11030016CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 10300 BUBB RD CONTRACTOR: SOUTH BAY PERMIT NO: 11030016
1 CONSTRUCTION CO INC I I
OWNER'S NAME: APPLE INC 1170 KNOWLE S DR I DATE ISSUED: 03/30/2011 1
OWNER'S PHONE: 4089748821 1 LOS GATOS, CA 95032 1 PHONE NO: (408)379-5500 1
El LICENSED CONTRACTOR'S DECLARATION
License Class Lic. # '33 Liq —74
-2
Date
Contractor v
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business &Trofessions
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 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 source regulations per the Cupertino Municipal Code, Section
9.18. t
Signature_ Date
0 ONVNER-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)
1, 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:
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 CERTIF41CATION
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.
BUILDING PERMIT INFO: BLDG' r* ELECT F PLUMB F
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: NEW ACCESSORY STRUCTURE ENCLOSURE FOR TWO
COMPACTORS ACCOCIATED (E,P) WORK
Sq. Ft Floor Area: I Valuation: $90000
APN Number: 35720020.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued b
Date: -
REA -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 COVE, RINGS TO BE CLASS "A" OR BETTE R
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.
Owner or autholized agent: --:;, I I k\
Date: c?
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 (See. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Date I Licensed
CITY OF CUPERTINO
[ 9 -mm I FEE ESTIMATOR - BUILDING DIVISION
19
ADDRESS: 10300 Bubb Road —T—DATE:
03/03/2011
REVIEWED BY: larry s
PC FEE ID
APN: 357-20-020
BP#:
WALUATION: 1$90,000
,,PERMIT TYPE: Building Permit ---
[PLAN CHECK TYPE: New Construction
PRIMARY
Commercial Building
Civil / Religious activities
I PENTAMATION
lul
USE:
in BQ zone? 0 Yes G No
I PERMIT TYPE: A
WORK
ne accessory structure: enclosure for two compactors. Associated electrical and plumbing work. No
SCOPE
at existing main warehouse.
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
PC FEES
PC FEE ID
BP FEES
BP FEE ID
U (Private Gar/Ag Bldg)
11-B,111-B,1V,V-B.
690
_j3iZ5.,:zM
Phimh. h),V). ree:
-$2,411.89
1 UJINSP
_j
$2,411.89
Suppl. Insp. FeeO Reg. 0 OT
ro 1-0 1
hrs
$0.00
PME Unit Fee:
$0.00
PNM Permit Fee:
$0.00
Constr. Tax: IBCONSTAX—CF--]
$1,656.00
Acoustical Fee: 0 Yes (D No
$0.00
Work Without Permit? 0 Yes (2) No
$0.00
TOTALS:
690
48-,2�
,Cravel Doculnenhaion Fees:
$2,411.891
Strong Motion Fee: IBSEISMCO
Iry Irl. L .4 41. "l)"U"hia asid aro mih) ait ovfiniatp� Cnntart the Dent for addn'l info.
FEE ITEMS (Fee Resolution 09-051 E6� 711110)
Xlech, Plon Check
plumb, Phol Check
Elec. Plon Chcck
I11'rech, permil ret".
I [111tillb, pelmil rec:
I Occ. permil F(,c:
Other Afech. Insp
Other Plumb Msp,
Other Elec� Insp. F-1
ljcch, In'sp, Fce:
Phimh. h),V). ree:
Elec, Insp. Fee:
Iry Irl. L .4 41. "l)"U"hia asid aro mih) ait ovfiniatp� Cnntart the Dent for addn'l info.
FEE ITEMS (Fee Resolution 09-051 E6� 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
4a,466,70-
— Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: E) Reg. 0 OT
-
F6.6 I
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,411.89
Suppl. Insp. FeeO Reg. 0 OT
ro 1-0 1
hrs
$0.00
PME Unit Fee:
$0.00
PNM Permit Fee:
$0.00
Constr. Tax: IBCONSTAX—CF--]
$1,656.00
Acoustical Fee: 0 Yes (D No
$0.00
Work Without Permit? 0 Yes (2) No
$0.00
PLLONGRNGC
$172.50
Select a Non -Residential G
Building or Structure 0
,Cravel Doculnenhaion Fees:
Strong Motion Fee: IBSEISMCO
$18.90
F-4 6-1 hrs Standard Hourly Rate
$504.01_— 1
Bldg Stds Commission Fee: IBCBSC
$4.00
SUBTOTALS:
$504.001 TOTAI,FEE:
I _$U22,99
Revised: 03/01/2011