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04050077 P OF CUPERTINO -% ''- °"� 'aLDING DIVISION PERMIT C0NTRACT'0RANF0RMTLONADDRESS: SOUTH BAY CONSTRUCTION CO r""04050077 AME:TC FUNDIN NE: SANITARY NO. CONTROL NO. (408) 379-0400 ARCHITEC XNGINEER: BUILDING PERMIT INFO BLDGELECr PLUMB MECH 0 t 0 0 u00 LICENSED CONTRACTOR'S DECLARATION lob Description wF 1 hcmby affirm thu I am IiameO under provisions of Chepar 9(commencing P iW with Section 7")ofDwmm Softhe Business ual Pr eydom Code.andmylicenuu 22L[��ggyy��pp 5qiLues rnr�ypp,ndcrrec -1DEMO LianuCLic.x �—p Daa• O Convenor I undersand my Ai shat W used DISCI publiRA nits 2/ 2004 ,,G In Licensssi ed Prufennal 3 Oat I am exempt from DECLARATION BUILDING„S �'�i Y I WrtM1y affirm Nm I am txcmpt from the Contractor's License Law for the Nb IN lVraf�l 0 o following mason.(Section 1131.5.Business and Professions Code:Any city or county 11 m which myuims a permit to enrtstrud alter,improv,demolish,or¢pair my structure u Frictions issuance.also requiem the applicant for such permit o File a,signed statement Nm W is licensed pursuant in the provision of the Comments's Liana Law(Chapter 9 Sq.Ft. Floor Area Valuation (commencing with Section]000)of Division 3 of On Businevand finfi.om Code) i $ that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 703 LS by any applicant for a permit subjects the applicmt to a civil penalty of 3 WgIaDWri53et00 Occupancy Type not mom thm Bw hundred dithers($500). ❑1,o owner of the propcny,w my employcn with wages as their sole compensation, will do the work and the swcwm is not intended or offered for We(See.7W,Busioess and Pmresorms Code:The Communities License Law don not apply in m owner of Required Inspections property who builds or improves thereon,and who dose such work himself or through his own employes,provided that such improvements ue notimended oroffemd for sale.If. however,Ne building or improvement is sold within one year of completion,the owncr- builder will can Nc burden of pmving that he did not Wild or improve for purpwc of salt.). ❑1.as owner of the property am exclusively connecting with licensed camacbrs to comtmet the project(Sec.7W.Business and Pmmolom Code:)The Contractor's Li _ come law dors not apply to an owner of property who Wilds or improves Burton.and who contracts for such projects with a contractor(s)unread Formation in the Courumre Liana law. I xrn exempt under Sec. .B k P C for this mason Owner Date WORKER'S COMPENSATION DECLARATION 1 hereby aRum under Nasky of perjury one of the following dalerationic ban and will mamedin a Ccrdfinw of Consent to self-insure for Wmkeh Compen- sation,as provided for by Scectm 31W of the Labor Code,for the performmce of the work for which this permit is issued. ❑I base and will maintain Worker's Compensation Insurance,as required by Section 37W of the Labor Cod,for Ne performance of the work for which this permit is issued. My Workers Compmeation mmnnw carrier and Policy number art: Carrier c�GINDfNtKktt. Policy Nn:Cr3(Flo CERTIFICATE Of EXEMPTION FROM WORKERS' COMPENSAnON&,45UAANCE (Ibis action need not W completed Rthe permit is force¢hundmddollare(g100) or less.) 1 eanify Out in the performance of the work for which Nis Permit u issued.I shall not employ any person in my manner m as an become sal to the WorkersCompcmation Laws of California.Data Applicant NOTICE TO APPLICANT:If,afar making this Contrition of Exemption,you should become subject to the Worker's Compcmuion provisions of the labor Code,you must .J,Z forthwith comply with such provisions or Nis permit shall W deemed revoked. Z O CONSTRUCTION LENDING AGENCY �-. I hereby affirm that etre is a contraction lending agency for the performance of C4 the work nor which this .it is bound(Ste.3091.Civ.C.) W Q lender's Nune Dz Leadch AJdrms V Q 1 enify that 1 have mad this application and show that the above information is W F' correct 1 agree to comply wits sll city and county ordinances and scale laws relating tu C U iflionngconstructionmdhor Impaction rpresenutives of this city to cover upon Ne r W ahovc-(We) noulare Propene for im nify an keephs. LL (We)agreemsaw,indemnifyandtech hay inmtWCise of Cupertinoagainst J UZ liabilities,criez ens,coetsand expenses which may in any way accmc againstsaid city / V z in consequence of Ne graining of this Fermis. ^ APPLI NT UNDERST S AND WILL COMPLY WITH ALL NON-POINT Issued by:s4t�zw Date SOURC AT / SS rbha.fAppficm0!hm.MU$MATERIALS DISCLOSURE � HType of Roof Will Be applicant or future building occupantatom or handle haoidous material as defined by tW Cupertino Municipal Code.Chapter 9.12 and the Health and Safety Code,Section 25532001 All roofs shall be inspected prior to any roofing material being installed. ❑Yes Nu Will the apphcmt or/mare wading..Pont ret yaipmmt or device,which If a roof is installed without first obtaining an inspection,I agree to remove I hv'rardous air comann nano as defined by me Bay Area Air Quality Management all new materials for inspection. svinl ❑yes V 1 have mail the beardous materials myuircments under Chapter 6.95 of the Califor- maHcal B:Salcty Code,Sectiwu 25505.25533suJrsca 25534.IundendtheliHW Wilding Jon not newly wwaten 0 . my mapomibiliry u notify the axupant of 0. myuire ens m t me or{uissumanneeni0ea traap,Tney. Signature of Applicant Date caner crinedagent Daa I All roof coverings to be Class "B"or better CITY OF CUPERTINO - BUILDING DIVISION PERMIT CONTRACTOR INFORMATIOj BUILDING ADDRESS: PERMIT NO. 10440 DE ANZA BLVD' SOUTHBAY CONSTRUCTION CO INC 02020077 OWNER'S NAME: APPLICATION SUB DATE DR. CHIU OFFICE 511 DIVISION STREET 02/21/2002 / HONE: (408) 379-0400 SANITARY N0, CONTROL NO. O-O ARCHITEC(ENGINEER: BUILDMG PERMIT INFO of BLDG ELECT PLUMB MECH �a LJ U LJ L> y N LICENSED CONT3.(,ha WRi ,S DECLARATION 1 hereby aRrm that t am licensed under proxisions o(Chapter 9(commencing Job Description iz�, wnn herebD00)orDi m'3onnee sand Prorossro.acoaeanamyuamsc TENANT IMPROVEMENT. i z w:3 xin f farce a <rf<t a LiccnuZClasa. Lic.p 7 / 13 LL G v •tand m�ARCHITECuse DECMTUecord O 4 1 undersand my plana shall h used as public records I ce O O Licensed Professional O OWNER-BUILDER DECLARATION L'4 1 hereby affirm that I am exempt from the Contractor's License Law for the L < following mason.(Section 7031.5,Business and Professions Coate:Any city or county $56000 E F O which aquius a permit to consumer,alter,improve,demolish,or repair any stracarc 3$ primmia issurecatilsare,rima lha applicantforsuchpermit to fileos:grcdnnamcm - .. ... - thin¢quLeripaulpuquan m0t;provisionsofdwConuxtolsLim.LawChapter 9 pp,,��TTa��aqq[ pValuation (commencing.with Section 7000)or Division 3 of the BpsiPPesu and Professions Code) , 1 i3�� UV T'J .-UC!':{'• :t or that he is exempt meieforia and the basis for the alldgieq exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant o a civil Penalty or ant m.,a thah five hundred dollars WWI, 10]` PN DATION Occupancy Type °1,as owner of the property,or my employees with wages as their sole compensation, - 'isill'do the work:and the,smac etc is not intended or offered for .It(Sec.TOw, - - - - - - - - 'Business and Pronasions Cada:Tim contractor.Licemae Law data not apply to an 10 3 - UFER Required Inspections - ,ofpmpsmyWho builds orimprevesthereon.and whedoes such work himself 104 - REBAR awnc or through his own employees.provided that such m'ol arc not mended or oRcdd im,Ile.owner-wilder the building o1 improvementafpis sola within one mild of 1 _ _._ _. .... .. . .... _.. • aompinion,theowner-buildcrwillhmetncbuNcnofpmvingthat M1edid not buildor 105 — ANCHOR BOLTS - • - improve for purpose ofsale.). 106 - SEWER & WATER °Irosownero(the pism.70um Business contractingwithorientation to - . ._..._ 202 UNDERFLOOR PLUMBING LicenseLaw does app.Toga,owneroartaertywhomeine:)Thevesthemes 203 - UNDERFLOOR MECHANICAL Liccnu Lew docs not apply to an owner o!property who builds or improve thcman, ' .and who.cormseta.frr,sucin.projects.with a.coruractods)Iicrosed,ursuant m.the CommeorsLieams<Iaw. i f„ ,,, ^ ' 204 - UNDERFLOOR 'FRAME °la ptndeS : B&PCfor this mason 205 — UNDERFLOOR' 'INSULATION wom Dart WORKER'S COMPENSATION DECLARATION 301 - ROUGH PLUMBING 302 - TUB & OR SHOWER I hereby effirm miler pemilty of ptijuri oneofine following declarauoma: 303 - ROUGH MECHANICAL ° I hila:na'wmfmxmndn a Cenificaie of l omomt to self-insure for Worker: 3 04 - ROUGH ELECTRICAL rW Compenmlum. as;provided for by Section 3700 of the Labor Code, for the - parr..mance.fatew.,ktimobic thispemdtisiss.ea.,., 305 - FRAME °1 have voidwill maintain Wdrker's Compensation Insunnm,as ra fired by Settle. 306 - HOLDOWNS 3700 of the labor Code,for the perrormaom of Ne work fm which this permit'is .. J isuad Myworkers C x tion Ins u - carrier od Pmicy mmmbcr are 307 - INSULATION tnDv;nrtryi N , o3t2z2-os 30.8 ,SHEETROCK': ii1 'CERTIFICATION OFEKEMProhlFROM WORKERS' il '3O'9 ' -'IEXTERIOR 'LA'TH' ....,.-. ....:. . '.'-COMPENSATIONaINSANCE ' a ,.> .. , n- _- ---­­- - ._.. ._._310 . LATH utfio.read noibe completed ifthe permit is for one hundred donate311 — SCRATCH COAT - t (SIM)orless.), _ - -1 arif-th:imthe rfomianm fine iiktrwn nth -- - 31`3 ROOF...NAIIr - y R pato . orW 1 ann- t ploy-enypersomm�iyma asmbuom - 63cnmNeWorkcrs 501 - FINAL ELECTRICAL'`ENERGY' Co pe tion ws f Cal film a.Date Andiron, "' ` " " 502. --- FINAL PLUMBING ENERGY — ,— NOTICETjectto APPLICANT:If. nnpenk Exemption.you 503 — FINAL MECHANICAL ENERGY ti forthwith amp y the Worker's Compensation pmvinons l be d labor Code,you must Z Q. .....with comply with such y.ovisions or this permit shell be demoted revoked. .. 504 7 FINAL BUILDING. ENERGX, -CONSTRUCTION LENDING AGENCY �" Ihemby ffrmdisc them isamtsmcu lending agencyfor the parfarminc< 505 — FINAL ELECTRICAL yAMeraNp hthmsp mlf iissu<d(5ec3WTC C) " t SO6 - GAS TEST _ Ladm Ada s 507 - FINAL PLUMBING UO ',l 1"mifyth'tlhsemadIfuseplpau CsuatMthebovainformationie SOS FINAL MECHANICAL 1 ��- • -Fi tmmn,l agree to comply with ql city and marry,ordinances and suer hwa mlaung 509 — FINAL GRADE .'De.V to building consmictio¢and hereby authorize upreimucti s of this city to enter upon >.elmt Ifni.tulle-msmitmedymp<rryforimsppctmrr po s., 510 — FINAL PLANNING (We)egream save.mdemnify end keep mandessthe City'of aperture,against r� Gabilirea,judg cnu.costs and expenses which may in any way accrue against said 514 — F INA PU I C WORKS �:) rZI Ciry in CANT UND of me UNDERSTANDS D WILL COMPLY OPL L / l (CANT UNDERSTANDS�WB.L COMPLY WRH'ALL NON-POINi'" I o /V/ Issued by: • ' Date 5 PP o uactm . Dart • Re-roofs E 5. ZARDOUS MATERWS DISCLOSURE '' ' + thc'eppllmt MurebldComortar,stainar9.1 orh file M1awdousmatenal Type Roof as declined f N by,me Cullen Mun c p I Cod Chapter 9 12 d theHealth and Safety - Cody Seu 255J2(e)a .. 't i ,, 1, •1 .. _.. .. °ve All roofs shall be ins acted nor-to an roofin material bei. installed_, _ P_ P Y g_ g a W'B thea pB f or future W ld g pant ac t d tees hmh - ---- P q P If a roof is installed'without first obtainin an inspection, I'agree to remove mit barardous a conunu ane u definW by the Bey Arca Au Quality Management g P District? _ all new materials for inspection. Applicant understands and will comply with I n': °Ye all non-point s-06rce regulations,-. 1 have read the Instant ous materials rcqumhacnKunder Chapter 6.95 of the Gbferi i Heald:&Safety C&IC Saadons 25505,]5533 and 25534.1 Understand that ,rfdid Wildin does nos cumend have a meant,that it is m - g Y y carmcfACri notify oc.pant of m cgovemevu which-mu t be Inn cin' io i e of a Cmificau of ' ' Signature of Applicant Date r own , umorized ^ - 3 1 -- All roof coverings to be Class "B"or better " .... . -OFFICE.. .._ • av �� CITY OF CUPLRTINO � p Z o 2 � CITY F PERMIT APPLICATION FORINT CUPEI,TINO 1- S APN# Date: aJ,S` . ,?-o02 g' Buildin Addiess: :. Owner's Name: Phone #: t)"-F— n1T� 46 ZSS-41uo Contractor: / License #: So 4� B CONS frMC4b . Contact: Phone#: Applicant/Contractor: B ' ding Permit Info: d 1 lum ech Job Description: Residential: Commerci l: TT Sq.Ft. Floor Area: Architect/Engineer: Valuation: S U ODU ype of Construction: Occupancy Group: uanti Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BBLDGFEE Bldg Permits . foot BUILDING BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler> 500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX, Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BO Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXRConstax—Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V <=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADDEner X Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING 1 of * City of Cupertino r;� - Plan Check Transmittal Permit# 02020077 Control# 10803 Project Tenant Improvement Plancheck# 2 Address 10440 S. De Anza FileDate 2/21/02 Blvd. #D-6 Owner Deke Hunter Description Plan Check Status (attach comments and return to Building with plan set) Plan Dept check# Date Due Date staff Comment Date Approval? ASE 2 3/13/02 1 3/20/02 Massoud Planning 1 2/21/02 3/7/02 Aarti 3/5/02 n Fire 1 2/21/02 3/7/02 Wes 2/21/02 EV Sanitary 1 2/21/02 3/7/02 CHIEN 3/7/02 Assessor 1 2/21/02 3/7/02 SENT 2/21/02 M Housing Mitigation Fee Amount Heart of the City Specific Plan Fee Amount �� S C March 12, 2002 A.S.E. Consulting Engineering, Inc. 255 N. Market St., Suite 220 San Jose, California 95110 Re: 10440 S. De Anza Blvd, Suite D-6 Permit: 2020077 Plan Review Comments March 6, 2002 Reviewer: Massoud Modjtehedi Architectural Comments ITEM RESPONSE • (1) Note has been added to detail VAT A new detail has been`added. See 17/A7. (2) Note has been added to indicate maximum angle of 45 degrees. See 3/A7. (3) Note has been added to indicate size and spacing of ceiling joist. See 4/A7. ICE C 6 BPI Howard Jeng SVBMYAL t302 e City of Cupertino aellk Plan Check Transmittal Permit# 02020077 Control# 10803 Project Tenant Improvement Plancheck# 1 Address 10440 S. De Anza FileDate 2/21/02 Blvd. #D-6 owner Deke Hunter Description Plan Check Status (attach comments and return to Building with plan set) Plan Dept check# Date Due Date Staff Comment Date Approval? Building 1 1 2/21/02 1 3/7/02 1 1 ❑ Planning 1 2/21/02 3/7/02 1f�fr Fire 1 2/21/02 1 3/7/02 ❑ Sanitary 1 2/21/02 1 3/7/02 ❑ Assessor 1 2/21/02 1 3/7/02 ❑ Housing Mitigation Fee Amount Heart of the City Specific Plan Fee Amount • 02/22/02 11:34 FAX 408 244 1858 THE HAAG'2t}A'N GROUP L91 002 GLw C�Gy FIRE DEPSTMEN S •CONTROL NUMBER E 'A SANTA CLARA COUNTY 14700 Winchester 8)vd.,Los Gatos, CA 95030-1818 PERMIT NUMBER (408) 378.4010(phone) a(408)378-9342(fax) PUN CHECK No. f�tgB cobs PLAN REVIEW COMMENTS CODE/SEC. SHEET NO. © F1=1 C40 %ZL f'IODC- L 0270ek />ocTot G Z The following CHECKED items apply to this project: ( Existing fire sprinkler system shall be modified as necessary. A licensed C-16 fire protection contractor shall submit to the fire department,three sets of shop drawings, a completed permit application and applicable fees for review and approval,prior to performing work. UFC 1001 Existing fire alarm system shall be modified as necessary to accommodate new construction.A licensed fire alarm contractor shall submit to the fire department,3 sets of shop drawings,a completed permit application and applicable fees,prior to performing their work UFC 1001 y Tenant shall have access to a minimum o lOBC minimum rated fire extinguisher(s), located within 75 feet travel distance. 1002 Tenant shall have access to one Class "K" type fire extinguisher,within 30 feet of commercial cooking equipment Post sign near"K"extinguisher noting commercial fire protection system ® should be activated prior to using the portable fire extinguisher. UFC 1002 3 Exit doors shall be operable from the inside without the use of any special knowledge or effort. Thumb-tum dead bolts that require more than 1/4 tum to operate are not acceptable.UFC 1207 Exit Illumination:Provide illuminated exit signs. UFC 1212 Contractor shall field verify the integrity of existing rated construction/assemblies and restore or repair as necessary as part of this work Penetrations in rated walls/ceilings shall be protected by listed fire rated assemblies (dampers,doors,caulking,fire stopping material etc.).UFC 1111 Ci{ At time of final inspection,the tenant shall provide to the fire department a labeled emergency Access key for placement in the building fire department key box. UFC 902.4 This plan check does not permit the use,storage or dispensing of hazardous materials,operations or waste. The tenant shalt provide a completed FD fIS to the fire department's hazardous materials specialist for review and comment. iq4APPROVED FOR BUILDING PERMIT ISSUANCE subject to compliance with the above checked comments prior to final inspection. JURIS }r�� PLANS SPECS NEW REMODEL AS CONST.DESCRIP. BY DATE PAGE e.ul g- ❑ ❑ P, ❑.m V " /2t �w2'Z/-C)Z �OF� SECJFLOOR OCC OCC,LOAD AREA ARC G/CONTRACTOFVOWNER D - I& q8 r-� � t1 ouP NAME OF FACILITY LOCATION 114 �o�Yo s. 'bE PJ7-,4 A California Ate Protection District serving Santa Clara County and the communities of Campbell, Cupertino,Las Altos;Los Alto,Hills,Los Gatos,Monte Sereno,Morgan Hili, and Saratoga 661P�6kiT4i &SY 4,Tr' R "' i§4i SANTA CLARA COUNTY BOARD OF DIRECTORS DISTRICT MANAGER-ENGINEER 20065 STEVENS CREEK BOULEVARD, BLDG. C CURTIS B.HARRISON,PRESIDENT MARK THOMAS&CO.INC. CUPERTINO, CA 95014-2350 JOHN M.GAUD,SECRETARY PHONE (408) 253-7071 . FAX (408) 253-5173 DR.JOSEPH F.BROWN DISTRICT COUNSEL WILLIAM A.BOSWORTH WENDELL H.KERR,JR. ATKINSON .FARASYN, LLP March 5, 2002 File: CuSD—MOP Building Dept. —Cupertino Community Development Department—Building City of Cupertino 10300 Torre Ave. Cupertino, CA 95014-3202 Subject: Tenant Improvements Name: Deke Hunter Address: 10440 S. De Anza Blvd. #D6 APN: 369-40-015 Control/Plan Ck No. 10803 Permit No. 02020077 The Cupertino Sanitary District has reviewed the plans for the subject project: Sanitary Sewer is available and the existing building is connected to sanitary sewer, see conditions/requirements below. The following Conditions/Requirements listed below. 1. All photographic processing to be containerized for processing outside. 2. No heavy metals discharge. Storm water from surface or roof drains, other general surface runoff water or condensate from any residential HVAC equipment shall not be discharged to the sanitary sewer. NOTE: Contact CuSD for"OFF-SITE REQUIRENINTS" Yours very truly, MARK THOMAS & CO. INC. District Manager-Engineer kav,(J�� By Chien Vu CVV:cm O cc: The Hagman Group Jason Chou, Assistant Civil Engineer, City of Cupertino-Public Works SUPPLYING SANITARY SEWERAGE SERVICES FOR CITY OF CUPERTINO.PORTIONS OF THE CITIES OF SARATOGA.SUNNYVALE AND LOS ALMS AND SURROUNDING UNINCORPORATED AREAS