15100122CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 15100122
19333 VALLCO PKWY CUPERTINO CA 95014 (316 20 075)
NOVO
CONSTRUCTION INC
MENLO PARK, CA
94025
OWNER'S NAME: APPLE INC
DATE ISSUED: 04/19/2016
OWNER'S PHONE: 510-491-8424
PHONE NO: (650) 701-1500
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class ]a Lia #791022
Contractor NOVO CONSTRUCTION INC Date 02/28/2017
—BLDG _ELECT — PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
_ MECH _ RESIDENTIAL _ COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
APPLE TENANT IMPROVEMENT FOR KITCHEN (582 SQ FT);
I hereby affirm under penalty of perjury one of the following two declarations:
CONSTRUCT TRASH ENCLOSURE WITH RECYCLING_
1. I have and will maintain a certificate of consent to self -insure for Worker's
COMPACTOR
Compensation, as provided for by Section 3700 of the Labor Code, for the
AND TRASH TRIO SETS.
/'performance of the work for which this permit is issued.
/ i.' I have and will maintain Worker's Compensation Insurance, as provided for by
REV # 1 (8/16/16) - REVISE FIXTURE/EQUIPMENT LAYOUT -
ISSUED 1/31/17
Section 3700 of the Labor Code, for the performance of the work for which this
Sq. Ft Floor Area:
Valuation: $750000.00
permit is issued.
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
316 20 075
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
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
i
Additionally, the applicant understands and will comply with all non -point
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 1/3112017
Issued by: ABBY AYENDE
Date: 04/19/2016
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:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. I, as owner of the property, or my employees with wages as their sole
installed without first obtaining an inspection, I agree to remove all-new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 1/31/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1. 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
performance of the work for which this permit is issued.
HAZARDOUS MATERIALS DISCLOSURE
2. I 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
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Se tions 505, 25533, and 25534. -
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION
Date: 1/31/2017
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
1 understand my plans shall be used as public records.
Code, Section 9.18.
Licensed
Signature Date 1/31/2017
professional
CITY OF CUPERTINO BUILDING PERMIT ;
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 15100122
19333 VALLCO PKWY CUPERTINO CA 95014 (316 20 075)
NOVO
CONSTRUCTION INC
MENLO PARK, CA
94025
OWNER'S NAME: APPLE INC
DATE ISSUED: 04/19/2016
OWNER'S PHONE: 917-566-0765
PHONE NO: (650) 701-1500
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:.
License Class GENERAL BUILDING CONTRACTOR Lic. #79102
_ELECT
Contractor NOVO CONSTRUCTION INC Date 02/28/2017
— BLDG PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— MECH — RESIDENTIAL_ COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
APPLE TENANT IMPROVEMENT FOR KITCHEN (582 SQ FT);
I hereby affirm under penalty of perjury one of the following two declarations:
CONSTRUCT TRASH ENCLOSURE WITH RECYCLING
1. I have and will maintain a certificate of consent to self-insure for Worker's
COMPACTOR
Compensation, as provided for by Section 3700 of the Labor Code, for the
AND TRASH TRIO SETS.
of the work for which this permit is issued.
/performance
2I 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
Sq. Ft Floor Area:
Valuation: $750000.00
permit is issued.
APPLICANT CERTIFICATION
certify that l have read this application and state that the above
information is correct. I agree to comply with all city and county ordinances
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
316 20 075
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
PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally, the applicant understands and will comply with all non-point
source regulations per the Cupertino Municipal Code, Section 9.18.
180 DAYS FRO SPECTION.
Signature_ ( Date 04/19/2016
Issued by: MELISSA
Date: 04/19/2016
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE-ROOFS-
following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
r. I, as owner of the property, or my employees with wages as their sole
installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
2. 1, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 04/19/2016
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1. 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.
HAZARDOUS MATERIALS DISCLOSURE
2, I 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
'permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code; Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
11 r
be deemed revoked.
Owner or authorized age (t/:/
APPLICANT CERTIFICATION
Date: 04119/2016
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.).
relating to building construction, and hereby authorize representatives of this city
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Licensed
Signature Date 04/19/2016
Professional
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 19333 VALLCO PRKWY
DATE: 10/15/2015
REVIEWED BY: SEAN
APN:
BP#:
'VALUATION: 1$750,000
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
$2,112.78
PENTAMATION 1B TI
PERMIT TYPE:
WORK
APPLE TENANT IMPROVEMENT FOR KITCHEN 582 SQ FT); CONSTRUCT TRASH ENCLOSURE
SCOPE
WITH RECYCLING COMPACTOR AND TRASH TRIO SETS.
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
B (Tenant Improvements) II-8,111-B,IV,V-B 582 $2,112.78 IBTIPLNCK $793.08 IBTIINSP
TOTALS582 $2,12.78 $793.08I I '
11ech..I'laiz {',heck
.lec77. f'ermrt Pee:
Other .4,14eeh. Imp.
AI ch. IY 5 p, Fee:
Plumb. Plan Check
Plumb. Peron I pct
tither 1'Iun2h .hup.
Plumb. Imp. Fee:
E:Iec. Phai Check
'lec. tae€77ut Fee:
Other Elea Imp.
Elea hap. Fee
jvvzr: rats esumate aoes not tnctuae fees aue to otner uepartments (i.e. rianntng, runic worxs, rtre, ,NanttaryNewer utstrtct, , cnoot
District, etc.. These ees are based on the preliminar information available and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution .1.1-053 E . 711113,)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,112.78
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Reg. O OT
0.0
hrs
$0.00
PME Plan Check:
$0:00
Permit Fee:
$793.08
Suppl. Insp. Feer Reg. C) OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00'
PME Permit Fee:
$0.00
Constrvelion Tdx:
cIminisirative P'ee:
0
E
Work Without Permit? 0 Yes (E) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure O
Trawl l.D c.2ilnentttlion ,t,'ec,,, :
Strong Motion Fee: IBSEISMICO
$210.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$30.00
SiTBTOTALS': $3,145.86 $0.00 = TCAI. FES• $3,145.86
Revised: 10/01/2015