08020026BUILDING DIVISION PERMIT
# CONTRACTORIIVFORiVIA ION'`q
""Tb'01AQ0)'h WOLFE RD #1043
1V
TBD - TO BE DETERMINED
FERMI 08020026
OWNERS NAME:
FE M" OUR DATE
CUPERTINO SQUARE LLC
04/04/2008
HONE:
SANITARY NO. CONTROL NO.
RCH7TECT/ENGINEER:
T.I.- RENOVATION /INSTALLATIOBLDO
BUILDING PERMIT INFO
ELECT PLUMB MECH
O O O O
DECLARATION
LICENSED O ECLARATIONp
NI RA Cu OdeRr 'S
_
JlabDCSC r UOn
Ibcrt bY a u nC nf
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—••^ ^� ^ ^��^ ^•• �� ---- �
wih Sctiw )ofDivdan l of tiwand PfeWou C, and mylke se la
in full rote. acad .f ett
'
Lle¢ w Clua Lk. P
Da Courtesan-
,
DECLARATION
As
daft use
1 undenund my plans NtlI W used as public mooed.
Licensed Professional
OW NER.BUILDER DECLARATION
I hereby affirms that 1 am exempt from the Contnm.rs License Law for Ole
fallowing mean. (section 7031.5, BILLIM+a and Pmfesalam Code: Any city of county
which rtQUlres a Ilcrel, in emnlmet. alue. mine <, derolbm. N at any ..no.
'
prior in its issuance. alw require. one +pplicam forsuch permit to rile a signed statement
he is licensed the of use Contractor's License Law 9
Sq. Ft. Floor Area
Valuation
that purwanuo provisions (Chapter
(commencing with Sermon 7") of Division 3 of the Business and professions Code) or
that he is eaempl therefrom and the but for the alleged exemption. Any violNOn of
APN Number
Occupancy Type
Section 7031.5 by any applim, for a permit subjects the applicant m+civil penalty of
rot mart Nut fire hundred dolW+(3500j.'
0 I, as owner of Bte property, or my play= with wa{ex as their role compenudan,
Required Inspections
fi
will do Nc work, and the incnte is not intended or offered for sale (Sec. 7044, Businw
and Professions Cade: The Communes License Law don not apply te an owner of
p
property who build. or improws thrAeun, and who dws such work himself., through her
own employee, provided Nat each improwmanu ere notimended oraffeted tarsals. if.
hawcvu, the building or Impnewmant iswld within one year of campletiw. the mume,
Wilder will haw the burden of proving that Ito did net build car Imprew for purpose of
sak.).
0 1. as owner of tee property, am exclusively concocting with licensed convenors to
construct tee pmjem (Sec. 7044. Business and Prafessians Code:) The Cwu.etais Lt.
an. law does not apply te an menu of property who builds or improvn Neuron, and
Who conu+m. for .uc t projects wlN a CwuMaf(.) licensed pursuant to the Contractor+
License law.
0 1 sm exempt under Sec. . B k P C far Nis mown
Owner Dale
WORKERS COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the fallowing dechoadanx
haw and will mmmos. CarOOnw of Consent in self -Inure for WaltersC.mpen-
It. as provided for by Section 3700 of the labor Cade. for the perfmmmw of tee
for which this permit Is Issued.
law and will maintain Workers Compensation Inetrance, u ayuirtd by Scedw
3 OOoftee labor Cade. far the page... afthe work for which NU permit is laved.
My Wastes Campeluadan Ins .curia and Polity numbs am:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTPON FROM WORKERS'
COMPENSA71ON INSURANCE
mm maw need set W completed Bthe Permit is foronc h rodmdd.Rar. ($100)
or lens)
1 oamify that in the perfmmem. of the wart for which this permit is issued, I Nall not
employ any person in any manwrse as to become subject to the Warkeri Composition
Laws of Califomia. Dale
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
became subjem in the Workers Compensation prevision of the labor Cade, you most
forthwith comply with such provisiana or this permit shall W cleansed resulted.
CONSTRUCTION LENDING AGENCY
1 Mmby affirm tiW then is a eonmeasm n lending agency for the performance of
Use wort for which this permit is issued (Sex. 3097, Civ. C.)
Landers Name
,
Lenders Addrnr C7 +ism
I ceAfy that I haw mad this application and sate Nu the above informadun is
cormm I a {rte to comply with all city and county aNimmes s and Awe laws relating b
Wilding construction. and hereby authadan mpreunutices of this city to enter upnn do
aurora- mommoCd pmpeny fm Inspection purposes
(We) agree to nave, indemnify and keep hanalese the City of Caperton, against
j riabilitin, judgments, emu and expense which may in any way aecma.:east said City
In consequence of Ne granting of this Permit.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -PoiNT
Issued by: Date
SOURCE REG TIONS.
Re -roofs
Type of Roof, . .
4: -^
Si :ature fA,Ij tJC.r.Ua1 —� Data
HAZARDOUS MATERIALS DISCLOSURE
Wilt the applicant or future building,ccrpant stare or handle haurdous material
u defined by Ole Cupertino Municipal Code. Chapter 9.1x, aim the Health and Safety
Cass. Scdlen sss3x( +)7
❑Yon YN —/ o
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
Will the applicant or future Wilding occupant use equipment or devlaa which
It hau,dous air contemin+nts dcrined by Ore Bay Area Air Quality Management
let?
all new materials for inspection.
0y. u
I haw mad time huallom materials recta temenu under Chapter 6.95 afthe Caiifor.
ni +HUI"Safcly Code,Sttvansx55Dy25533a 25534.Iundemmnd NUiflhe Wilding
does wl currendy haw a unotnt. Nu it is my responsibility to notify tea =van, of Ne
mqui mwn Inch muebem etPrior wluuurcofa Certificate ofOcm
Signature of Applicant Date
�6" L���
All roof coverings to be Class'%?.•' or better
blue
Owner or mthmntd.gen
ON- 00 L(p
CITY OF CUPERTINO
' TENANT IMPROVEMENT
CUPEI�TINO PERMIT APPLICATION FORM
9 / 9-/-)
APN # i 0�`( o Lt :5
l
Date:
��5"9-Y c' , 2000
Building Address: �*TfXR � r
2 K C,4) Fr�T1 No
Mailing Address (if different from building address):
695N �. ���, r—� 146 11
Owner's Name:
Phone #:
����� 1
FAT( No �o-o�
Contractor: To �f 9f4-FeTfD
Phone #:
Fax #:
Contractor License #:
Cupertino Business License #:
Contact:
Phone #:
Fax #: 1 3q -946 2,
Alternate Contact:
Phone #:
Fax #:
Valuation (cost of project):
Job Description (be specific):
h(o YIATI 6N rsf �A Tf= - SFII�e (N6U9l N6 (N9r�Ali7ATt &,N ef--
N ^TM t4I Gt+T->p-d P � �FW 1, 1 +v^:5, UOfzK / W4
45VJ To 11-F-T&7 , Ar MoP i f ic-AT ON of F(PF- 9 f
Tenant Improvement Includes Re -Roof: Yes ❑ No4 If yes, number of squares
Tenant Improvement Includes Structural .Yes ❑ No
Type of Construction (Usage Class):
Occupancy Type:
1 FR, 11FR K 11, 111, V -1HR ❑ 11, 111, lV V -N ❑
Project. Size: Standard K Large❑ Major ❑
Green Building: Attach LEED Checklist to plans and identify in sheet indes.
0 0
LEED Points Achieved:
* ** For Office Use Only * ** Over The Counter ❑
CITY OF CUPERTINO
TENANT IMPROVEMENT
FEE SCHEDULE
Quantity
Fee ID
Fee Description
Fee Group
Permit Type
1ATINSP
Tenant Improvement
B
IATI
Inspection
1ATIPLNCK
Tenant Improvement Plan
B
Check
1BTIINSP
Tenant improvement
B
1BTI
Inspection
1BTIPLNCK
Tenant Improvement Plan
B
Check
lETIINSP
Tenant Improvement
B
IETI
Inspection
1ETIPLNCK
Tenant Improvement Plan
B
Check .
1FTHNSP
Tenant Improvement
B
1FTI
Inspection
1FTIPLNCK
Tenant Improvement Plan
B
Check
1HTIINSP
Tenant Improvement
B
1HTI
Inspection
1HTIPLNCK
Tenant Improvement Plan
B
Check
lITIINSP
Tenant Improvement
B
lITI
Inspection
l ITIPLNCK
Tenant Improvement Plan
B
Check
1MTIINSP
Tenant Improvement
B
1MTI
Inspection
lMTIPLNCK
Tenant Improvement Plan
B
Check
1RTILNSP
Tenant Improvement
B
1RTI
Inspection
1 RTIPLNCK
Tenant Improvement Plan
B
Check
1 STIINSP
Tenant Improvement
B
1 STI
Inspection
1 STIPLNCK
Tenant Improvement Plan
B
Check
2 of 3
CON STRUCTION
[TESTING SERVICES
. L '0
FINAL AFFIDAVIT
April 24, 2008 -.
Security Safe
Attn: Gary Hane
1753 Addison Way
Hayward, CA 94544 -6900
Job Name: United Commercial Bank
-10123 N. Wolf Road
Cupertino, CA
Permit No: COMT- 201 -692
• TESTING
• INSPECTING
• ENGINEERING
• CONSTRUCTION MANAGEMENT
8001.988 a(�
Job Number: J5750
� In accordance with the UBC requirements, Section 1701 (Special Inspections) and the
Cupertino Building Code, CTS performed special inspections summarized below. In-
spections were performed on April 1, 2008.
UBC Section 1701.5.5 Structural Welding (field)
Work was, to the best of our knowledge, performed in accordance with approved plans
and specifications.
Responsible Engineer
ji7ckGreenan, P.E.
CTS, Inc.
L L
ya � aSEPy '�l
h 0z 9,
Limitations: These inspections were performed in accordance with project require-
ments, but please note, this report shall not be relied upon by others as acceptance or
guarantee of the work. Even with diligent inspection techniques, the contractor is
solely liable for defects or failures to adhere to the code.
cc: City of Cupertino — Building Department
1233 East Bea"er Street, Unit B • Woodland, CA 95776 • Phone: (530) 666 -4774 Fax: (530) 666 -4749
2174 Rheem Drive, Suite A • Pleasanton, CA 94588 • Phone: (925) 462 -5151 Fax: (925) 462 -5183
One Embarcadero Center, Suite 535 • San Francisco, CA 94111 • Phone: (415) 438 -2357 • Fax: (415) 334 -4747
246 30th St., #101 . Oakland, CA 94601 . Phone: (510) 444 -4747 • Fax: (510) 835 -1825
�o 14,wad- Ap, --;0--fo1(-9
EXPERT AIR BALANCE
Lic. #888818 -D62
AIR BALANCE REPORT FORM
P.O. Box 1330
Hollister, CA 95024
831- 902 -0596
Fax 831 -536 -1619
mjtco@yahoo.com
rf
L OLJNZ
G\
P.O. Box 1330
EXPERT AIR BALANCE Hollister, CA 95024
AIR BALANCE REPORT FORM 831- 902 -0596
Name of Establishment ►T- D l._oin WY tc c.1 Fax 831- 536 -1619
Address l c)( Z 2, w o l ft 1 City rh o
Hood Equipment Manufacturer 4 L N10 e-
installation'Contractor E— A .g
Architect W
Air Testing Company
Equipment Used For Testingto�nn�{
r dui once
p� -u Lic. #888818 -D62
Certification of Air Testing .
i certify exha and make -up air system(s) have been balanced in
accor46nce with ifications and/or conditions on the approved plans.
Signature
�-- 2 0
Date
Mak"p Air and/or HVAC System(s)
ff
0
Z
PCL,NG�
Unit No.
Make
Model
Fan HP
Required
Actual
Fan RPM
Fan CFM
Fan RPM
Fan CFM
r.., W
MOW
6W
*For HVAC units CFM of outside air must be shown.
Page 2
A .
I
P_0. Box 1330
EXPERT AIR BALANCE Hollister, CA 95024
Make -Up Air and/or MAC Svstem(s)-Continued
Building Pressure &PKitive ❑ Negative
d
Banonwdric Pressure
Smoke Tested ❑ Yes & No
Page 3
Pressure in Inches W.G.
Outside Air Temperature
-72-`
NOME
MMM��=M�=
8�m
ir
M
NOME
MME
IM
MR!EM
M=��MMMIIM
MMEMM
11MIMMEMEN
HIM
MINEEM
Building Pressure &PKitive ❑ Negative
d
Banonwdric Pressure
Smoke Tested ❑ Yes & No
Page 3
Pressure in Inches W.G.
Outside Air Temperature
-72-`
CITY OF
CUPEkT(NO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777 -3228
Fax (408) 777 -3333
Building Department
JOB ADDRESS: JD 123
PERMIT #
OWNER'S NAME:`t'I (N 6
PHONE # _ 'Dg-
GENERAL CONTRACTOR:
JBP
FAX #
I am not using any subcontractors:
Signature Date
Please check annlicable subcontractors and complete the followincr information
er /Contractor Signature
Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
-
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
er /Contractor Signature
Date