12040169CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 4 INFINITE LOOP
OWNER'S NAME: APPLE INC
OWNER'S PHONE: 4089961010
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. #� J i
Contractor � .� !
I hereby affirm that I am licensed under the provisions of Ch pter 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 order 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-po' tlsource regplatiotts per the Cupertino Municipal Code, Section
9.18.
_ 7
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, 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 harness 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: XL CONSTRUCTION PERMIT NO: 12040169
851 BUCKEYE CT DATE ISSUED: 06/05/2012
MILPITAS, CA 95035 PHONE NO: (408) 240-6000
BUILDING PERMIT INFO: BLDG ELECT r PLUMB F
MECH *F RESIDENTIAL r COMMERCIAL
JOB DESCRIPTION: COMMERCIAL -ADD 5000 SQ FT EXTERIOR DECK
(STRUCTURAL)
Sq. Ft Floor Area: I Valuation: $750000
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 by:
Date:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material berg 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 fir: Safety Coop, Sections 25505, 25533, and 25534.
Owner rra 4oragent:
Date:. �,
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of Nwrk'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
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 4 Infinite Loop
DATE: 04/30/2012
REVIEWED BY: jsg
APN: V d /0 '
BP#: 1,20� V1
'VALUATION: $750,000
'PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY
USE: Commercial Building
Civil / Religious activities
in BQ zone? 0 Yes � No
PENTAMATION
PERMIT TYPE: 1 GENCO
WORK
Add approx. 5000 sq ft deck includes structural
SCOPE
;btei:lr, Phm Check
Plrunh, Plr¢a Check
On-- Plon Check
Tech. Permil Gee:
Plconb. Permit Gee,
Elec. Pc1711il FFrr:
Oilier Alech. ln7V7.
Other Pbnmb T -up,
01her Glcc. Insp,
Ak<bh lnsp. Fcc.
Pln+uh, Inap, Fec.,
Glee Insp, Fore;
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
1)Lctrirt_ etc.) Thvcv fees are haled an the nreliminary information available and are only an estintate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resohrtion 11-053 Eff. 71111 U
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? G Yes 0 No
$0.00
® hours
$520.00
Plan Check, Hourly
ISTPLNCK
i
Suppl. PC Fee: Q Reg. OT
0,0
hrs
$0.00
PME Plan Check:
$0.00
1� #
$457.00
Deck / Deck Railing
1DEcKwooD Deck (wood)
Permit Fee:
$0.00
Suppl.. Insp. Fee:Q Reg. Q OT
0 0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXCF-1
$0.00
,4chninist1,a1Nc fee:
0
G
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
I
G
0
77ecn,c/ Docuirientotion Fees:
Strong Motion Fee: IBSEISMICO
$157.50
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$30.00
SUBTOTALS: '
$187.50
$977.00
TOTAL FEE:
1 $1,164.50
Revised: 04/01 /2012