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11030034CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1 INFINITE LOOP CONTRACTOR: XL CONSTRUCTION PERMIT NO: 11030034 OWNER'S NAME: APPLE INC 851 BUCKEYE CT DATE ISSUED: 06/02/2011 OWNER'S PHONE: 4082406438 MILPITAS, CA 95035 PHONE NO: (408) 240-6000 ❑ LICENSED D CONTRACTOR'S DECLARATION r r— ELECT / /Q L `f O BUILDING PERMIT INFO: BLDG PLUMB License Class Lic. # O I— r � y Contractor-7—re.,T d-ae4,AAbate 612,111 MECH RESIDENTIAL COMMERCIAL If 1 hereby affirm that I am licensed under t rovisions of C apter 9 JOB DESCRIPTION: 4TH FLOOR- SOUTH WING: INSTALL EXISTING NEW (commencing with Section 7000) of Division 3 of the Business & Professions SECURITY DOOR AN MODIFY EXISTING Code and that my license is in full force and effect. 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: $200000 Section 3700 of the Labor Code, for the performance of the work for whi is permit is issued. APN Number: 31602105.00 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 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 permit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date 61-ZIL Issued by. Date:Signature ❑ OWNER -BUILDER DECLARATION RE -ROOFS: 1 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: I, 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: [ 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 1 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 Owned, r ly�r' d ag rt: forthwith comply with such provisions or this permit shall be deemed revoked. / Date:_/ APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of %ork'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 Leader'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 _w ww2n►1 X 1 CITY OF CUPERTINO BUILDING PERM ATV BUILDING ADDRESS: 1 INFINITE LOOP CONTRACTOR: XL CONSTRUCTION PERMIT NO: 11030034 OWNER'S NAME: APPLE INC 851 BUCKEYE CT DATE ISSUED: 06/02/2011 OWNER'S PHONE: 4082406438 MILPITAS, CA 95035 PHONE NO: (408) 240-6000 ❑ LICENSED CONTRACTOR'S DECLARATION r— y 7 L/o BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class ` Lie. #1 U "r f— f— f l Contractor �l�Iv Date MECH RESIDENTIAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: 4TH FLOOR- SOUTH WING: INSTALL EXISTING NEW Z'/� (commencing with Section 7000) of Division 3 of the Business & Professions SECURITY DOOR AN MODIFY EXISTING // 2 6/2/2011- REVISION#I1 - SECURING EXISTING & NEW DOOR$ WITH CARD Code and that my license is in full force and effect. READERS TO A PORTION OF THE SOUTH WING ON THE 4TH FLOOR. MINOR DEMO I hereby affirm under penalty of perjury one of the following two declaration OF NON-STRUCTURAL WALLS IN ORDER TO MEET EGRESS REQUIREMENTS I have and will maintain a certificate of consent to self -insure for Worker's Q" Compensation, as provided for by Section 3700 of the Labor Code, for the 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 permit is issued. Sq. Ft Floor Area: Valuation: $200000 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 APN Number: 31602105.00 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 which may accrue against said City in consequence of the PERMIT EXPIRES IF WORK IS NOT STARTED granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulaticns per the Cupertino Municipal Code, Section WITHIN 180 DAYS OF PERMIT ISSUANCE OR 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date / Issued by. Date: ❑ OWNER -BUILDER DECLARATION I hereby affirm 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. 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business &Professions Code). Signature of Applicant: Date: I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 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 6.9of the Section 3700 of the Labor Code, for the performance of the work for which this 1 California Health &Safety Code, Sections 2, 25533, and 25534. 1 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. I 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 Mai tain co lance with the Cupertino Municipal Code, Chapter 9.12 and the become subject to the Worker's Compensation provisions of the Labor Code, I must Hea h & Sa Cod Sections 25505, 25533, and 25534. forthwith comply with such provisions or this permit shall be deemed revoked. Owne or anrized gen . Date:�h APPLICANT CERTIFICATION I certify that 1 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 herb affirm that there is a construction lending agency for the performance of Hork's upon the above mentioned property for inspection purposes. (We) agree to save for which this permit is issued (Sec. 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 i�M FEE ESTIMATOR - BUILDING DIVISION 19 ADDRESS: 1 infinite loop 4th floor DATE: 03/08/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$200,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION 1GENCOM PERMIT TYPE: WORK install exisiting new security door and modifV existing exiting SCOPE NOTE. These fees are haled on the nreliminary information availahle and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 09-05I F_ '. 7� FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 # $506.00 New Door Opening IDOORNONST Non -Structural Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. © OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes 0 No $0.00 0 0 Work Without Permit? © Yes 0 No $0.00 Plannin Fee: $0.00 Select a Non -Residential 0 Building or Structure A Strom Motion Fee: IBSEISMICO $42.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $8.00 pe Revised: CITY OF CUPERTINO w�ii I FEE ESTIMATOR - BUILDING DIVISION imlADDRESS: 1 infinite loop 4th floor DATE: 06/02/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: $85,000 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION PERMIT TYPE: WORK reivise new doors and card readers includes demo non wall to meet egress. SCOPE -bearinq NOTE: These fees are haled an the nreliminary information availahle and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 09-051 E '. 711110) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: G Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. 0 OT 0.0 I hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical. Fee: 0 Yes (F) No $0.00 Q e) Work Without Permit? Yes G No $0.00 Plannin Fee: $0.00 Select a Non -Residential Building or Structure Q i Strong Motion Fee: IBSBISMICO $17.85 1 # $760.00 Revision IREVCOMTI Tenant Improvement Bld�Stds Commission Fee: IBCBSC $4.00 ;r B' �1 21. 85 $ . 760.0 $ 0 : :'F3':.:. $781.85 Revised: 04/29/2011