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12010080CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6 INFINITE LOOP OWNER'S NAME: APPLE COMPUTER INC OWNER'S PHONE: 4089961010 IQ LICENSED CONTRACTOR'S DECLARATION License Class p Lic. # OZZ Contractor W\ID Date (t 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. CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 12010080 4025 BOHANNON DR DATE ISSUED: 01/11/2012 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB MECH r RESIDENTIAL r COMMERCIAL F_ JOB DESCRIPTION: APPLE - 4TH FLOOR - COMMERCIAL TENANT IMPROVEMENT PREPARATION;NON-STRUCTURAL 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: 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. Signature Date lk 1.11 4vn�n­ El 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. APN Number: 31602110.00 Valuation: $100000 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: 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 & Safety Code, Sections 25505, 25533, and 25534. Owe r�or author 'ed agent: Date: 1 12 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Date I Licensed Professional CITE' OF CUPERTINO BUILDING PERMIT DAB BUILDING ADDRESS: 6 INFINITE LOOP f CONTRACTOR: NOVO CONSTRUCTION I PERAUT NO: 12010080 1 OWNER'S NAME: APPLE COMPUTER INC 14025 BOHANNON DR l DATE ISSUED: 01/11/2012 I S PHONE: 4089961010 M LICENSED CONTRACTOR'S DECLARATION License Class y Lic. # I 1 0 Z Contractor Lowy l wi I ( l(ii^ ate� (� � I hereby aff€rn€ that I a€n 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 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 tlhe 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 constriction, 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-poin source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date ® 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, air exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). I hereby aftirin 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 die 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 (his 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. hIENLOTARK, CA 94025 PHONE NO: (650)701-I500 BUILDTaG1,, ELECT r PLUMB i— MECH j_ : RESIDENTIAL j COMMERCIAL j JOB DESCRIPTION: APPLE - 4TH FLOOR - COMMERCIAL TENANT IMPROVEMENT PREPARATION;NON-STRUCTURAL 3/15/2012- REV#1- REVISION TO DEMO TO INCLUDE BATHROOM AND ELECTRICAL ROObf- REV#1 ISS'D 3/15/2012 Sq. Ft Floor Area: I Valuation: $100000 APN Number: 31602110.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT 8O DAYS,FROM LAST CALLEDs Date: RE -ROOFS: All roofs sltall 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 a nit hazardous air contaminants as defined by the Bay Area Ali- Quality Management District I will maintain compliance with (lie Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owuer r uthorized 901,1—, Date: J CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of «ork's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION Signature Date I I understand my plans sltall be used as public records. Licensed � 31 FEE ESTIMATOR - BUILDING DIVISION lr-0�% ADDRESS: 6 Infinite Loop DATE: 03/15/2012 REVIEWED BY: Sylvia APN: 3 1 o BP#. 12010080 -VALUATION: Es, 6, 66 o '°PERMIT TYPE: Building Kermit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION MMLDEM USE: I PERMIT TYPE: ICO wom%, #1 - Revise Demo- to include bathroom and electrical room SCOPE NOTE: This estinude does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitaty Sewer Distriet, School hkiwof cater ) Thovo fove ftr,, hacrad n§2 thp h1h)1-fol"Innn avidlahloand aro aniv an owbrnato. Conlaot the Dent foraddn'l into. FEE ITEMS (Fee Resohetion 11-053Eff 7,1/ U1 FEE QTY/FEEF MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes 0 No $0.00 Select a Misc Bldg/Structure or Element of a Building Suppt. PC Fee: (D Reg, 0 OT L0,0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppt. Insp. Fee.G Reg. 0 OT El hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 (D Work Without Permit? 0 Yes Q No $0.00 Ad�,aticed Plannin-1 Fee: $0.00 2 hours Plan Check, Hourly $260 A0 ISTPLNcx CQ 0 Fee., IBSEISMICO $2.10 Select an Administrative Item B ld Stds Commission Fec: IBCBSC $1.00 SUBTOTALS: $3.10 $260.001 TOTAL FEE: $263. 1 Revised: 1/19/2012 CITY OF CUPERTINO W—M FEE ESTIMATOR — BUILDING DIVISION 6 infinite loop 4th floor DATE: 01/11/2012 REVIEWED BY: bobs. jigADDRESS: APN: BP#: "VALUATION: j$100,000 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: PENTAMATION 1TIPREP PERMIT TYPE: WORK t.i. prep commercials ace non structural. SCOPE Ltrcrt t % it?i I'i:rr; ;, I' , y Fe:e: ,'cstDFiz Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are oniv an estimate. Contact the Dent for addn'1 into. FEE ITEMS (Fee Resolution 11-053 Eff Zj/, 1� FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # $380.00 Tenant Improvement Prep 1TIPREP Suppl. PC Fee: Q Reg. Q OT 1 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Flee: $0.00 t' r7t,cP. r t l i.'i1:1 s7 o,?" l f.7f7l;YI i:17t''t7tt t`£;' Fc . Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 i Fees., Strom Motion Fee: 1BSEISMICO $21.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $25.00 $380.00 TOTAL FEE: 1 $405.00 Revised: 1/01/2012