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11070153I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10475 BANDLEY DR I CONS RUCTOION E CON I PERMIT NO: 11070153 OWNER'S NAME: ❑ LICENSED CONTRACTOR'S rDECLARATION License Class_ Lic. # Z-%'S/ /,6 Contractor KA& ,-ti ff _Date �Chvt,-9 I hereby affirm thatl am licensed under the provision (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 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 whichthis 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. APPLICANT CERTIFICATION 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 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 with all non -point sour gulations per the Cupertino Municipal Code, Section 9.18, Signature Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, 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 construct the project (Sec.7044, Business & Professions Code). I (hereby affirm under penalty of perjury one of the following three 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 permit is issued. 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. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 690 GIBRALTAR DR I DATE ISSUED: 02/03/2012 MILPITAS, CA 95035 1 PHONE NO: (408)942-8200 JOB DESCRIPTION: RESIDENTIAL APPLE PROJECT PHASE 2-TI IMPROVEMENT OF CUBACLE & PRIVATE OFFICE SPACE, LOBBY ENTRY, RESTROOMS, BREAKROOM, & CONFERENCE ROOM. NON- STRUCTURAL Sq. Ft Floor Area: I Valuation: $625000 APN Number: 32633111.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued Date: ,-:3—/2 RE -ROOFS: 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. Signature of Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupe o Municipal Code, Chapter 9.12 and the Health & Safety Code, Sec 'ons , 25 3, grid 25534. Owner or authorized Dater CO �UCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION understand my plans shall be usedas public records. Licensed Signature Date CITY OF CUPERTINO FM_F FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10475 bandley drAe6bD6-15 I DATE: 07/21/2011 REVIEWED BY: bobs. APN: BP#: D "VALUATION: 1$625,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION 1 B TI PERMIT TYPE: WORK hase 2 - t.i comm. offices ace non structural includes mech elect plumbing. No new hvac units SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 9,372 $2,433.96 /BTIPLNCK $5,782.70 /BTIINSP TOTALS: 9,372 $2,433.96 $5,782.70 MECH, HOURLY 0 Yes 0 No PLUMB, HOURLY 0 Yes 0 No ELEC, HOURLY Q Yes 0 No Li NOTE: These fees are based on the nreliminary information available and are onlv an estimate Contact the Dent for addn'l info. FEE ITEMS (Pee Resolution 11-053 E . 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,433.96 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $5,782.70 Suppl. Insp. Fee:O Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (,'nats[rrrttiuir .!r1L Acoustical Fee: 0 Yes 0 No $0.00 0 0 Work Without Permit? 0 Yes 0 No $0.00 Planning Fee $0.00 Select a Non -Residential Building or Structure 0 0 i Strom Motion Fee: IBSEISMCO $131.25 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $25.00 SUBTOTALS: $8,372.91 $0.001 TOTAL FEE: $8,372.91 Revised: 07/04/2011 CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 10475 bandley dr. /09 DATE: 07/21/2011 REVIEWED BY: bobs. APN: a ` BP#: o 3 "VALUATION: $625,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION 1 B TI PERMIT TYPE: WORK Phase 2 - t.i comm. offices ace non structural includes mech elect plumbing. No new hvac units SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 9,372 $2,433.96 1BTIPLNCK $5,782.70 1BTIINSP TOTALS: 9,372 $2,433.96 $5,782.70 MECH, HOURLY © Yes (F) No PLUMB, HOURLY 0 Yes Q No ELEC, HOURLY 0 Yes (D No - Li Ll NOTE. These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7/1111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,433.96 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: G Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $5,782.70 Suppl. Insp. Fee{') Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (, {7fwLIl1 wrion TtI,k Acoustical Fee: 0 Yes (D No $0.00 Q Work Without Permit? 0 Yes G No $0.00 Planning Fee: $0.00 Select a Non -Residential Building or Structure O O i l'rtir4 >; 1:af,<:I�r7r rr;itin l.t'czr�: Strom; Motion Fee: /BSEISMICO $131.25 Select an Administrative Item Bldg Stds Commission Fee: /BCBSC $25.00 SUBTOTALS: $8,372.911 $0.001 TOTAL FEE: 1 $8,372.91 Revised: 07/04/2011