11030075CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10400 RIDGEVIEW CT
OWNER'S NAME: APPLE INC.
OWNER'S PHONE: 4088624397
❑ LICENSED CONTRACTOR'S DECLARATION
License Class 1 Lic.# 3g e1 !6
Contractor () 1�_ V COW e6AIEJ� Date s—
I hereby affirm that I am licensed under the provisions of Chapter 9
(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:
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 wo� r which this
permit is issued. / L . I
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.
Signature Date3 /5'-1
❑ OWNER -BUILDER DECLARATION
I 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.
CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 11030075
INC
690 GIBRALTAR DR DATE ISSUED: 03/15/2011
MILPITAS, CA 95035
PHONE NO: (408)942-8200
BUILDING PERMIT INFO: BLDG r— ELECT r PLUMB r
MECH r— RESIDENTIAL r— COMMERCIAL r
JOB DESCRIPTION: 3 OFFICES- COMMERCIAL TENANT IMPROVEMENT
INCLUDING
NEW LIGHTS, CEILING, WALL, DOORS & FRAME,
NON-STRUCTURAL
Sq. Ft Floor Area: Valuation: $15000
APN Number: 31606046.10400 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Date: �-f
RE -ROOFS:
Al I roofs shall I be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove al I new materials for
inspection.
Signature of Applicant:
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. 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 I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owne or authorized a rt:
Date: �—
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of %ork's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
Signature Date
I understand my plans shall be used as public records.
Licensed Professional
( f��-06-7�
CITY OF CUPERTINO
FM_
I FEE ESTIMATOR - BUILDING DIVISION
19
ADDRESS: 10400 ridgeview ct.
DATE: 03/15/2011 7REVIEWED
BY: bobs.
APN:
BP#:
I "VALUATION:
1$15,000
'PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
PENTAMATION 1 B TI
PERMIT TYPE:
WORK
t.i. comm. offices ace non structural include M E Ps.
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE 1D
BP FEES
BP FEE 1D
B (Tenant Improvements)
II-B,III-B,IV,V-B
483
$1,865.32
IBTIPLNCK
$641.02
IBTIINSP
TOTALS:
:4:83
$1,865.32
$641.02
MECH, HOURLY 0 Yes (E) No
PLUMB, HOURLY Q Yes Q No
ELEC, HOURLY Q Yes Q No
C1,`ifa'i' r�i:.4.'!1. G•.'s;:_
E'tflu'r t�lllAli
O?l�c:r !. f�-.,�.
NOTE: These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addn 7 info.
FEE ITEMS (Fee Resolution 09-051 E . 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$1,865.32
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 0 Reg. 0 OT
0.0
h.
$0.00
PME Plan Check:
$0.00
Permit Fee:
$641.02
Suppl. Insp. Fee{'0 Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
{.rrlSlY�rr'tit�at 'l.'r.,,
Acoustical Fee: 0 Yes (F) No
$0.00
0
Work Without Permit? 0 Yes G No
$0.00
Planniny, Fee:
$0.00
Select a Non -Residential
Building or Structure
0
Strong Motion Fee: IBSEISMICO
$3.15
Select an Administrative Item
Bldg: Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$2,510.49
$0.00
TOTAL FEE:
1 $2,510.49
Revised: 01 /15/2011
� � 3 00-7 S
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
CRUPERTINO (408) 777-3228 - FAX (408) 777-3333 • buildinG@..cuoertino.org
NEW CONSTRUCTION ❑ ADDITION / ALTERATION ❑ REVISION / DEFERRED SUBMiITAL
PROIEGT ADDRESS1
4'
APN p I O
0 as e V f C e
OWNER NAME
PHOLAJL
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STREET ADDRESS
CITY[, STATE, ZIP
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FAX
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APPLICANT NAME V f a*AW & *R F'S&X�`Ci •
PHONE
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STREET ADDRESS
Geto G-T69k*(-_S"
CITY, STATE, ZIP
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FAX
68- 2 G2-23ti2
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT NLcoNTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC p
t)EV60AJ GOnr r.
13 -
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS -10 t aRA T 2
CITY-rATE sT �c C 15 zip
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PHONE
ARC =CT/ENGTNEER NAMELICENSE NUMBER
S{}qn� SCOLIMI kPaR
BUS. LIC N
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CRY, STATE, ZIP
PHONE
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IV
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EXISTING US
PROPOSED USE
CONSTR. E
p STOR¢$
EXISTG
AREA
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA
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-
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BATHROOM
KITCHEN
OTHER9.
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REMODEL AREAREMODEL
AREA
REMODEL AREA
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PORCH AREA
DECK AREA
TOTAL DECKIPORCH AREA
GARAGE AREA. ❑ DETACH
_
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=-_••
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❑ATTACH
- ` _
^Y
_
9 DWELLING UNrIS:
IS A SECOND UNIT ❑YES
SECOND STORY ❑ YES
u
BEING ADDED? NO
ADOmON7 ❑ NO
PRE -APPLICATION ❑ YES
IF YES, PROVIDE COPY OP
PLANNER'S NAME:
RBCENEQ&Y r r"
� �"T AL VALUAT�IQiNIrl yp -
T`--"
#
PLANNING APPL # ❑ NO
PLANNING APPROVAL LETTER
yv _-' •"1 i , t
( j
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property 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 uilding constru tion. I au rize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent:
Date: 3" $—
SUPPLEMENTAL INFORMATION QUIRED
SFD or Multifamilydwellings: APP1 for demolition permit for
A�OV"New
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
a
Cl C► rr cGUNTER I rrrLaNI y
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
E7EPRESSF zPLANNITLE HI AtV R&F a. '
form if any Hazardous Materials are being used as part of this project.
� STANDARD - �'PiIBLIE;I�I!ORKS;�.... r':
_ Copy of Planning Approval Letter or Meeting with Planning prior to
( LnlicE ❑ 1P= Deixr
submittal of Building Permit application.
Q Mn rOR C :ENVIRolVb1ENTAS HEALTH '
B1dgApp_201 Ldoc revised 03/03/11
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: JOL100 AX06L VlfWj,
CovAr PERMIT #
OWNER'S NAME: APPLE
PHONE # C-10 9 • Cfz- q 400
GENERAL CONTRACTOR: p F VCorj e-opi5r,
BUSINESS LICENSE #
ADDRESS: qd 6-T% f-TIQfL..
CITY/ZIPCODE: PX1445
*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: 3 15 -It C
SKete
ture Date
Please check applicable subcontractors and comp thefollowing information:
V
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum./ Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner / Contractor Signature
Date