13090101CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19050 PRUNERIDGE AVE
CONTRACTOR: DPR SKANSKA, A JOINT
PERMIT NO: 13090101
VENTURE
OWNER'S NAME: CAMPUS HOLDINGS INC
1450 VETERANS BLVD
DATE ISSUED: 09/13/2013
OWNER'S PHONE: 4087834613
REDWOOD CITY, CA 94063
PHONE NO: (650) 474-1450
AK LICENSED CONTRACTOR'S DECLARATION
�__
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class C_ Lic. # ct"Tot
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���r
MECH RESIDENTIAL COMMERCIAL
Contractor � R"� Date
I hereby affirm that 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION: APPLE - T.I. TO RECONFIGURE OFFICE SPACE
(commencing with Section 7000) of Division 3 of the Business & Professions
(4000S.F.)
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
Sq. Ft Floor Area:
Valuation: $70000
o I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 ofthe Labor Code, for the performance of the work for which this
permit is issued.
APN Number: 31606033.00
Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs, and expenses which may accrue against said City in consequence of the
180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally, the applicant understands and will comply
with al I non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Issued by: Date:
e�ek�
Signa Date (3'.+��'Z0V%
❑ OWNER -BUILDER DECLARATION
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1 hereby affirm that I am exempt from the Contractor's License Law for one of
installed without first obtaining an inspection, I agree to remove all new materials for
the following two reasons:
inspection.
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,
Signature of Applicant: Date:
Business & Professions Code)
I, as owner ofthe property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations:
HAZARDOUS MATERIALS DISCLOSURE
I have and will maintain a Certificate of Consent to self -insure for Worker's
I have read the hazardous materials requirements under Chapter 6.95 ofthe
Compensation, as provided for by Section 3700 of the Labor Code, for the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
performance of the work for which this permit is issued.
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
I have and will maintain Worker's Compensation Insurance, as provided for by
Safety Code, Section 25532(a) should I store or handle hazardous material.
Section 3700 ofthe Labor Code, for the performance ofthe work for which this
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued, I shall
Health & Safety Code, Sections 25505, 25533, and 25534.
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
Owner or aut
Date:
become subject to the Worker's Compensation provisions ofthe Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I hereby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is
for which this permit is issued (Sec. 3097, Civ C.)
correct. I agree to comply with all city and county ordinances and state laws relating
Lender's Name
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Address
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence ofthe
granting of this permit. Additionally, the applicant understands and will comply
ARCHITECT'S DECLARATION
with all non -point source regulations per the Cupertino Municipal Code, Section
I understand my plans shall be used as public records.
9.18.
Licensed Professional
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 i ng Oku perti no. orq
❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION/DEFERRED ORIGINAL PERMIT N
PROJECT ADDRESS GiJIE.�lu2�
APN b
3 1 0- C)L- O-
OWNER NAME I
PHONE
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E-MAIL
STREET ADDRESS
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CONTACT NAME �� a I - , , e
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❑ OWNER ❑ OWNER -BUILDER El OWNER AGENT 11 CONTRACTOR 11 CONTRACTOR AGENT 11_ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME ` J ,., _ �p
s &64_
LICENSE NUMBER ��m (
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LICENSE TYPE
BUS. LIC #
COMPANY NAME WK
Ca,�` -0' `
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC H
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
6
t"�"D_s fhct r
t-&,A L -,-S CPMk-VL wt"'
WCcSFAGY.S"75-0 $ -P+ .
EXISTING USE
PROPOSED USE CONSTR.
TYPE
N STORIES
USE TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
AREA
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
RCH AREA
DECK AREA
TOTAL DECKfPORCH AREA
GARAGE AREA: DETACH
ZDW_E_LLING
❑ ATTACH
UMTS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑YES
BEDVC ADDED? []NO
ADDITION? []NO
PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑YES
j�y"I- ' ✓
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- �/
TOTAL VALUATION:
PLANNINGAPPLN ❑NO PLANNING APPROVAL LEITER
EICHLER HOME? ONO
i��e
/0/
ii
By my signature below, 1 certify to each of the following: 1 am the property owner or authorized agentf. act on I. perry owner's behalf. I have read this
application and the information 1 have provided is correct. 1 have read the Description of Work and vers Waccurate. I agree to comply with all applicable local
ordinances and state laws relating to building cons representatives of Cupertino to enter the above -identified property for inspection purposes.
�3 �s- 2mi3
Signature of Applicant/Agent: Date:
SUPPLE NTAL INFORMATION REQUIRED
Q
%'v/,'
—New SFD or Multifamily dwellings: Apply for demolition for
existing building(s). Demolition permit is required nor to Issuance ofbuilding
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.
Bldgflpp_2011.doe revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 19050 Pruneridge Ave
DATE: 09/13/2013
REVIEWED BY: Sean
PC FEE ID
APN:
BP#: 13le
'VALUATION: 1$70,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
$2,168.20
PENTAMATION 113TI
PERMIT TYPE:
WORK
Apple - Tenant Improvement of office and conferences spaces on first and second floors 2000 sq ft).
SCOPE
�Cc+cia. lia, 1. kcc:
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
2,000
$2,168.20
IBTIPLNCK
$1,757.85
IBTIINSP
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Permit Fee:
$1,757.85
Suppl. Insp. Fee:Q Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
2,000
$2,168.20
'� `
$1,757.85
1Tiy Ll�i�
",LwP
FEE
/AfAT
Plan Check Fee:
$2,168.20
Select a Misc Bldg/Structure
or Element of a Building
Li nh 1'errrzfl V c:
(Icr. Pcu mif
01ho frc h, jxv,p
0f/w, 1'7cF vh 7r, vp.
E
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NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc). These tees are based on the ureliminary information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,168.20
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,757.85
Suppl. Insp. Fee:Q Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Con" 1, r c lr rx fel.
7
E)
Work Without Permit? 0 Yes Q No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0 �
/`a(6'k'� I�c�L'iffYf:'0�(T�d(fdtl't /"cc;.
Strong Motion Fee: IBSEISMICO
$14.70
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$3.00
;ST 'IIfI'A:S`
$3,943.75
$0.00
xf'ALFi;;
$3,943.75
Revised: 08/01/2013
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: V11050 MoWkl &F— AAj CvPWt1 z CA
PERMIT #
OWNER'S NAME:(
PHONE #
GENERAL CONTRACTOR: +�p�c��•19TPu.161J
BUSINESS LICENSE #
ADDRESS,Ivo�Z Vli' *Af5 $0,01 RSA C41'( C
CITY/ZIPCODE:
'Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature
Please check applicable subcontractors and complete the following information:
Date
V
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Ste— 791..E
Date
S N
TUDIOS
architecture
405 Howard Street Suite 588 1 San Francisco CA 94105 1 p 415.398.7575 1 1 415.398.3829
September 12, 2013
Job No./Ref.- RC3 Tenant Improvement (19050 Pruneridge Ave), Permit No. 13030109
To whom it may concern:
This letter serves as authorization for DPR-Skanska, A Joint Venture to use the following architectural drawings for reference
only in future tenant improvements at the above -referenced location.
Sheet Number
Description
Dated for Record
Stamped
A2.01
PARTITION PLAN — FLOOR 1
6.18.2012
DAVID SABALVARO
A2.02
PARTITION PLAN — FLOOR 2
6.18.2012
DAVID SABALVARO
A2.03
ROOF PLAN
6.18.2012
DAVID SABALVARO
A8.20
ENLARGED RESTROOM PLANS
6.18.2012
DAVID SABALVARO
A9.20
ENLARGED PLANS AND SECTIONS -STAIR
6.18.2012
DAVID SABALVARO
Please direct all inquiries related to this project to Andy Bench of DPRS-Skanska, A Joint Venture, at
andy.benchLdprskanska.com or 408-314-6059.
Sincer
Authors ignature
Printed N me
Da