14110051CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 18920 FORGE DR I CONS RUCTIO R INC R:DEVCON I PERMIT NO: 14110051
I OWNER'S NAME: APPLE INC 1 690 GIBRALTAR DR I DATE ISSUED: 11/10/2014 1
OWNER'S PHONE: 4087384444
❑ LICENSED CONTRACTOR'S DECLARATION
License Class J Lic.
Contractor 40"C* 11 /Y'�1>r` Date # 0
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:
1 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
oprformance 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.
y� APPLICANT CERTIFICATION
"1 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 14
❑ OWNER- BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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)
1, 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.
1 certify that in the performance of the work for which this permit is issued, 1 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.
Date
MILPITAS, CA 95035
PHONE NO: (408)942 -8200
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
APPLE TENANT IMPROVEMENT TO CREATE SOUND
ROOM (500
SQ FT).
Sq. Ft Floor Area: I Valuation: $98500
APN Number: 31609030.18920 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:, !::g %1/ iq%r�i � Date: !� "l0 '/�
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, Sect5, 25533, and 25534.
Owner or authorized agent: Dater
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Profess
CUPERTINO
> y11006 1
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • building(Dcupertino.org
❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION/ TI ❑ REVISION /DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS 18920 Forge Drive
APN # 316 -09 -030
OWNERNAME Apple Inc
PHONE 408 - 738 -4444
E -MAIL
STREET ADDRESS 1 Infinite Loop
CITY, STATE, ZIP Cupertino CA 95032
FAX
CONTACT NAME Terry Fullerton
PHONE 408- 519 -8383 7E-MAIL
tfullerton @devcon- const.com
STREET ADDRESS
690 Gibraltar Drive
CITY, STATE, ZIP Milpitas, CA, 95035
FAX
408 - 946 -5513
y�
❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT X CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME DEVCON Construction
'399163 LICENSE NUMBER
LICENSE TYPE B
BUS L1C #
COMPANY NAME DEVCON Construction
E -MAIL tullerton @devcon- const.com
FAX408- 946 -7713
STREETADDRESS690 Gibraltar Drive
CITY, STATE,ZIPMilpitas, CA 95035
PHONE 408-519-8372
ARCHITECT/ENGINEER NAME Brent Downing
LICENSENUMBERC -32444
BUS LIC#
COMPANY NAME DEVCON Construction
E-MAIL bdowJnGin devcon- const.com
FAX408- 942 -7713
STREETADDRESS690 Gibraltar Drive
CITY, STATE, ZIP Milpitas, CA, 95035
PHONE 408-942-8200
DESCRI PTION OF WORK Addition of a sound room/ speech lab, with Elect, Mech.
EXISTING USE
B
PROPOSED USE CONSTR.
B
TYPE
I # STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION($)
lllb
1
EXISTG
AREA
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA
p
98,500.00
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECKIPORCH ATADDITION?
GARAGE AREA DETACH
[]ATTACH
#DWELLING UMTS
IS A SECOND UNIT ❑YES
ECOND STORY []YES
BEING ADDED? ❑NO
[]NO
PRE - APPLICATION []YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECE. VED By;
TOTAL VALUATION:
PLANNING APPL # []NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
By my signature below, I certify to each of the following: 1 am the property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information I have provided is correct. 1 have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to bui nstruction. 1 autho ze representatives of Cupertino to enter the above - identified property for inspection purposes.
11/10/14
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CRIDMTYPE
ROUTING SLIP
❑ tIVER.IHE COUNTER
YN BUILDING PLAN REVIEW -
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS"
❑ PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
0 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 &EWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
B1dgApp_2011.doc revised 06 121111
CITY OF CUPERTINO
Fm-7,o FEE ESTIMATOR — BUILDING DIVISION
IVAADDRESS: 18920 Forge Drive
TYPE OF
CONSTR.
DATE: 11/10/2014
REVIEWED BY: Sean
APN:
BP #:
BP FEE ID
`VALUATION: 1$98,500
PERMIT TYPE: Building Permit
PLAN CHECK TYPE:
Tenant Improvement
PRIMARY Commercial Building
USE:
IBTIINSP
$0.00
PME Plan Check:
PENTAMATION 1B TI
PERMIT TYPE:
WORK
Apple Tenant Improvement to create sound room 500 sq ft).
SCOPE
Permit Fee:
$724.72
Suppl. Insp. Fee :Q Reg. Q OT
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
II- B,III- B,IV,V -B
500
$2,107.52
IBTIPLNCK
$724.72
IBTIINSP
$0.00
PME Plan Check:
$0.00
Permit Fee:
$724.72
Suppl. Insp. Fee :Q Reg. Q OT
O,Q
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
500
$2,107.52
$724.72
MECH, HOURLY 0 Yes E) No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes 0 No
177F Ll
NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11 -053 I ff. T'7:73)
FEE
QTY /FEE
MISC ITEMS
Plan Check Fee:
$2,107.52
Select a Misc Bldg /Structure
or Element of a Building
Suppl. PC Fee: Q Reg. ® OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$724.72
Suppl. Insp. Fee :Q Reg. Q OT
O,Q
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
E)
Work Without Permit? ® Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential
Building or Structure
Q
0
t
Stronp, Motion Fee: IBSEISMICO
$27.58
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$4.00
SUBTOTALS:
$2,863.82
$0.00
TOTAL FEE:
$2,863.82
Revised: 10/01/2014
NOV 12 '14 08:28 FROSI:DEVCON CONSTRUCTION INC
CUPERTINO
4082622342 T -313 P.01 /01 F -722
/Building Department
City Of Cupertino
10300 Torre Avenue
ertino, CA 95014 -3255
Telephone: 408 - 777 -3228
Fax: 408- 777 -3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: Q0 r-Qc C
PERMIT # 0 O
OWNER'S NAME:
PHONE # O
GENERAL CONTRACTOR: (p2 qC.On
BUSINESS LICENSE # 0 a
ADDRESS: ip
CITY /ZIPCODE:
'Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature
Please check applicable subcontractors and complete the following information:
Date
0 1
�� btli! Cr
Owner / Contractor Signature Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Ct
j
Linoleum / Wood
Glass / Glazing
Heating
CD
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Mck
Sheet Rock
v
Tile
0 1
�� btli! Cr
Owner / Contractor Signature Date