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13030109CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19050 PRUNERIDGE AVE CONTRACTOR: DPR CONSTRUCTION, A PERMIT NO: 13030109 GENERAL OWNER'S NAME: CAMPUS HOLDINGS INC 1450 VETERANS BLVD DATE ISSUED: 04/16/2013 OWNER'S PHONE: REDWOOD CITY, CA 94063 PHONE NO: (650)474-1450 13 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Classj Lic. # 377 D APPLE- COMM T.I RECONFIGURATION OF PARTITION WALLS Contractor ��P� � -Gyl ai ' `l Date t Z� �� FOR TEMP USE OF OFFICES SPACE, STRUCTRAL I hereby affirm that I am licensed under the provisions of Chapter 9 EXTERIOR (commencing with Section 7000) of Division 3 of the Business & Professions ENVELOPE & PLUMBING WILL REMAIN Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: REVISION #1- SAWCUT CONDUIT INSTALL FROM MDF TO I have and will maintain a certificate of consent to self -insure for Worker's COW-ISSD 4/25/2013 Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft FI r Area: Valuation: $100000 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 whic0 permit is issued. Number 31606033.00 Occupancy "type: APPLICANT CERTIFICATION I 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 WITfIIN 0 DAYS OF PERMIT 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 DAY M LAST CALLEDINSP CTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, may accrue against said City in consequence of the costs, and expenses which Issued by: Date: granting of this pe it. Additionally, the applicant understands and will comply with all non -poi, rce regulations per the Cupertino Municipal Code, Section 9.18. i RE -ROOFS: Signature Date 2 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: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 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. 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(a) should I store or handle hazardous I 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 C e tino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Cod , Secti 05, 25533, and 25534. I Section 3700 of the Labor Code, for the performance of the work for which this p 7 Owner or authorized agent: Date: �✓ 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 CONSTRUCTION LENDING AGENCY 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 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 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 • build ing0cuoertino.org ❑ NEW CONSTRUCTION ❑ ADDITION 9 ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 19050 PRUNERIDGE AVENUE 7APN# 316 06 033. 00 OWNER NAME APPLE - JOHN HILLEGASS PHONE 408-203-3262 E-MAIL jhillegass@apple.com STREET ADDRESS 1 INFINITE LOOP, MS 47-2DDC CITY, STATE, ZIP CUPERTINO, CA 95014 FAX CONTACT NAME YOOJU NO PHONE 408-783-1334 7 E-MAIL yno@fosterandpartners.com STREET ADDRESS 1 Infinite Loop, MS: 47-213MC CITY, STATE, ZIP CUPERTINO, CA 95014 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT 12� ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME GAVI N KEITH LICENSE NUMBER LICENSE TYPE BUS. LIC # 33330 COMPANY NAME DPR CONSTRUCTION E-MAIL gavink@dpr.com FAX STREET ADDRESS 1450 Veterans Blvd CITY, STATE, ZIP Redwood City, CA 94063 PHONE 650-474-1450 ARCMTECT/ENGINEERNAME WOLFGANG WAGENER LICENSE NUMBER C27550 BUS. LIC # COMPANY NAME FOSTER AND PARTNERS E-MAIL wwagener@fosterandpartners.com FAX STREET ADDRESS 1 Infinite Loop, MS: 47-213MC CITY, STATE, ZIP CUPERTINO, CA 95014 PHONE 408-783-1334 DESCRIPTION WORK �OLFF (� (�. l � � �p r � '-�� p�-�p� F lil— t `-1V (*k LG', � A. J hG�t:�09Q%`q Vii ri vt•J v�-C� sK -rs� N�xT 3o1�to�7�5 ; .�UGrv�-� �cr- �,►��P�� EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES B B V -B 2 USE TYPE OCC. SQ.FT. VALUATION (S) AREA AREA 54,480 SF NEW FLOOR AREA 0 SF DEMO AREA 0 SF TOTAL NET AREA 0 SF .- /' � �� V BATHROOM KITCHEN OTHER REMODEL AREA 0 SF REMODEL AREA 0 SF I REMODEL AREA 0 SF PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH 0 SF 0 SF I 0 SF 0 SF []ATTACH # DWELLING UNITS: IS A SECOND UNIT []YES BEING ADDED' &JO SECOND STORY ❑ YES ADDITION' QAO 0 PRE -APPLICATION ❑ ] ES ff YES, PROVIDE COPY OF PLANNING APPL # O PLANNING APPROVAL LETTER IS THE BLDG AN ❑ }'ES EICHLER HOME' O RECEIV BY: TOTAL VALUATION: ¢ t co po-).00 By my signature below, 1 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. 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 building construction. I uthorize representatives of Cupertino to enter the above -identified properrtty for inspection purposes. Signature of Applicant/Agent: Date: / V `'fie-/ � ( 20 t 2— SUPPLEMENTAL INFO RMA ION REQ IRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER 1 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 / L`1t PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure C11STANDARD ❑ 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 El MAJOR` SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doc revised 06/21/11 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) .777-3228 • FAX (408) 777-3333 • building (akuperti no. org r-1 r—I rl nnr_n n1>1/7T11IAT PPPKATT$ IJ NEW CONST KUC l lUN LJ Avur t Ivly u PROJECT ADDRESS n� APN # OWNER NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME .. PHONE E-MAIL - - STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRA RNnAAME LICENSE NUMBER LICENSE TYPE BUS. LIC # l` 5 V�CA COMPANY NAME E-MAIL FAX STREET ADDRESS .. CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK aM M17� 4D "V) EXISTING USE PROPOSED USE CONSTR-_ P #STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMOTOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA - DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH #DWELLINGUNITS:' ISA SECOND UNrr ❑YES SECOND STORY OYES - - BEING ADDED' ❑ NO ADDITION! ❑ NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES - RECEIVED I ': - TOTAL VALUATION: `P PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME' ❑ NO �% Un By my signature below, I certify to each of the following: I am the property owner or authorized age to ct on the property owner's behalf. I have read this application and the information I have providd is correct. I have read the Description of Work and verif/pt is accurate. I agree to comply with all applicable local ordinances and state laws relatm5,to build' c traction. I authorize representatives of Cupertino to ettAr the above-identifi d pro rrt2ty for inspection purposes. Signature of Applicant/Agent: Date: 7��J SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THI COUNTER ❑ BurLDING 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. ❑ FXPRESS ❑ PLANNING PLAN RF,VIFW 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 ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. - - ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19050 PRUNERIDGE AVE CONTRACTOR: DPR CONSTRUCTION, A PERMIT NO: 13030109 GENERAL OWNER'S NAME: CAMPUS HOLDINGS INC 1450 VETERANS BLVD DATE ISSUED: 04/16/2013 OWNER'S PHONE: REDWOOD CITY, CA 94063 PHONE NO: (650)174-1450 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIALD COMMERCIAL �J C1 APPLE- COMM T.I RECONFIGURATION OF PARTITION License Class Lic. # t WALLS I� / Contractor VP(Z �71tG'rF'k��j A Date 7 FOR TEMP USE OF OFFICES SPACE, STRUCTRAL I hereby affirm that I am licensed under the provisions of Chapter 9 EXTERIOR (commencing with Section 7000) of Division 3 of the Business & Professions ENVELOPE & PLUMBING WILL REMAIN 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. Sq. Ft Floor Area: Valuation: $100000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 31606033.00 Occupancy Type: 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 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 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 DAYS FR CALLED 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 / Iss Date: ! 6 granting of this permit. Additionally, the applicant understands and will comply with all non -point sour regulations per the Cupertino Municipal Code, Section 9,18. Signature Date/ b/LS 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: 1 hereby affirm that I 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. 1 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 I 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 1 performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 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 the Health & Safety Code, Sections 25505, 25533, and 25534. p / Owner or authorized agent: Date: G 6 permit is issued. 'D Pr_S 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 CONSTRUCTION LENDING AGENCY 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 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 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 inconsequence 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 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: 19050 Pruneridge ave DATE: 03/20/2013 REVIEWED BY: mendez ilia[ADDRESS: APN: BP#: *VALUATION: j$100,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: IBTIPLNCK PENTAMATION 1 B TI PERMIT TYPE: WORK Apple- comm t.i reconfi uration of partition walls for temp use of offices space, structral exterior SCOPE envelope & plumbing will remain OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,111-B,IV,V-B 54,480 $5,756.20 IBTIPLNCK $20,442.95 IBTIINSP $0.00 PME Plan Check: $0.00 Permit Fee: $20,442.95 Suppl. Insp. Fee:O Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: F 54,480 1 $5,756.20 1 1 $20,442.95 MECH, HOURLY O Yes G No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No Afeclr. f ian C ect; f - rni i. i,ZO ;:I k Plan (.:6�ec Alech. Permit Fee: Plan ih. t�ermir- t-ee t.ICC. hE'1771t!' i'c'P: 01her In SP. f3i! p j�JF?,�?i)' s?: � ?, t }iher Elec. 1nsp. hrs $0.00 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only air estimate. Contact the Dept for addn 7 into. FEE ITEMS (Fee Resolution 11-053 E . 7/1112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $5,756.20 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. ® OTT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $20,442.95 Suppl. Insp. Fee:O Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C otistruction T a.a: ,1Idnzinistrafive Fee: 0 G Work Without Permit? O Yes O No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G 0 7 > Fees: Strong Motion Fee: IBSEISMICO $21.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $26,224.151 $0.00 TOTAL FEE: 1 $26,224.15 Revised: 01/01/2013 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS:t , PERMIT # -3- 0/ OWNER'S NAME: 6 P-- -:'L) PHONE # GENERAL CONTRACTOR: QPM BUSINESS LICENSE # J 33>0 ADDRESS:. ` ' i V Tc1i/1}-CA", 4 CITY/ZIPCODE: is � '! *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 tkon-k-b[eatA Cement Finishing Electrical 0 woo 0 o tc 8� (' a Excavation �� { �S ��} fir, 44L4 -7 1'l (p Fencing Flooring / Carpeting `� eA Linoleum / Wood Glass / Glazing l�Z Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper P v Paving Plastering Plumbing -'r/MA, WCckAyXXCak cj Roofing Septic Tank Sheet Metal Sheet Rock Vl n %j��j _ Tile La' Owner / Contractor Signature bate 1 M CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 10,050f PERMIT # 13030/09 OWNER'S NAME: k4 Tyy,. PHONE # GENERAL CONTRACTOR: OP(? `jk.�/1S� -rJ BUSINESS LICENSE # ADDRESS: iU Q1 IV- T 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 INSPECTIONS) 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 / Contractor Efate SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile / Contractor Efate HAZARDOUS MATERIALS CHECKLIST COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildingC@cupertino.orq PURPOSE To minimize possible delays that would result for the Fire Department plan review, please complete the following checklist to determine if an additional level of Hazardous Materials plan review will be required. MARK `YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING? PLEASE MARK YOUR ANSWER WITH AN `X' IN THE YES OR NO BOX ON THE SIDE BELOW. YES NO 1. Use, dispensing, mixing or storage of flammable or combustible liquids or gases, hazardous materials, etc. 2. Battery back-up rooms or racks. X 3. Propane tanks. X 4. Gasoline stations with underground tanks. X 5. Installation or replacement above ground or underground storage of liquid petroleum products, liquefied petroleum gases, compressed natural gas, explosives or other regulated hazardous materials. X 6. Gas rooms for dentist, doctors or veterinarians. X 7. Generators with back-up diesel or other fuels. 8. Large refrigeration systems. 9. Fuel cell systems. 10. Commercial pool systems. 11. Chemical Storage areas. 12. Flammable liquid storage. 13. Compressed Gases. X 14. Dry cleaners. 15. Print Shops. 16. Auto Repair and Auto Body Shops. 17. Research and Development. For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa Clara County Fire Department, at (408) 378-4010. Has Mat 2011.doc revised 03/07/11 160 CUPERTINO UNREASONABLE HARDSHIP EXEMPTION FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(d)cuper ino.orq (For Tenant ImDrovements where the Cost of Construction does not exceed $136,060.00) SITE ADDRESS 19050 PRUNERIDGE AVENUE APN 316 06 033 BP# CITY CUPERTINO ZIP CA 95104 TOTAL CONSTRUCTION COST A $ 1QQ,000-00........_...... ....... DESCRIPTION OF WORK: TENANT IMPROVEMENT PROJECT -INTERIOR ONLY -FOR A TEMPORARY OFFICE BUILDING WHICH WILL BE USED FOR THE NEXT 30 MONTHS. THE OFFICE BUILDING WILL BE ENTIRELY DEMOLISHED AFTER 30 MONTHS. The following is a list of costs to provide access features in order to comply 100% with the current State Title -24 Disable Access Standards.(AII costs to be documented by actual bids or other information accepted by the Buildinq Official.) Accessible Features Complies with If not, list required upgrades in order for Cost to make feature I Description of access features to be provided: Items 2,3,4,5 and 7 are existing current standards? features to full com 17 fully accessible? 1. Path of travel to accessible entrance. New cur NO cuts & demolition of partial landscape & $ 85 000.0 regrading& new path to the public pedestrian walk 2. Cost of providing a primary entrance. (Including but not limited to, thresholds, landings, door hardware, YES $ 0 max. door pull, etc. 3. Cost of providing the primary path of travel to the specific area of alteration, structural repair, or YES $ 0 addition. 4. Cost of providing accessible restroom facilities. YES $ 0 5. Cost of providing an accessible drinking fountain. (If YES $ required or if a drinking fountain is provided.) 6. Cost of providing accessible public telephones (if $ 0 provided) _ 7. Cost of providing other accessible features, including YES $ 0 but not limited to, parking, storage, alarms etc. "N'NTOTAL COST OF ACCESS FEATURES (B): $ 85,000.00 Has the same tenant performed work in the same tenants ace within the last three ears? NO Calculate (B 1 A) x 100% Description of access features to be provided: Items 2,3,4,5 and 7 are existing TOTAL COST OF PROPOSED UPGRADEexpenditure $ 118,000.00 PERCENTAGE (20% minimum is required) % ARCHITECT 0 E►dGlfy�EJ�� C;�F EC RD INFORMATION: I certit� if�at/4he �b ve gted information is trueand correct. Name (print): UIQ// ll //I�///fly J Signature: IVl'�/J V Date:ptv Firm addresM le: Phone. --------------- -----{--- Ce - .-- FOR DEPARTMENT USE ONLY----------------------------------------------------------------------------- V ❑ The above named project has been denied an unreasonable hardship exemption under 2010 CBC Section 1134B.2.1. ❑ The above named project has been granted an unreasonable hardship exemption from the requirements of the State of California CCR -Title 24 (Regulation for the Accommodation of the Disabled) pursuant to 2010 CBC Section 1134B.2.1. COMMENTS: Building Official Designee (print): Signature: Date: HardshipEzemptionForm 2012.doc revised 06/25/12 PROJECT DATA - COMMERCIAL COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 CUPERTINO (408)777- 322 FAX (408) 777-3333 - building0cuoertino.ora PROJECT ADDRESS 19050 Pcuneridge Avenue APN'316 06 033 OWNERNAME APPLE INC. - JOHN HILLEGASS PHONE408-203-3262 E-11jhillegass@apple.com STREET ADDRESS 1 INFINITE LOOP, MS 47-2DDC CITY, STATE, ZIP CUPERTINO, CA 95014 FAX CONTACT NAMEYOOJU NO I PHONE 408-783-1334 EMAIL yno@fosterandpartners.com STREET ADDRESS 1 INFINITE LOOP, MS 47-2BMC I CITY, STATE, z>PCUPERTINO, CA 95014 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ® ARCHITECT 11 ENGINEER ❑ DEVELOPER ❑ TENANT TENANT CONTACT NAME JOHN HILLEGASS 7 PHONE 408-203-3262 E-MAR.jhillegass@apple.com BUSINESS NAME APPLE INC. FAX BUILDING OR TENANT SPACE DIMENSIONS 27,240 sf PER EACH FLOOR. 54,480 sf TOTAL FOR TWO STORIES. DESCRIPTION OF WORK I J C&O(QFI61KATOIJ f t - I ,, t F = -- �' OFOFFIeC- S�' e F6- Al�`� 3 c, nr FAV( � � C l.i�I,�:.� t� � �irJ M�rv�%HS S�'�l./�f1-�- i✓1c��i�>� F�1�1�iCP� �P�itN�B�ntc`� �J1�c- �ir��nl �+S--iS _ . EXISTING USE(S): OFFICE PROPOSED USE(S): OFFICE OCCUPANCY(S): B OCCUPANT ' /3Fj ts+ t� LOAD: $-d P--rr- TYPE OF `' p CONSTRUCTION v -v AREA OF REMODEL SPACE: 4,480 SF FLOOR(S)HAZARDOUS OF REMODEL SPACE: 2 Y O MATERIALS? FIRE O N SPRINKLERS: WUI Y O AREA:- FLOOD Y O AREA: SIESMIC Y O AREA: LEARNING CENTERS AND EDUCATIONAL OPERATIONS: 24 HOURS CARE? Y N NUMBER OF CHILDREN < 2 YRS OLD: NUMBER OF STUDENTS >= 2 YRS OLD UP TO 12TH GRADE: NUMBER OF ADULT CLIENTS: NUMBER OF EMPLOYEES: TOTAL OCCUPANTS: Governing Codes: 2010 California Building Code (based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residential Code) 2010 California Plumbing Code (based on the 2009 Uniform Plumbing Code) 201;0'091 Fb iia Mechanical Code (based on the 2009 Uniform Mechanical Code) 2010 California Electrical Code (based on the 2009 International Electrical Code) p, X I'41dalifornia Energy Code 2010 CalifQMja Green Building Standards Code Cun�r�u�tlicipal Code ProjectData-CommerciaLdoc revised 12/01/11 CUPERTINO PLAN REVIEW SUBMITTAL CHECKLIST COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(alcupertino.org PERMIT TYPE: Building Permit USE, Commercial Building PLAN CHECK TYPE: Tenant Improvement ROUTING TYPE: Large FOOD ESTABLISHMENT? O Y ON PUBLIC SWIMMING POOL? O Y ON OWNER / BUILDER? O Y ON FENCING PROPOSED? O Y ON Plans/Documents Required: 6 Sets of Plans 2 Sets of Su000rtina Documents APPLICATION SUBMITTAL INFORMATION Required Provided Scope of Work specified on cover sheet ❑x 0 Specify the following Governing Codes on cover sheet: • 2010 Calif. Building Code (based on 2009 International Building Code) • 2010 Calif. Residential Code (based on 2009 International Resid. Code) • 2010 Calif. Plumbing Code (based on 2009 Uniform Plumbing Code) • 2010 Calif. Mechanical Code (based on 2009 Uniform Mechanical Code) ❑Q LU • 2010 Calif. Electrical Code (based on 2009 National Electrical Code) _ • 2010 Calif. Energy Code Cn • 2010 Calif. Green Building Standards Code W w • Cupertino Municipal Code Name and Address of property owner Q L) Provide a Drawing Index that lists all pages part of the official drawing set ❑x Project Data Form information (including assessor's parcel number, use of building, etc.) (link to Residential Form) (link to Commercial Form) Deferred Submittal Items (if applicable) ❑x ❑ Special Inspection / Structural Observation Items (if applicable) ❑x ❑ Alternate Materials and Methods granted for project (if applicable) ❑ Fully dimensioned site plan with a minimum scale of 1/8"=1' or 1:20 to include North arrow, type and dimension of existing overhead utility lines and easements, perimeter outline and dimensions of existing and proposed Q ❑ building and/or structures, property line and setback dimensions, existing tree ND"'oeK -E species & trunk diameter measured 4' above natural grade). L✓ru_ s U) Floor Plans (existing and proposed) Q J a Elevations (North, South, East and West ) with Section View referenced ❑ ❑ Z Section Views (Longitudinal and Transverse) ❑ ❑ 0 Electrical plans stamped and signed by licensed professional ❑x Plumbing Plans stamped and signed by licensed professional ❑x P °e,N�❑ Mechanical Plans stamped and signed by licensed professional 0 z Grading and Drainage Plans ❑ ❑ L) Excavation and Shoring Plans ❑ ❑ Foundation Plan with cross-referenced structural details ❑ ❑ Floor and Roof Framing Plans with cross-referenced structural details ❑ ❑ Gas and Plumbing Isometric Drawings (for one-two family dwellings and ❑ ❑ accessory buildin s P1anCheckSubmittalChecklist 2012.doc revised 11/29/12 I understand this may not be a complete list of required items due to the variations for each project and additional code related information may be required. / understand that an incomplete plan check submittal may result in delays in the plan review process. Applicant Name (Print): Y00 JU �J° Applicant Signature: &-Vt / Applicant's Phone: �IoS J 1$3 -- 133tk Applicant's Email: yam® &%r o dpxv4- ers"""' Date: MRtC�P /2,0 /2-013 PlanCheckSubmittalChecklist 2012.doc revised 11129/12 Window alignment and privacy protection requirements for second stories or ❑ ElZ new second story windows or letter of waiver. � One 8 1/2 x 11 co of the site Ian, with privacy protection planting shown PY P P Y P P 9 (tree location, tree canopy, tree species, dimensioned planting distance) O Affidavit from a certified arborist/landscape architect. (Affidavit should have a Z copy of the privacy plantingplan attached). X Landscape Water-Efficiency Checklist (click for entire landscape ordinance) Q ❑ = Fence Approval Form (click for entire fence ordinance) ❑ ❑ p Incorporate the City of Cupertino Best Management Practices (BMP) sheet into 0 all plan sets. Completed and Signed Plan Review Submittal Checklist Q Completed and Signed Construction Permit Application Form Q CD (n Structural Calculations stamped and signed by licensed professional �� ❑ Geotechnical Soils Investigation report stamped and signed by licensed El El0 iz professional 2 co ies a Title 24 Energy Certificate of Compliance forms incorporated into all plan sets. ❑ 0-0 Oo Manufacturer's Specifications ❑ N Owner-Builder Disclosure Form (for property owners applying for their own ❑ ❑ building permit) Hazardous Materials Questionnaire Form ❑ o Building Department 408-777-3228LU ❑ Planning Department 408-777-3308 ❑ Public Works Department — New SFD, addition/remodel with 25% increase in LU floor area, hillside construction, grading and drainage permits, retaining wall ❑ permits, swimming pools new/demo 408-777-3354 w Santa Clara County Fire Department 408-378-4010 ❑ z County Health Department 408-918-3400 ❑ X Cupertino Sanitary Sewer District 408-253-7071 ❑ ❑ LU Other:11&/2F:AcoNA6IF f(tFr-Pt> tr -Ex"G-A4PTt-kJ R7r" U Other: ❑ ❑ If an existing residence is proposed to be demolished as part of the U construction of a new residence, a DEMOLITION PERMIT APPLICATION Cn shall be applied for at the same time the construction permit application for the El 11 new residence is applied for. I understand this may not be a complete list of required items due to the variations for each project and additional code related information may be required. / understand that an incomplete plan check submittal may result in delays in the plan review process. Applicant Name (Print): Y00 JU �J° Applicant Signature: &-Vt / Applicant's Phone: �IoS J 1$3 -- 133tk Applicant's Email: yam® &%r o dpxv4- ers"""' Date: MRtC�P /2,0 /2-013 PlanCheckSubmittalChecklist 2012.doc revised 11129/12