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10080064CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10500 N DE ANZA BLVD CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 10080064 INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 10/14/2010 OWNER'S PHONE: 4089744876 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION r- (— � Y/& License Class__ Lic. # 3 97 �� BUILDING PERMIT INFO: BLDG ELECT PLUMB r r r ! 1 MECH RESIDENTIAL COMMERCIAL Contractor -k) �7i��tvcT2c,✓ Date C✓ P I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: FLOOR 2 - COMM'L TI PROVIDE FOUR(4) NEW SHIELDED (commencing with Section 7000) of Division 3 of the Business & Professions ROOMS ON FLOOR FARCHITECTURAL WORK PROVIDE NEW LEVEELL SURFACE CE FOR EQUIPMENT(1528SQ); 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. 1 have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $60000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 31622017.00 Occupancy Type: APPLICANT CERTIFICATION 1 certify that 1 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non -point source r I tions per the Cupertino Municipal Code, Section 9.18. q Signature Date Issued Date: ❑ OWNER -BUILDER DECLARATION RE -ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for I, as owner of the property, or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: Date: 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code), ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE Compensation, as provided for by Section 3700 of the Labor Code, for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain I have and will maintain Worker's Compensation Insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will I certify that in the performance of the work for which this permit is issued, I shall maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health & Safety Code, Sections 25505, 25533, and 25534. Compensation laws of California. If, after making this certificate of exemption, 1 become subject to the Worker's Compensation provisions of the Labor Code, I must Owner r author' int: forthwith comply with such provisions or this permit shall be deemed revoked. Date: -7 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO BUILDING PERM BUILDING ADDRESS: 10500 N DE ANZA BLVD CONTRACTOR: DEVCON CONSM UCTION PERMIT NO: 10080064 INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 10/14/2010 OWNER'S PHONE: 4089744876 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S r ELECT r PLUMB r INFO: DECLARATION BUILDING PERMIT BLDG License Class Lie. # / r r r /� �� _ Contractor DGVG®� (p96 f— Date Z MECH RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: FLOOR 2 - COMM'L TI PROVIDE FOUR(4) NEW SHIELDED (commencing with Section 7000) of Division 3 of the Business & Professions ROOMS ON FLOOR 2.MINIMAL ARCHITECTURAL WORK, PROVIDE NEW LEVEL SURFACE FOR EQUIPMENT(] 528SQ); Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: 6//_-,k_ Y1 4-- t �-f� p� +-G r1 cm t GoLl I have and wilt maintain a certificate of consent to self-insure for Worker's du d. �-� -� �j P,, , �� C Compensation, as provided for by Section 3700 of the Labor Code, for the N o �� i} m• ;� �r P C- 4 j �.� (�/` �� o performance of the work for which this permit is issued. fr'(� it's, �' 1 have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $60000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 31622017.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations the Cupertino Municipal Code, Section 9.18. - Issued by �� Signature Date4�0 ❑ OWNER-BUILD TION RE-ROOFS: 1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for 1, as owner of the property, or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: Date: I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE Compensation, as provided for by Section 3700 of the Labor Code, for the 1 have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain I have and will maintain Worker's Compensation Insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.1.2 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this 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 contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued, I shall maintain compliance with the Cupertino Municipal Code, Chapter 9.1.2 and the not employ any person in any manner so as to become subject to the Worker's Health & Safety Code, Sections 25505, 25533, and 25534. Compensation laws of California. If, after making this certificate of exemption, I / become subject to the Worker's Compensation provisions of the Labor Code, 1 must forthwith comply with such or this shall be deemed revoked. or autho ized En1,6 O t: - h Date: provisions permit APPLICANT CERTIFICATION LSTRU N LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. 11 1 understand my plans shall be used as public records. Signatu Date O Licensed Professional ��,�� CITY OF CUPERTINO ISI FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: DATE: REVIEWED BY: PC FEE ID APN: BP#: *VALUATION: 1$125,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY/'> USE: Commercial Building ]7'. L t=r.C�<)lz .r l - PENTAMATION 16 TI PERMIT TYPE: WORK deferred mechanical and electrical plans. SCOPE Suppl. Insp. Feer Reg. O OT 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 1,528 $2,887.20 1BTIPLNCK $1,976.63 1BTIINSP Grec. Insp. Pce: $1,976.63 Suppl. Insp. Feer Reg. O OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiruclion Tax Acoustical Fee: 0 Yes E) No $0.00 Q 0 Work Without Permit? 0 Yes 0 No $0.00 TOTALS: 1,528 $2,887.20 Tpavel Documenlalion Fees: $1,976.63 Strong Motion Fee: 1BSEISMICO MECH, HOURLY 0 Yes Q No PLUMB, HOURLY Yes Q No ELEC, HOURLY ® Yes Q No >1 kch. flan C'hcrE k Phunh. Purr �'heA Elee . Plan Check Permit Fee: Plrr;zh. Pcrmil Fecc Elec. Permit Fcc. Orherblech. 1n,I'E1__L_ InspET-L- Other'Insp, lle(h. Imp. Fce: Phmrh. hr.ep. F e. Grec. Insp. Pce: NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 09-051 a. 7/1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,887.20 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: $1,976.63 Suppl. Insp. Feer Reg. O OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiruclion Tax Acoustical Fee: 0 Yes E) No $0.00 Q 0 Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: PLLONGRNGC $0.00 Select a Non -Residential E) Building or Structure 0 I Tpavel Documenlalion Fees: Strong Motion Fee: 1BSEISMICO $ 5 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC SUBTOTALS: $4,895.08 $0.00 TOTAL FEE: $4,895.08 Revised: 9/29/2010 go CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 10500 N. De AnzaDATE: 08/09/2010 REVIEWED BY: gs BP FEES APN: BP#: I-A,I-B 'VALUATION: 1$60,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement IBTIINSP PRIMARY Commercial Building USE: TOT4..1. FL00R .ahG,4: APPLICATION TYPE: 16 TI MECHANICAL. Yes Q No PLUMBING Yes 0 No I ELECTRICAL 0 Yes 0 No �W 0 OT 0.0 hrs a 00 3C $0.00 PME Permit Fee: 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 1,528 $2,887.20 IBTIPLNCK $1,976.63 IBTIINSP $0.00 PME Plan Check: $0.00 Permit Fee: $1,976.63 Suppl. Insp. Fee:O Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 1,528 $2,887.20 $1,976.63 A,Jech. Plan C"hcck ilr, �1permit Fcc. Other Mech. Imp. Ph.irnh. Phm Check P1uruh. Prwih1Fee: Other Plrrnlh hcsp. Elec. Plan Check Glee Perrnit Fee- Other Eh c. hash. NOTE. These fees are b¢ced on the nreliminary information available and are nnly an octimato_ Contort tho Dont fnr addn'l infn FEE ITEMS (Fee Resolution 09-051 E(f. 7/1109) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,887.20 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,976.63 Suppl. Insp. Fee:O Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consfrucliun Tux Acoustical Fee: 0 Yes Q No $0.00 0 (D Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: / PLLONGRNGC $382.00 Select a Non -Residential Building or Structure 0 0 Trawl nt,cuntcr,tcrtiatz F<< -s: Strong, Motion Fee: IBSEISMICO $12.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $3.00 SUBTOTALS: $5,261.43 $0.00 TOTAL FEE: 1 $5,261.43 Revised: 8/06/2010