15020059CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10100 N TANTAU AVE
CONTRACTOR: NOVO CONSTRUCTION
PERMIT NO: 15020059
OWNER'S NAME: CUPERTINO GATEWAY PARTNERS LLC
1460 O'BRIEN DR
DATE ISSUED: 02/10/2015
OWNER'S PHONE: 5108613299
MENLO PARK, CA 94025
PHONE NO: (650)701 -1500
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
APPLE T.I. TO CONVERT OFFICE TO CLOSED CUBICLE
License Class Lic. # d 22
AREA (600 S.F.)
Contractor 1Pt1 y C��•Stlt�CCtosJ iN� Date 2 lo. I�
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.
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: $30000
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: 31619061.10100
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 180 DAY 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 M L D 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
sued by:
granting of this pe Additionally, the applicant understands and will comply
ate•
with all non -point o ce regulatio er the Cupertino Municipal Code, Sec
9.18.
2 {0 lss
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
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
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 1 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/19ea Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cu er 'no Munic' I Code, Chapter 9.12 and
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
the Health & Safety Code, Sections 2 5, 25533, a 25534.
z
Owner or authorized agent: Date: i a
permit is issued.
I certify that in the performance of the work for which this permit is issued, 1 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
1 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 c O
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 1
(408) 777 -3228 • FAX (408) 777 -3333 • building(a)cupertino.org \ JJJ
Irma
❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION/TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT # i
PROJECT .ADDRESS 10100 North Tantau Ave
APN# .b 9 — / 10 �6
/
OWNER NAME Apple, Inc.
PHONE 510- 861 -3299
E -MAIL
STREETADDRESS 1 Infinite Loop
CITY, STATE,ZIP Cupertino, CA 95014
FAX
CONTACT NAME Mike Lynch
PONE 650 - 399 -5326
E-MAIL mlynch@novoconstruction.com
STREET ADDRESS 1460 Obrien Ave
CITY,�S,ITATE, ZIP Menlo Park, CA 95014
FAX
❑ OWNER ❑ OWNER - BUILDER 11 OWNER AGENT 11 CONTRACTOR ICI CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER 791 022
LICENSE TYPE B
BUS. LIC # 23891
COMPANY NAME NOVO Construction
E -MAIL
FAX
STREET ADDRESS 1460 Obrien Ave
CITY, STATE,ZIP Menlo Park, CA 94025
PHONE 650 - 701 -1500
ARCHITECT /ENGINEER NAME Studios Architecture
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK Convert open office to lockdown cubicle bullpen area.
EXISTINCy.�; SE
tj
PROPOSED USE CONSTR.
B
TYPE
1 A
# STORIES
4
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
AREA 600
NEW FLOOR
AREA 600
DEMO
AREA
TOTAL
NET AREA
B
1 A
B
600
$30,000
BATHROOM
REMODEL AREA
KITCHEN
REMODEL AREA
OTHER
REMODELAREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
[]ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
BEING ADDED? []NO
SECOND STORY []YES
ADDITION? NO
PRE - APPLICATION []YES IF YES, PROVIDE COPY OF
PLANNING APPL # []NO PLANNING APPROVAL LETTER
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
RECEIV Y:
TOTAL VALUATIOTA
jOr OO
jjj
By my signature below, I certify to each of the following: I a he property owner or authorize ent to a property owner's behalf. I have read this
application and the information I have Ovid Is correct. I e read the Description of Work and verify it is rate. I agree to comply with all applicable local
ordinances and state laws relating to ildin const ction. I uthorize representatives of Cupertino to enter a above -ide tified operty for inspection purposes.
Signature of Applicant/Agent: Date: Z l 0
SUPPLEMENTAL 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
form if any Hazardous Materials are being used as part of this project.
Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application.
PLAN CHECK TYPE
ROUTING SLIP
❑ OVER- THE - COUNTER
❑ EXPRESS
❑ STANDARD
❑ LARGE
❑ MAJOR
❑ BUILDING PLAN REVIEW
❑ PLANNING PLAN REVIEW
❑ PUBLIC WORKS
❑ FIRE DEPT
❑ SANITARY SEWER DISTRICT
❑ ENVIRONMENTAL HEALTH
BldgApp_201 Ldoe revised 06121111
FMI-1 CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
1AADDRESS:
10100 N TANTAU AVE
DATE: 02/10/2015
REVIEWED BY: MELISSA
PC FEE ID
APN: 31619 061.10100
BP #: 1,6'576'
`VALUATION:
1$30,000
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
$1,189.59
PENTAMATION 1 B TI
PERMIT TYPE:
WORK
APPLE T.I. TO CONVERT OFFICE TO CLOSED CUBICLE AREA 600 S.F.
SCOPE
0,0
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
I -A,I -B
600
$3,169.73
IBTIPLNCK
$1,189.59
Permit Fee:
$1,189.59
Suppl. Insp. Fee :Q Reg. ® OT
0,0
1 hrs
$0.00
aIBTIINSP
1
PME Unit Fee:
$0.00
PME Permit Flee:
$0.00
0
0
Work Without Permit? 0 Yes E) No
$0.00
TOTALS:
600
$3,169.73
$1,189.59
Strong Motion Fee: IBSEISMICO
MECH, HOURLY Q Yes D No
PLUMB, HOURLY Q Yes Q No
ELEC HOURLY d Yes 0 No
MISC ITEMS
Plan Check Fee:
LT
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (•) Reg. ( OT
0.0
hrs
kl"v Li
x'' Y
$0.00
Permit Fee:
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 Dreliminary information available and are only an estimate. Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 11 -053 Eff 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$3,169.73
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (•) Reg. ( OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,189.59
Suppl. Insp. Fee :Q Reg. ® OT
0,0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Flee:
$0.00
0
0
Work Without Permit? 0 Yes E) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential G
Building or Structure
Strong Motion Fee: IBSEISMICO
$8.40
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$2.00
SUBTOTALS:
$4,369.72
$0.00 TOTAL FEE:
1 $41369.72
Revised: 01/06/2015