14120046CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19333 VALLCO PKWY
CONTRACTOR: DEVCON PERMIT NO: 14120046
CONSTRUCTION INC
OWNER'S NAME: APPLE INC
690 GIBRALTAR DR DATE ISSUED: 01/21/2015
OWNER'S PHONE: 4089749591
MILPITAS, CA 95035 PHONE NO: (408)942-8200
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
APPLE - (BLDG C 2ND FLR) INSTALLATION OF A FUME
License Class C4 C-1 Lia # '27"-107 ( (",3,
HOOD IN EXISTING LAB.
Contractor j%w te,, wt 14,y� rA' o ✓1 Date I :2-- I I I S
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: $25000
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
ection 3700 of the Labor Code, for the performance of the work for which this
APN Number: 31620075.00
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. I agree to comply with all city and county ordinances and state laws relating
WITHIN 18 ERNIIT 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
180 DAYS�kQM LAS CALLED 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
/� jS
granting of this permit. Additionally, the applicant understands and will comply
Issued by: Date:
with all non -point source r gulations per the Cupertino Municipal Code, Section
9.18. '
RE -ROOFS:
Signature
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, 1 agree to remove all new materials for
inspection.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1, 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)
1, 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. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 912 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 with the Cupertino Municipal Code, Chapter 9.12 and
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
the Health & Safety Code, Sections _ 5533, a 34.
Owner or authorized agent: Date:
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
CONSTRUCTION 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
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
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I understand try 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
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION` \�
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 \ "\
(408) 777-3228 • FAX (408) 777-3333 • building(a__)cupertino.org
❑ NEW CONSTRUCTION ❑ ADDITION 0 ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # 13120193
PROJECT ADDRESS 19333 Val lco Pkwy
APN # 3 6-- 2 G U
OWNERNAME Apple, Inc.
PHONE408-974-9591E-MAlLemolloy@apple.com
STREET ADDRESS 1 Infinite Loop
CITY, STATE, ZIP Cupertino, CA
FAX
CONTACT NAME Kevin Irwin
PHONE 408-712-9
E-MAI`kirwin@devcon-const.com
STREETADDRESS690 Gibraltar Dr.
CITY, STATE, ZIP Milpitas, CA 95035
FAX 408-262-2342
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT E CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME Kevin Irwin
LICENSENUMBER 399163
I
LICENSE TYPE CA GC
BUS. LIC # 11068
COMPANY NAME Devcon Construction, Inc.
E-MAILkirwin@devcon-const.Corn
FAx408-262-2342
STREETADDRESS690 Gibraltar Dr.
CITY, STATE, ZIP Milpitas, CA 95035
PHONE 408-942-8200
ARCHITECT/ENGINEER NAME Kate Greenberg
LICENSE NUMBER
BUS. LIC #
COMPANY NAME Studios Architecture
E-MAILkgreenberg@studios.com
FAX
STREETADDREss405 Howard St, Suite 488
CITY' STATE' ZIP San Francisco, CA
PHONE 415-732-5358
DESCRIPTION OF WORK
Installation & co�nnection of lab fume hood to existing utilities in existing space (PPO Lab).
2 " fl#o,' of/6VItd G -
EXISTING USE
Lab
PROPOSED USE CONSTR.
Lab II -B
TYPE
# STORIES
2 USE TYPE OCC.
SQ.FT.
VALUATION ($)
AREA
AREA
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA
Lab(�� 11-5
$25,000
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
❑ ATTACH
# DWELLING UNITS:
IS A SECOND UNIT E]YES
SECOND STORY YES
BEING ADDED? []NO
ADDITION? [3NO
PRE -APPLICATION []YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ CEIVED
- VALUATION:
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME?
__TOTAL
' -- _ $25,000
By my signature below, I certify to each of the following: I am the property ownCY4S�it Iorized a to act oA�proowner's behalf. I have read this
application and the information I have provided is correct. I have read the DescnpTUon of Wor d verify it acee to comply with all applicable local
ordinances and state laws relating to b onstruction. trize representatives of Cupertino to ente ed roperty for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
❑ OVER-THE-COUNTER ❑
BUILDING PLAN REVIEW
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑EXPRESS ❑
PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
STANDARD ❑
PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
/❑ LARGE ❑
FIRE DEPT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
❑ MAJOR ❑
SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑
ENVIRONMENTAL HEALTH
BldgApp 201 ].doe revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 19333 VALLCO PKWY DATE: 1210812014
REVIEWED BY: MELISSA
APN: 316 20 075
BP#:,
`VALUATION: $25,000
°PERMITTYPE: Building Permit
BP FEE ID
PLAN CHECK TYPE:
Tenant Improvement
PRIMARY
USE: Commercial Building
$0.00
0.0
PENTAMATION
PERMIT TYPE: 1F1"A
WORK
APPLE T.I. - 2ND FLR BLDG C
ORIGINAL T.I. IS 13120193
- INSTALLATION 8� HOOK LIP OF N
SCOPE
FUME HOOD (789S.F.)
Permit Fee: Hourly Only? ® Yes Q No
$0.00
OCCUPANCY TYPE:
TYPE .
CONSTR.
s.f.FLR AREA
PC FEES
PC FEE ID
BP FEES
BP FEE ID
F (Tenant Improvements)
II-B,III-B,IV,V-B
0
$0.00
0.0
$0.00
$0.00
PME Plan Check:
$0.00
1 #
$143.00
Mechanical
IMCHOOD Hood, Mech. Exhaust
Permit Fee: Hourly Only? ® Yes Q No
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
p,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
TOTALS:
0
$0.00
$0.00
MECH, HOURLY E) Yes 0 No
PLUMB, HOURLY Q Yes Q No
ELEC, HOURLY Q Yes Q No
Mech. Plan Check O.p hrs $0.00
Plan Check Fee: Hourly Only? 0 Yes (j) No
Mech. Permit Fee: IMPERMIT
2 1 hours
$286.00
Plan Check, Hourly
ISTPLNCK
Other Mech. Insp. 0.0 hrs $48.00
Suppl. PC Fee: (j) Reg. 0 OT
0.0
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 preliminary information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E_ff 7.%1/13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes (j) No
$0.00
2 1 hours
$286.00
Plan Check, Hourly
ISTPLNCK
Suppl. PC Fee: (j) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
1 #
$143.00
Mechanical
IMCHOOD Hood, Mech. Exhaust
Permit Fee: Hourly Only? ® Yes Q No
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
p,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$48.00
G
Work Without Permit? 0 Yes (D No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
Travel Documentation Fee: ITRA VDOC
$48.00
Strom Motion Fee: IBSEISAIICO
$7.00
=hrs
$143.00
Inspections
1STINSP 7Inspection, Hourly
B1dQ, Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$104.00
$572.00
TOTAL FEE:
1 $676.00
Revised: 10/01/2014
- Building Department
Citv° OFC'upertino
10300 "1 orre A� enue
Cupertino, CA 95014-32_55
Telephone: 408-777-3228
C UPE RTI NO Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS_19333 Vallco Pkwy
P1_:RMI- 14120046 1
--- ---- — ---
OWNF,R'S NAME:Apple, Inc.
GENE;RAI, CON-RAC'TOR:Devcon Construction
_ - — -- ---
PI IONE #1408-974-5951 {
BUSINESS LIC'ENSF a,�11068
ADDRESS:690GibraltarDr
CITY/ZIPC'ODE:Milpitas, CA 95035
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) NVIIA_ BE SCHEDULED UNT11, THE
GENERAI. CONTRACTOR AND ;kLA, SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPER'LINO
BUSINESS LICENSE.
am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
✓
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
x
Electrical
Redwood Electric Group
Excavation
Fencing
}'Mooring / C arpetlllg
Linoleum / wood
Glass / Glazing
Heating
ACCO Engineered Systems
tXA
[I1SUlatl011
Landscaping
Lathing
Masonry
Painting / wallpaper
-------- ------ ----------------
-
-------
Paving
Plastering
United Mechanical, Inc.
-----
X
Plumbing
Roofing —
� -
- --
Septic Tank _____L_
- -------
Sheet Metal
1,
Sheet Rock
--
Tiles
--- - -
O�� ner / Cm►trac or _ Igriature
2/i! a / 15
Date