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11030062CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6 INFINITE LOOP FLR 1 CONTRACTOR: SOUTH BAY PERMIT NO: 11030062 CONSTRUCTION CO INC OWNER'S NAME: APPLE INC 170 KNOWLES DR DATE ISSUED: 03/24/2011 OWNER'S PHONE: 4089744876 LOS GATOS, CA 95032 PHONE NO: (408)379-5500 ❑ LICENSED CONTRACTOR'S DECLARATION 2 BUILDING PERMIT INFO: License Class Lic. # J� 14-Y f 4 n1ECII Contractor , &,� Date 311 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 the Cupertino Municipal Code, Section 9.18. Signature Date 31 e ❑ 1OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, 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 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 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. BLDG ELECT PLUMB r RESIDENTIAL COMMERCIAL JOB DESCRIPTION: FLOOR 1 - ADDITIONAL SECURITY TO EXISTING LAB SPACE, INCLUDES NEW DOOR, NEW CARD READER & MODIFY EXISTING DOOR; NON-STRUCTURAL Sq. Ft Floor Area: Valuation: $10000 APN Number: 31602110.FLR1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 1 PERMIT ISSUANCE OR 180 DAY ©M,LAST CALLED INSPECTION. Issued bDate: 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 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, Sections 25505, 25533, and 25534. 11. Owner or authorized agent: Date: 31 Till 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 Ad ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Signature Date CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 6 infinite loop 1st floor DATE: 03/14/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$10,000 rPERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATIOPERMITTYPEN 1GENCOM WORK t.i, commercial non structural add security door modify existing door. SCOPE ,.f;'#;ft, O°I7't' NOTE: These fees are based on the Drellininary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resohition 09-051 Eft' 7/1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 # $506.00 New Door Opening 1DOORNONST Non -Structural Suppl. PC Fee: (D Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes 0 No $0.00 0 Work Without Permit? 0 Yes G) No $0.00 Planning Fee. $0.00 Select a Non -Residential 0 Building or Structure 0 Strong Motion Fee: 1BSEISMICO $2.10 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $3.10 $506.00 TOTAL FEE: $,5 ' 9.10 Revised:.01/15/2011 ,i