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14080026CITY OF CU PlEll2TINO Buff L>IDI NG PERMIT BUILDING ADDRESS: 10440 BUBB RD CONTRACTOR: DEVCON PERMIT NO: 14080026 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 08/05/2014 OWNER'S PHONE: 4088624575 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Class__ Lic. # 3� REVISION #2 REVISE THE LOCATION OF THE ACCESSIBLE PATH AND ( , ( Contractor-,AOn- CM1tVV1� Vd4�ate Oq Ivi EV STALLS. 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: $695000 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 APN Number: 35720036.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is EllD PERMIT EXPIRES ES IL]F WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating W)<'1<')1 N 180 DAYS OF PERMIT l 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 FROM (LAST 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 Issued b �n✓ �/c Date: granting of this permit. Additionally applicant understands and will comply y: _ with all no -p ' t source regulation p e Cupertino Municipal Code, Section RE-ROOFS: 9.18. og Signature a 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 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 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 1 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 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally, should 1 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 1 performance of the work for which this permit is issued. will maintain compliance wi the Cupertino icipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code, ec 25505, 55 3, nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agen : ate: ®, 7-q 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 I certify that 1 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 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 CTY OF cCUP E] UNO FEE IESTE1D'I[ATOR — BUM NG MVEKON NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Deptfor addh7 info. EEE ITEMS (Fee Resolution 11-033 Eff' 7./1.%13) ADDRESS: 10440 B Bubb Road DATE: 09/2412014 REVIEWEID BY: Sean mi -ch. Permit Fees: APN: BP#: *VALUATION: Iso *PERMIT TYPE: Building Permit PIAN C'HEC'K TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building pirmib. hisp, Fee PENTAM[ATION PERMIT TYPE: 1GENCOM WORK Revision #2: Revise the locations of the accessible path and EV charging station. SCOPE Suppl. Insp. Fee:) Reg. ) OT NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Deptfor addh7 info. EEE ITEMS (Fee Resolution 11-033 Eff' 7./1.%13) 1"' h1'lon ( hc('A pkmlb. Man k mi -ch. Permit Fees: F1,111mb. Pcvmil 'cu: l "c p<rnur C)rbrr rltech. In.m.Lj I Utber phirnb Iriet, U;hr) t.,ies. il,sp. t/ <h tt„p. /cre: pirmib. hisp, Fee NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These Pees are based on the preliminary information available and are only an estimate. Contact the Deptfor addh7 info. EEE ITEMS (Fee Resolution 11-033 Eff' 7./1.%13) ]FEE QTY/FEE M[ISC ITEMS Plan Check Fee: Hourly Only? Yes No $0.00 1 2 hours Plan Check, Hourly $286.00 1STPLNCx Suppl. PC Fee: ) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:) Reg. ) OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C fmr. it trc tion Tu:r: zlr.lpiaisrrarA FCC: ) Work Without Permit? 0 Yes ) No $0.00 Advanced Planning,, Fee:$0.00 Select a Non -Residential E) Building or Structure G Troi eel Dot tunentutior�r Fees. Strom Motion Fee: $0.00 Select an Administrative Item 7 Bldg, Stds Commission Fee: $0.001 SUBTOTALS: $0.00 $286.00 TOTAL ]FEE: $286.00 Revised: 07/10/2014 CONSTRUCTION PERMIT APPLICAT r COMMUNITY DEVELOPMENT DEPARTMENT . BUILDING ")ffN 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building(cD.cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS t ®LLJJV 13 1BU Ills M ' APN # OWNERNAME fkppl PROPOSED USE '1? CONSTR PHONE 4��, -1I E-MAIL�c c le �', STREET ADDRESS OP ordinances and state laws relating o b ild�ng construction. I u rize representatives of Cupertino to enter the above -identified property for inspection purposes. CITY, STATE,ZIPPlN ,O"�09110t �Ur FAX 1 CONTACT NAME Pits 1MIC„4mor� PLAAFCHECKTYPE PHONE ,00,511-sLi® w ni t che STREET ADDRESS L0 0 (albraft” Nr. TYPE CITY, STATE, ZIP M -11 ms ()A qsci,�3 5) FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT *CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME n�l 1,t 1a A r ` „ ► `c LICENSE NUMBER ^ n 'OY LICENSE TYPE , M1 YU u BUS. LIC # Y 0 'fir COMPANY NAME t)t ,^ �1�InstruLN �� U ` E-MAIL Ot,VV1Qtu6trYi&:6Q e�cen—ColrbS°P. Lm FAX STREET ADDRESS LAO b Y brakv Df, EXISTG _ CITY, STATE, ZIP `� D /' per, /1 C ��S PHONE, ARCHITECT/ENGINEER NAME e So yl LICENSE NUMBER BUS. LIC # COMPANY NAME �S Vi n oq, AREA : E-MAIL �0�� .g.A., „ re C NET AREA STREET ADDRESS�� 1 [ + CITY, STATE, ZIP (n s �Q � CRo et - PHONE,,,® DESCRIPTION OF WORK Qf,\ i st lacaft t \ OF -RDR iPedhv%jat� W-�a f -N Sta� EXISTING USE PROPOSED USE '1? CONSTR TYPE # STORIES By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I h provided is correct. I h ead the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating o b ild�ng construction. I u rize representatives of Cupertino to enter the above -identified property for inspection purposes. V Signature of Applicant/Agent: Date: SUPPLEME INFORMATION REQUIRED PLAAFCHECKTYPE ROUTA` SLIP ' 1 USE TYPE OCC. SQ.FT. (S) 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 _-VALUATION EXISTG _ NEW FLOOR DEMO TOTAL ❑ ENVIRONMENTAL HEALTH AREA : AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH 1 ❑ ATTACH # DWELLING UNITS: ISASECONDUNIT' []YES SECONDSTORY []YES BEING ADDED? []NO ADDITION? []NO . Cc n% YKt-ArFL1UAIIVI4 UYtb U Y tJ, YRUVWt UUYY UY PLANNINGAPPL# []NO PLANNING APPROVAL LETTER IJ InEMLUb AN U Ytb EICHLERHOME? []NO RhUEIVED I"UTAL VALUAIIUN: By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I h provided is correct. I h ead the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating o b ild�ng construction. I u rize representatives of Cupertino to enter the above -identified property for inspection purposes. V Signature of Applicant/Agent: Date: SUPPLEME INFORMATION REQUIRED PLAAFCHECKTYPE ROUTA` SLIP OVER-THE-COUNTER ❑ BUILDING PLA14 REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of build 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 Ldoc revised 06/21/11 Y% a CITY OF CU P]ERTINO BUILDING PERMIT BUILDING ADDRESS: 10440 BUBB RD CONTRACTOR: DEVCON PERMIT NO: 14080026 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 08/05/2014 OWNER'S PHONE: 4088624575 MILPITAS, CA 95035 PHONE NO: (408)942-8200 Cl LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL j License Classn Lic. � 51 APPLE -SOUTH WING-GOI�M.INTERIOR T.II 9455 SQ PT NEW N Contractor�� 11Uate �' ��- PARTITIONS, STORE._.,., .. SUSPENDED CEILINGS, CASEWORK ASSOGIA M,E,P S hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions ��p REVISIOA PLACE MECHA `.i AL UNIT- ISSD OTC IVir�uM Code and that my license is in full force and effect. 8/28/2014 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: $695000 erformance of the work for which this permit is issued. 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: 35720036.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that [ have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. l 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 �� ®� PERMIT �� ®� upon the above mentioned property for inspection purposes. (We) agree to save 180 DA S FROM A T CALLED N�jP indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Date: granting of this permit. dditionally, the applicant understands and will comply Issued by: with allnon oint our a egulations p the upertino Municipal Code, Section 9.18. RE -ROOFS: Signatu Date 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. 11 V ❑ 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 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 1 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 1 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 Qu 'ty Management District performance of the work for which this permit is issued. will maintain compliance with the Cupe tino Muni p I ode Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, ec 'ons 5 25533, d 34. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized age Dater °� permit is issued. I certify that in the performance of the work for which this permit is issued, 1 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 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 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 1 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 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.orq ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/ TI REVISION / DEF ERREID ORIGINAL PERMIT # PROJECT ADDRESS +,^ O ` APN# OWNERNAME �I P -MAIL 1Q STREET ADDRESS p1 CIT S TE, Pni V1 ® FAX CONTACTxhk,u 1 On. E -MA 0 l o co h d STREET ADDRES FAX T SATE, IP 'J50 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRA ; O 1,^ LIC NS Elt � � LICENSE TYP BUS. LIC H /1 _ O' ^ COMPANY NAME e� �/ , E-MAIL r Ap-� p I 0 � FAX STREET ADDRESS V e ^ a 1 � / n CITY, STATEN, lln al -v ve P -94-1 - Ou l ARCIHTECT/ENGrNEER NAME j "y) 0 16 U /N LICENSE NUMBER BUS. LIC # COMPANY NAME ii E� ATL I / FAX I V STREET ADDRE S rrY, TATE, ZIP n�� V/ P ONE ®(a CJ V DESCRIPTION OF WORK , ^ n f!�b 1c j /./1 ,1 In /1 j. (/(J r �/ `� EXISTING USE PROPOSED USE L.GONSTR.TYPE ® -FSE TYPE OCC. SQ.FT. VALUATION (5) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA 1 NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PO CH AREA GARAGE AREA: DDETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY DYES BEING ADDED'. ❑NO ADDITION'. ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED TOTAL VACUATIO PLANNINGAPPL# ❑NO PLANNING APPROVAL L/ TTER EICHLERHOME? ❑ NO By my signature below, l certify to each of the following: 1 am the property owner or authorized agent to act on owner's behalf. 1 have read this application and the information 1 have provi d is correct. 1 have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relatin o bd i g n ruction. 1 au iz r pres ntatives of Cupertino to enter the above -identified Top Ity for inspection purposes. Signature of Applicant/Agen Date: ,_ E/ p SUPPLEMENTAY INFORMATION PEQUIRED PLAN CHECKTYPE 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 B/dgApp_201l.doc revised 06/21111 :A7M IM-41 �C� Y OF SCUP E][�'� NO FEE ]ESUMATOR - BU MD N G DMRON 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 Dent for addn'l info. FEE ITEMS (Fee Resolution 11-033 E f 7,%1/13) ADDRESS: 10440 Bubb rd DATE: 08/28/2014 REVIEWED BY: IVIENDEZ Mech. Permit Fee: IMPERMIT APN:BP#: ! 1"( f't r,r it Fee VALUATION: $20,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: Plunih. hrsp, PENTAMATION FURN/AC PERMIT TYPE: d WORK REVISION #1 REMOVE AND REPLACE MECHANICAL UNIIT- ISSD OTC 8/28/2014 SCOPE $0.00 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 Dent for addn'l info. FEE ITEMS (Fee Resolution 11-033 E f 7,%1/13) Mech. Plan Check 0.0 hrs $0.00 Phnuh. P/un ('hccti MISC ITEMS Mech. Permit Fee: IMPERMIT Ph nh I'C'rmu I -e ! 1"( f't r,r it Fee Other Mech. Insp. 0.0 hrs $48.00 orhea Numb lash. ;;Ac. Insp. 0 1_1",h Imp. hec: Plunih. hrsp, /''ee 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 Dent for addn'l info. FEE ITEMS (Fee Resolution 11-033 E f 7,%1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 ®# $572.00 Mechanical A/C Units (>I OK cfm) Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT Q Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $48.00 Con.?rruction 7il:r: Administrative Fee: ]ADMIN $45.00 0 E) Work Without Permit? 0 Yes (D No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 d Travel Documentation Fee: ITRAVDOC $48.00 Strom; Motion Fee: IBSEISMICO $5.60 0 # $0.00 Revisions tREVCOMTI Tenant Improvement Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $147.60 $572.00 TOTAL FEE: $719.60 Revised: 08/20/2014 CETT OF CU PlEI[aTENO BUE LDEN G IPlERMET BUILDING ADDRESS: 10440 BUBB RD CONTRACTOR: DEVCON PERMIT NO: 14080026 CONSTRUCTION INC OWNER'S NAME: APPLE INC 690 GIBRALTAR DR DATE ISSUED: 08/05/2014 OWNER'S PHONE: 4088624575 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL 1117- OI APPLE- SO><Tl('1H[ WING- COMM. T.19455 SQ FT Lic. # License Classppnn�� IInn �/`�� 11 Contracto>�(/u V1/ � t y� � hDate ' F 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. 1 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: $695000 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; 35720036.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is ED IS NOT STARTED PERMIT ]EVLAST correct. I agree to comply with all city and county ordinances and state laws relating ��k�� Il� �� ®� to building construction, and hereby authorize representatives of this city to enter t upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS IIED I1�1indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of thegranting of this permit. Additionally, the applicant understands and will comply Issued by:Date: with all non-p int s regulations p the Cupertino Municipal Code, Section 9.18. {� -D • RE-ROOFS: Signatur Date �l ✓✓ 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). 1 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 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally, should 1 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 1 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 2 5, 25533, 34. < Owner or authorized alDate 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. I 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 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 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinga-cupertino.org [INEW CONSTRUCTION ElADDITION ALTERATION/TI [:1REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS)�� APN # o WO OWNER NAME �-Q P ONE -5w •�E-MAIL_AD —� `Q• . C cm STREET ADDRESS ` 1, ^ L(J "` h W CITY, TAT ZI 11r_7 FAX)e CONTACT NAME OO k, R /I;rj,�.�l W �j� 1`v✓ IV, (�I I>j IYIN �i0,+0 PHONE E-MAIL el move vron-cosi. ii STREET ADDRESSO 1 y D CITY STATE ZIP FAX ❑ OWNER ❑ OWNER -BUILDER 11OWNER AGENT CONTRACTOR 11CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME p �- I , . A F�1 _ ^ LICENSE NUMBER �� to LICENSE TYPE BUS. LIC # 11 Q COMPANY NAME II �J� (i � ^ � �j^ E-MAIL FAX ► 1 v^��M /v rp l/v v' STREET ADDRESS !,\ „��1`lyl/gi� C `kST TE, ZIP 2 CA P OA- ARCHITECTIENG _"E LICENSE NUMBER BUS. LIC # COMPANY NAME �OLC FAX o I r✓ STREET ADDRESS �` TY, S ATE, ZI V L O �lltJ/v opt HONE Jf.Y Cya O O DESCRIPTION OF WORK 1 �1 � T /�/1t /il�j , 1) VlT (� (A Y q d IT� l W1 • 0 e /1 I , '� y p V� „ u C 1 lVV wb S X�J V•�`-1 ' " V �1/ I SP CVS ; EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) AREA AREA NEW FLOOR AREA DEMO AREA TOTAL NEI'AREA �^ (v� C)�� A 0095 o00 ' / BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UMTS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # []NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? []NO RECEIVED Y,TAL VALUATION: D J)o /1 V a By my signature below, l certify to each of the following: I am the property owner or authorized agent act the property owner's behalf. I have read this application and the information I have provided is correct. 1 have d th Des ription of Work and v rift' it is accb1ate. I agree to comply with all applicable local ordinances and state laws relating tq builAing o struction. I aut o ze r res tatives of Cupertino to enter ove-identified prop rty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAIVINFORMATION ktQUIRED PLAN GRECK TYPE ROUTING SLIP OVER-THE-COUNTERBUILDING 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_2011.doc revised 06/21/11 7 AT lf1 . WTlITTn TT rT Tf T. I, OCCUPANCY TYPE: �+ FEE EST�1 �'1_ JI ll R cLPT �1.77��1U l77� 1L1iQ ll 1��L7717 lJ7l� �7 ATOR — BUffLDffNG llJt VI M1�7 PC FEE ID ADDRESS: 10440 bubb rd DATE: 0810512014 REVIEWED BY: mendez B (Tenant Improvements) APN: BP#:' VALUATION: 1$695,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building Phow". h1sp, 1 ee. is tt:t /NS/L %' it . PENTAMATION 1 B TIS USE: hrs $0.00 PERMIT TYPE: WORK an- comm. tJ 9455 sq ft $0.00 SCOPE C nstruclion .Tar: OCCUPANCY TYPE: TYPE OF FL,R AREA CONSTR. s.f. PC FEES PC FEE ID BP FEES BP FEE RD B (Tenant Improvements) II-B,III-B,IV,V-B 9,455 $2,675.70 IBTIPLNCK $6,380.25 1BTIINSP la%p /'Ne: Phow". h1sp, 1 ee. is tt:t /NS/L %' it . Suppl. Insp. Fee:Q Reg. C) OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C nstruclion .Tar: _1ciministrolive F'ee: TOTALS: 9,455 $2,675.70 $0.00 $6,380.25 $0.00 MECH, HOURLY LY 0 Yes No PLUMB, HOURLY C) Yes Q No E]LEC, HOURLY 0 Yes E) No :1 ech. /'lin ("WCk Pluii Chr(b 1-b" . 1,1";j Ffech. Permit Fee: Ftimb Pcr.nP / cc Orltr ,1lech. El Orher 1'tUmb lror7 00wi l_(,'(. Ins'). la%p /'Ne: Phow". h1sp, 1 ee. is tt:t /NS/L %' it . 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 onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7111131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,675.70 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (D Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $6,380.25 Suppl. Insp. Fee:Q Reg. C) OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C nstruclion .Tar: _1ciministrolive F'ee: Work Without Permit? 0 Yes ) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure d Truvel Doc -i rnenlaiion Fees: Strom Motion Fee: IBSEISM1CO $194.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $28.00 SUBTOTALS: $9,278.55 $0.00 TOTAL FEE: $9,278.55 Revised: 07/10/2014