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15050076CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20400 MARIAN I AVE CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 15050076 OWNER'S NAME: MISSION WEST PROPERTIES 1460 O'BRIEN DR DATE ISSUED: 05/13/2015 OWNER'S PHONE: 6507842338 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ - T.I. TO RECONFIGURE & REMODEL (E) OFFICE, aAPPLE License Class Lic. H l ( 0'2 1,231 S.F. /D�-'o Uir97c-�0� DEF # 1 - EXTERIOR SITE ACCESSIBILTIY - ISSUED 6/18/15 Contractor ►r-• Date 1 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 Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $130000 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 APN Number: 31622018.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that l 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 IT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon above mentioned property foinspectionpurposes.) gr sen 18W0 D LED INSPECTIO indemnify and keep ha mlless the City of Cupertino against liabilities, gm costs, and expenses which may accrue against said City in consequence of the / �Sed bgranting of this permit. Additionally, the applicant understands and will coa with all non -point source regulations per the Cupertino Municipal Code, io 9.18. ( / �(� RE -ROOFS: Signature It< 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: 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). 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 I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections05, 25 , an 534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or agent Date: permit is issued. authorized 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, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must l 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 1 have read this application and state that the above information is correct, l 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, ARCHITECT'S DECLARATION 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228• FAX (408) 777-3333 • buildinq(d-)cuoertino.orq ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI It REVISION / FERRE l -Oso �- ORIGMAL PERMIT R PROJECf ADDRESS^ O 4 OC> �i 6—o\ A✓� . L APN /// OWNERNAME PHONE! / �n E-MAIL STREET ADDRESS CITY, STATE, ZIP I FAX CONTACT NAME � ,.,^ A ' �� f� PHO / �O ,( E-MAIL �J1r "j STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ ONVNERRjAG�E-NT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT �o� CONTRACTOR NAME` ` LICENSE NUMBER LICENS TYPE BUS, LIC 4 0, 1 0 'L COI✓,PANY NAS E-MAIL FAX STREET ADDRESS A ` CITY,STATE, I �`I��S PHONE &C(I v O GS c 2 ARCHI ECT/ENGLNEFR NAME LICENSE NUNMER BUS. LIC' COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE,//, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE 4 STORIES - USE TYPE OCC. SQ.FT. VALUATION (S) E=TG NEW FLOOR- DEMO TOTAL AREA AREA AREA NET AREA - BATHROOM KITCHEN OTT-�R. REMODEL AREA REMODEL ,AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJDETACH ❑ ATTACH k DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES B€INGAID DED? El NO ADDITION? NO PRF. -APPLICATION ❑YES IF YES, PROVIDE COPY OF ISTHE BLDG AN❑YES rn, - u TOTAL VALUATION: PLANNG APPL k ❑ NO PLANNING APPROVAL LETTER IN EICHLER HOME. :. �.4Pnt r7' br54li%r✓w e..' ���k1 i f��"'� By my signature below, I certify to each of the following: I am the property ON or autho 'a agent to a e property owner's behalf. I have read this application and the information I have psov' d is correct. I have read the Description of ork and v is accurate. I agree to comply with all applicable local ordinances and state laws relating to mg constructio Vze esentatives of Cupertino o enter the aboVee-id /ti�njed roperty for inspection purposes. Signature ofApplicant/Agent: Date: C[/�j D SUPPLEMENTAL INFORMATION REQUIRED 11'�'X"'r p 011 r New SFD or Multifamily dwellings: Apply for demolition permit for New a existing building(s). Demolition permit is required prior to issuance of building, permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure au _ form ifany Hazardous Materials are being used as part of this project. Copy Planning Approval Letter or Meeting with Planning to _ of prior submittal of Building Permit application. �,i,.i + , �.•. a. OlstlrYk. LT i$� a ���,� B1dgApp_201 Ldoc revised 06/21/11 CITY OF CUPERTINO rm-N FEE ESTIMATOR - BUILDING DIVISION JAADDRESS: 20400 MARIANI AVE DATE: 06/18/2015 REVIEWED BY: MELISSA APN: 316 22 018 BP#: 15050076 *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY Commercial Building USE: Civil / Religious activities in BQ zone? () Yes Q No PENTAMATION 1GENCOM PERMIT TYPE: WORK DEF # 1 - EXTERIOR SITE ACCESSIBILTIY - ISSUED 6/18/15 SCOPE $0.00 NOTE: This estimate does not include fees due to other Departments (i. a Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimates Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE t'llow, / -err f'h��c� MISC ITEMS f'1 .wl, idrill v.'C'. Oc )"'row )'ce $0.00 0 /u,/- P t a'. hvS,. i P,liC'1 1' ire t . bl),V,.Ll V1umb, h2,j), l'c" l to %6'l,v('c'c'_ NOTE: This estimate does not include fees due to other Departments (i. a Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimates Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # $286.00 Deferred Submittal IDEFSUBM Suppl. PC Fee: Q Reg. Q OT TO.OThrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC T7 $0.00 iclrr ia?iw l','itC I^.'r:': O E) Work Without Permit? C) Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 i Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 t : $0.00 $286.00 TOTAL "EE $286.00 Revised: 05/07/2015 l►A CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20400 MARIAN[ AVE CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 15050076 OWNER'S NAME: MISSION WEST PROPERTIES 1460 O'BRIEN DR DATE ISSUED: 05/13/2015 OWNER'S PHONE: 6507842338 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL yy 1102,Z, APPLE - T.I. TO RECONFIGURE & REMODEL (E) OFFICE, License ClassLic. k ( 1,231 S.F. lI Contractor IV �V m mDate 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 Sq. Ft Floor Area: Valuation: $130000 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 1 he work for which this APN Number: 31622018.00 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 WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 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 AYS FROND M INSPEC ION. indemnify and keep harmless the City of Cupertino against liabilities, judgme ,.••°�%' costs, and expenses which may accrue against said City in consequence of the Date.. - 13 L 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. r RE -ROOFS: Signature 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: 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). 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(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 Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this 13 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 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 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 ing(a cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION/Tl ❑ REVISION /DEFERRED ORIGINAL PERMIT 9 PROJECTADDRESs 20400 Mariani Ave APNN v l OWNERNA,ME Apple, Inc. 6 [SfW ONE 650-784-2338 E-n9AIl'i^"" v STREETADDRESS 1 Infinite Loop CITY, STATE, ZIP Cupertino, CA 95014 FAX CONTACT NAME Lucy Nguyen PHONE 408-569-9455 E-MAI-Inguyen@novoconstruction.com STREET ADDRESS 1460 Obrien Ave CITY, STATE, ZIP Menlo Park, CA 95014 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR M CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER 791022 LICENSE TYPE B BUS. LIC H 23891 COMPANY NAME NOVO Construction E-MAIL FAX STREET ADDRESS 1 460 Obrien Ave CITY, STATE, ZIP Menlo Park, CA 94025 PHONE 650-701-1500 ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIC N Jason Holleb COMPANY NAME Hayes Group Architects E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK Partial demo of mechanical ductwork / wall and demo of office. New walls and storefronts stem for an office on the 1 st floor. BXISTINUSE PROPOSED USE CONSTR. TYPE N STORIES tj B 1 USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR. AREA DEMO AREA TOTAL NET AREA B B $130,000 BA"FHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKMORCH AREA GARAGE AREADETACH ❑ ATTACH d DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY []YES BEING ADDED? [:]NO ADDITION? []NO PRE -APPLICATION []YES IF YES. PROVIDE COPY OF IS THE BLDG AN ❑ YES .; TOTAL VALUATION: PLANNINGAPPLA []NO PLANNING APPROVAL LETTER EICHLER HOME? JR -$130,000 By my signature below, I certify to each of the following: 1 am the property owner or authorized agent o roperty owner's behalf. I have 4Aiiis application and the information I have provided is correct. 1 have read the Description of work and vehff1ris accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize repr LCupertino to enter the above -identified property for ins rposes. -._. Date: Z Signature of Applicant/Agent: _.--- .-.-..-.-..- SUPPLEMENT// ORM/ TON 1 URED FLAN,, cJJ>r,CK TYPE ROtITt G $LIP New SFD or Multifamily d Ilings: Apply for demolition permit for ❑ ovEx-T" OUNTER BUILDING PLAN REVIEW 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 D STANDARD C1 PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. 0 LARGE ❑ IRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to MAJOR { sANtTARYSEWRD19TRIGT submittal of Building Permit application. C ENVIRONMENTALREALTtt BldgApp_101 Ldoc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 20400 MARIAM AVE DATE: 05/13/2015 REVIEWED BY: MELISSA PC FEE ID , APN: 316 22 018 BP#:07 *VALUATION: 1$130,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: IBTIPLNCK PENTAMATION 1 B TI PERMIT TYPE: WORK APPLE - T.I. TO RECONFIGURE & REMODEL E OFFICE 1,231 S.F. SCOPE Suppl. Insp. Fee:Q Reg. C) OT 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 1,231 $2,149.60 IBTIPLNCK $1,271.60 IBTIINSP Permit Fee: $1,271.60 Suppl. Insp. Fee:Q Reg. C) OT 0.0 hrs $0.00 PME Unit Fee: $0.00 Permit Fee: $0.00 {PME t on," ti i,icti n L,ux, qa: 0 Work Without Permit? C) Yes No $0.00 TOTALS: 1 1,231 $2,149.60 Tlravc/ Oo(, [,ccs: $1,271.60 Strong; Motion Fee: IBSEISMICO ZVI C'#; HOURLY' 0 'Yes Nor ; I'LUNiB;" I©URLY, ( Yes � No UC' ,,"H©URLY" Q ;Yes MISC ITEMS Plan Check Fee: $2,149.60 Select a Misc Bldg/Structure or Element of a Building l'' load 1),iimil /"z( Fit( . ,", $0.00 PME Plan Check: � J,, p b Pec NWM). hr Permit Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn 7 info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,149.60 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. C) OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,271.60 Suppl. Insp. Fee:Q Reg. C) OT 0.0 hrs $0.00 PME Unit Fee: $0.00 Permit Fee: $0.00 {PME t on," ti i,icti n L,ux, qa: 0 Work Without Permit? C) Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Q Building or Structure 0 i Tlravc/ Oo(, [,ccs: Strong; Motion Fee: IBSEISMICO $36.40 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $6.00 "SuBTOTAm, $3,463.60 $0.00 TO'f $3,463.60 Revised: 05/07/2015 Btfilding Department City Of(Alpc-l-ol)0 10300 '1 orre,Nvennc Cupertino, CA 9501 4-325�)' Telephone.- 408-777-3228 Fax: 408-777-3 17 DIIIIIIII, 1111,14 b, Jacob Mill DN: m --Jamb Whi, o=NOVO Comtrucbon, —Ganeral Jacob White C—tractor, 9mafl=jwhite@mv�nstmction,wm, c.US 06/1 Date: 2015,06.15 15:21:55 -OTOO' Owiter / Contractor Sigpiature Date