Glass/Glazing
Heating r�2 ?
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper 0jj
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock Al t1l0—
Tile
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Owner Contractor Signature Date
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CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20330 stvns crk blvd. 4th floor DATE: 12/13/2011 REVIEWED BY: bobs.
APN: BP#: "VALUATION: 1$30,000
'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building PENTAMATION 1 B T)
USE: PERMIT TYPE:
WORK t.o, comm offices ace non structural include M E no plumbing.
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
B (Tenant Improvements) II-A,111-A,V-A 0 $0.00 $0.00
TOTALS: 0 $0.00 $0.00
MECH,HOURLY . O Yes (E) No PLUMB,HOURLY 0 Yes Q No ELEC,HOURLY Q Yes Q No
';4y r 1ri r£,r�e�l„ z'izar:rlt.
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . Thesefees are based on the prelinina information available and are only an estimate. Contact the De t or addn't info,
FEE ITEMS (Fee Resolution 11-053 Eff 71LILIZ FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? Q Yes E)No $0.00 0 hours Plan Check,Hourly
Suppl.PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $130.00 1STPZNCx
PME Plan Check: $0.00
Permit Fee: Hourly Only? Q Yes G No $0.00
Suppl.Insp.Fee:Q Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Work Without Permit? 0 Yes (F) No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential G
Building or Structure 0
Strong Motion Fee: IBSEISMICO $6.30 =hrs Inspections
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Bldg Stds Commission Fee: IBCBSC $2.00 $910.00 1STINSP Inspection,Hourly
SUBTOTALS: $8.30 $1,040.00 TOTAL FEE:
$1,048.30
Revised: 12/04/2011
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