12030012CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 5 INFINITE LOOP
OWNER'S NAME: APPLE COMPUTER INC
OWNER'S PHONE: 9259568376
❑ LICENSED CONTRACTOR'S DECLARATION
License Class g Lic. # t 1 O
22,
Contractor oVN Date
I hereby affirm that I am licensed under the provisions of efiapter 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 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 applicant understands and will comply
with all non -point source regulats per the Cupertino Municipal Code, Section
9.18. r
k r
Signature VDateu
_....
❑ 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.
CONTRACTOR: NOVO CONSTRUCTION
PERMIT NO: 12030012
4025 BOHANNON DR
DATE ISSUED: 05/30/2012
MENLO PARK, CA 94025
PHONE NO: (650)701-1500
BUILDING PERMIT INFO: BLDG I— ELECT -- PLUMB j—
MECH ' RESIDENTIAL V COMMERCIAL
JOB DESCRIPTION: TI-NORTHEAST CORNER OF THE 2ND FLOOR. INCLUDES
CONFERENCE ROOMS, COFFEE BARS, PRODUCT DEVELOPMENT
AREAS, AND HIGH -DENSITY STORAGE ROOMS-HAZMAT. NO
Sq. Ft Floor Area: I Valuation: $900000
APN Number: 31602109.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: �� e �l�T� �7 Date:G�' /
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.
Ow ukoruthoriz agcut: e _
Date:
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
I understand my plans shall be used as public records.
Date I Licensed Professional
[m]
OCCUPANCY TYPE-
. ..................
TYPE OF
-
FLR A
PC FEES
PC FEE tD
BP FEES
BP FEE ID
CONSTR.
(s.f.)
B (Tenant Improvements) J
II-B,111-B,1V,V-B
7,067
$2,320.34
IBTIPLNCK
$4,999.55
IBTIINSP
TOTALS:
7,067
$2, .20.34
$4,999.551
NOTE: This esthnale does not include fees clue to other Departments (i.e. Planning, Public Works, Fire, Sanitaty Sewer District, School
J1%i,,,i n4, i 'pl—., e" —, Pa—d n s M, M1,Ala m2d nra nyih) mi ovii'maio 1-hoitapi tho Dont
FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/11)
FEE
+QTYIFEE
MISC ITEMS
Plan Check Fee:
$2,320.34
Select a Misc Bldg/Structure
or Element of a Building
Suppt. PC Fee: (F) Reg. 0 OT
10.0
1 firs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$4,999.55
.0 Suppl, Insp. FeeReg,
0 OT
=hrs
$0.00
PME Unit Fee:
$0,00
PME Permit Fee:
$0,00
r.
E)
Work Without Permit? 0 Yes (D No
$0.00
Advanced PlqnniLigjj��(,,.
$0.00
Select a Non -Residential
Building or Structure
G
0
Strom-, Motion Fee:
IBSEISMCO
$189.00
Select an Administrative Item
B14_Ltds Co&S nimission Fee: IBCBSC
$36,001
SUBTOTALS:
$7,544.89
$0.00
TOTAL FEE:
$7,544.89
Revised: 1/19/2012