14050007RA
CTTY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 18880 HOMESTEAD RD
CONTRACTOR: XL CONSTRUCTION PERMIT NO: 14050007
OWNER'S NAME: CUPERTINO OFFICE PARTNERS LLC
851 BUCKEYE CT DATE ISSUED: 05/01/2014
OWNER'S PHONE: 4088624397
MILPITAS, CA 95035 PHONE NO: (408) 240-6000
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL
License Class? Lic. # ¢�Q'
APPLE T.I. - RECONFIGURE INTERIOR OFFICE SPACE,
1NCLUDINNG ELECTRICAL & MECII (6,887 S.F.)
Contractor YL CJ1N S Tf1M(i1_10►J Date -511/4
1 hereby affirm that 1 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
Compensation, as provided for by Section 3700 of the Labor Code, for the
Sq. Ft Floor Area:
Valuation: $200000
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: 31609037.18880
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that 1 have read this application and state that the above information is
PERMIT EXPIRES IF W T STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
wI TiiIN 180 D P + 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 DA O ALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which y crue against said City in consequence of the
—
granting of this permit. ddy io Ily, the applicant understands and will comply
Date: /L/
with all non -point sourc regula 'tons per the Cupertino Municipal Code, Section
9.18.
RE -ROOFS:
Signature Date 1
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, 1 agree to remove all new materials for
inspection.
13O NER-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)
1, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
1 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 1 store or handle hazardous
1 have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should 1 use eq me t or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Ba ea it Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance wit the Cu a tin unicipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Se it2 5 5, 533 nd 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent Dater 1
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
CONSTR TION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, 1 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
1 certify that l have read this application and state that the above information is
correct. 1 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
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
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 ^ building(okupertino.org
bool
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❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS
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OWNER AME P NE
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STREET ADDRESS
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CONTACT NAME
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XOWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONT ACT_ OR NAME
LICENSE NUMBER
LICENSE TYPE BUS. LIC #
COMPANY NAME
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CITY, STATE, ZIP PH9 E
ARCHITECT/ENGINEER NAME
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LICENSE NUMBER BUS. LIC #
COMPANY NAME
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E-MAIL FAX
STREET ADDRESS
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CITY, STATE, ZIP PH NE
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DESCRIPTION OF WORK pp
-11
o Itl 11 ® e�
'# LOP15nwm&j —r NOM®1*40 w4w6M*
EXISTING USE
PROPOSED USE CONSTR.
TYPE
#STORIES
cor-ri CI&
Fi Ce I
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTGNEW
FLOOR
DEMO
TOTAL
AREA _
AREA —
AREA
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
v
REMODEL AREA —
REMODEL ARE
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: U DETACH
❑ ATTACH
#DWELLINGUNITS:
IS ASECOND UNIT []YES
SECONDSTORY []YES
BEING ADD�� []NO
ADDITION? ❑ NO
PRE -APPLICATION []YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECEI D BY:
VALUATION:
PLANNING APPL # ANO PLANNING APPROVAL LETTER
EICHLER HOME? NO
^ /
TOTAL
By my signature below, 1 certify to lio Ing: I m e property owner or authorized agent to act on the property owner's behalf. 1 have read this
application and the information 1 has ect. ha re the Description of Work and verify it is accurate. 1 agree to comply with all applicable local
—id ufied property for inspection purposes.
ordinances and state laws relating tst ction. I th ize epresentatives of Cupertino to enter the above-
le
Signature of Applicant/Agent: Date: r 1 ij
SUPPLEMENTAL I ANION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
OVER-THE-COUNTER
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
NNyy''❑�� 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
❑
❑
submittal of Building Permit application.
MAJOR
SANITARY SEWER DISTRICT
❑ ENVIRONMENTAL HEALTH
B1dgApp_2011.doc revised 06121111
M
C'IT'Y OF CUP ER'] INO
Iwo, FEE ESTIMATOR - BUMWNG DRVISION
OCCUPANCY TYPE:
ADDRESS: 98880 Homestead Road
DATE: 05/01/2014
REVIEWED BY: Sean
PC FEE ID
APN:
DP#:
*VALUATION: 1$200,000
"PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY
USE: Commercial Building
1BTIPLNCK
PENTAVIATION
PERMIT TYPE: 16 TIS
WORT{
Apple office tenant improvement 6882 sq ft
SCOPE
$0.00
OCCUPANCY TYPE:
TYPE OF
CONSTR.s.f.
FLR AREA
PC FEES
PC FEE ID
DP FEES
DP FEE IID
B (Tenant Improvements)
II-B,III-B,IV,V-B
6,882
$2,461.34
1BTIPLNCK
$5,251.34
1BTIINSP
I ICC' h np. FCC.'
$0.00
Permit Fee:
$5,251.34
Suppl. Insp. Fee -.(E) Reg. Q OT
Q,Q
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
F 6,882
$2,461.34
$5,251.34
MECH, HOURLY 0 Yes G No
PLUMB, HOURLY 0 Yes E) No
ELEC, HOURLY Q Yes Q leo
i fvth. Plcrrt Check
I'kiu; b. Plan C
F/C(, ['lair
FX171,11Permit Fe"
11/ttmb. Permit File:
Flec. Termit Fee
Ot/7ur Ah h, rrvwLLJ
Other Plumb Irtsp,
Otlrer (le(, 174.S,U.
A*xw. lnsp. Fo'&.
1111a)lh h7sp, Fce:
I ICC' h np. FCC.'
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 prelintinary information available and are only an estimate. Contact the Dept for addn'1 info.
FELE ITEMS (l ee Resolution 11-0153 Ef ' 7,%1!131
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,461.34
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (2) Reg. 0 OT
0.0 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$5,251.34
Suppl. Insp. Fee -.(E) Reg. Q OT
Q,Q
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Constr uctior 71,Zv:
'Adminisircarive
0
Work Without Permit? 0 Yes (E) No
$0.00
Advanced Planning? Fee.
$0.00
Select a Non -Residential
Building or Structure
U
0
d
Trot ;e?i Docuiner2"'Xi )r't 11eeS.
trong Motion Fee: IBSEISWCO
$42.00
$8.00
$7,762.68
$0.00
Select an Administrative Item
TOTALFEE $7,762.68'
da Stds Commission Fee: 1BCBSC
SUBTOTALS-,
Revised: 04/01/2014
CUPERTONO
CONTRACTOR / SUBCONTRACTOR M57
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: t Fr V30
PERMIT # '/0 rQQ0'4--
OWNER'S NAME: p �-
PHONE V
GENERAL CONTRACTOR: ' ( W,;/-7r-k&.,*J
BUSINESS LIC NSE #
ADDRESS:
CITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City of Cupertino business Dicense.
NO BUILDING ]FINAL OR ]FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF C>C? EIRTIINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
?lease check applicable subcontractors and complete the Tollllowing information:
V
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
�-
Flooring / Carpeting
/I
S
Linoleum / Wood
--�'
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner / Contractor Signature
1
Date