14010133 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 5 INFINITE LOOP CONTRACTOR:NOVO CONSTRUCTION PERMIT NO: 14010133
OWNER'S NAME: APPLE COMPUTER INC 1460 O'BRIEN DR DATE ISSUED:01/23/2014
OWN ' S PHONE: 4157103063 MENLO PARK,CA 94025 PHONE NO:(650)701-1500
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL E]
APPLE T.I. FOR INTERIOR DEMO OF NON-STRUCTURAL
License Class B Lic.H 71/O Z Z WALL&FINISHES. RENOVATE OTHER DOORS,
�^ t z FINISHES,
Contractor �o (Js�/c TR�GTronl Date CASEWORK,FIXTURES,HVAC UPSIZING AND
I hereby affirm that I am licensed under the provisions of Chapter 9 ELECTRICAL
(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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$115000
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:31602109.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
1 certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree tocomply with all city and county ordinances and state laws relating WITHIN 180 DAYS O � SSUANCE 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 LAST`" 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
granting of this permit. Additionally,the applicant understands and will comply Wu-ed b L Date: Z�
with all non-point source regulati s per the upertin unicipal Code,Section
9.18.
E-ROOFS:
Signature Date 2 Y I 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
1 hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,C pter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,255 n 2 34.E
Section 3700 of the Labor Code,for the performance of the work for which this t Z y
Owner or authorized agent ate:
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 1 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 O
(408)777-3228• FAX(408)777-3333•building a(),cupertino.org
CUPERTINO
❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS 5 _7APN# 2 14
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OWNER NAME P J 4 E-MAIL
AIf P("f- r,lc . /9) -710 - 30 6 3
STREET AD SS CITY, STATE,ZIP FAX
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CONTACT NAMEP NE E-MAIL �j
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STREET ADDRESS r` n! Crr TATE,ZIP O S FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMELICENSE NUMBER LICENSE TYPE BUS.LIC#
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COMPANY NAME /' E-MAIL FAX
STREET ADDRUS CI STATE,ZIP PHONE
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ARCMTECT/FNGLRER NAME LICENSE NUMBER BUS.LIC#
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COMPANY NAME EMAIL FAX
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STREET ADDRESS CITU STATE IP PHONE
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DESCRIP&N OF WORK Lv A N. 40� FI J�I S K'CS
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EXISTING USE PROPOSED USE CONST'R-TYPE #STORIES
/3 1 -9 / A 5- �UJSE TYPE OCC. SQ.FT. VALUATION(S)
OTAL
AREAEXISTL 3Sn AREA NEW FLOOR 3e2o DEMO
3C5'0TNEr AREA 3 SO L7 /A /3 �� ��J OGO
a7
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH
❑ATTACH
#DWELLING IINEI'S: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? E]NO ADDITION". []NO
PRE-APPLICATION ❑YES I YES,PROVIDE COPY OF IS THE BLDG AN ❑YES REC BY: _ TOTAL VALUATION:
PLANNING APPL# ❑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 agent to- ave read this
application and the information I have provided is corre I have read Descri on of Work and verify it is accurate. _agree to comply with all applicable local
ordinances and state laws relating to b cc nstru I. I ori e r rese ives of Cupertino to enter the aboYe-identified property for inspection purposes.
Signature of Applicant/Agent Date: I Z/
SUPPLE AL INFO TION REQUIRED PLAN CHECK TYPE ROUTING SLIP
—New SFD oz M amily dwellings: Apply for demolition permit for `[�]OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building (_
permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ 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: 5 INFINITE LOOP DATE: 0112312014 REVIEWED BY: MELISSA
APN: 316 02 109 BP#: ' ` °VALUATION: $115,000
PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY PENTAMATION
USE: Commercial Building PERMIT TYPE: 1 B T'A
WORK APPLE T.I. FOR INTERIOR DEMO OF NON-STRUCTURAL WALL & FINISHES. RENOVATE OTHER
SCOPE DOORS, FINISHES, CASEWORK, FIXTURES, HVAC UPSIZING AND ELECTRICAL
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
B (Tenant Improvements) I-A,I-B 350 $3,061.68 1BTIPLNCK $956.55 IBTIINSP
TOTALS: 350 $3,061.68 $956.55
MECH,HOURLY 0 Yes E) No PLUMB,HOURLY 0 Yes (F) No ELEC,HOURLY 0 Yes 0 No
h. flan Check i'lumb. t'luu C_fre(k cies. i l,)n Check
Nlech. Permit Fee: Plumb.Permit Fee Elec. Permit Fee
Other Meeh.Insp. Other Plumb Insp. Ll 7__ Other Elec.Insp. ET
Hech.Insp. Feo: Plumb. Insp. Fee Elec.Insp,Fee:
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Puhlic Works,Fire,Sanitary Sewer District,School
District etc). These ees are teased on the relimina information availahle and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $3,061.68 Select a Misc Bldg/Structure
Suppl. PC Fee: O Reg. 0 OT 0.0 hrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $956.55
Suppl. Insp. Fee:Q Reg. 0 OT 0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tav: T
Adtninistrative Fee: 0
Work Without Permit? 0 Yes E) No $0.00 E)
Advanced Planning,Fee: $0.00 Select a Non-Residential 0
T r,n el Documentation Fees: Building or Structure 0
Strong Motion Fee: IBSEISMICO $24.15 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $5.00
SUBTOTALS: $4,047.38 $0.00 TOTAL FEE: 1 $4,047.38
Revised: 01/15/2014
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR I SUBCONTRACTOR LIST
JOB ADDRESS: j- r. t—comP PERMIT# 14010 13 3
OWNER'S NAME: pe" Ale. PHONE# -j;o — 15 7 1 Z—
GENERAL CONTRACTOR: W61,16 6�66,M:yz-77clerl BUSINESS LICENSE# Z38q
ADDRESS: / l (-F e,� CITY/ZIPCODE: Q /
*Our municipal code requires all businesses working in the city to have a City of Cupertino gusiness 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 Date
Please check applicable subcontractors and complete the following information:
✓ 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
Owner/Contractor Signature ate