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12070130CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 3 RESULTS WAY CONTRACTOR: XL CONSTRUCTION PERMIT NO: 12070130 OWNER'S NAME: ECI TWO RESULTS LLC 851 BUCKEYE CT DATE ISSUED: 07/17/2012 OWNER'S PHONE: 4084911641 MILPITAS, CA 95035 PHONE NO: (408) 240-6000 / LICENSED CONTRACTOR'S DECLARATION License Class_ Lic. # LW:�0-0 Contractor XL Co,, ,A�v1Date - 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: 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. 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 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 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additional,the ppplicant understands and will comply with all non -point s9urce regulati s per a Cupertino Municipal Code, Section 9.18. A / Signature — Date 111 1116 ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three 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 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 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. BUILDING PERMIT INFO: BLDG r— ELECT r PLUMB MECH r— RESIDENTIAL F COMMERCIAL )- JOB DESCRIPTION: APPLE - FLOOR 1 & 2 - T.I. PREP DEMOLITION OF INTERIOR WALLS, FLOORING AND CEILING, 25,740 SQFT Sq. Ft Floor Area: I Valuation: $110000 APN Number: 35720042.3 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued byr Date: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the qay Area Air Quality Management District I will maintain compliance wit?the pertino Municipal Code, Chapter 9.12 and the Health & Safety Code, ction 5505, 25533, and 25534. Date: T/ 1 i CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of wrk's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date ' Licensed Professional Peace CONSTRUCTION PERMIT APPLICATION Is COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 C O P E RTI N O (408) 777-3228 • FAX (408) 777-3333 • building(Dcupertino.org nXT 117 rnATQT TrnI-1 rr TrnwT I I ATITirnXI Ill1m717DT--I N1 AT TD A rnV TiTr 1 I RT:VTCinW/nPPPPRPn ORUINMAT. PPRMTTit PROJECT ADDRESS 3 Results Way .-� APN # 357 2 0 042 OWNERNAME ECI TWO RESULTS LLC PHONE JC Ul (i / 1p �J t E-MAIL STREET ADDRESS 1301 SHOREWAY RD S TE 250 CITY, STATE, ZIP gelmont CA 9 4 0 0 2 FAX CONTACTNAME Marco Innocenti PHONE 408.240.6000 E-MAIL, minnocenti@xlconst.com STREETADDRESS 851 Buckeye Court CITY,STATE, ZIP Milpitas, CA 95035 FAX 408 . 240 . 6001 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT M CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Marco Innocenti LICENSE NUMBER 6 4 7 4 8 0 LICENSE TYPE B BUS. LIC # 21836 COMPANYNAME XL Construction E-MAIL minnocenti@xlconst.com FAX 408.240.6001 STREET ADDRESS 8 51 Buckeye Court CITY, STATE, ZIP Mi l p i t a s, CA 95035 PHONE 4 0 8. 2 4 0. 6 0 0 0 ARCHITECT/ENGINEER NAME David Saba lvaro LICENSE NUMBER C - 015 9 2 5 BUS. LIC # COMPANYNAME Studios Arch E-MAltcrossman@studiosarch. COM FAX 415 . 398 .3829 STREET ADDRESs 4 0 5 Howard St Suite 588 CITY, STgan E,ZIPFrancisco, CA 941051 PHONE 415 . 398 . 7 5 7 5 DESCRIPTION OF WORK TI Prep: Demolition of interior walls, flooring, and ceilings. EXISTING USE Business Group B PROPOSED USE I CONSTR Business Group B III TYPE NR # STORIES 2 USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO 25,740 TOTAL AREA 25,740 AREA AREA NET AREA BATHROOM N/A KITCHEN N/A OTHER REMODEL AREA N/A REMODEL AREA REMODEL AREA PORCH AREA DECKAREA TOTAL DECKTORCH AREA GARAG AREA: DETACH N/A N/A I N/A N/FA ❑ATTACH # DWELLING UNITS IS A SECOND UNIT ❑ YES SECOND STORY E] YES N/A BEING ADDED? ®NO ADDITION? ®NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BY:. ^ TOTA$110,000 VALUATION: PLANNING APPL # MNO PLANNING APPROVAL LETTER EICHLER HOME? I@ NO —1 11 0T 0 0 0 By my signature below, I certify to each o e f wing: I am the perty owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have p de correct. I have r d the scnption of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to b I g nstruction. I auth 'ze r r sentatives of Cupertino to enter the above-ideM6;� inspection purposes. LISignature of Applicant/Agent: Date: SUPPLEMENTTORMATION RE UIRE PLAN CHECK TYP ROUTING SLIP ❑ OVER-THE-COUNTER BUILDING PLAN REVIEW New SFD or Multifamily dwgs: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of build permit for new building. El 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 06121/11 � CITY OF CUPERTINO ISI FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc ). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/11) 3 RESULTS WAY DATE: 07/17/2012 REVIEWED BY: SYLVIA JimADDRESS: APN: BP#: -VALUATION: 1$110,000 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building Elea. Insp, Fee: PENTAMATION PERMIT TYPE: 1TIPRE WORK APPLE- FLOOR 1 & 2 T.I PREP DEMOLITION OF INTERIOR WALL FLOORING AND CEILING SCOPE 125,740 SQ FT NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc ). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/11) ran ( unite. Plan Check cc. Plan (;heck Alumb. Permit Fee: o,bicrAlech. Insp. Other Plumb Insp. FT Other Elea. Insp. EI :11ech. Insp. Fee: Plumb. hn p, fee: Elea. Insp, Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc ). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 � # $388.00 Tenant Improvement Prep 1TIPREP i Suppl. PC Fee: (F) Reg. © OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. 0 OT 0.0 Iirs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Conswuction .Tay. 1 "I'e". O 0 Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 O i Trm,el Docmnentation Fees: Strong Motion Fee: IBSEISMICO $23.10 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $5.00 SUBTOTALS: $28.10 $388.00 TOTAL FEE: $416.10 Revised: 07/01/2012 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS:3 Results Way PERMIT # 12070130 OWNER'S NAME:ECI TWO RESULTS LLC PHONE #408-240-6000 GENERAL CONTRACTOR: XL Construction BUSINESS LICENSE #21836 ADDRESS:851 Buckeye Court CITY/ZIPCODE: 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) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICE E # X Cabinets & Millwork Mission Bell Casework 25336 ' x Cement Finishing B e nt x Electrical Redwood Electric Group 21108 Excavation R.E. Cuddie Fencing x Flooring / Carpeting 1429 Linoleum / Wood X Glass / Glazing Silicon Valley Glass 26943 x Heating Unite Mechanical 27361, x Insulation Accurate Firestop 34279 x Landscaping Jensen Corporation Pyramid Painting United Mechanical Statewide Roofing 9697,/ Lathing Masonry X Painting/ Wallpaper 25999,,,- 5999✓Paving Paving Plastering x Plumbing 27361 x Roofing 23509 Septic Tank x Sheet Metal United Mechanical Bayside Interiors Rinaldi Tile 27361 x Sheet Rock Tile 25898,/ x 27336 5/28/13 Owner / Contractor S' ture ; f W, AOL TESTING ENGINEERS, INC. JAN 0 2 RFrn 2811 Teagarden St. 510-835-3142 By fax San Leandro, CA 94577 800-660-3142 PROJECT # 56637 PROJECT: Results Way Apple Campus Buildings Cupertino, CA Permit # 12070130 DATE 11/27/12 HOURS 4 INSPECTOR M. Ardizzone San Leandro • San Jose • Martinez INSPECTION REPORT Week Ending: 11/30/12 TYPE OF INSPECTION: Epoxied Dowels PLACE OF INSPECTION: Jobsite, Building 3 Reported to Mike Cyr of XL Construction at the jobsite as requested. /i Inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and the injection of Hilti Re 500 SD epoxy (exp. 3/13). Witnessed the proper insertion of one hundred thirty-four (134) # 4 reinforcing steel bars, 24" in length, embedded 4" at plumbing trench slab between lines 3-E and 3-C at 3-6. The preceding work was, to the best of my knowledge, in compliance with approved plans and specifications, including revisions by engineer. Reviewed by. ' . David Chippero Special Inspection Division Manager 1cc: Apple, Inc. / J. Rickard XL Construction / C. Hamilton Structural Engineers, Inc. / J. Fishpaw Studios Architecture / K. Crossman City of Cupertino / Bldg. Inspection Dept. This report can be reproduced only in its entirety unless written permission from TEI is obtained. Page 1 of 1 EJA T� � 2 RFf.'0TESTING ENGINEERS, INC. 2811 Teagarden St. 510-835-3142 510-834-3777 fax San Leandro, CA 94577 800-660-3142 San Leandro • San Jose • Martinez INSPECTION REPORT Week Ending: 12/7/12 PROJECT # 55637 PROJECT: Results Way Apple Campus Buildings Cupertino, CA DATE HOURS Permit # 12070130 12/4/12 12/6/12 INSPECTOR M. Ardizzone TYPE OF INSPECTION: Epoxied Dowels / Concrete Placement PLACE OF INSPECTION: Jobsite, Building 3 Reported to Mike Cyr of XL Construction at the jobsite as requested. 12/4/12 Inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and the injection of Hilti Re 500 SD epoxy (exp. 3/13). Witnessed the proper insertion of fifty-two (52) # 4 reinforcing steel bars, 24" in length, embedded 4" at electrical trench slab at rooms 3-102, 3-130 and 3-122A. 1V6112 Monitored loads arriving at the jobsite for correct mix and proper slump. Inspected placement operations and vibrating procedures. Performed 1 slump test (5") and cast 1 set of compression test specimens (5 each), Sample # 239071, for Concrete Mix # 3FOEG9D1 from Central Concrete Supply Co., (specified strength 3000 psi, slump 4") for concrete placed at plumbing trenches between lines 3-E and 3-C at 3-6 and electrical trenches at rooms 3-102, 3-130 and 3-122A. Total cubic yards placed: 12. Inspected the placement of anchor bolts and reinforcing steel for the above. The preceding work was, to the best of my knowledge, in compliance with approved plans and specifications, including revisions by engineer. Reviewed by: avid C ppero Special Inspection Division Manager 1cc: Apple, Inc. / J. Rickard XL Construction / C. Hamilton Structural Engineers, Inc. / J. Fishpaw Studios Architecture / K. Crossman City of Cupertino / Bldg. Inspection Dept. This report can be reproduced only in its entirety unless written permission from TO is obtained. Page 1 of 1 TESTING ENGINEERS, INC. (G D NOV 2 6 2012 2811 Teagarden St. 510-835-3142 510- 4-3777 fax San Leandro, CA 94577 800-660-3142 San Leandro • San Jose • Mar ' ez INSPECTION REPORT Week Ending: 10/29/12 PROJECT # 55637 TYPE OF INSPECTION: Concrete Placement PROJECT: PLACE OF INSPECTION: Results Way Jobsite, Building 3 Apple Campus Buildings Cupertino, CA Permit # 12070130 DATE 10/25/12 HOURS 2 INSPECTOR M. Ardizzone Reported to Mike of XL Construction at the jobsite as requested. Monitored loads arriving at the jobsite for correct mix and proper slump. Inspected placement operations and vibrating procedures. Performed 1 slump test (4") and cast 1 set of compression test specimens (5 each), Sample # 239131, for Concrete Mix # 3FAEG9Q1 from Central Concrete Supply Co., (specified strength 3000 psi, slump 4") for concrete placed plumbing trench in -fill. Total cubic yards placed: 3. Inspected the placement of reinforcing steel for the above. The preceding work was, to the best of my knowledge, in compliance with approved plans and specifications, including revisions by engineer. Reviewed by: vid Ch' ero Special Inspection Division Manager lz• ave lcc: Apple, Inc. / J. Rickard XL Construction / C. Hamilton Structural Engineers, Inc. / J. Fishpaw Studios / K. Crossman City of Cupertino / Bldg. Inspection Dept. This report can be reproduced only in its entirety unless written permission from TEI is obtained. Page 1 of 1 us=" Results Way Bldg. 3 City of Cupertino Permit 12070130 RECEIVTED MAR 0 5 X013 Name: - I Testing Engineers, Inc. Quality Assurance Services Materials Consulting Since 1954 Regular Concrete Compression Test Report Project No.: 55637 Client: APP337 Sample No.: 239131 Project Name: Report Date : 11/21/12 Results Way Sample Date: 10/25/12 Apple Campus Buildings Time Sampled: 0755AM Cupertino, CA Date Received: 10/26/12 Inspector: M. Ardizzone, TEI Supplier: Central Concrete Mix: 3FAEG9Q1 Ticket No.: 18539617 Location: Building #3, Permit # 1207-0130. Plumbing trench in -fills. Specimens Cast (ASTM C-31) : 5 Air Temperature (ASTM C-1064) : 53 deg F Mixture Temperature (ASTM C-1064) : 87 deg F Slump (ASTM C-143) : 4 inches Date Tested 11/01/12 11/21/12 11/21/12 11/21/12 HOLD ID Number 10A 10B 10C 10D 10E Mark Sample Dimension, Inches Diameter 4 4 4 4 Length 8 8 8 8 Area, sq. inches 12.57 12.57 12.57 12.57 Ultimate Load, Ibs 27000 54000 56000 57000 Ultimate Str., psi 2150 4300 4460 4530 Average, Str., psi Age Tested, Days 7 27 27 27 HOLD Fracture Type 1 1 1 1 Dry Unit Weight, pcf Specified Strength, psi I 3000 3000 3000 SPECIMENS NOT SCHEDULED FOR TESTING WILL BE DISCARDED AFTER 28 DAYS OLD The Material__Y, WAS WAS NOT The Material Tested /�C MET DID NOT MEET THE SAMPLED AND TESTED IN ACCORDANCE WITH THE REQUIREMENTS OF THE BLDG. DEPT. OR DSA APPROVED DOCUMENTS. REQUIREMENTS OF THE BLDG. DEPT. OR DSA APPROVED DOCUMENTS. Remarks: Samples Tested in General Conformance with ASTM C-39 1 cc. City of Cupertino 1 cc. Studios Architecture 1 cc. Structural Engineers, Inc. 1 cc. Apple, Inc. 1 cc. XL Construction Reviewed By: Robert Green Concrete Lab Supervisor Corporate Office - 2811 Teagarden Street, San Leandro, California 94577 - (510) 835-3142 - Fax (510) 834-3777 Testing Engineers, Inc. Quality Assurance Services Materials Consulting Since 1954 Regular Concrete Compression Test Report Project No.: 55637 Client: APP337 Sample No.: 239071 Project Name: Report Date : 01/03/13 Results Way Sample Date: 12/06/12 Apple Campus Buildings Time Sampled: 0832AM Cupertino, CA Date Received : 12/07/12 Inspector: M. Ardizzone, TEI Supplier: Central Concrete Mix: 3FOEG9D1 Ticket No.: 18554729 Location: Building #3, Permit # 1207-0130. Footings on line N at 15 & 14 and on line M at 15. Specimens Cast (ASTM C-31) : 5 Air Temperature (ASTM C-1064) : 61 deg F Mixture Temperature (ASTM C-1064) : 73 deg F Slump (ASTM C-143) : 4-1/2 inches Date Tested 12/13/12 01/03/13 01/03/13 01/03/13 HOLD ID Number 2A 213 2C 2D 2E Mark Sample Dimension, Inches Diameter 4 4 4 4 Length 8 8 8 8 Area, sq. inches 12.57 12.57 12.57 12.57 Ultimate Load, Ibs 34000 65000 60000 66000 Ultimate Str., psi 2700 5170 4770 5250 Average, Str., psi 5060 Age Tested, Days 7 28 28 28 HOLD Fracture Type 1 1 1 1 Dry Unit Weight, pcf Specified Strength, psi 3000 1 3000 3000 SPECIMENS NOT SCHEDULED FOR TESTING WILL BE DISCARDED AFTER 28 DAYS OLD The Material K WAS WAS NOT The Material Tested _K MET DID NOT MEET THE SAMPLED AND TESTED IN ACCORDANCE WITH THE REQUIREMENTS OF THE BLDG. DEPT. OR DSA APPROVED DOCUMENTS. REQUIREMENTS OF THE BLDG. DEPT. OR DSA APPROVED DOCUMENTS. Remarks: Samples Tested in General Conformance with ASTM C-39 1 cc. City of Cupertino 1 cc. Studios Architecture 1 cc. Structural Engineers, Inc. 1 cc. Apple, Inc. 1 cc. XL Construction Reviewed By: Robert Green Concrete Lab Supervisor Corporate Office - 2811 Teagarden Street, San Leandro, California 94577 - (510) 835-3142 - Fax (510) 834-3777