11050038CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10440 BUBB RD CONTRACTOR: DPR CONSTRUCTION INC PERMIT NO: 11050038
OWNER'S NAME: APPLE INC 1450 VETERANS BLVD DATE ISSUED: 05/05/2011
OWNER'S PHONE: 4089744876 REDWOOD CITY, CA 94063 PHONE NO: (650)474-1450
El LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG F ELL, CT r PLUMB 1—
" C�4� /
License Class- /1� LIC.
Contractor 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.
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 permit. Additionally, the applicant understands and will comply
with all non -point source regulations per he Cupertino Municipal Code, Section
9.18. /J
Signature Z
Date
0 OWNER-BUH�DER DECLARATION
I hereby affirm that I am exempt from the Conti -actor'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,
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 Cal ifamia. 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
MECH r RESIDENTIAL r COMME RCIAL r
JOB DESCRIPTION: STE A - DEMO(9873SQFT) MINOR STRUCTURAL INTERIOR
ONLY
Sq. Ft Floor Area: I Valuation: $20000
APN Number: 35720036.00 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:'----�— -ate:
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 BETTE, R
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health& Safety Code, Sections 25505,25533, aud25534. Iwillmaintain
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.
or authorized
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
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3265
(408) 777-3228 - FAX (408) 777-33 33 - buildinqCcDcupertino.oncl
C U P ERT 1 r4 0
El NEW CONSTRUCTION 0 ADDITION 0 ALTERATION/TI RFviSION /DEFERRED ORIGINAL PERNiTr #
PROJECT ADDRESS AFN
O=L PHONE E-MAIL
L bn A PRI ILE- a
STREET ADDRESS CITY, STATE,ZT-,,-- I FAX
CONTAC,; NAME PHONE E-MAIL
I � r fi'hr)l i n �� 1 1 A-,4,140 / ) f� \/ (� )
STREET ADDRESS
NEWFLOOR.
AREA
DEMO (qS -? �
AREA
/-4
FAX
* �",'
BATHROOM
KITCHEN
OWNER owNEEL-BumnEP El OWNERAGENT 1:1 CONTRACTOR El CONTRACTOR AGENT ARCHITECT BNGR,1EER 11 DEMOPER TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSETYPE
BUS. LIC hi
REMODEL AREA
REMODEL AREA
CIMPANYN"%-�]
PORCH AREA
E-MA!L
TOTAL DECK/PORa-i AREA
FAX
STREET ADDRESS
4�
CITY(
,&AT ZIP",
ARCHITECT/ENGMERNAME LICE SENUMBER *2 BUS. LIC
COMPANYNAME F -r
FAX
et C P- .0
STREET ADDRESS CITI,:, A ZIP �,PHONF
ik �e, A
0
DESCRIPTION OF WORK
EXISUNGUSE I PROPOSED M I CONSTILTYPE I 9STORIES
EXISTG
AREA
NEWFLOOR.
AREA
DEMO (qS -? �
AREA
T OTAL A
NET ARE
* �",'
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORa-i AREA
GARAGE AREA: DETACH
ATTACH
9 DWELLING UNITS:
IS A SECOM UNIT C] YES
SECONDSTORY YES
REMADDED? NO
ADDITION? E] NO
PRE -APPLICATION El YES
IF YES, PROVIDE copy OF
PLANNERS NA?a:
PLANNING APPL H NO
PLANNING APPROVAL LETTER
By my signature below, I Certify to each of the following: I am the property owner or authorized agent to Act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and �erify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to quilding construct' I authorize r p I -&entatives of Cupertino to enter the above-ide ified propfty for inspection purposes.
Signature of Applicant/Agent: A-tt Date:
SUPPLENINTAL INFORMATION REQUIRED
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.
— Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
Torm if any Hazardous Materials are being used as part of this project.
- Copy of Planning Approval Letter or Meeting with Planning prior to
Tub�nittal of Building Permit application.
BldgA,pp_�201 1. doc revised 03116111
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS:
PERMIT # /Za sc-)():3014�7
OWNER'S NAME:
PHONE# t/�;' �>
GENERAL CONTRACTOR:
BUSMESS LICENSE #
ADDRESS:
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
V
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
LVIZ
Cement Finishing
Electrical
Excavation
Fencing
J
Flooring / Carpeting
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
Date
DEMOLITION
CITY OF CUPERTINO
W -w- FEE ESTIMATOR - BUILDING DIVISION
19
ADDRESS: 10440 A Bubb rd
DATE: 05/05/2011
REVIEWEDBY: Mendez
APN:
BP#:
VALUATION: 1$20,000
'PERMIT TYPE: Demolition Permit
;TIC1, 7:1,11 1*1.,
1,1_24;\, 7 " R 1: E
PRIMARY Commercial Building
USE:
I
PENTAMATION 1COMMLDEM
I PERMIT TYPE:
WORK
Demo -minor structural interior only
SCOPE
Suppl. Insp. Fee:G) Reg. 0 O��s
FEE ID FLR AREA
(S.L)
1DEMOCOM 9,873
NOTF.- These teps are hased on the nrefiminary information availahle and are on1v an estimate. Contact the Dent for addn'l info.
FEE ITEMS.(Fee Resohition 09-051 fff. 7/]�UQ
FEE
P",
Ele,, POY�
P� P(.,
Nil/ wl, PC F"'?
El
ED
Plal�?
NOTF.- These teps are hased on the nrefiminary information availahle and are on1v an estimate. Contact the Dent for addn'l info.
FEE ITEMS.(Fee Resohition 09-051 fff. 7/]�UQ
FEE
QTY/FEE
MISC ITEMS
Nil/ wl, PC F"'?
Plal�?
Permit Fee:
$1,266.00
Suppl. Insp. Fee:G) Reg. 0 O��s
$0.00
7
Cow,wwcfio�� T"n,
TT
Ti-avell
Strong Motion Fee: IBSEISMCO
$4.20
Select an Administrative Item
Bldg Stds Con-imission Fee: IBCBSC
$1.00
SUBTOTALS:
$1,271.20
$0.001 TOTALFEE:
1 $1,271.20
Revised: 04/29/2011