13120092CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18920 FORGE DR
CONTRACTOR: DEVCON
PERMIT NO: 13120092
CONSTRUCTION INC
OWNER'S NAME: APPLE INC
690 GIBRALTAR DR
DATE ISSUED: 12/11/2013
OWNER'S PHONE: 4089745662
MILPITAS, CA 95035
PHONE NO: (408)942-8200
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL LJ
License Class_ Lic. # 'SCR t (Q_1
APPLE- INSTALLATION OF EXTERIOR AWNING AT EAST
Contractor ��, `� Date 2.
ENTRY DOOR TO MATCH EXISTING
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 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
Sq. Ft Floor Area:
Valuation: $12000
performance of the work for which this permit is issued.
1 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
APN Number: 31609030.18920
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
180 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
----� _
costs, and expenses which may accrue against said City in consequence of the
Iy 1 I
granting of this permit. Additionally, the applicant understands and will comply
Issued by: c- —" — Date: f
with all non -point source regul ions per the Cupertino Municipal Code, Section
9.18.
,
Ja
RE -ROOFS:
SignaturA Date
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.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1, 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
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Ai Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cu ertino nicipal Code, Chapter 9.12 and
1 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
the Health & Safety Code, S ' ns 2 0 25 and 25534.
11
Owner or authorized agent: Date:
permit is issued.
1 certify that in the performance of the work for which this permit is issued, l 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
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
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,
ARCHITECT'S DECLARATION
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION (�a�
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1
(408) 777-3228 •FAX (408) 777-3333 • buildinaCa cuaertino.org
❑ NEW CONSTRUCTION ❑ ADDITION ❑X ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS 18920 Forge Drive, Cupertino,CA 95014
APN# 31609030.18920
OWNERNAME Apple Inc.
PHONE 408. 974. 5662
E-MAIL
STREET ADDRESS 1 Infinite Loop
CITY, STATE,ZIP Cupertino, CA. 95014
FAX
CONTACT NAME Crohn Rickard, Apple, Inc.
PHONE 408.974.5662
E-MAIL jrickard@apple.com
STREET ADDRESS 1 Infinite Loop
CITY, STATE, ZIP Cupertino, CA 95014
FA"
❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER N TENANT
CONTRACTOR NAME Jim Le ibo 1 d
LICENSE NUMBER 399163
LICENSE TYPE B
BUS. LIC # 11068
COMPANY NAME Devcon Construction,Inc.
E-MAIL jleibold@devcon-const.com
FAX 408.262.2342
STREETADDRESS 690 Gibraltar Dr.
CITY, STATE, ZIP Milpitas, CA 95035
PHONE 831 .212 .9676
ARCHITECT/ENGINEER NAME Steven Duquette
LICENSE NUMBER S 3 019 exp .3.31.13
BUS. LIC #
COMPANYNAME Duqette Engineering
E-MAIL
FAX 408.615.9900
STREETADDRESS 4340 Stevens Creek 131vd.St. 200
CITY,STATF„ZIP San Jose, CA. 95129
PHONE408 . 615 . 9200
DESCRIPTION OF WORK Installation of exterior awning at East entry door to match existing
awnings on North and West sides of bldg.
EXISTING USE I
office/Labs
PROPOSED USE CONSTR.
Off ice/Labs
TYPE
III -B
# STORIES
1
USE
TYPE
Occ.
SQ.FT.
VALUATIONS)
EXISTGNEW
AREA 91 K S
FLOOR
AREA N/A
DEMO
AREA
TOTAL
NET AREA
$12,000.00
BATHROOM KITCHEN
REMODEL AREA REMODELAREA N/A
OTHER
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
N/A
N/A
N/A
N/A ATTACH
# DWT.LLING UNITS:
IS A SECOND UNIT []YES
SECOND STORY [I YES
N/A
BEING ADDED? ONO
ADDITION? ONO
PRE -APPLICATION []YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RE D_fiX.:
C °
TOTAL VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ® NO
------ ---- --...
$12,000.00
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on e property owner's behalf. 1 have read this
application and the information ave provided 's co ct. I have read the Description of Work and verify it is accura e.- agree to mply with all applicable local
ordinances and state laws relat ng c s on. 1 authorize representatives of Cupertino to enter the above-iden 'fled erty for inspection purposes.
�Ibuil
Signature of ApplicandAg 2
SUPPLEMENTAL A ON E RED
PIAN TYPE
MUTING SLIP
New SFD or Multifamily dweIli gs: AppI for demoliti permit for
_
existing building(s). Demolition permit is required prior to issuance of building
OVER THE -COUNTER
BUILDING PLAN REVIEW
permit for new building.
11 EXPRESS
4D -`PLANNING PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
ell
❑ STANDARD
❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑ LARGE
❑ FIRE DEPT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
❑ MAJOR
❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FEW FEE ESTIMATOR - BUILDING DIVISION
imADDRESS:
18920 Forge Dr
QTY/FEE
DATE: 12/11/2013
REVIEWED BY: MENDEZ
Plan Check Fee:
APN:
BP#: �
*VALUATION: 1$12,000
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
hrs
PENTAMATION 1GENCOM
PERMIT TYPE:
WORK
installation of exterior awning at east entry door to match existing..
[qRa!fj-
SCOPE
011w%i, i
O kl (C
/;Irt at "j'. i'co,
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
nictrirt otr )_ Thoco foot aro ha.cod not tho nroliminary infnrmatian availahle and are only an ostimatn_ Cantart the Dent far addn'I info_
FEE ITEMS (Fee Resolution 11-053 Eff 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
=#
$349.00
Awning / Canopy (Support'd by Bldg)
1AWNA;BLD Awning
Suppl. PC Fee: (!) Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Co�zsrr'r[t'iion a.;:
1 r'i�nriti.rtE caitic> fc>�:
1
0
0
Work Without Permit? 0 Yes E) No
$0.00
Advanced Planniniz Fee:
$0.00
Select a Non -Residential
Building or Structure
r..
1r<7cel lJc�:trtr.c;r'�f�ttic%pt Es�a_
Strong Motion Fee: IBSEISMICO
$2.52
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$3.52
$349.00
TOTAL FEE;
$352.52
Revised: 1010112013