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11080009CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 2 INFINITE LOOP CONTRACTOR: XL CONSTRUCTION PERMIT NO: 11080009 OWNER'S NAME: APPLE 851 BUCKEYE CT DATE ISSUED: 08/15/2011 OWNER'S PHONE: 4089744876 MILPITAS, CA 95035 PHONE NO: (408) 240-6000 ❑ LICENSED CONTRACTOR'S DECLARATION F BUILDING PERMIT INFO: BLDG ELECT PLUMB WwLicense Class Lic.# r Contractor 5 Date � 1 S , l MECH RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: COMMERCIAL TENANT IMPROVEMENT(2400SQFT} (commencing with Section 7000) of Division 3 of the Business & Professions SELECTIVE WALL DEMO, CEILING ELECTRIC & HVAC. ADD NEW Code and that my license is in full force and effect. OFFICES WITH ELECTRIC HVAC 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: $300000 permit is issued. APPLICANT CERTIFICATION APN Number: 31602106.00 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs, and expenses NMch may accrue against said City in consequence of the granting of this pe 't. Vddi ' nally, the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-p int so reg tions per the Cupertino Municipal Code, Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signature Date t5 V' Issued by. Date: O —1 f-'j ❑ NER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE -ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1, as owner of the property, or my employees with wages as their sole compensation, installed without first obtaining an inspection, I agree to remove all new materials for will do the work, and the structure is not intended or offered for sale (Sec.7044, inspection. Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance, as provided for by California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain Section 3700 of the Labor Code, for the performance of the work for which this compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & 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 efined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain.com a ce the Cupertino Municipal Code, Chapter 9.12 and the Compensation laws of California. If, after making this certificate of exemption, I Health of deoons 25505, 25533, and 25534. 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. Owner ut o �ze`d t: �> TDate: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's to building construction, and hereby authorize representatives of this city to enter for which this permit is issued (Sec. 3097, Civ C.) upon the above mentioned property for inspection purposes. (We) agree to save Lender's Name indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Lender's Address 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. Signature Date Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 2 INFINITE LOOP CONTRACTOR: XL CONSTRU&ION PERMIT NO: 11080009 OWNER'S NAME: APPLE INC 851 BUCKEYE CT DATE ISSUED: 08/15/201 1 OWNER'S PHONE: 4089744876 MILPITAS, CA 95035 PHONE NO: (408) 240-6000 LICENSED CONTRACTOR'S DECLARATION 4- J Q� BUILDING PERMIT INFO BLDG ELECT CT PLUMB License Class I,ic. N q C/ 11 Contractor �� �����" Date 1,• I — t MECH RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: COMM T.I (2400SQFT)- SELECTIVE WALL DEMO, CEILING (commencing with Section 7000) of Division 3 of the Business & Professions ELECTRIC & HVAC ADD NEW OFFICES WITH ELECTRIC HVAC Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: 8/29/201 1 - REV# 1 - REVISE FIRE SMOKE DAMPERS AT GRIDLINE I have and will maintain a certificate of consent to self -insure for Worker's 25.5- ISSD 9/13/1 Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $300000 performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of [lie work for which this permit IS issued. 4/ LW APN Number: 31602106.00 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for spection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the t o Cupertino against liabilities, judgmen[s, costs. and expenses which may a true a inst said City in consequence ofthe /°� Cy I granting of this per n. Additio ally, h pplicant understands and will comply Issued by: `''-- Date: / xrith all non-poin sour ere" a ion er t e Cupertino Municipal Code, Section 9 18. ( RE -ROOFS: /2 _ Si nawre Date >> tt 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirmthat I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I s e r handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's de ' es which emit hazardous material. Additionally, should I use equipk23, Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay A ua)' Management District 1 performance of the work for which this permit is issued. will maintain compliance with the uper ci Code, Chapter 9.12 and 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 the Health & Safety Code, Section 5 , 34. 9� ' permit is issued. Owner or authorized agent: Date: I 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of Ibrthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signa[ure Date Fm_� CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 2 infinite loop DATE: 08/29/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: $100 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION 1GENCOM PERMIT TYPE: WORK revise fire smoke dampers at gridline 25.5 SCOPE Oro NOTE: These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addh 7 into. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/1) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building 'A Suppl. PC Fee: O Reg. 0 OT 0.0 1PME hrs $0.00 Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 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 _ Strong Motion Fee: IBSEISMICO $0.50 # $783.00 Revision IREVCONfTI Tenant Improvement Bldg Stds Commission Fee: IBCBSC $1.001 ? l t.. $ 4.50 $ 783.00 S r. $ 784.50 Revised: 07/04/2011 CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION dlADDRESS: 2 infinate loop DATE: 08/01/2011 REVIEWED BY: larry s APN: BP#: "VALUATION: 1$300,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION 16 TI PERMIT TYPE: WORK selective wall demo ceiling electric and hvac. add new offices with elec. hvac. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR- FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) I-A,I-B 2,400 $3,133.02 IBTIPLNCK $2,914.47 IBTIINSP TOTALS: 2,1100 $3,133.{)2 $2,91447 '��H:'>Ef� ";?�;,.::.�:'. .,y;��::..',,�•<.; ,�:Ii �:� .� �;`l'��f�':'��• :l':�1b:�' ;�)� `�G`�l � ��:'�°`.� ' `:'�'..e�:��::�: •:l'4�:1:: NOTE: These fees are hated on the nrelimfnary information availahle and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E '. 7/1111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,133.02 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0.0 1. $0.00 PME :Plan Check: $0.00 Permit Fee: $2,914.47 Suppl. Insp. Fee-0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 _T7 Acoustical Fee: 0 Yes 0 No $0.00 0 Work Without Permit? 0 Yes 0 No $0.00 Plannin, Fee: $0.00 Select a Non -Residential Building or Structure 0 0 Strom Motion Fee: IBSEISMICO $63.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $12.00 :....:..r: .'r . ::::::.. 1C`�J►..AL'i�., 6 1 �t9 2� ". $6,122.49 Revised: 07/04/2011