15040162CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 1 INFINITE LOOP
CONTRACTOR: NOVO CONSTRUCTION
PERMIT NO: 15040162
OWNER'S NAME: APPLE COMPUTER INC
1460 O'BRIEN DR
DATE ISSUED: 04/22/2015
OWNER'S PHONE: 4084380968
MENLO PARK, CA 94025
PHONE NO: (650)701 -1500
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
APPLE T.I. - LAB S218, 2ND FLR IL 01 - RECONFIGURE
License Class � Lic. 4 i �-L,Z
(E) LAB (WITH STRUCTURAL, MECH & ELECTRICAL
Contractor N -ON1,C) Date
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:
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
Sq. Ft Floor Area:
Valuation: $100000
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
APN Number: 31602105.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. 1 agree to comply with all city and county ordinances and state laws relating
WIT 111 80 DAYS IT ISSUANCE 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
A S L ALLED 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
— - - - -- L
granting of this permit. Additionally, the applicant understands and will comply
Issue by: Date:
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date "i L'L L
RE- ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ OWNER- BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
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 wit?thcCup tino Municipal Code, Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, S, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: "1 'L,z I
permit is issued.
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
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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
ARCHITECT'S DECLARATION
costs, and expenses which may accrue against said City in consequence of the
I 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
CUPERTINO
ILY
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 �O
(408) 777 -3228 • FAX (408) 777 -3333 • building Dcupertino.orq \
U NEW CONSTRUCTION U ADDITION L J ALTERATION/Ti U REVISION / DEF ORIGINAL PERMIT #
PROJECT ADDRESS
/ERRED
APN # r Q 7 _ o�
c—
/ /
t.
OWNER NAME
PHONE �
E -MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
/
CONTACT NAME
PHON
EAIL
E4 AIL
4-
TOTAL VALUATION:
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ,CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
By my signature below, I certify to each of the following: I am the property o,,vno0Kr'authon`zed_ag-e`nt to act on th operty owner's behalf. I have read this
(v
)
COMPANY NAME
E -MAIL
FAX
RouTnvc sLlr
❑: OVER- TIff_CGIINTER
❑ BUILDING PLANREVIEw
STREET ADDRESS
CITY STATE, ZIP
PHONE
t
CA 02 -
GSA 1 ��r -1500
ARCHITECT/ENGINEER NAME
Tr_
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E -MAIL
FAX
l4
e-<;, Q as o
- ❑' MAJOR ,
STREET ADDRESS �//�
7 Z
CITY, STATE, ZIP
PHONE
%(o d2
DESCRIPTION OF WORK S2_1
F
�-
EXISTING USE
PROPOSED USE
CONSTR. TYPE
# ST;
y
/J
2K
_
7S
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
AREA
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA
�.P
N A
BATHROOM
REMODEL AREA
KITCHEN
REMODEL AREA
OTHER
REMODEL AREA
❑ ATTACH
# DWELLING UNITS,
IS A SECOND UNIT []YES
SECONDSTORY E] YES
1
i
BEING ADDED? []NO
ADDITION? ❑NO
/
PRE- APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
TOTAL VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
%iio
6�0
By my signature below, I certify to each of the following: I am the property o,,vno0Kr'authon`zed_ag-e`nt to act on th operty owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify itisecurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I ptesentatives of Cupertino to enter the above - identified property for inspection purposes.
%authorize
Signature of Applicant/Agen � ✓ Date: c7E3
SUPP TAL INFORMATION REQUIRED
PLAcaECxTYrE
RouTnvc sLlr
❑: OVER- TIff_CGIINTER
❑ BUILDING PLANREVIEw
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
t
permit for new building.
❑ EXPRES4 °:'
❑ �iANNI*C PUN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑: STaxnaaD
❑ Pr�BLICwoxtcs
form if any Hazardous Materials are being used as part of this project.
❑ -LARGE
❑ DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to
- ❑' MAJOR ,
FIRE
❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
-
❑ T,ENVIRONMENT AL HEALTH - -
BldgApp_2011.doc revised 06121111
e eV.i
CUPERTINO
TEMPORARY CERTIFICATE OF OCCUPANCY FORM
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777 -3228 • FAX (408) 777 -3333 • building @cupertino.org
APN
BP #:
FLOOR
AREA
DATE:
�
1
S
PROJECT
VALUATION: $
160 2 10'57
U t'I 6�-
c WorK9
/
bpi aop
SITE �- �/1 . �� Dr
ADDRESS:
v v
trA 1,5-0/ty
OWNER'S NAME: p
�Other:
PHONE #:
Ln _ (13� ,oy(,8
1 a-v (
.......................... ...............................
Signature:
FAX #:
MAILING ADDRESS (if different fr6m site address):
COUTRACTOR:
PHONE #�
b o — ( d
/V ) b Ira GDS
FAX #:
CONTACT:
PHONE #:
(bso) 2 3
L 1 rA
FAX #:
TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION
BOND TYPE: ❑ SURETY BOND AMOUNT (1% VALUATION $ CDOV BLDBONDS CODE
El CHECK ❑ CASH BOND OF BOND: 5K min -10K max ✓ EDITION:
TCO EXPIRATION r
DATE (6 MONTHS MAX): L FEE: $2$6,00 /fll0 TOTAL FEE: $ �—� [1TEMPOCC]
USE
TYPE OF
CONSTR
FLOOR
AREA
OCC
LOAD
LEVEL
COMMENT
❑ APPROVED
APPROVED WITH CONDITIONS -
c WorK9
❑APPROVED
❑ APPROVED WITH CONDITIONS-
.......................... ...............................
Signature:
Date:......................
�Other:
❑APPROVED
❑ APPROVED WITH CONDITIONS-
.......................... ...............................
Signature:
Date:......................
OTHER DEPARTMENT 1 AGENCY APPROVALS:
anrnng
Sinature:........................ ...............................
Date:........................
❑ APPROVED
❑ APPROVED WITH CONDITIONS'
ire
Signatur
Date:.. �, ....
❑ APPROVED
APPROVED WITH CONDITIONS -
c WorK9
❑APPROVED
❑ APPROVED WITH CONDITIONS-
.......................... ...............................
Signature:
Date:......................
�Other:
❑APPROVED
❑ APPROVED WITH CONDITIONS-
.......................... ...............................
Signature:
Date:......................
*CONDITIONS OF COMPLETION - Attach a letter signed by the contractor and owner of the property
stating the list of items required to be completed for each individual Department before final occupancy
can be granted. Include approximate completion dates for each item.
The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or
buildings complete and in compliance with all building codes, ordinances and regulations and ready for inspection prior to the expiration
date specified. If this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited and the non - compliance
may result in an enforcement action.
/ l Contractor . Date:6 4 ....Si nature:. ..... .......... D% /y
!I 4 Signature: .. .. .....................
This temporary certifi to ensures that all fire protection and life safety systems have been completed, inspected, successfully tested and
approved for the spe ifi area of the building specified above to provide a reasonable degree of safety to the occupants from fire and
similar emergencies..
Building Official:.... �......... /!!t, .......... ......................Print:... .... .........VV. "/ I.4 ........ .................... Date:.. .......
DEPARTMENT ACTION: After ddtermination, copies to: 1) applicant, 2) permit file
TempOccForm_2013.doc revised 717114
TEMPORARY CERTIFICATE OF OCCUPANCY FORM
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
CUPERTINO (408) 777 -3228 • FAX (408) 777 -3333 • building(a�cupertino.org
�S
��
APN
75-o #:
(1% VALUATION
$ 0620 [BLDBONDS]
DATE:
}
1
j
PROJECT $
VALUATION:
160 2 10 5-
4 &2-
TCO EXPIRATION
/I/
Date:......................
/
oe> 6 a
SITE �- Z/� rT.�C. Q
ADDRESS:
v v
!S_0
OWNER'S NAME:
�<t
PHONE #:
_n _ t13g ,0y69
V ,�
L
FAX #:
MAILING ADDRESS (if different frbm site address):
CO TRACTOR:
/%
PHONE #i� d ?o -15-00
b LTb (,4 a 5 4 ry c ha r)
FAX #:
CONTACT:
PHONE #:
(63o) Z 3
1 rub l v
FAX #:
TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION
BOND TYPE: ❑ SURETY BOND
AMOUNT
(1% VALUATION
$ 0620 [BLDBONDS]
CODE
❑ CHECK El CASH BOND
OF BOND:
5K min -10K max ./
EDITION:
TCO EXPIRATION
/I/
Date:......................
FEE: $286.00/mo
TOTAL FEE: $ � 7 -1 4 [1TEMPOCC]
DATE (6 MONTHS MAX):
Date:......................
❑ APPROVED
❑ APPROVED WITH CONDITIONS'
USE
TYPE OF
CONSTR
FLOOR
AREA
OCC
LOAD
LEVEL
COMMENT
[]APPROVED
APPROVED WITH CONDITIONS -
c Works
Signature: .........................................................
Date:......................
❑ APPROVED
❑ APPROVED WITH CONDITIONS -
t er:
Signature: .........................................................
Date:......................
❑ APPROVED
❑ APPROVED WITH CONDITIONS'
OTHER DEPARTMENT I AGENCY APPROVALS:
annq
Signature: ........................ ...............................
-Tire
Date:........................
❑ APPROVED
❑ APPROVED WITH CONDITIONS"
CONDITIONS-
Signatur ........ ...
............. Date:.? ..71 L5....
[]APPROVED
APPROVED WITH CONDITIONS -
c Works
Signature: .........................................................
Date:......................
❑ APPROVED
❑ APPROVED WITH CONDITIONS -
t er:
Signature: .........................................................
Date:......................
❑ APPROVED
❑ APPROVED WITH CONDITIONS'
*CONDITIONS OF COMPLETION - Attach a letter signed by the contractor and owner of the property
stating the list of items required to be completed for each individual Department before final occupancy
can be granted. Include approximate completion dates for each item.
The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or
buildings complete and in compliance with all building codes, ordinances and regulations and ready for inspection prior to the expiration
date specified. If this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited and the non - compliance
may result in an enforcement action.
Owner Contractor
Signature: .... ..................... Date: .......... Date: 7 /V�
.
This temporary certifi to ensures that all fire protection and life safety systems have been completed, inspected, successfully tested and
approved for the spe ifi area of the building specified above to provide a reasonable degree of safety to the occupants from fire and
similar emer encies.
Building Official:....... ..t ............... 'Ak ................ ......................Print:... ..... ... ............................... Date:.........1. ......
DEPARTMENT ACTION: After dellermination, copies to: 1) applicant, 2) permit file
TempOccForm_2013.doc revised 717114
FM_7 CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
OCCUPANCY TYPE:
1 INFINITE LOOP
DATE: 04/22/2015
REVIEWED BY: MELISSA
PAADDRESS:
APN: 316 02 105
BP #: 52
'VALUATION: 1$100,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
IBTIPLNCK
PENTAMATION 1 B 11
PERMIT TYPE:
WORK
APPLE - T. 1. LAB S218 2ND FLR IL 01 - RECONFIGURE E LAB WITH STRUCTURAL MECH &
SCOPE
ELECTRICAL)
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
I -A,I -B
1,010
$3,209.28
IBTIPLNCK
$1,702.24
/BTIINSP
1 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,702.24
Suppl. Insp. Fee-0 Reg.
Q OT
0 0
hrs
$0.00
PME Unit Fee:
$0.00
TOTALS:
1,010
$3,209.28
$0.00
$1,702.24
MECH, HOURLY O Yes Q No
PLUMB, HOURLY 0 Yes ) No
ELEC, HOURLY Q Yes Q No
MISC ITEMS
.
------ -
$3,209.28
t
C I a, i_ -. E3
Suppl. PC Fee: 0 Reg. 0 OT
0.0
1 hrs
NOTE. This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.). These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addh7 info.
FEE ITEMS (Fee Resolution 11 -053 E .' 7/1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$3,209.28
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 0 Reg. 0 OT
0.0
1 hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,702.24
Suppl. Insp. Fee-0 Reg.
Q OT
0 0
hrs
$0.00
PME Unit Fee:
$0.00
Permit Fee:
$0.00
{{PME
0
Work Without Permit? Yes (F) No
$0.00
Advanced Planning Fee.
$0.00
Select a Non - Residential
Building or Structure
E)
�
Strong Motion Fee:
IBSEISMICO
$28.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$4.00
SUBTOTALS:
$4,943.52
$0.00
TOTALFEE:
1 $4,943.52
Revised: 04/01/2015