11050196CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 4INFINITE LOOP
CONTRACTOR: ICOM MECHANICAL INC
PERMIT NO: 11050196
OWNER'S NAME: APPLE INC
477 BURKE ST
DATE ISSUED: 06/02/2011
C ZR'S PHONE: 4089744876
SAN JOSE, CA 95112
PHONE NO: (408)792-2292
❑ LICENSED CONTRACTOR'S DECLARATION
j` f-
BUILDING PERMIT
1 n
s L'3
License Clas(o Lie. # - /�, bg A 2e
INFO: BLDG ELECT PLUMBr
MECH f- RESIDENTIAL r COMMERCIAL f—
Contractor / Q /-( /,��_�'�J_ Date , 2
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: REMOVE TWO WATER HEATERS &REPLACE WITH
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
HEAT EXCHANGERS.
EAT EXCHANGERS. TIE HEAT EXCHANGERS INTO EXISTING
DOMESTIC HOT WATER SYSTEM
I hereby affirm under penalty of perjury one of the following two declaration
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: $107000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 31602108.00
Occupancy Type:
I certify that I have read this application and state that the above information is
;orrect. I agree to comply with all city and county ordinances and state laws relating
:o building construction, and hereby authorize representatives of this city to enter
rpon the above mentioned property for inspection purposes. (We) agree to save
ndemnify and keep harmless the City of Cupertino against liabilities, judgments,
PERMIT EXPIRES IF WORK IS NOT STARTED
;osts, and expenses which may accrue against said City in consequence of the
,,ranting of this permit. Additionally, the plicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Nith all non -point so a regul t e Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
).18.
r
signature \ Date r I
�'
Issued by: �
Date C�
OWNER -BUILDER DECLARATION
hereby affirm that I am exempt from the Contractor's License Law for one of
RE -ROOFS:
he following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
, 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
vill do the work, and the structure is not intended or offered for sale (Sec. 7044,
inspection.
3usiness & Professions Code)
, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
;onstruct the project (Sec.7044, Business & Professions Code).
hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
leclarations:
have and will maintain a Certificate of Consent to self -insure for Worker's
;ompensation, as provided for by Section 3700 of the Labor Code, for the
HAZARDOUS MATERIALS DISCLOSURE
lerformance of the work for .which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
ection 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 &
ermit is issued.
Safety Code, Section 25532(a) should I store or handle hazardous material.
certify that in the performance of the work for, hich this permit is issued, I shall
✓w
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined b the Ba Area Air
y y Quality Management District I will
of 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
;ompensation laws of California. If, after making this certificate of exemption, I
Health Safe ections 25505, 25533, and 25534.
ecome subject to the Worker's Compensation provisions of the Labor Code, I must
)rthwith comply with such provisions or this permit shall be deemed revoked.
O r or au ' e agent:
Date:
APPLICANT CERTIFICATION
certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
orrect. 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
) building construction, and hereby authorize representatives of this city to enter
for which this permit is issued (Sec. 3097, Civ C.)
n -n the above mentioned property for inspection purposes. (We) agree to save
Lender's Name
iify and keep harmless the City of Cupertino against liabilities, judgments,
and expenses which may accrue against said City in consequence of the
Lender's Address
ranting of this permit. Additionally, the applicant understands and will comply
lith all non -point source regulations per the Cupertino Municipal Code, Section
.18.
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
ignature Date
Licensed Professional
CITY OF CUPERTINO
BUILDING PERMIT INSPECTION CARD
BUILDING ADDRESS:4 INFINITE
LOOPCONTRACTOR:ICOM
MECHANICAL INC
PERMITNO:11050196
OWNER'S NAME. APPLE INC
477 BURKE ST
DATE ISSUED: 06/ 02 /2011
OWNER'S PHONE: 4089744876
SAN JOSE, CA 95112
PHONE NO: (408)792-2292
10 C ,;c �:;
FOUNDATION/PIERShLD.S.
r /0
BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH
RESIDENTIAL COMMERCIAL
JOB DESCRIPTION: REMOVE TWO WATER HEATERS & REPLACE WITH TWO (2) NEW
LIFER GROUND
PAD/SET BACK-CERT
EAT EXCHANGERS. TIE HEAT EXCHANGERS INTO EXISTING
GARAGE SLABS/PREGUNITE
DOMESTIC HOT WATER SYSTEM
UNDERGROUND/SLAB
UNDERGROUND PLUMBING
UNDERGROUND ELECTRICAL
F(}�Ns R LQS? z
UNDERFLOOR PLUMBING
' `� L[) 2-2-AA RIJ
UNDERFLOOR MECHANICAL
WILDLAND URBAN INTERFACE FIRE AREA ERN
UNDERFLOOR ELECTRICAL
UNDERFLOOR FRAMING VENTS
TO ARRANGE INSPECTION
Call 777-3228 between 7:30 am and 3:30 pm Monday through Friday, at least 24 hours
before required inspection. Job address and Permit Numbers are needed when
UNDERFLOOR INSULATION
I' . < p DBFI ;. ,;
ROOF SHEATHING
requesting an inspection.
ROUGH PLUMBING
CUPERTINO SANITARY DISTRICT
Closed circuit video inspection of property line cleanout, point of connection
and street lateral required prior to passing FINAL CITY PLUMBING
TUBS & SHOWER PAN
ROUGH MECHANICAL
INSPECTION. Call the District (408-253-7071) for an appointment.
NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED
BUSINESS LICENSES ARE OBTAINED
PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT
ROUGH ELECTRICAL/POOL BOND
FRAMING/STAIRS/E. EGRESS
INSULATION/VENTILATION
EXTERIOR SHEAR/HOLD DOWN
OWN
ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION.
IMPORTANT
INTERIOR SHEAR/HOLD DOWN
SHEETROCK/SHEETROCK SHEAR
When a permit has expired, a charge totaling one-half the fees to obtain a new permit me
EXTERIOR LATH/W-SCREED
be paid in order to reactivate the permit. If a permit has been expired for more
than one year, a charge totaling the full fees to obtain a new permit must be paid
to reactivate the permit.
INTERIOR LATH
SCRATCH COAT
NOTES:
SEWER/WATER
T-BAR/MECH/ELECT ABOVE CEIL
ATS,„<
ELECTRIC METER RELEASE
SPECIAL INSPECTIONS Inspector: Date:
GAS TEST/METER RELEASE
ROOF INSPECTIONSPRE-INSPECTION: Inspector: Date:
GRADE -PUBLIC WORKS
FIRE - CALL (408) 3784010
TEAR-OFF: Inspector: Date:
PLANNING (408) 777-3308
PLYWOOD: Inspector: Date:
SANITARY (408) 253-7071
ATTENS: Inspector: Date:
ELECTTRICAL
MECHANICAL
IN PROGRESS: Inspector: Date:
AL: Inspector: Date:
PLUMBING
J
NOTE: OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION.
OCCUPANCY OF BUILDING NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED BY
PECTOR
HANDICAP
ENERGY
BUILDING
CERTIFICATE OF OCCUPANCY
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 4 INFINITE LOOP CONTRACTOR: ICOM MECHANICAL INC PERMIT NO: 11050196
OWNER'S NAME: APPLE INC 477 BURKE, ST DATE ISSUED: 06/02/2011
OWNER'S PHONE: 4089744876 SAN JOSE, CA 95112 PHONE NO: (408)792-2292
❑ LICENSED CONTRACTOR'S DECLARATION
License Class C36 Lie. # _/ 69 6 2Z--
Contractor L Ct5N( &L--Z1C1J:J_Date rZr
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declaratii
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 plicant understands and will comply
with all non -point so a regul t e Cup"thin
Municipal Code, Section
9.18.
Signature Date r f, r ( !
❑ OWNER -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).
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 r ELECT r PLUMB
MECH ) RESIDENTIAL m COMMERCIAL
JOB DESCRIPTION: REMOVE TWO WATER HEATERS & REPLACE WITH
TWO(2)NEW
HEAT EXCHANGERS. TIE HEAT EXCHANGERS INTO EXISTING
DOMESTIC HOT WATER SYSTEM
Sq. Ft Floor Area: I Valuation: $107000
APN Number: 31602108.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued b �l
Date'
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health,$t SafetyJEoections 25505, 25533, and 25534.
O er or au a agent: ��
Date: ,.2,
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of vmrk'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.
Date
Licensed
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 4 Infinite Loop
DATE: 05/23/2011
REVIEWED BY: gs
APN:
BP#:
'VALUATION: 1$107,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
PENTAMATION 1CMB6
PERMIT TYPE:
USE:
W ORIC
SCOPE
Mech. Plan Check 0.0 hrs $0.00
Plumb. Plan Check 0.0 hrs $0.00
Occ 0w C fic 1,
Mech. Permit Fee: IMPERMIT
Plumb, Permit Fee: IPPERMIT
�/E . ftvntrt 1r_:
Other Mech. Insp. 0.0 hrs $42.00
Other Plumb Insp. [E] hrs $42.00
L 0wI 0('f _ hn'p. Li
Al ".h Ittsp.
Phwmh. late. f;ht.;
F:10 � /Inp.
NOTE• TIrb s d on the relyndnar in orn:ation available and are onl an estimate. Contact the Dept or addn'1 info.
ese ees are a e
FEE ITEMS (Fee Resolution 09-051 Eff: 7/1/10)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
I L I #
$358.00
Mechanical
IBBoiLER(5) Boiler/Comp. >50hp
Suppl. PC Fee: (D Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
#
$126.00
Plumbing
IPGAsREs Piping, Gas <=4 Outlets
Permit Fee:
$0.00
Suppl. Insp. Fee: Reg. 0
OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$84.00
Co;s1Pt.fcl ion l a.v
Acoustical Fee:
0 Yes 0 No
$0.00
0
0
Work Without Permit? 0 Yes (D No
$0.00
Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
Travel Documentation Fee: ITRAVDOC
$42.00
Stronf Motion Fee:
IBSEISMICO
$22.47
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$5.00
SUBTOTALS:
$153.47
$484.00
TOTAL FEE:
$637.47
Revised: 04/29/2011