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B-2017-0629 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO �408)777-3228•FAX(408)777-3333•buildinq(a�cupertino.orq ❑NEW CQhSI-RL'C'fI[]N ❑ ADDITION ALTERATION/TI ❑ RL:VIS30N 1�EF£RR[D ORIGINAL PERMIT# PROJECT ADDRESS 1 9333 V8IIC0 PBfICWa�/ ^P"# 316-20-075 OWNERNAME Apple Inc. c/o Eileen Molloy PHONE 408-974-5951 E-MAIL emOIIO a le.com Y@ PP STREETADDRESS,� IC1fIflltE LOOp, mailstop 18-DDC C[TY, STATE,ZIP FAX corrrncT NnME Bryan Carrera, Nterra Group PxoNE408.610.9958 E-MAI`bryan@nterragroup.com STREET ADDRESS CITY,STA"CE, ZIP FAX 1155 N. First Street, Suite 214 San Jose, CA 95112 ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENC ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITEC'C �ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME Christine Minert LICENSENUMBER 916366 L[CENSETYPE B BUS LIC# COMPANYNAME Barron Builders E-MAIL cminert@barronbuilders.com F� STREET ADDRESS C1TY,STATE,ZIP PHONE 415 Clyde Ave, Suite 105 Mountain View, CA 94043 650.964.4493 ARCHITECT/ENGINEER NAME L[CENSE NUMBER BUS L1C# Matt Benas coMrar,vNnME Mobile Modular Rents E-MAIL Matt.Benas@mobilemodular.com FAx STREE"C ADDRESS 5700 L8S POSItBS ROaCj c�TY,s-rnre,ziP Livermore, CA 94551 PHONE 925.453.3122 oescxirrroN oF woxK Installation and operation of temporary modular building and necessary sitework, including flatwork upgrades for accessibility, underground utility connections and site lighting attached to modular building. The project will require (1) parking lot light pole and (2)trees to be removed for the period of time the modular building is in use. tX151 lNG USE PROPOSED USE CONSTR TYPE #STORIES USE rYPE OCC SQ.FT VALUATION(�) EXISTG NPW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITC[-�N U I tltl( REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA CiA1tAGr.4ktt.A: U Ut I ACH �ATTACH #DWELLINGUNITS: ISASECONDUNIT QYES SECONDSTORY �YES BEINGADDED? QNO ADDITIONY '�]NO PRf-APPLICAT[ON �YES �'YES,PROVIDE COPY OF IS THE BLDG AN �YES RECEIVED BY: TOTAL VALUATION� PLANNINGAPPL# �NO PLANNINGAPPROVALLETI'ER EICHLERHOME? �NO 300,000 By my signature below,I certify to each ' ' I lo�ti ing: m the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information 1 ro�•i is COrrec I have read the Description of Work and verify it is accurate I agree to comply with all applicable local ordinances and state laws re1� � g to b ild �� �onstruct n I au orrr.e represerttatives of Cupertino to enter the above-identified property for inspection purposes. SignatureofApplicanUAgent: � Date: 4/18/17 SUPPLEMENT11}._ .���ORMATION REQUIRED pLANCHECKTYPE ROUTINCSLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-TH�COUNTER ❑ BO[LDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ Exv�ss ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sT.vwaxn ❑ eusL�c wox[cs form if any Hazardous Materials are being used as part of this project. O Lutce ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ �ox ❑ SAIVITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIItONMENTALHEALTH BldgApp_2011.doc revised 06/21/11 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 •FAX (408) 777-3333 • building ancuDertino.org __10 11— 0OZ9 ❑ NEW CONSTRUCTION ElADDITION 0 ALTERA. 7 REVISION J DEFEUCUPERTINO I D PROJECT ADDRESS 19333 Vallco Parkway APN 0 316-20-075 OWNERNAME Apple Inc. c/o Eileen Molloy PH°NE 408-974-5951 E-MA,L emolloy@apple.com STREET ADDRESS 1 Infinite Loop, mailstop 18 -DDC CITY, STATE, ZIP FAX CONTACT NAME Bryan Carrera, Nterra Group PHONE 408.610.9958 F-MAILbryan@nterragroup.com STREET ADDRESS 1155 N. First Street, Suite 214 CITY, STATE- ZIP San Jose, CA 95112 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT • ENG MI ER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Christine Minert LICENSE NUMBER 916366 LICENSE TYPE, B BU C COMPANYNAME Barron Builders E-MAIL cminert@barronbuilders.com FAX STREET ADDRESS 415 Clyde Ave, Suite 105 CITY, STATE, ZIP Mountain View, CA 94043 PHONE 650.964.4493 ARCHITECTJENGINEER NAME Matt Benas LICENSE NUMBER BUS LIC # COMPANYNAME Mobile Modular Rents EMAIL Matt.Benas@mobilemodular.com FAX STREET ADDRESS 5700 Las Positas Road CITY, STATE, ZIP Livermore, CA 94551 PHONE 925.453.3122 DESCRIPTION OF WORT: Installation and operation of temporary modular building and necessary sitework, including flatwork upgrades for accessibility, underground utility connections and site lighting attached to modular building. The project will require (1) parking lot light pole and (2) trees to be removed for the period of time the modular building is in use. EXISTING USE PROPOSED USE CONSTR TYPE it STORIES I USE TYPE OCC SQ FT_ VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL .AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: DETACH ATTACH #DWELLING UNITS:ISASECOND UNrr ❑YES SECOND STORY YES BEING ADDED! ❑NO ADDrrION! ❑NO PRE -APPLICATION YES IF YES, PROVIDE COPY OF IS THE BLDG AN 0 YES R BY TOTAL VALUATION' PLANNING APPL u NO PLANNING APPROVAL LETTER EICHLER HOME! 13NO 300,000 By my signature below, I certify to each Ilowlng: m the property owner or authorized agentTo act on the property owner's behalf: I have read this application and the information 1 ovi is coffee I have read the Description of Work and verify it is accurate I agree to comply with all applicable local ordinances and state laws reh g to b dd nstfurt n [a rize representatives of Cupertino to enter the above -identified property for inspection purposes oe -�� 4/18/17 Signature of ApplicanUAgent: Date: SUPPLEMENTA . FORMATION RF,QU[RFD PLAN CKEXX TYPE ROG'rINGSLIP 11OVE&THE•COUNTER 11BOU,DMG 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 ❑ PLANNMI PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 11STANDARD ❑ PUBLIC WORICS form if any Hazardous Materials are being used as part of this project. ❑ LARGE Cl FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ INAMR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_1011.doc revised 06/21'11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0629 19333 VALLCO PKWY CUPERTINO, CA 95014-2506 (316 20 075) BARRON BUILDERS OWNER'S NAME: Mrs Ellen Molloy ( APPLE INC) OWNER'S PHONE: 408-974-5951 License Class @ Lic. #916366 Contractor BARRON BUILDERS INC Date 07/31/2017 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: t. 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. 2. 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 permit is issued. 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 upon the above mentioned property for inspection purposes. (We) agree to save 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. io/� Signature �,L�f" Date 06-14-2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project(Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1. 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. 2. 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 permit is issued. 3. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 upon the above mentioned property for inspection purposes. (We) agree to save 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 06-14-2017 SANTA CLARA, CA 95054 DATE ISSUED: 06/14/2017 PHONE NO: (650) 964-4493 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH _ RESIDENTIAL X COMMERCIAL JOB DESCRIPTION: INSTALLATION OF MODULAR BUILDING (5680 sq ft) -APPLE Sq. Ft Floor Area: Valuation: $300000.00 APN Number: Occupancy Type: 316 20 075 A (Tenant Improvements) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 06/14/2017 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without fust obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 06-14-2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &Safety CodeSec�5505, 25533, 5534 Owner or authorized agent: Date: 06-14-2017 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional