05070055 l �
CITY OF CUPERTINO " + l '.�)
ka x.J
BUILDING DIVISION PER �,C� TRAC' b121+N ' RM;n.. ,s: � '
BUILDINGADDRUS: OPI COMMERCIAL BUILDERS 111111No05070055
L RESULTS WAY
WNER'S NAME: PERMIT ISSUE DATE
ARC-S I JLT SANITARY NO. CONTROL NO.
PHONE:
(408) 377-4800
ABUILDING PERMIT INFO
RCHITECT/ENGINEER:
BLDG ELECT PLUMB MECH
u00 LICENSED CONTRACTOR'S DECLARATION Job Description
0 I hereby affirm Nu I am licensed under provisions of Chapter 9(commencing
witA Solion]pk))af DiviaionJof the Budnces mdP (cesium Codeya dmylicepeeis
noE imm�mm aneerrecL GZS REVISED FLOOR PLAN FOR OFFICE
Licenu Clpea LIc.N
3!�—p Dem ^ Conummr -11v^^ NO NEW PERMIT-IN HOUSE ONLY
3 C£W A DEC A Ice a �_�� s
IunderwnJmy plana shall he Usedsspuhlic recnrdst��) \ ORIG PERMIT #05030299
]U.0
U.t; Licensed Professional
S OWNER-BUILDER DECLARATION
n0 I herchy.(Sec dupe I em exempt from the Contractors Licenu Law for sou
❑D following a ramcdun 713 L5,Businessand ve.thuoli Codc:Any air m OrCounty
$ which its hum a permit m cnnsuue alms improve,demolish,nr repair any awcture
y OnesohnIto its lensed Palsu.,to oo.the M.vbdlicnnl for.mle permit C.Mumba's Elca Le.ed(Chapter
Valuation
-�mC thatmecing witpursuant mdse of Dialope of the eBuaomrindU.c.Proflsw(Chepur9 Sq.Ft. Floor Area
F$ that M Is examint Section of Diviaion3 of dur alegedmssap on.Anyape Code)ser 0
Nu Section
r campy tlurefmm and the aper for Ne alleged the uemant to Any it Penalty
or
Out more
than
any for a subjects the Applicant St Civil penalty of AFN Number Occupancy Type
Out more Nan Ove hundred tlolhn(5500).
❑I,pe owner of the propmty,Cor mY emPlayces with wages pe the'v sole ampepeauen,
willcia the were.and the Macmre is not inlcndedoranered IO Ome(Sm.7D44,Bushwas -Required Inspections
and Professions Code:The Convectors License Law does not apply to an owner of
property who bulldaar improves thereon,andwho doessuch work himselfor through his
own employers,p avidetl that such improvements tie not intended or offered formle If,
however,the building or improvement Is mid within on Year,o(completion,the owners
builder will have the burden of proving that he did not build or Improve for purpose of
sale.).
❑1.u owner of the property,sm whotively contracting with licensed Contractors In
construct the project(See.7044,Business and Padessiom Code:)The Comme tors Li. -
cense Law does not apply to an owner of property who builds or Manor.thereon,and
who contracts for such projeN with aconuactor(s)licensed p omm nt to the Contractors
License law.
❑IamexemPtunder Sec. ,B&PCfmuhismaaon
tuner Dau
WORKER'S COMPENSATION DECLARATION
I hereby sRimfunder penalty of perjury oro of the following deeleraciope:
❑I hero and will maintain a Cermbeae of Conant to self-Insurefor WorlecraCompen-
setion,as pmvided for by Section 3700 of the labor Code.for the Ferrosmana of the
work for which Nis permit Is issued.
❑1 have and will maintain Workers Compensation Insurance,as required by Section
3700 of Ne Labor Code.ror the performance of the work for which this Permit is issued.
My Worker, pensWon natio a caamrrm Pnliry numberam: f/
Cartier: Policy No.:
CERTIFICATE OF EXEMPTION FROM R ERS' 1
COMPENSATIONINSURANC11 SJl
(Thrsectlan need notMcomPleud if the Permit rforone hundred dollars( Hill
or Ica)
1 certify Not In the performance of the work for which this Permit is issued.I shall not
employ any person in my Mars.,0 as b become subject re the Workeri Compcmedon .
Laws of California.Dau
Applicant
NOTICE TO APPLICANT:Jr.after making this CerORcau of Exemption.you should
become subject to the Worker's Compensation previsions or the labor Code You must
.J O forthwith Comply with such provisions or this permit shall be domed moked.
CONSTRUCTION LENDING AGENCY
[—r I hereby edam that thea in cmuthOedmi lending agency or the performance or
pea the work far which this permit is Wood(Sec.3047.Civ.C.)
W Q lander,Name
Ea z Lcndere Address
U C) 1 Coolly that I have mad this application and state dust the above information Is
Igo F cmucL I agree to comply with all city and county ordinances and stats leas relating to
O U building convection,and hereby Soubmine representatives of this city 10 enter upon the
W shave-mentioned property for inpeeJon purposes.
1�ra a (We)agree to save.indemnify and keep h omlea the City of Cupertino against
i-+In liabilitics,judgments,costs and expenses which may In any way&comeagainst said City
Ula in consequence or the grunting of this Permit Dates
r7• APPLICANT UNDERDS AND WILL COMPLY WITH ALL NON-P INT Issued by:
souac �N; Re-roofs
Signature of ApplicanUCanuxmr juare
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future building Occupant atom or handle hmuOdous material
as defined by tie Cupertino Municipal Code,Chapter 9.12.and rhe Health and Safety
Code,Section 15532(a)? All roofs shall be inspected prior to any roofing material being installed.
❑Yes l£lnu
future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or
emit havardom air contaminants at defined by the Bay Arca Air Quality Management all new materials for inspection.
Disuict?
❑Yes ZNu
I haw road!thede,Senor 25505,2553 and nts255 under Chrstand m95 ofthe Wilding
Califor-
nia s not currently have
P meant that It i my responsibility sore25574.1 to notify Nm ifthe huildihe
reqs nom encs why have a benano Not It is sac ncef aeito notify N cec cy, of the
requirements whjphmust Mmet poor U)issumccofe Cerd Oceu of Occu ey. Signature of Applicant Date
All roof coverings to be Class"B"or better
Owner authorised agent Date
(1 @ OCITY OF CUPERTINOO
i
CITY OF PERMIT APPLICATION FORM
CUPERTINO
D
APN# ( ' L Date:
Building Address: �I Mailing Address Zif different from building address):
Owner's Name: Phone,#:
( oY — O6 .
Contr ctor: n A � Lice�i y #• �(
Co tact: c/`c , Phone: Cupertino Business License#:
Fax: 7
Building Permit Info:
Bld Elect ❑ Plumb ❑ Mech ❑
Job D scription:
Residential ❑ Commercial
Sq.Ft. Floor Area: $/Sq.Ft.:
Cost of Pro��ect: rLe.;7U �5/Okl ,r O Occupancy Group:
Type of Cohstructi n: Please check this box if the project is a
second-story addition: ❑
Project Size:-Standard Laze ❑ - Major ❑
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
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 BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax-Resi/Mobile BUILDING
BELEC1000 Elec 600V<= 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V <= 200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi BUILDING
BINVESTIGA Investigation fee BUILDING
1 of 3
r
*CITY OF CUPERTINA
CUPEf�TINO PERMIT APPLICATION FORM
uanti Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm. Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCODIIvIM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTHAE Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn S rinkler/Backflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BRENLkHMAN A/C Units<= 10,000 cfin MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
2 of 3
OITY OF CUPERTINO*
cITM F PERMIT APPLICATION FORM
CUPER,TINO
Quantity Fee ID Fee Descri tion Fee Group
BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL
BREMSIGNS Remodel Signs, Marquee ELECTRICAL
BREMTHEATR Theatrical Lighting Fix ELECTRICAL
BREMVENFAN Vent Fan Single Duct MECHANICAL
BREMVENSYS Ventilation Systems MECHANICAL
BSCBLVD Scb Specific Plan BUILDING
BSEISMICOM Seismic Commercial BUILDING
BSEISMICRE Seismic Fee Res BUILDING
BSPECIAL Special Insection BUILDING
BSWIM Swimming Pool BUILDING
BTEMP Temporary Power ELECTRICAL
BTEMPPERM Temporary Bldg Permit BUILDING
BTEMPSVCS Temp Dist Svcs ELECTRICAL
BUSLIC Business License BUILDING
ELECTRIC Electrical sq foot ELECTRICAL
EPERMITFEE Elec Permit Issuance ELECTRICAL
MPERMFEE Mechanicals . foot MECHANICAL
MPERMITFEE Mech Permit Issuance MECHANICAL
PPERMITFEE Plumbing Permit Issue PLUMBING
PPLBG Plumbing Fee sq foot PLUMBING
PLLONGRNGC Planning LR Comme/Multi-Fam PLANNING
PLLONGRNGR Planning Long Range Residential PLANNING
ZADDCHG Address Chane BUILDING
•
3 of 3
1
(N) ORIEWATION RM
II I
'; 00 STAGMI RICHARI
a_9. -2 1/2. I PEDLEY
_ I
ARCHITECT
INTERIORS • PLANNING
bib
I \
UM COPY0 0P=eridge Ave., Ste. 370
Santa Clara, Ca 95051
\ \ I Td:408.244.5200 Fax:408.244.5240
\ \ Ca.Llc.No.C.14419
• //
I \ \ I
PROJECT
'NAE
MMpOVEMM
MR
Y
(N, M= SM I\\ ArcSight, Inc.
\\\ 5 Results Way
t_h Cupertino, Ca
\ CIJRlT.
1
ArcSight, Inc.
5 ResuRs Way
Cupertino, Ca
AREAOF WORK CONTRACTOR:
,So AR
Oti
FLOOR PLAN �`' PR�� pPO�o
* NO.0 9 M1
OQ-
Commerical Builders
445 Leigh Ave,Suite 100
REV.06/10/05 Los Gatos,CA 95032
Ph:408-377-4800
City of Cupertino
Plan Check Transmittal
Permit# 05070055 Plancheck# 1
Project REVISION FileDate 07/11/05
Address 5 RESULTS WAY
Owner PEDLEY
Description REV, NINOR FLOOR PLAN CHANGE
Plan Check Status (attach comments and return to Building with plan set)
Plan
Dept check# Date Due Date Staff Comment Date Approval?
Buildin 1 07/01/05 07/15/05 1 BOB 1 07/01/05
Fire 1 1 07/01/05 07/15/05 1 WES 1 07/01/05
Additional Plan Check Fee ❑ Hours
Planning Fees
Housing Mitigation Fee Amount
Heart of the City Specific Plan Fee Amount
•
J
CITY OF CUPERTINO "?�%;^�+
BUILDING DIVISION PERMIT yMC01. 12A�0Yi TNFQMATTO,N
tA�'FAySct� art + 3`' "�R7;a,.r.,;gyfi an FdiS3A�28s.
BUILDING ADDRESS: OPI COMMERCIAL BUILDERS PEI""°05070055
IN
R'S NAME: PERMIT ISSUE DATE
ARC-SIJLT
NE: SANITARY NO. CONTROL NO.
(408) 377-4800
ARCHITIECTIENGINEER
08 377-
ARCHI'IeCTIENGINEER: BUILDING PERMIT INFO
BLDG ELELT PLUMB MECH
O l�
386 LICENSED CONTRACTOR'S DECLARATION JobDescri tion
I homey efrtrre Nu
at l sum licecd under provisions of Chapter 9(Commencing P
with Section 7000)of Division 3 of me Business and Code a dray tire.is
w tomll(orceandafek Mines
Lulea Clue REVISED FLOOR PLAN FOR OFFICE
Ix.«
L D,rccantrurar NO NEW PERMIT-IN HOUSE ONLY
CHITECrS DECL.IcRATIONORIG PERMIT #05030299
3�
1 1 1
undemm�J my plans shill be used u public records `n�tiS A
50 Lkenud Pro(essiaml
OWNER-BUILDER ER DECLARATION
Q1 mase a(Ikm thus I I. exempt hum the Cortin,;Co :my c Law far the
00 followingmoon.permit
7113L3,Budner,and Aafeutom Code:my city or County
9 which requires,eemmk recumthe.pier, tforse,deormilt ore repair anyetmmam
— y
prior to its lssuanra Mw IIto me Pr applicant the Co permitmfile amLaw statement
< NatWisliccnwd pusuanuo me pmvivions3 of tha nud.nitcnu6w(Chapter Code)
Sq.Ft. Floor Area . Valuation
D than a 1.ixem with Senfrom and of bares n 3 dace Budnnss,and on.Myovi Code)a
$
that be is exempt therefrom acus We bum for ce alleged esempdon.Any Wo1Wun of 0
Section 7031.5 by any applicant for a permit subjects the applicant to•Civil penalty of APN Number Occupancy Type
nm more than five hundred dollars($500).
❑1,u dourer of Ne properly,m mY emplaycn wW wgu u theirsole Compewtion.
will do the work.and NaIWCWR Is Out leknded an offered fonek(Sec.7044.Business 3 b 2 U U 4 2 U 0Required Inspections
and Professions Cade:me Contractor's LlRnee Lew does not apply m an owner of q ns P
property who bui IN ori mprom,t ereon.and who dossouch work himself err though his
own employees,provided datsuch improvements art not IatentlW oraRemd forule.IL
however,me building or Improvement Is sold within one year of completion,the Owner. 1
buBNr will have me burden of proving that he did sur Wild or Improve for purpose of \
ark.).
❑1.as owner of the property,am eulonvely contracting with licensed contractors b
construct the project(Sec.7044.Business and Profusions Cotler)The Cwtracmr's LL
cause Law does,not apply to an owner of property who battles,or Improves thereon.and.
who contracts for much projects with aco aractor(O licensed pursuant w the Conuume. \
License Law.
❑I am esempt under Sea .B k PC for this reason
Date
WORKERS COMPENSATION DECLARATION
I hereby afnew under peoelty of perjury one of the following decimations:
❑1WwandwillmainuinaC<nl0nmaf Comenimulf-Insumfor Wofte,Comp 0-
sation,as provided for by Sutian 3700 of me Labor Coda,for me performance of me
work for which this permit Is issued.
❑1 have and will maintain Wmkces Compensation Insurance,as acquired by Section
3700 of the Labor Cade.for the performance of me work for which this pamrk is issued.
My Workef/C Ixmrsadon nsun ce amu and Polity num ram: L/
Comer. Policy No.: �
C RTIFICATE OF E%EMPfION FROM R— RSnA �]
COMPENSATION INSURANCE C�, / / Q
(ThisucOoe neN notbecompleud if me pormhisfaanehundmddnik /m( 100)
or los)
1 terrify Net in the performance of the work far which this permit is Issued.I NMI not
cmploy any person in any manner an u to become subject to the Wartu'Compowllon
Laws of California.Data
Applicant
NOTICE TO APPUCANI.If.after making this Certificate of Exemption,you should
become subject he me Warter's Compensation provisions of the Lear Code,you most
3Z forthwith comply with such Provmdns or this permit shall be doomed rewked.
.Z.r O CONSTRUCTION LENDING AGENCY
[-r I hereby affirm that dere is a censuuctinn lending agency for the penfmmarem of
(Yi> the work for which this permit Is issued(See.3097,Civ.C.)
boy tender's Nurse
z Lendces Address
U Q I Coolly that I haw reed this application and rete that Its:above InformNon Is
it, correct.1 agree to Comply with all city and county ordinances and rete laws totaling 10 -
() building construction,and hereby a merrier mpnesematiwe of this city to ever upon me
W show-mantioned property for Inspection purymns.
(We)agree to sew,indemnify and keep harmless;de City of Cupertino against
y liabilities,judgments.casts and eapenw which may In any way corms against said City �-y a..�
V z In consequerwe of me granting of this permit Issued by: Date?_//—f / ]with
"" APPLICANT of
me DS AND WILL COMPLY WITH ALL N N- INT
SOURCF�$HGtlL �� Re-roofs
Sigauure of
HAZARDOUS
AINIinate
HAZARDOUS MATgoccum DISCLOSURE Type of Roof
WIII the applicant or future Wilding s,Chapter
or handle Health
material
u defined by me Cupertino Municipal Cale,Chaper 9.13.And the HesIN and Safety
Section 355334)7 All roofs shall be inspected prior to any roofing material being installed.
❑Yus FG.
Will the applicant or futture Wilding occupant as equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
cmithavardons air canmmimnts as dented by the Bay Area Air Quality Management all new materials for inspection.
Ois ,ct7
[3 yea u
I haw read me hatcanlous materials requirements under Chapkr6.95 ofdc Caliaor.
nia Hcalth&Safety Cods,Sccdms 35505,35533 and 35534.1 understood that if the Wilding
docs trot eumentiy haw a ummt.that itis my responsibility an notify the occupant of the
mquimmenlswh' be met prior to issuance ofaCucfeatoofOcc Signature of Applicant Date
Owner .nmdflmd. ant Dak All roof coverings to be Class"B"or better