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10120060CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: I INFINITE LOOP CONTRACTOR: XL CONSTRUCTION PERMIT NO: 10120060 OWNER'S NAME: APPLE INC 851 BUCKEYE CT DATE ISSUED: 03/03/2011 OWNER'S PHONE: 4089745951 MILPITAS, CA 95035 PHONE NO: (408)271-2425 ❑ LICENSED CONTRACTOR'S DECLARATION r ELECT r PLUMB r BUILDING V PERMIT INFO: BLDG License Class Lic. # MECH r r RESIDENTIAL COMMERCIAL r (/- Contractors"'� �� Date 1 hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions JOB DESCRIPTION: SITE ACCESSIBILITY UPGRADES FOR ADA COMPLIANCES Code and that my license is in full force and effect. ffT� 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: $70000 permit is issued. APPLICANT CERTIFICATION APN Number: 31602105.00 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 which may accrue against said City in consequence of the granting of this perm . d I't' nally, the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR n- with all nooint so rce a ations per the Cupertino Municipal Code, Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. 2 I\ Signature Date �' J Issued by: Date: ❑ OWNER -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 I, 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 defined 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 ma' tain comia a with the Cupertino Municipal Code, Chapter 9.12 and the Compensation laws of California. If, after making this certificate of exemption, I Heal & Saf ty C Sections 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. Owne or aut ord gent: l . Date: 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 FM-7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 1 Infinite Loop DATE: 12/10/2010 REVIEWED BY: A. Salvador EM APN: BP#: 0l1?1 00 'VALUATION: $70,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: TO T4L F1 OUR .4REA: PENTAMATION 1GENCOM PERMIT TYPE: WORK SCOPE Xlcch. Plan Check 1'111mh. Phut Chcrh Llr,c:. Plan Chccck L1ec:h. Permit Fee: F Pb1mh. Pe�rmil 1'c:c. F ec Perniir Fee Usher illech. 1rup. Usher Plurni" Ins/).Li Usher 6Ycc. Itup. Li A/cch. hmp. Fcce: Phmtb. hisp. Fee 1:1c(. I , , i . rcc NOTE: These fees are based on the Preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 09-051 Eff. 7/1110) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 2 hours $252.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee'O Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (.Onstruction Tax Acoustical Fee: 0 Yes No $0.00 0 0 Work Without Permit? 0 Yes 0 No $0.00 Plannin Fee: $0.00 0 I 71-avel Docrnrxernlalion Furs,: Stroniz Motion Fee: 1aSEISMICO $14.70 4.0 hrs $504.00 Inspections IINSPMIS Standard Inspections Bldg Stds Commission Fee: IBCBSC $3.00 SUBTOTALS- $17.70 $756.00 TOTAL FEE: $773.70 Revised: 12/07/2010 CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION ADDRESS:,J,4,6 infinite loop DATE: 11/17/2011 REVIEWED BY: bobs. APN: BP#: dO ax(2ip "VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: PENTAMATION 1GENCOM PERMIT TYPE: WORK method and materials for accessibility upgrade. [q!tmate SCOPE ,.:�, i:n� . !. ", Cr'rt<tk i,lc�c•. ! :'crrf C "r,.��..i; NOTE: This estimate does not include fees due to other Departments (Lea Planning, Public Works, Fire, Sanitary Sewer District, School District. eta). These fees are based on the nreliminary information available and are only an estimates Contact the Dent for addh7 info. FEE ITEMS (Fee Resolution 11-053 E . 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. © OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.S Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 /-t,C. 0 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 Travel 1)ociancniatiorr f s es Strong Motion Fee: $0.00 3 # $510.00 Alternate Materials and Methods IALTMAT Bldg_ Stds Commission Fee: $0.00 SUBTOTALS: 1 $0.001 $510.00 TOTAL FEE: 1 $510.00 Revised: 10/01 /2011