10080046 CITY OF CUPERTINO BL ILDING PERMIT
BUILDING ADDRESS: 20300 STEVENS CREEK BLVD CONTRACTOR:DEVCON CONSTRUCTION PERMIT NO: 10080046
INC
OV",711'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED:08/05/2010
C 'ER'S PHONE: 4089745951 MILPI7 AS,CA 95035 PHONE NO:(408)942-8200
LICENSED CONTRACTOR'S DECLARATION r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.#
C f� MECH RESIDENTIAL r COMMERCIAL r
Contractor C Date � C/
1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DI?SCRIPTION: IST FLOOR-COMM'L TI-CONSTRUCTION(I)FULL
(commencing with Section 7000)of Division 3 of the Business&Professions HEIGHT PARTITION WALL,INSTALL NEW DOOR W/CARD
Code and that my license is in full force and effect. READEF_,PAINT NEW WALL,CARPET FLOOR&RE-WIRE
I hereby affirm under penalty of perjury one of the following two declarations:
1 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 F oor Area: Valuation:$14000
permit is issued.
APPLICANT CERTIFICATION APN Number:36901019.00 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 181) DAYS M LAST CALLED INSPECTION.
with all non-point source regulations per the Cu rtino Municipal Code,Section
9.18.
- � Issued 3y: - -!� Date:
e
Signature
r OWNER-BUILDER DECLARATION
RE-ROOFS:
1 hereby affirm that I am exempt from the Contractor's License Law for one of All roof shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,1 agree to remove all new materials for
1,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) Signatur�of Applicant: Date:
1,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
1 hereby affirm under penalty of perjury one of the following three
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 1 have r-ad the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. Califorr,fa Health&Safety Code,Sections 25505,25533,and 25534. 1 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(s)should I store or handle hazardous material.
Additio tally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will
I certify that in the performance of the work for which this permit is issued,I shall maintai i 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. SCode,Section 5,25533,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,1 must ;
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
1 certify that l have read this application and state that the above information is 1 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 whic n 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
in,' •ify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
C( td expenses which may accrue against said City in consequence of the
g g of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
H I non-point so a regulations per the Cu o unicipal Code,Section —
9.18. / I undets and my plans shall be used as public records.
Signatur U / License I Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20300 STEVENS CREEK BLVD
CONTRACTOR: DEVCON CONSTRUCTION
PERMIT NO: 10080046
INC
OWNER'S NAME: APPLE INC
690 GIBRALTAR DR
DATE ISSUED: 08/05/2010
OWNER'S PHONE: 4089745951
MILPITAS, CA 95035
PHONE NO: (408)942-8200
• LICENSED CONTRACTOR'S DECLARATION
F
�/RATION BUILDING
BLDG F
I
PERMIT INFO: ELECT PLUMB
License Class Lic. # ! (l
ril r.
C
Contractor Date J
MECH RESIDENTIAL COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: I ST FLOOR - COMM'L TI- CONSTRUCTION (1) FULL
(commencing with Section 7000) of Division 3 of the Business & Professions
HEIGHT PARTITION WALL, INSTALL NEW DOOR CARD
Code and that my license is in full force and effect.
READER,PAINT NEW WALL, CARPET FLOOR & RE-WIRE
I hereby affirm under penalty of perjury one of the following two declarations:
1 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
Sq. Ft Floor Area:
Valuation: $14000
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
APN Number: 36901019.00
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 M LAST CALLED INSPECTION.
with all non-point source regulations per the Cu Lino Municipal Code, Section
9.18.
Signature Dat e— 5�
Issued by: — 5--/0 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
constrict 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:
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
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. 1 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.
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 b the Ba Area Air
y y Quality Management District I will
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 & SCode, Section 5, 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
Ow r uthorized age j'
forthwith comply with such provisions or this permit shall be deemed revoked.
Date c.5 Q
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
I certify that 1 have read this application and state that the above information is
I hereby affirm that there is a constriction 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 so a regulations per the Cu o unicipal Code, Section
ARCH 1TECT'S DECLARATION
9.18.
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS:
FLR AREA
(Sq -ft-)
DATE:
REVIEWED BY:
BP FEES
BP FEE ID
APN:
BP#:
`VALUATION:
1$14,000
*PERMIT TYPE: Building Permit
$1,185.61
PLAN CHECK TYPE: Tenant Improvement
Permit Fee:
PRIMARYCommercial Building'TOTAL
USE:
FL OOR .4RE,4:
APPLICATION
TYPE:
1 B TI i
1VIECHANICAL cQ, Yes No
PLUMBING 0 Yes. �: No ELECTRICAL
$0.00
as
$0.00
Construction Tax
00
.
Acoustical Fee: Yes Q No
3�
E)
Work Without Permit? Q Yes Q No
$0.00
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
(Sq -ft-)
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
II-B,111-B,IV,V-B
1,323
$1,907.26
IBTIPLNCK
$1,185.61
IBTIINSP
Permit Fee:
$1,185.61.
Suppl. Insp. Feer Reg. 0 OT
0.0
hrs
$0.00
P
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax
Acoustical Fee: Yes Q No
$0.00
E)
Work Without Permit? Q Yes Q No
$0.00
TOTALS:
1,323
$1,907.26
Travel pocumentittion.F'E�es:
$1,185.61
Strong Motion Fee: IBSEISMLCO
,loch. P101.1 Check
Mech. Permit Fee:
Other Alech. Insp.
Pltrmh. Pltur C/teelc Eiec. Plan Check
P/undh, Perrnii Fee: Elec. Permit Fee:
Other Plumb. his)). Other Elec. I ap. FT
NOTE: These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resohilion 09-051 E f.• 7;'1!09)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$1,907.26
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (F) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,185.61.
Suppl. Insp. Feer Reg. 0 OT
0.0
hrs
$0.00
P
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax
Acoustical Fee: Yes Q No
$0.00
E)
Work Without Permit? Q Yes Q No
$0.00
Planning IJe,e: PLLONGRNGC
$330.75
Select a Non -Residential
Building or Structure
�
Travel pocumentittion.F'E�es:
Strong Motion Fee: IBSEISMLCO
$2.94
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
a SUBTOTALS:
$3,427.56
F,
$0.00 TOTAL FEE
$3,427.56
Revised: 7/28/2010