AMC - Waive Oper Permit ALTERNATE MATERIALS AND METHODS / MODIFICATION FORM
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE •CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408) 777-3333• buildinqna,cupertino.orq
GUPERTINO
❑ REQUEST FOR MODIFICATION OF CODE(CBC 104.10,CFC 104.8)
❑x REQUEST FOR ALTERNATE MATERIAL, DESIGN OR METHOD OF CONSTRUCTION(CBC 104.11,CFC 104.9)
❑ REQUEST FOR HARDSHIP EXEMPTION OR EQUIVALENT FACILITATION (HEALTH AND SAFETY CODE 19957)
To a i for this re uest,com lete sections 1,2,&3 ink or t e
SITE 4 A le Pkw APN DATE 11�09/2016
ADDRESS pp y
Owner.APPIe. Inc.................. _....._...._........ _. .. . _ ......................._..... ................ . _.
PC#: .._..._............. . . ....... Type: ..._...�......._........_.......
Address 1 infinite Loop, MS21-1AC2 z � I Z
Permit# �.LI� 3 Stories:
ESANDOVAL@APPLE.COM 408 783-4613 �(}-�
Emaii..... Phone.�. .. �.
� .... PLN# . .... Occupancy. .. I✓........
_.
Edith Sandoval Pro�ect Coordinator Dept.iDiv.�!�J.�..i,;,����Ca� Floor Area:.............................
Applicant................................._.........,.... ........ ... ..Title.......1.
1 Infinite Loo MS21 1AC2 JobStatus: ..... ........ .. _ __.. Occ Load: ............................
Address.........................P.�............"............ .... .........._.._.. .._.............
EmaiI.ESANDOVAL@APPLE.COM 408 783-4613 Use of Bldg:..��U�'�i............. .
Phone.�.......�...................... .. .......... V
2 REQUEST: For code modifications,please state the applicable code requirement and the extent of relief desired. For alternate requests,state the type of system
ro osed and desi n methods. Submit lans if necessa to illustrate re uest. Additional sheets or data ma be attached.
and ressure vesseis ro osed at the AC2 cam us.
3 JUSTIFICATION/FINDINGS OF EQUIVALENCY: For code modifications,applicant shall demonstrate that Code Section(s):
speciai,individual reasons exist that make compiiance with the strict letter of the ordinance impractical and that
equivalency is provided For alternate requests.applicant shall demonstrate suitability,strength,effectiveness,fire 2010 CMC Section 1022.0
resistance,durabilit ,safe and sanitation that is e uivalent to the code for a similar use.
Attach additional sheets if necessary
at such intervals as deemed necessar but not less fre uenc than noted in 2010 CMC Section 1023.2
thru 1023.5. equip all be operated and maintained in accordance with the requirements for
protection f the ubli and in accordance with nationaily recognized standar s.
Petitioner's Reviewed / � • J
Pro ect Coordinator �� t� �. �✓J<...� � �........Date:..�l.L.�...�..�.
Si nature: ............ ....... :.............. Position:......).......................... Date:....... . B :..............
The Request is: GR TED ❑ DENIED Dept.Comments:
CONDITIONS OF APPROVAL:
No of Items: ............._....._... ..
Fee Due:$....... . ......................
Date Paid: ........ .......................
Receipt No.: .............................
Processed by:.................... .......
8uildin O�ciai:..... . .. . _.. . . ........... . . . ...Y.�L.-�"�........Print:.f.�V.!�.�.Y)...._,�L�7..�`�..[.1..Q��..................Date:....�.�....��../.�.4".
FireMarshal:....__....._...._..............................................................._PriM:................. ................................_.....:.....................Date:......................._.........
DEPARTMENT ACTION: After determination,copies to: 1)applicant, 2)permit file
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