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10080103CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10460 BANDLEY DR CONTRACTOR: XL CONSTRUCTION PERMIT NO: 10080103 OWNER'S NAME: APPLE INC 851 BUCKEYE CT DATE ISSUED: 09/09/2010 OWNER'S PHONE: 4089745951 MILPITAS, CA 95035 PHONE NO: (408)271-2425 ❑ LICENSED CONTRACTOR'S DECLARATION INFO: FPLUMB r qBUILDING PERMIT BLDG ELECT License Class_�� Lic.# f7 MECH RESIDENTIAL " ` COMMERCIAL rt j� n I � Contractor X 1, (IM',J�' (JI.P { 104 Date `'1 I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: COMM'L TI ONE STORY 2,286SQ OFC SPACE, PROJECT (commencing with Section 7000) of Division 3 of the Business & Professions INCLUDES DEMO OF EXISTING OPEN/CLOSED OFFICE SPACE Code and that my license is in full force and effect. & CONSTRUCTION OF NEW 21 OFFICES. RECONFIGURATUON 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. I have and will maintain Worker's Compensation Insurance, as provided for by Sq. Ft Floor Area: Valuation: $800000 Section 3700 of the Labor Code, for the performance of the work for which is permit is issued. f- APN Number: 32633105.00 Occupancy Type: APPLICANT CERTIFICATION 1 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this pe t. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-poin re gulations per upertino Municipal Code, Section 9.18. q �j r I I C7 Issued byr',•--"--�"'---�__---•- •----- Date: Signature ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for I, as owner of the property, or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: Date: 1, as owner of the 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: 1 have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation, as provided for by Section 3700 of the Labor Code, for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued, I shall maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health & Safety Code, Sections 25505, 25533, and 25534. 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 Or authorized en t: �' Date: forthwith comply with such provisions or this permit shall be deemed revoked. CERTIFICATION CONSTRUCTION LENDING AGENCY VAPPLICANT I certify that I have read this application and state that the above information is l hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address costs, and expenses which may accrue against said City in consequence of the 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 — 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional REVASION CITY OF CUPERTINO BUILDING PERMIT DAA BUILDING ADDRESS: 10460 BANDLEY DR CONTRACTOR: XL CONSTRUCTION PERMIT NO: 10080103 OWNER'S NAME: APPLE INC 851 BUCKEYE CT DATE ISSUED: 09(09(2010 OWNER'S PHONE: 4089745951 MILPITAS, CA 95035 PHONE NO: (408)271-2425 LICENSED CONTRACTOR'S DECLARATION 1-11 .- - License Lic. EC BUILDING PERMIT INFO: BLDG ELECT PLUMB Class # J � h_( r Contractor x— ('_Q VQ 5`i JAfflt 0/-J Date MECH RESIDENTIAL COMMERCIAL ` I hereby affirm that I am Iicensed under the provisions of Chapter 9 JOB DESCRIPTION: COMM'L Tl ONE STORY 2,286SQ OFC SPACE, PROJECT (commencing with Section 7000) of Division 3 of the Business & Professions INCLUDES DEMO OF EXISTING OPEN/CLOSED OFFICE SPACE Code and that my license is in full force and effect. & CONSTRUCTION OF NEW 21 OFFICES. RECONFIGURATION 9/13/2010 - REV#1 - SMALL LAB/OFFICE I hereby affirm under penalty of perjury one of the following two declarations: CHANGES(HARDWALL),STRUCTURAL(ROOF),MECHANICAL(ROOF ), LIGHTING MODIFICATIONS.9/28/10 REV#1 ISSD 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. 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. Sq. Ft Floor Area: Valuation: $800000 APPLICANT CERTIFICATION I certify that 1 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 APN Number: 32633105.00 Occupancy Type: 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 w h may accnr against said City in consequence of the in PERMIT EXPIRES IF WORK IS NOT STARTED granting of this � . Additionally the applicant and will comply with all non- ins ce regulation per the Cupertino Municipal Code, Section WITHIN 180 DAYS OF PERMIT ISSUANCE OR 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatu Datel/ /..U/ /O L (I — Issued by: Date: ❑ OWNER-BUIL ER DECLARATION hereby a rrm that I am exempt from the Contractor's License Law for one of the following two reasons: RE-ROOFS: 1, as owner of the property, or my employees with wages as their sole compensation, All roofs shall be inspected prior to any roofing material being installed. If a roof is will do the work, and the structure is not intended or offered for sale (Sec.7044, installed without first obtaining an inspection, I agree to remove all new materials for Business & Professions Code) inspection. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). Signature of Applicant: Date: hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the work for which this California Health &Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & permit is issued. Safety Code, Section 25532(a) should I store or handle hazardous material. 1 certify that in the performance of the work for which this permit is issued, I shall Additionally, should I use equipment or devices which emit hazardous air not employ any person in any manner so as to become subject to the Worker's contaminants as defined by the Bay Area Air Quality Management District I will Compensation laws of California. If, after making this certificate of exemption, I maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the become subject to the Worker's Compensation provisions of the Labor Code, I must Health & Safety Code, Sections 25505, 25533, and 25534. forthwith comply with such provisions or this permit shall be deemed revoked. Own or author' ed a t: /] p Date: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's upon the above mentioned property for inspection purposes. (We) agree to save for which this permit is issued (See. 3097, Civ C.) indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Name costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply Lender's Address with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. ARCHITECT'S DECLARATION Signature Date I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: DATE: REVIEWED BY: PC FEES APN: BP#: "VALUATION: $80,000 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: l'OTIL FLOOR ARBA: APPLICATION 1B TI TYPE: A WORK IBTIINSP SCOPE $2,802.04 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-A,111-A,V-A 2,826 $2,614.00 IBTIPLNCK $2,802.04 IBTIINSP Elec. Imp, Fee. $2,802.04 Suppl. Insp. Fee -0 Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee:- : _ _ $0.00 PME Permit Fee: $0.00 Conswilction Tax Acoustical Fee: Y 0 No $0.00 0 - Work Without PeniAt` 0 Yes • No $0.00 TOTALS: 2,826 $2,614.00- 7i cn>el Docrrrru;nlu/iorr f'c >s: $2,802.04]; Strong Motion Fee:. IBSEISMICO 1VIECHANICAL` Yes No ° PLUMBING ®Yes Q No . ELECTRICAL �1Yes . . Q No: If (A Plan Check plumb. Plarr Check L, lea. Plan Check rLfe.ch. Perron Fee: Plumb. Perini! Fee: fYec. Permir Fee: Orber .,Wecrh. Insp. Other Plumb Insp. Other Elec. Insp. Ll I .11ech. Insp. Fee. Plumb. /mvp. Fee. Elec. Imp, Fee. NOTE: These -fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS ('Fee Resolution 09-051 E '. 7/1%10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,614.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,802.04 Suppl. Insp. Fee -0 Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee:- : _ _ $0.00 PME Permit Fee: $0.00 Conswilction Tax Acoustical Fee: Y 0 No $0.00 0 - Work Without PeniAt` 0 Yes • No $0.00 PLLO GRNG PLL $706.50 Select a Non -Residential G Building or Structure 0 i 7i cn>el Docrrrru;nlu/iorr f'c >s: Strong Motion Fee:. IBSEISMICO $16.80 Select an Administrative Item Bld�T Stds Commission Fee: 1BCBSC $4.00 SUBTOTALS: $6,143.34 $0.00 TOTALFEE �� $6,143.34 Revised: 8/12/2010