11030122CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 6 INFINITE LOOP FLR 2
OWNER'S NAME: APPLE INC
OWNER'S PHONE: 4089744876
❑ LICENSED CONTRACTOR'S DECLARATION
License ClassJJLic. #
Contractor �•7,,,� WG—//mate
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
C e and that my license is in full force and effect.
I e e y 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 c t4t-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. J
Signature — ` Date -/-2 t
❑ O -BUILDER DECLARATION
I hereby affirm that I 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)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
CONTRACTOR: SOUTH BAY PERMIT NO: 11030122
CONSTRUCTION CO INC
170 KNOWLES DR DATE ISSUED: 04/12/2011
LOS GATOS, CA 95032 PHONE NO: (408)379-5500
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 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.
BUILDING PERMIT INFO: BLDG F ELECT F PLUMB r
MECH f— RESIDENTIAL r COMMERCIAL
JOB DESCRIPTION: FLOOR 2- ALTERNATION OF EXISTING LAB, DEMO
WALLS &
DOORS, MODIFY LIGHTS & EXISTING HVAC, BUILD NEW
WALLS & INSTALL RADIO FREQUENCY CHAMBER(827SQFT)
Sq. Ft Floor Area: Valuation: $50000
APN Number: 31602110.FLR2 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued bf Date:
/��
RE -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 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. I 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 eq+dpment 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 aut ri -agent:.,-.---
Date:
gent:. Date:
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 (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 6 INFINITE LOOP FLR 2
CONTRACTOR: SOUTH BAY
PERMIT NO: 11030122
CONSTRUCTION CO INC
OWNER'S NAME: APPLE INC
170 KNOWLES DR
DATE ISSUED: 04/12/2011
OWNER'S PHONE: 4089744876
LOS GATOS, CA 95032
PHONE NO: (408)379-5500
❑ LICENSED CONTRACTOR'S DECLARATION
f—
BUILDING PERMIT INFO: BLDG ' ELECT PLUMB
License Class Lic. # .33 �l
r
COMMERCIAL
Ali Z /
MECH RESIDENTIAL'
Contractor rJ t— ate /
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: FLOOR 2-ALTERNATION OF EXISTING LAB, DEMO
(commencing with Section 7000) of Division 3 of the Business & Professions
FALLS &
DOORS, MODIFY LIGHTS & EXISTING HVAC, BUILD NEW
andhat my license is in full force and effect.
C My
WALLS & INSTALL RADIO FREQUENCY CHAMBER(827SQFT)
I lffirm 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: $50000
permit is issued.
APPLICANT CERTIFICATION
I c at-fhave read this application and state that the above information is
APN Number: 31602110.FLR2
Occupancy Type:
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 permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non -point source regulations per the Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature ... Date '(� P 1 (
g
Issued�s" Date: /',e j
_
❑ OWN 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 carder 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
compliance with the Cupertino Municipal Code, Chapter and the Health &
Section 3700 of the Labor Code, for the performance of the work for which this
ous material.
Safety Code, Section 25532(a) should I store or handle hazardous
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
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Compensation laws of California. If, after making this certificate of exemption, I
Health & Safety Code, 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 autl ri , gent: I . ,.,_— /
Dater
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 Nwrk'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.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
____ CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 6 Infinite Loop
DATE: 03/28/2011
REVIEWED BY: gs
APN:
BP#:
-VALUATION:
1$50,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
PENTAMATION 1B TI
PERMIT TYPE:
WORK
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
II-B,III-B,IV,V-B
827
$1,883.96
IBTIPLNCK
$883.06
1BTIINSP
TOTALS:
827
$1,883.96
$883.06
MECH, HOURLY 0 Yes 0 No
PLUMB, HOURLY Q Yes _Q No
ELEC, HOURLY Q Yes Q No
r r...7 C. d7fiC 7f
f
H r
�Ptd;°t'riYe`t'!t. iti �1,
�}taitu rrfa.fi�i ii7r�?;;.
El(.
{.Ji1tF'f'tr:; t:'F:. If7);t3.
Vkl,h. h?;v,,I`r_._.
1-311.d;strt. 137,ii.; 1-:.,
i5i'eu, 1£r.;;p
7VnTF! Tit~ fvv.c aro hacvd nn the nreliminary infnrmation availahle and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resohition 09-051 Eff'. 7/1110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$1,883.96
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: G Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$883.06
Suppl. Insp. Fee:0 Reg.
0 OT
0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Acoustical Fee:
0 Yes (D No
$0.00
0
0
Work Without Permit? 0 Yes G No
$0.00
Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
i
Strong Motion Fee:
IBSEISMICO
$10.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$2.00
SUBTOTALS:
$2,779.52
$0.00
TOTAL FEE:`
$2,779.52
Revised: 01/15/2011