11080177CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 10131 BUBB RD I CONTRACTOR: 1 MECHANICAL INICED I PERMITNO: 11080177
OWNER'S NAME: APPLE INC 12161 OAKLAND RD I DATE ISSUED: 1 1/02/201 1 1
I OWNER'S PHONE: 4089744876 1 SAN JOSE, CA 95131 1 PHONE NO: (408)232-9000 1
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. N�g-LVng;—
Contractor Date
1 hereby affirm that 1 am licensed under the provis' ns of 4apter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
1 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.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. 1 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 re ulations per the Cupertino Municipal Code, Section
9.18. ;
Signaturez�w:];;�7Date-L?�%`/?�7�`
❑ OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons:
I, 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)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
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
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.
F_ F 1
BUILDING PERMIT INFO: BLDG ELECT PLUMB
F_
MECH RESIDENTIAL
F_ r—
COMMERCIAL
JOB DESCRIPTION: APPLE - REPLACE EXISTING 8 HEAT PUMPS
**SEE NOTES"
Sq. Ft Floor Area: I Valuation: $1 12000
APN Number: 35720004.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAY OM LAST CALLED INSPECTION.
Issued by: �tt,74 Date:
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 Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 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 1
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25 , 2559, and 25534.
Owner or authorized agent: •Date:
CONSTRUCTION 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 Ad
ARCHITECT'S DECLARATION
1 understand my plans shall be used as public records.
Licensed Professi
Date
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10231 BUBB RD
CONTRACTOR: UNITED MECHANICAL INC
PERMIT NO: 11080177
OWNER'S NAME: APPLE INC
2161 OAKLAND RD
DATE ISSUED: 11/02/2011
OWNER'S PHONE: 4089744876
SAN JOSE, CA 95131
PHONE NO: (408)232-9000
❑ LICENSED CONTRACTOR'S DECLARATION
0 f— F r
<Z a rr
��
INJILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic. tl OJ
��(
[_ r—
F
I
Contractor Date
MECH RESIDENTIAL COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: APPLE - ACE EXISTING 8 HEAT PUMPS
(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 declaratio
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.
Sq. Ft Floo A a:
Valuation: $I 12000
1 have and will maintain Worker's Compensation Insurance provided for by
Section 3700 of the Labor Code, for the performance of the work which this
APN �er: 35720007.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and. state that the above informati is
correct. I agree to comply with all city and county ordinances and state law relating
PERMIT EXPIRES IF WORK IS NOT STARTED
to building construction, and hereby authorize representatives of this city to ter
upon the above mentioned property for inspection rposes. ee to sa a
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino ainst liabilities, udgmen
180 DAYS FROM LAST CALLED INSPECTION.
costs, and expenses which may accrue against said ty in consequen of the
granting of this permit. Additionally, the ica t u ers[ands and wi co
with all non -point source re ulations per the pert.- unicipal Code Se on
Issued Date:
9.18.
J I
Signature V AADa I r
RE -ROOFS:
❑ OWNER -BUILDER DECLAIATION
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
I hereby affirm that I am exe from the Contr tor's Li use Law for one of
inspection.
the following two reasons:
I, as owner of the property, or my emplo es with wag as eir sole compensation,
Signature of Applicant: Date:
will do the work, and the structure is not int ed or o for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracti i licensed contractors to
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
construct the project (Sec.7044, Business & Professio s Code).
I hereby affirm under penalty of perjury one of a following three
HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain a Certificate of Consen o self -insure for Worker's
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
Compensation, as provided for by Section 370 of the Labor Code, for the
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
performance of the work for which this permi is issued.
Safety Code, Section 25532(a) should I store or handle hazardous material.
I have and will maintain Worker's Compens ion Insurance, as provided for by
Additionally, should I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code, for the pe ormance of the work for which this
contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
[ certify that in the performance of the w rk for which this permit is issued, I shall
not employ any person in any manner as to become subject to the Worker's
ier or uthor' n
Compensation laws of California If, fter making this certificate of exemption, I
become subject to the Worker's Co pensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
APPLICANT CERTIFICATION
for which this permit is issued (Sec. 3097, Civ C.)
I certify that I have read this application and state that the above information is
Lender's Name
correct. 1 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
Lender's Address
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
ARCHITECT'S DECLARATION
granting of this permit. Additionally, the applicant understands and will comply
I understand my plans shall be used as public records.
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18•
Licensed Professional
Signature Date
CITY OF CUPERTINO
FM-7 FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10231 bubb rd.
DATE: 08/24/2011
REVIEWED BY:
APN:
BP#:
"VALUATION: 1$112,000
*PERMIT TYPE: Mechanical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY Commercial Building
USE:
PENTAMATION FURN/AC
PERMIT TYPE:
WORK
lace existing 8 heat pumps.
SCOPE
�re
APPLIANCE / EQUIP TYPE
FEE ID
QTY
UNITS
BP FEES
Heat Pump (<=10K cfm)
1BCAIRHA
8
#
$1,040
TOTALS:
$1, 040.00
Mech. Plan Check 0.0 hrs $0.00
Mech. Permit Fee: IMPERMIT
.
Other Mech. Insp. 0.0 hrs
NOTE: These fees are based on the vreliminary information available and are onlv an estimate. Contact the Devt for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E . 7,1/11)
FEE
QTY/FEE
MISC ITEMS
PME Plan Check:
$0.00
PME Unit Fee:
$1,040.00
PME Permit Fee:
$44.00
("o, varnc.'f un Tor
-T-1
Acom,,tL t Rcview F c
Work Without Permit? O Yes (D No
$0.00
f'laniang Fee.,.,
i
Travel Documentation Fee: ITRAVDOC
$44.00
Strong Motion Fee: IBSEISMICO
$23.52
0.5 hrs Admin./Clerical Fee
$41.00 IADMIN
Bldg Stds Commission Fee: IBCBSC
$5.00
SUBTOTALS:
$1,156.52
$41.00 TOTAL FEE:
$1,197.52
Revised: 07/04/2011