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15010061CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19333 VALLCO PKWY CONTRACTOR: DEVCON PERMIT NO: 15010061 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 02/17/2015 OWN S PHONE: 4089745951 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ License Class /��l_(5 Lic. # C } APPLE - T.I., IST FLR BLDG C - RECONFIGURATION OF (.E) OFFICES INCLUDING M.E.P.'S. MODIFY (E) LAB Contractor V Date AREA (21,900 S.F.) DEF #2 -STRUCTURAL HIGH DENSITY SHELFING, SHOP DRAWINGS & hereby affirm that I am licensed under the provisions of Chapter 9 CALC'S - ISSUED 6/12/15 (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: $2000000 rmance of the work for which this permit is issued. ave and will maintain Worker's Compensation Insurance, as provided for by I ction 3700 of the Labor Code, for the performance of the work for which this APN Number: 31620075.00 Occupancy Type: 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 18 F PE 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 I SPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said Ci in consequence of the Date: lam/ granting of this permit. Additionally, the applicant understands and will com sue':' with all non -point s e regula 'ons per the Cupertino Municipal Code, Sstion 9.18. Signature to 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: 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 arum 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 Cu o Cod hapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 5 , 2 33, a 4. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 2 permit is issued. 1 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUIL I 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228• FAX (408) 777-3333 • building(okupertino.org v.urCmi Irmo 1 ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION EFERRED ORIGINAL PERMIT # PROJECf ADDRESS APN N -3 ( / — Q � OWNER NAME r� �MpI c. STREET ADDRESS ` CITY, STATE, ZIP �- FAI CONTACT NAME PHO � I E-MAILCy F 1�0f eXA4 STREET ADDRESS y� � a �v+ A 1 � FAX V or OWNER ❑ OWNER-BUMDER ❑ OWNER AGENT CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT 1:1 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSEZ�t .7 LICENSiy TYPE BUS. LIC N 1 O ( qb l V� COMPANY N` — V ,X_�/ p nf � yl � E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP L0 PHONE ARCHITECT ENGINEER NAME LICENSE NUMBER BUS. LIC N COMPANY NAME E -M L j FAX f �Q A - STREET ADDRESS C TATE, ZIP PHO DESCRIPTION OF WORK An -ed i (�� G EXISTING USE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR, DEMO TOTAL AREA AREA AREA NET AREA - JA' i BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA \'1 PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH ,.� i k DWELLING UNUS: IS A SECOND UNFr ❑ YES SECOND STORY []YES BEING ADDED? C]NO ADDITION? E]NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF O NO PLANNRJG APPROVAL LETTER IS THE BLDG AN El YES✓ EICHLER HOM E? NO CEIVEp $}(' ,�+n F�' rp },�' f � U � � f� � TOTAL VALUATION: PLANNING APPL ❑ E] By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is c et. 1 have read Des ion of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relatin o b ilding ns tion. 1 authori r res ve f Cu ertino to enter the above,-„ide��ntifiie/e��d property for inspection purposes. Signature ofApplicant/Ager Date: I�1g- M� SUPPLEMENTAL ORMATION REQ RED ��'�r” �i� > ? l ✓,P«�''� �i''� r�g4��Fr7s r�i„J�i1��� y ry1i ” THEOi7riiTkB�y�l ", TSUiL DINGLN� RLT IFS ✓P'�d7)i _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building.�C3,� FOVEA Ii � y � k �✓sl �'Eu�R � � � J7� i� a la'r � 1 Y' i�7 r✓/� gYtl r1� "�� �`�i ��i�la�;��r✓" �i^�1� i"r� Tr�� � � G j �P'; �� �1t; yrert> � ��J���a� �ncsp����C ��,8��hir� ^„ � a »^arr r i ✓r R,�� r � 1 � Mr r (���r��i��r��� ^ r�'r¢#`n1�t1� rt`�' Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. Letter Meeting Planning Yi sm1� d"a2 "' r y 1 1 �iI'�9�(�w���ir�h�P �1 I7 I RVgR tui �H/1�� y iw " lu ha,rll uI rr+fr x�(ii` Copy of Planning Approval or with prior to submittal of Building Permit application. t do %�� � �� 1� w @ 0' � I(in '� ne � � IT a�� >•.W RDI$TRIC7�'ti u' � � ) BldgApp_2011.doc revised 06/21/11 coq7 CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION iaADDRESS: 19333 VALLCO PKWY DATE: 05/06/2015 REVIEWED BY: MELISSA APN: 316 20 075 BP#: 15010061 "VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE Commercial Building Civil / Religious activities in BQ zone? Q Yes � No PENTAMATION PERMIT TYPE: 1GENCOM WORK DEF #2-STRUCTLIRAL HIGH DENSITY SHELFING SHOP DRAWINGS & CALC'S SCOPE l'" N 1Ll E3 NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Dictrirt otr_ ) Thoco foot aro hncod an tho nroliminary infnrmatian availahle and are nnly an owimnto_ rontart the Dent for addn'l info_ FEE ITEMS (Tee Resolution 11-053 Eff.' 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # $286.00 Deferred Submittal IDEFSUBM Suppl. PC Fee: (F) Reg. C) OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. () OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 0 Work Without Permit? Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure I Strom Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE; $286.00 Revised: 04/01/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19333 VALLCO PKWY CONTRACTOR: DEVCON PERMIT NO: 15010061 CONSTRUCTION 1NC OWNER'S NAME: APPLE 1NC 690 GIBRALTAR DR DATE ISSUED: 02/17/2015 OWNER'S PHONE: 4089745951 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL B G% APPLE - T.I., 1ST FLR BLDG C - RECONFIGURATION OF License Class Lic. # (E) OFFICES INCLUDING M.E.P.'S. MODIFY (E) LAB AREA (21,900 S.F.) Contractor rx— U�LOB DateS 22 REV #2 -ADD EXHAUST IN IST FLR SPACE & CHILLER ON ROOF - I hereby affirm that I am licensed under the provisions of Chapter 9 ISSUED 5/22/15 (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 o pensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $2000000 rformance 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 the work for which this APN Number: 31620075.00 Occupancy Type: 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 WITIIIN I RMIT 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 ALL INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of 2Z granting of this permit. Additionally, the applicant understands and will comply by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). l 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 l performance of the work for which this permit is issued. will maintain compliance with the Cuperti unicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code, Sections 25 33, d 25 Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: I Date: permit is issued. _5&0 1 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 CONSTRUCTION PERMIT APPLI[C�ACCT,,I��//ON�,/^'� COMMUNITY DEVELOPMENT DEPARTMENT • BUILD EVIMION „ m 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building (d)cupettino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TIREVISION / EFERRED ORIGINAL PERMIT o I PRO=f ADDRESS 19 3� APN M OWNER NAME PHONE,• STREET ADDRESS 1 1 � �,�^, � �„y��. CI Y, STATE, ZIP ,• ,� � �r�---/�/�� • Wi FAX CONTACT NAME J��/I j/ (O P Olt � E -MAI ` 'mU'��`— ,,..i„i l•��j' CSC ice' � STREET ADDRESS( /6 - 1 �-�: t / C❑•�OWNEERR CITY ST TE, ZIP ti FAX ❑ OWNER ❑ OWNER-BUn,DER AGENTV XCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER r LICENSE TYJA J BUS. LIC H COMPANY � I I V `j EMAIL l v FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME a ” 1� LICENSE NUMBER BUS. LIC H COMPANY NAME E- L �4 FAX STREET ADDRESS CITY, STATE, ZIP *r5 - OF WORK i OO EXISTING USE PROPOSED USE CONSTR TYPE k STORIES USE TYPE OCC, SQ.FT. VALUATION ($) AREA AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA O BATHROOM KITCHEN OTHER. REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREAS LJDETACH ❑ ATTACH k DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF 4 NO PLANNG APPROVAL LETTER PLANNING M IS THE BLDG AN ❑ YES EICHLER HOME? NO RE(,`]; `�Lj - ,, t? � � ;� v� s, 1 * A k ff� �' �1�'�y�v TOTAL ALUATION: APPL ❑ ❑ � y� ��� �nK���j y��(y 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 ha e read this application and the information I have provided is correct. I have read the scr' Ino ork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rel to ilding ons tion. I authorizer r se at' es upe 'no to enter the above -identified property for inspection purposes. QV Signature of Applicant/Agent� Date: n 04- 15 ZI SUPPLEMENTAL ORIsIATION REQ U D {�%✓A" t'% '- 2'N`r i'1 ('( ° "'`Yf"i `I" Ut ' 7 """"f "- _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of buildinguf permit for new building, P Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTAIvpAp i7r 'r1,r d uB �cwo ' P"' RJf% form if any Hazardous Materials are being used as part of this project.gr Copy ofPlanning Approval Letter or Meeting with Planning Prior to of Building Permit application. ❑A7iY�y{i°„T� a„ i/ i a �Ai+lTA1t SEViLbIT CP'1 ” submittal I, 5� 1 / 4 IP ± 1 /' 1 0 ✓ w Il FI!'Y �',7P/l irl"t'i y� �7� 1" �u 11��, F G y �„ F ��T✓N�'OT�TMEN.�..iTw,T"II��tIn��.".Ii BldgApp_201 1. doe revised 06/21/11 M& CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION 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 an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E..ff 711113) 19333 VALLCO PKWY DATE: 05/06/2015 REVIEWED BY: MELISSA AwADDRESS: l APN: 316 20 075 BP#: 15010061 *VALUATION: Iso "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? Yes 0 No PENTAMATION 1 GENCOM PERMIT TYPE: 14 WORK REV #2 - ADD EXHAUST IN 1 ST FLR SPACE & CHILLER ON ROOF SCOPE Suppl. Insp. Feer Reg. 0 OT 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 an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E..ff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (D No $0.00 F___27 hours Plan Check, Hourly $286.00 1STPLNCK Supp[. PC Fee: Q Reg. 0 OT El ET $0.00 PME Plan Check: $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 an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E..ff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (D No $0.00 F___27 hours Plan Check, Hourly $286.00 1STPLNCK Supp[. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXCF7-- $0.00 0 Work Without .Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential 0 Building or Structure 0 i Strong•, Motion Fee. $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE: $286.00 Revised: 04/01/2015 CUPERTINO TEMPORARY CERTIFICATE OF OCCUPANCY 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(JcDcupertino.org AP / l �, �p�'1CD BP #: bol o l 5 b l l� I DATE: tri (!i -7i2' t% PROJECT q � �. f�� � � O VALUATION:SITE ADDRESS: f ` J ' 3 Vz,�c/o rk" OWNER'S NAME: j Q `e, F # E #: �q ` V MAILING ADDRESS (if different from site address): I 1 M �, V iA-p cy �I l � 501- Z C� 1/ la \ nA- , CONTRACTOR: I� , _r _ i , DeV�r ` ���/UL 1 SCI V , PHONE #: FAX#: `��� ��`� CONTACT: c) G O ,I 1 V �+ ` V FAX # E #: TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION BO D TYPE: ❑ SURETY BOND AMOUNT (1% VALUATION0 CODE CHECK El CASH BOND OF BOND: 5K min -10K max $ 1 �� v (BLDBONDS] EDITION: TCO EXPIRATION DATE (6 MONTHS MAX): FEE: $2$6,$286.00/mo TOTAL FEE: $i b — [1TEMPOCC] USE TYPE OF CONSTR FLOOR AREA OCC LOAD LEVEL COMMENT �E2 t'A Z 3 P�APPROVED //. l)" APPROVED WITH CONDITIONS' Signature :........1................................u�Fa. Date:.. ..............1. u tic or s ❑APPROVED WITH CONDITIONS- Signature: ... Signature: .........................APPROVED OTHER DEPART[II ONT/AGENCY APPROVALS: PanningDate: Signature: .................... .............. (Ll ..... ,... APPROVED Q APPROVED WITH CONDITIONS' Fire �E2 t'A Z 3 P�APPROVED //. l)" APPROVED WITH CONDITIONS' Signature :........1................................u�Fa. Date:.. ..............1. u tic or s ❑APPROVED WITH CONDITIONS- Signature: ... Signature: .........................APPROVED er: ❑ APPROVED El APPROVED WITH CONDITIONS. Signature: ......................................................... Date:.................. 'CONDITIONS OF COMPLETION - Attach a letter signed by the contractor and owner of the property stating the list of Items required to be completed for each individual Department before final occupancy can be granted. Include approximate completion dates for each item. The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or buildings complete and in compliance with all building codes, ordinances and regulations and ready for inspection prior to the expiration date specified. If this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited a he on -compliance may result in a n rcement action. n Owner Contract ...Signatur Signature..... �',k ........................................ Date:..................... ...... & c This temporary certificFtehsures that it otection and life safety systems have been completed, inspected, successfully tested and approved for the speciof the ilding pecified above to provide a reasonable degree of safety to the occupants from fire and similar emergencies. ' s/ Buildino Official:... . ... ......................Print:... ............ Date:. ! 2 Y/� DEPARTMENT ACTfON: After deternlin4ion, copies to: 1) applicant, 2) permit file TempOccForm_2013.doc revised 717114 CUPERTINO Ak� TEMPORARY CERTIFICATE OF OCCUPANCY FORM g( COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION C'tcis-d ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL It(� I 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 16, X-0 ` � y` Is— (408) 777-3228 - FAX (408) 777-3333 • building(ftupertino.org AT, / � — C7 BP #.15 o 10 6DATE: FLOOR AREA OCC LOAD PROJECT VALUATION: -�. JOO 000 SITE ADDRESS: ��.. APPROVED OWNER'S NAME:j pp� 11W2 y t t/ PHONE #: FAX #: 400 ` j.�. Date:.. .....1. MAILING ADDRESS (if different from site address):I t v, G Vlt� b� �� ru h Vve CA_ CONTRACTORDz vC �v �g�_ , r 0 V1 FAX #E #PHON: +0 TJ � �" CONTACT: � -mom GO � FAX#PHONE#: TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION BOND TYPE: E] SURETY BOND AMOUNT (1% VALUATION FED E CHECK ❑CASH BOND OF BOND: SK min-10Kmax $' 0 �O IBLD80NDSJION: TCO EXPIRATION71:411,G I/I5 � FEE: $2$6,00/1710 TOTAL FEE: $— [1TEMPOCC] DATE (6 MONTHS MAX): :„ /i USE TYPE OF CONSTR FLOOR AREA OCC LOAD LEVEL COMMENT ��.. APPROVED ,/ �” APPROVED WITH CONDITIONS' Signature:......../.................................u,F j.�. Date:.. .....1. u is Works Signature:... ❑APPROVED WITH CONDITIONS' t er: Signature: ......................................................... Date:...................... ❑ APPROVED ❑ APPROVED WITH CONDITIONS - OTHER DEPART(AgNT%/AGENCY APPROVALS: Planning Signature: .....=.V............................. Date: (L! . %..... APPROVED [7 APPROVED WITH CONDITIONS' ire �E2 �' ��.. APPROVED ,/ �” APPROVED WITH CONDITIONS' Signature:......../.................................u,F j.�. Date:.. .....1. u is Works Signature:... ❑APPROVED WITH CONDITIONS' t er: Signature: ......................................................... Date:...................... ❑ APPROVED ❑ APPROVED WITH CONDITIONS - *CONDITIONS OF COMPLETION - Attach a letter signed by the contractor and owner of the property stating the list of items required to be completed for each individual Department before final occupancy can be granted. Include approximate completion dates for each item. The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or buildings complete and in compliance with all building codes, ordinances and regulations and ready for inspection prior to the expiration date specified. If this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited a he on -compliance may result in a rcement action. Owner 'j L,,,�—�� 6.2215 Contract r I Signature: ,; ,(.:,. Date: .............'.......... Signatur:................................... te:..lt........ This temporary certificate sures that-aNdreAtotection and fife safety systems have been completed, inspected, successfully tested and approved for the specifi re of the riding pecified above to provide a reasonable degree of safety to the occupants from fire and similar emergencies. .. .. Building Official:.. ... ........................Print:........ 1.x....1 . ....................Date:?' V ./-T .— ... DEPARTMENT ACTfON`. After deternlingtion, copies to: 1) applicant, 2) permit file TempOccForm_2013.doc revised 717114 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19333 VALLCO PKWY CONTRACTOR: DEVCON PERMIT NO: 15010061 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 02/17/2015 OWNER'S PHONE: 4089745951 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL EJ COMMERCIAL E] APPLE - T.I., IST FLR BLDG C - RECONFIGURATION OF License ClassG<( C� Lic. to Z✓`1'7 a (E) OFFICES INCLUDING M.E.P.'S. MODIFY (E) LAB Contractor Pt", 6cLn,54 , f,, c . Date 2 I"1 15 AREA (21,900 S.F.) 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. I hereby affirm under penalty of perjury one of the following two declarations: 1 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: $2000000 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 the work for which this APN Number: 31620075.00 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 180 RMIT 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 ROM L w ALLED 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 granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non-point source regulations per tt o Municipal Code, Section 9.18. 2 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, 1 agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that 1 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) 1, 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 Cuperti Municipal Code Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Secti 5533, 3 Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: 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 / O 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 f (408) 777-3228 - FAX (408) 777-3333 - building(a.cugertino.org ❑ NEW CONSTRUCTION ❑ ADDITION Q ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 19333 Vallco Pkwy APNN -31 j' OWNER NAME Apple, Inc PHONE408-974-5951 E-MAILemolloy@apple.com STREET ADDRESS 1 Infinite Loop CITY, STATE, ZIP Cupertino FAX CONTACT NAME Darcy Narduzzi PHONE408-519-8321 E-MAILdnarduzzi@devcon-const.com STREET ADDRESS690 Gibraltar Dr. CITY, STATE, ZIP Milpitas, CA 95035 FAx408-262-2342 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 91 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Kevin Irwin LICENSE NUMBER 399163 I LICENSE TYPE CA GC 1 BUS. LIC N 11068 COMPANY NAME Devcon Construction, Inc. E-MAILkirwin@devcon-const. Corn FAx408-262-2342 STREETADDRESS690 Gibraltar Dr. CITY, STATE, ZIP Milpitas, CA 95035 PHONE408-942-8200 ARCHITECT/ENGINEER NAMEj K pl "1 ','J_V1 rLi r LICENSE NUMBER BUS. LIC N COMPANY NAME e j� + 5 (� 1 aS �GVI I T� C N � E-MAIL 411 G a M FAX STREET ADDRESS Li I }l , Y� C1 1 �G ?j f 513 CITY, STATE, ZIP PHONE 15 - 7 3 z. - S358 DESCRIPTION OF WORK Tenant improvements to lab & support space, including new interior partitions, doors, finishes, lighting, ceilings mechanical, electrical, gioNIM& structural modifications to slab for pit & trench in lab area. EXISTING USEPROPOSED B USE CONSTR. B II -B TYPE N STORIES 2 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA B �- 6�, p ✓�,II"1� $2,000,000 BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH N 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 GEIVED BY:✓ TOT ATION: PLANNING APPL0 ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO 1or ,.�+"'"" By my signature below, I certify to each of the following: I am the property owner authorized ent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I havrread the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to buildjp ructio thorize representatives of Cupertino to enter the above -identified roperty for inspection purposes. Signature of Applicant/Agent: C Date: SUPPLEMENTAL fKPORMATIOn REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ 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 ❑ PLANNING PLAN REVIEW 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_201 Ldoc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 19333 VALLCO PKWY DATE: 01/12/2015 REVIEWED BY: MELISSA 1138=1 APN: 316 20 075 BP#: *VALUATION: $2,000,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1B TI USE: PERMIT TYPE: A WORK APPLE - T.I. 1ST FLR BLDG C -RECONFIGURATION OF E OFFICES INCLUDING M.E.P.'S. 71 SCOPE MODIFY (E) LAB AREA (21,900 S.F.) OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 21,900 $3,173.41 IBTIPLNCC $10,120.36 IBTILVSP $0.00 Permit Fee: $10,120.36 Suppl. Insp. Fee -.0 Reg. PME Unit Fee: PME Permit Fee: Q OT 0.0 1 hrs $0.00 $0.00 $0.00 TOTALS: 21,900 $3,173.41 1 $10,120.36 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Diclrirt etc )_ Thvice feet ire haeed nn the nrpliminary informatinn availahle and are nnly an estimate_ Contact the Dent for addn'/ infix FEE ITEMS (Fee Resolution 11-053 Eff 7%1/1 FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl. PC Fee: Q Reg. 0 OT 0,0 hrs $3,173.41 $0.00 Select a Misc Bldg/Structure or Element of a Building PME Plan Check: $0.00 Permit Fee: $10,120.36 Suppl. Insp. Fee -.0 Reg. PME Unit Fee: PME Permit Fee: Q OT 0.0 1 hrs $0.00 $0.00 $0.00 Work Without Permit? 0 Yes E) No 0 0 $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 Q Strom Motion Fee: IBSEISMICO $560.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $80.00 SUBTOTALS i$13,933.77 $0.00 TOTALFEE:; $13,933.77 Revised: 01/06/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19333 VALLCO PKWY CONTRACTOR: DEVCON PERMIT NO: 15010061 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 02/17/2015 OWNER'S PHONE: 4089745951 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] APPLE - T.I., 1ST FLR BLDG C - RECONFIGURATION OF License Class � Lic. # �3 7!(r, 7 (E) OFFICES INCLUDING M.E.P.'S. MODIFY (E) LAB !� Contractor (!� (G (V Date I `- 1 AREA (21,900 S.F.) 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 DEF q 3 - WALK IN CHAMBER SHOP DRAWINGS & CALC'S (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. ISSUED 6/15/2015 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: $2000000 pe ormance of the work for which this permit is issued. 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: 31620075.00 Occupancy Type: 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 FROM LAST 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 granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. �°" RE-ROOFS: Signature 4� ate 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 1 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) 1, 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 1 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 Area it QualityManagement District 1 performance of the work for which this permit is issued. Muni ' ode, Chapter 9.12 and will maintain compliance with the CupJe7 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 25 25534. ' Owner or authorized agent: Date: permit is issued. L 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ' I CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building d)cupertino.orq ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI �KREVISIO DEFERRED ORIGINAL PERMIT 4 PROIECf ADDRESS / ! APN t! 2 U OWNER NAME PHOIy'F, P ( _ V 1 ] �i EMAIL G STREET ADDRESS 'T -IF- L�� l� CITY, STATE, ZIP' - ell 4 S© CONTACT NAME ,^ r V PHONE E-MAIL STREET ADDRESS r CITY, STATE, ZIP r� / L� }❑ FAX OWNER ElOWNER-BUI DER ❑ CANERAGEN-r(� CONTRACTOR 1:3 CONTRACTOR AGENT El ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE,,3E BUS. LIC COMPANY NAME E-MAIL FAX Q - vs,-� s STREET ADDRES§ CITY, STATE, ZIP PHONE 6140 GI z — Z 2LL* X22± e- ARCMTECT/ENGLNEER NAME LICENSE NUMBER BUS. LIC M ef4e S 6W =E COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, TAIP PHONE F r` C YC DESCRIPTION OF WORK ,y 1 f I I Cs Cx4 C S 1+ EXISTING USE PROPOSED USE CONSTR. TYPE k STORIES 1 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR- DEMO TOTAL AREA AREA AREA NET AREA - BATHROOM KITCHEN. OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: Ll DETACH ❑ ATTACH K D WELLING UNTrs: IS A SECOND UNrr ❑ YES SECOND STORY ❑ YES BEINGADDED? ONO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑- 7 "�] Z16`; TOTAL VALUATION: PLANNING APPL - []NO PLANNING APPROVAL LETTER EICHLER HOME? 11 d oilW VIM By my signature below, I certify to each of the fo ing: I am the property owner or authorize gent to act on the property owner's behalf. I have read this application and the information I have provi s o ect. I ead th tion of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b g c st ction. I auth n r resentatives of Cupertino to enter the aboveryL�fled yoperty for inspection purposes. S ignature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED NO ire;i°at(rr I���1t✓ OYER-'I"i3E-C�r�"" t� �' " I C�"� �lS Al=G'�L REVD ` `nV"`' New SFD or Multifamilydvv�ellings: Apply for demolition permit for is issuance building existing building(s). Demolition permit required prior to of permit for new building.�ii�' _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure g P form if any Hazardous Materials are being used as part of this project. E I T , 4,Egd ' rw UB wo Copy of Planning Approval Letter or Meeting with Planning to _ prior submittal of Building Permit application.t` rmn BIdgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 19333 VALLCO PKWY DATE: 05/06/2015 REVIEWED BY: MELISSA APN: 316 20 075 BP#: 15010061 *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: Civil / Religious activities in BQ zone. Q Yes Q No PENTAMATION 1 GENCOM PERMIT TYPE: WORK DEF # 3 - WALK IN CHAMBER SHOP DRAWINGS & CALC'S SCOPE $0.00 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School nietrirtt Ph- )_ T&eco fees are hacod an the nreliminary infnrmation availahie and are nnly an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 717/132 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # $286.00 Deferred Submittal IDEFSUBM Suppl. PC Fee: (F) Reg. C) OT0.0 T hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.e Reg. Q OT ro.Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 Work Without Permit? Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure Strong Motion Fee: $0.00 Select an Administrative Item Bl , Stds Commission Fee: $0.00 Y SUBTOTALS: $0.00 $286.00 TOTAL FEE. $286.00 Revised: 04/01/2015 WTr am i CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19333 VALLCO PKWY CONTRACTOR: DEVCON PERMIT NO: 15010061 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 02/17/2015 OWNER'S PHONE: 4089745951 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ��-��j ��7 � , � APPLE - T.I., IST FLR BLDG C - RECONFIGURATION OF License Class_ /_ rL3 Lic. # V (E) OFFICES INCLUDING M.E.P.'S. MODIFY (E) LAB 11 cold -.Date AREA (21,900 S.F.) Contractor 1—,eyto I hereby affirm that I am licensed under the provisions of Chapter 9 DEF #l -STRUCTURAL DRAWINGS FOR ADDED CHILLER AND (commencing with Section 7000) of Division 3 of the Business & Professions EQUIPMENT ANCHORAGE. ISSUED 5-5-15. 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: $2000000 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 the work for which this APN Number: 31620075.00 Occupancy Type: 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 FROM LAST 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 o Issued by: l� Date: granting of this permit. Additionally, the applicant understands and will comply f with all non -point source "u per p ino Municipal Code, Section 9.18. RE -ROOFS: ` Signat Date �/ V 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) 1, 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 1 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 1 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 Cupert' o Municipal ode, 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, Secti s 5 5533,e Owner or authorized age t: Date permit is issued. I certify that in the performance of the work for which this permit is issued, l 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. 1 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 CUPERTINO ❑ NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION 4� l COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 •FAX (408) 777-3333 • building a(�cupertino.or ❑ ADDITION ❑ ALTERATION / TI fdJ REVIS1440ERRED ORIGINAL PERMIT # BldgApp_201 1. doc revised 06/21/11 S C-I<D W1 d- PROJECT ADDRESS 1 /�\ 19 O��d APN N OWNER NAME j PHONE40 �� r•-• j Ljgll—o1 ILD I /, I O C ' STREET ADDRESS ) �. 1 �� CITI', STATE ZIP „^ j FAX CONTACT NAME E-MAIL �`!��! \I nig J ` STREET ADDRESS i Q l �1 a !I i• v CIT�S, E ZI� FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR M `1 a� � ! �//*� Ili./"�/� LICEN� R LICENSE TYP BUS. LIC 0 1 v,y COMPANYNAM��W+n Cho pp ,, `�)Y 1�1 1 `/� v�j j E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC d COMPANY NAME LFAX STREET ADDRESS CITY, S ATE, ZIP PHONE DESCRIPTION OF WORK (MWCNal � ^ /VOlrv�/ J �/ n _ ! % ' /k 1 ]Lev C' V EXISTING USE PROPOSED USE CONSTR- TYPE H STORIES USE TYPE OCC. SQ.FT. VALUATION ($) ExGsTG NE4 FLOOR DEMO TOTAL e 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 4 -DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDITION? ❑ NO PRE -APPLICATION ❑ VES EFYES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED I}X., TO ALUATION: PLANNING APPL N ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO _ By my signature below, I certify to each of the following: I am the property owner or authorized agentto act on the property owner's behalf. I have read this application and the information I have provided is orrect. I have rea e Dese 'prion Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relat to uil ' g co t ction. I author' epres ry f Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENT A FORMATION REQUIRED ,, �r G cx rxvE, ROUTINGS u> New SFD or Multifamily dwellings: Apply for demolition permit for ❑; -- existing building(s). Demolition permit is required prior to issuance of building OVER PREGOUNIER❑DULLDIINGPLANREVTEW permit for new building. ❑ EXPR„ ;' '� ❑ PI ANNING PLAIN ItE� IEW ❑ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTANDAxD PUBL[GwpRKs _ form if any Hazardous Materials are being used as part of this project. ❑ LARGE � ❑ FIItI~ DEPT � � �� _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑;'MAJOR ❑sANI'PARXsEWERlJI6TRICP submittal of Building Permit application. ❑ ENVHip1Y111F;NTAIs IiEALTH ' `% BldgApp_201 1. doc revised 06/21/11 S C-I<D W1 d- CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION M1 ADDRESS: 19333 VALLCO PKWY DATE: 04/08/2015 REVIEWED BY: MENDEZ APN: I BP#: `VALUATION; Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1GENCOM USE: PERMIT TYPE: , WORK REVISION #2- STRUCTURAL DRAWINGS FOR ADDED CHILLER AND EQUIPMENT ANCHORAGE SCOPE Nrurr;r. Perufrl """c' 1�:G r t'e mrl f'ec 0�'/wr til J",s'Y) (1Jhcr °a� l)rs , iicc/z /m�cc 11hi'nlr 1,cc 1I('(. fn"ap l c: NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School District etc ). These fea_c are hated an the nrelfminary infnrmation available and are only an estimate. Contact the Dent for addn'l infn_ FEE ITEMS (Fee Resolution 11-053 Elf. 7/1/13 FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 3 hours $429.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes Q No $0.00 Suppl. Insp. Fee.-(F)Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 �,r,P�`w"t"PFr fl'Cld7 icJ:°e. (Jn iiJl.N:Ij xii (' Vec Work Without Permit? Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 1 Strong Motion Fee: $0.00 1.0 hrs $143.00 Inspections ISTINSP Inspection, Hourly Bldg, Stds Commission Fee: $0.00 +iBT4TALS: $0.00 $572.00 F"EE:> 1 $572.00 Revised: 04101/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19333 VALLCO PKWY CONTRACTOR: DEVCON PERMIT NO: 15010061 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 02/17/2015 OWNER'S HONE: 4089745951 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E] p� APPLE - T.I., IST FLR BLDG C - RECONFIGURATION OF License Class, Lic. #- (.� (E) OFFICES INCLUDING M.E.P.'S. MODIFY (E) LAB w -,A Q � _ � I AREA (21,900 S.F. Contractoy�! I � Date I `�� X11 I hereby affirm that I am licensed under the provisions of Chapter 9 REVISION #1 (-1- NGIN�ERED GYP CEILING IN (commencing with Section 7000) of Division 3 of the Business & Professions ROOMS C121, C123A, C123. Issued 4-1-15. 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: $2000000 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 the work for which this APN Number: 31620075.00 Occupancy p y Type 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. 1 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 FROM LAST 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 theL /,r . Issued by: /V" % G Date: 15 granting of this permit. Additionally, the applicant understands and will comply 7 with all ce regulation er a up rtmo Municipal Code, Section 9.18.RE-ROOFS: AnonoinI,,ou SignatuDate 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). 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(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 Municip9A Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sec io2551115. 25533, an 2 Q Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent Date: p I d 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, t 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 CUP'ER'T'I'NO CONSTRUCTION PERMIT APPLIC *V I COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVI NIP'" 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a()-cupetno.orq NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGINAL PERMIT #_ _I ` D 100 PROJECT ADDRESS �J IJV APN # OWNER NAME- PH NE n E-MAIL6moh I O t /` STREET ADDRESS J i r j ` )ite �{ S'� L (� y 1 YV ` + –� C Y, STAT , ^ FAX �^ CONTACT NAME tr PHONE E-MAIL shirtm I STREET ADDRESS � �� n VYY g, TAT ZIP 9 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT !kCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NA I, r n /I>L /} r L`V !xwl�lo LICENSE NUMBER �i j (� 1(/� LICENSE TYPE BUS. LIC # COMPANY NAME �/7� f /� 11�/� E-MAIL V/ FAX STREET ADDRESS /i I J� CITY, S ATE, ZIP ARCHITECT/ENG R N LICENSE NUMBER BUS. LIC H COMPANY NAME �MA(� �� p ()G; E-MAIL n,n ^� FAX STREET AD CITY, TATE, ZIP 01 A T32 -_1535�3 DESCRIPTION OF WORK lee a_�C�ML 023A Qesd A&eRl= d?,;-) 1 EXISTING USE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG DEMO TOTAL AREA FN=EWFLOOR AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH []ATTACH # DWELLING UMTS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEINGADDED? ❑NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES �REC$IVED TOTAL V PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO ����r � rr� lI r !� ��f/ i 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 ha ea�Descrip!jon of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build- g co struction. I a th riives of Cupertino to enter the above -identified property for inspection purposes. Date: Signature of Applicant/Agent SUPPLEMENTAL FORMATION itQtIRED �„�'.;�- � , .�r1,,,1�, Pi, ,Ci3'w;CK'LXI'Frp„ k ��'i�i ✓,�„arl�.,,f�9�r.,,�F10TJ1`IhIiGSLiIPl�, I � ; Ci VTER THi COiiNTEIt /, iii BUILAiIVG PLAN VIEK 'r r 7���r� �1,�'/' I1/,r����'ir✓i, — New SFD or Multifamily dwellings: Apply for demolition permit for existingbuilding(s). Demolition permit is required prior issuance of building�,�°,'x permit for new building.,rir�a��l�> ,� Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ry,Y/t ���+}e�J/'"!�.i"�Iw l�y�/f ��!�+,fl,� '� „z1/!y iUN�JP,rk✓'� %'l1�,/ k�� bel _ form if any Hazardous Materials are being used as part of this project. ✓�f yl�L'/ ��IX���G;���J�fj�`,,��f�,/�dy�p �+y f'}r"(F ��'��l�M �'^V,c+ �w�//�f�lJ�//f���f��lr��! h1�����,. _ Copy of Planning Approval Letter or Meeting with Planning prior to Building Permit �G,"�/�1�/� submittal of application. i / i/r � 7i` t !gyp✓ld/ / � �,f�9y1F�U/�1ur.�ll ,co�%���P'� �� Dy BldgApp_2011.doc revised 06/21/11 ff CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION M1 ADDRESS: 19333 Vallco Parkway DATE: 04/01/2015 REVIEWED BY: Sean APN: BP#: *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Civil / Religious activities PENTAMATION USE: Commercial Building in BQ zone? Yes � No PERMIT TYPE: 1GENCOM , WORK Revision #1: Submittal for en ineered ceilin in rooms C121 C123A C123. SCOPE Ell NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc-). These feet are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 11113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Yes E) No $0.00 1 hours Plan Check, Hourly $143.00 ISTPLNCx Suppl. PC Fee: Q Reg. 0 OT NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc-). These feet are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 11113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Yes E) No $0.00 1 hours Plan Check, Hourly $143.00 ISTPLNCx Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fees. Reg. Q OT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 $0.00 Construction Tax: IBCONSTAXC 1 cue°' Q E) Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee_ $0.00 Select a Non -Residential 0 Building or Structure i Strong Motion Fee: $0.00 Select an Administrative Item Bldg _Stds Commission Fee: $0.00 UBTOTALS: " $0.00 $143.00 TOTAL FEE: $143.00 Revised: 02/14/2015