14050003CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18920 FORGE DR
CONTRACTOR: DEVCON
PERMIT NO: 14050003
CONSTRUCTION INC
OWNER'S NAME: APPLE INC
690 GIBRALTAR DR
DATE ISSUED: 05/01/2014
OWNER'S PHONE: 4084990223
MILPITAS, CA 95035
PHONE NO: (408)942-8200
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
"� .�
APPLE T.I. - RECONFIGURE (E) OFFICE SPACE
License Class4 ,�
INCLUDING MECH & ELECTRICAL (2,500 S.F.)
/'Liic.
&&A)
Contracto l Date
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.
1 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
tion, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $175000
pompe
ormance of the work for which this permit is issued.
1 have and will maintain Worker's Compensation Insurance, as provided for by
ection 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
1 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
building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
180 D AST LLED 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
°
granting of this permit. Additionally, the applicant understands and will c
Is Date:
with all non -poi rce regulations per the Cupertino Municipal Code, Section
RE -ROOFS:
9.18.
Signat 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 1 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. I 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(x) should I store or handle hazardous
1 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 Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the upertino Municipal e, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Se on 2550 33, and 53 .
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agen Date. D
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
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
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
1 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
00
COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 �{b
(408) 777-3228 • FAX (408) 777-3333 • building(fcuaertino.oro _ \
❑ NEW CONSTRUCTION " ADDITION U ALTERATION / TI
PROJECT ADDRESS
18920 Forge Drive, Cupertino,CA 95014
REVISION / DEFERRED ORIGINAL PERMIT #
APN# 31609030.18920
OWNERNAME Apple Inc.
USt
Office/Labs
PHONE 408 .499. 0223 E-MAIL
H S7UKIt5
1
STREET ADDRESS 1 Infinite Loop
CITY, STATE, ZIP Cupertino, CA. 95014
FAX
CONTACT NAME Tina Moore, Apple, Inc.
NEV
AREA FLOOR/ A
PHONE 408 , 499. 0223
E -MAI
Ltina
moore@apple.com
STREET ADDRESS 1 Infinite Loop
CITY, STATE, ZIP Cupertino, CA 95014
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER 29 'TENANT
CONTRACTOR NAME Jim Le ibol 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
STREET ADDRESS 690 Gibraltar Dr.
CITY, STATE, ZIP Milpitas, CA 95035
PHONE 831 .212. 9676
ARCHITECT/ENGINEER NAMEDavid Sabalvaro
LICENSE NUMBER C15925, exp. 3/31/2015
BUS. LIC#
COMPANY NAME Studios Architecture
E-MAILcwerner@studios.com
FAX
STREETADDRESS 405 Howard St., Ste 488
CITY, STATE, ZIP Sari Francisco, CA 94105
PHONE415.732 .5336
DESCRIPTION OF WORK
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
Minor remodel of private and open office area in original phase I
area of bldg.
❑ LARGE
❑ F7RE DEPT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
Y:XISTINU USEPROPOSED
Office/Labs
USt
Office/Labs
CON571(. TYYt
III -B
H S7UKIt5
1
USE TYPE OCC.
SQ.FT.
VALUATION (S)
�AG2 5 0 0 S F
NEV
AREA FLOOR/ A
DaRIMEn
I TOTAL VALUATION:
rTroET AREA
PORCH AREA
Z')p
1$175,000
BATHROOM
REMODEL AREA
LSASC(;VINUUPM UYt.J
BEING ADDED? ®NO
KITCHEN
REMODEL AREA N/A
OTHER
REMODEL AREA
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
D BY
I TOTAL VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LEITER
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
a ent owner's behalf. I have read this
application and the information I have rde s correct. I have read the Descrip '
N/A
N/A
N/A
N/A ATTACH
H
I
Signature of Applicant/Agent:
Date: V
IF VWLLL1N(i UNIID:
N/A
LSASC(;VINUUPM UYt.J
BEING ADDED? ®NO
5C.t.VNUJ1VRY I..1Ytb
ADDITION? ®NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
D BY
I TOTAL VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LEITER
EICHLER HOME? ® NO
1-11-75, 000
By my signature below, I certify to each of th Ilowing: I am the property owner or
a ent owner's behalf. I have read this
application and the information I have rde s correct. I have read the Descrip '
ork and v Is accurate. I agree
to comply with all applicable local
representa ves o Cupertino to enter the above-iden 'fled/plro
ordinances and state laws relating uildinordinances and state laws relating onstructioo rize representa ves o Cupertino to enter the above-iden 'fled
pro erty for inspection purposesrize
erty for inspection purposes.
Signature of Applicant/Agent:
Date: V
SUPPLEMENT INFORMA QUIRED
PLAN CHECK TYPE
ROUTING SLIP
0 OVER-TH&COVNT'ER
❑ 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
❑. PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑ LARGE
❑ F7RE DEPT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
❑ `IlnAaoR
❑ SANrrnRYSEwERDISTTucr
submittal of Building Permit application.
BldgApp_201 Ldoc revised 06/21/11
CITY OY cCUP ERTINO
.0 Wo YEE ESTIMATOR — BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 18920 FORGE DR
DATE: 05/01/2014
REVIEWED BY: MELISSA
PC FEE ID
APN: 31609030
BP#: QVALUATION:
$175,000
PERMIT TYPE: Building Permit
PLAN CIIECK TYPE: Tenant Improvement
PRIMARY
USE: Commercial Building
IBTIPLNCK
PENTAMATION
PERMIT TYPE:1B TIS
WORT{
APPLE T.I. - RECONFIGURE E OFFICE SPACE INCLUDING MECH & ELECTRICAL (2,500 S.F.
SCOPE
0,0 hrs
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BPFEES
BP FEE IID
B (Tenant Improvements)
II-B,III-B,IV,V-B
2,500
$2,238.40
IBTIPLNCK
$2,147.70
IBT11NSP
I;!(' i'CC
Suppl. Insp. Fee:Q Reg. Q OT
0,0 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
L onsoi fie ion Tax:
(Idininistrative Fee:
E)
Work Without Permit? ® Yes Q No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential E)
Building or Structure
TOTALS:
2,500
$2,238.40
$36.75
$2,147.70
Bldg Stds Commission Fee: IBCBSC
ME(C]H[,1HlOUR LY O Yes ) No
PLUMB,HOURLY Q Yes (E)No
IEILIEC, lH1OUR LY ®Yes (!) No
Plarj Ch(!:A
pounrh. PiciiI Cheel.
,/e . �':•,�� C.°.'<i
l.Pi_ch. Perini! 1"n':
plump pee -mit i' <.
l,7 r }''cI)i?if I'l,C
Other .lfech. Insp.
Other PNn7b Insp.E]__L_
$0.00
Rech. lwsp. Fee:
phuuh Insp. I'ed"
I;!(' i'CC
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (1 ee Resolution 11-053 Ejf. 711113)
FEE
QTY/]FEE
1D ISC ITEMS
Plan Check Fee:
$2,238.40
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (D Reg. 0 OT
0,0 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,147.70
Suppl. Insp. Fee:Q Reg. Q OT
0,0 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
L onsoi fie ion Tax:
(Idininistrative Fee:
E)
Work Without Permit? ® Yes Q No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential E)
Building or Structure
Trovel Docinnentation Fees:
Stronp, Motion Fee: IBSEISMICO
$36.75
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$7.00
SUBTOTALS:11
$4,429.85
$0.00
TOTAL ]FELE:
$4,429.85
Revised: 04/01/2014
CUP EfRTONO
CONTRACTOR / SUBCONTRAC70R UST
Bufllflang pDepartment
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: 18920 Forge Drive, Cupertino, CA. 95014
PERMIT #
OWNER'S NAME: Apple Inc.,/Tina Moore
PT[ON.E #408-499-62S-
GENERAL CONTRACTOR: Devcon Construction, Inc
BUSINESS LICENSE # 11068
ADDRESS: 690 Gibraltar Drive
CITY/ZIPCODE: Milpitas, CA. 95035
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSIPIECTI®N(S) WILL BE SCHEDULED (UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITE' OF CU? ERTINO
BUSINESS LICENSE.
0 am not using any subcontractors:
Signature
IPllease check applicable subcontractors and complete the ffollowEng nnfformatiion:
Date
V
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
X
Cabinets & Millwork
Complete Millwork Services3�
Cement Finishing
X
Electrical
Redwood Electric Group
Excavation
Fencing
X
Flooring / Carpeting
R.E. Cuddie Co.
AV
Linoleum / Wood
X
Glass / Glazing .
Walters & Wolf
`j S
X
Heating
Thermal (HVAC)
Insulation
Landscaping
Lathing
Masonry
X
Painting / Wallpaper
Magnum Drywall
• ` ,-X/-2,
Paving
Plastering
Plumbing
X
Roofing
Statewide Roofing
Septic Tank
Sheet Metal
X
Sheet Rock
Magnum Drywall
j
Tile
41
1
Owner -tea actor Signature Date