12040171CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 5 INFINITE LOOP I CONTRACTOR: NOVO CONSTRUCTION I PERMIT NO: 12040171 I
OWNER'S NAME: APPLE COMPUTER INC 14025 BOHANNON DR I DATE ISSUED: 05/08/2012 I
OWNER'S PHONE: 4089961010 I MENLO PARK, CA 94025 I PHONE NO: (650)701-1500 I
❑ LICENSED CONTRACTO//��R'S DECLARATION
License Class Lic. # 1®1 1
Contractor V� Date �r
p r t t dVd `(
I hereby affir► t tta r 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 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 per 't. Additionally, the applicant understands and will comply
with all non -point o irce regulati per the Cupertino Municipal Code, Section
9.18.
Signature Date I�
❑ 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)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sce.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 F. ELECT iPLUMB
MECH r RESIDENTIAL r COMMERCIAL
JOB DESCRIPTION: 2ND FLOOR -COMMERCIAL TENANT IMPROVEMENT
NON-STRUCTURAL,INCLUDES MECHANCIAL & ELECTRICAL;NO
PLUMBING
Sq. Ft Floor Area: I Valuation: $40000
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:% Date: r.
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 e12 authorize
7�
Date:
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of -,wrk'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
CITY OF CUPERTINO
59w FEE ESTIMATOR — BUILDING DIVISION
iaADDRESS:
,
5 infinite loop 2nd floor
DATE: 04/30/2012
REVIEWED BY: bobs.
APN: 3MO 09
BP#: 1 __� ()q C
*VALUATION:
1$40,000
PERMIT TYPE: Building Permi
PLAN CHECK TYPE: Tenant Improvement
PRIMARY
Commercial Building
PENTAMATION
1 B T�
USE:
PERMIT TYPE:
WORK
U. comm labs ace non structural include M E. no plumbing
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
I-A,I-B
0
$0.00
$0.00
TOTALS:
0
$0.00
$0.00
MECH, HOURLY 0 Yes G No
PLUMB, HOURLY 0 Yes` 2 No
ELEC, HOURLY 0 Yes Q No
Xfcch, Plan Check
Phtmb. Noll Check
E/cc. Non Chcck
A4ech. Pcrmil Fee
Plumb. Permit Fee:
Elec. Permh Fee:
Other Afec•h, Bash.
Other Phimb hasp.
Other Elec. ln.sP.
Alecb. Insp. Fcc
Plumb. hap. FP'C.
Elec. lnsp. Fee:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sever District, School
Wwriet. etc). These fees are based an the nreliminary information available and are only an estimate. Contact the Dent for addn'1 into.
FEE ITEMS (Fee Resohttion 11-053 E f 7/1/11j
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? Q Yes 0 No
$0.00
® hours
$520.00
Plan Check, Hourly
ISTPLNCK
i
Suppl. PC Fee: Q Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? 0 Yes G No
$0.00
Suppl. Insp. Fee:Q Reg. 0 OT
0 0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
_F_T
CollsIrliclion Te'n-:
A('bifil/L4fl'Grfive 17ec
0
E)
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential 0
Building or Structure 0
i
Tr arel Doctonenlotion Fccs:
Strong Motion Fee: IBSEISMICO
$8.40
7.0 hrs
$910.00
Inspections
1STINSP Inspection, Hourly
Bldg Stds Commission Fee: IBCBSC
$2.001
SUBTOTALS:
$10.40
$1,430.00
TOTAL FEE: '1
$1,440.40
Revised: 04/01 /2012