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08050019
CITY OF CUPERTINO �y�a,gr - /tg "�^7,��g�'�1pt' g�"yg� yy}�a,�sT1`��1 BUILDING-DIVISION' PERMIT Vo1�-;=cal?R"7 Q'- A 1�NFQR Y ATAt10 , BIIILpT);lfAAOgRE9 WOLFE RD BSM, INC BUILDING 08050019 PERMIT NO. OWNlEWS�1N2A�M.SE: 1VSEKVIeEg/SYSTEM PERM1BT�UEDAIE KIMCO REALTY CORP 2490 ARNOLD INDUSTRIAL WAY 05/01/2008 IN ONE: (925) 688-1234 SANITARY NO. CONTROL NO. ARCHI EC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH 0 0 0 0 �o0 LICENSED CONTRACTOR'S DECLARATION Job Description iI u ffirm dol 1 am licensed under provisions of Chapter 9(cum cc min{ P with section 7=)of Division 3 of the Busirmatyul Profession'onn&.and my lice=is REPLC BEAMS @ERSTNG AWNING a, in full forte and effect. D lRi Z Lice gs. nF Dmm //04� Confnclor e ARCHITECTS DECLARATION y 1 understand my plans shall he used u public recnrda 0.pati s Licensed Pmfossional OWNER-BUILDER DECLARATION a�i F 1 hereby,aRm that 1 emmexempt from the Convuor's Lkense Law for the ' C pe O following moon.(Section 703I.S.Business and Profusion'Cole:My city to county S_ which requires a permit In.oro slue+.improve.demolish,or repair my awetum Z< prior to is issuance.also requims Ne applicant for such permit to file a signed statement pp thus heuliecn'cdpursuant touse,pmvision'ofthe Conuactoe.LiceeoLaw ch.p.9 Sq.Ft. Floor Area C Valuation r'.0 (commencingwith Salon7000)ofDivision 3ofduBusiness and Profess $1 ionsCode)or 500 Nat he u caempt therefrom and the bola for the alleged oemption.Any violation of Section 703"by airyapplicam for a permit Wbjecus dee applicant to a civil penalty of NNumber Occupancy not mare than RK hundred dollars(SM. 3 1605 051 .,6pP Y Type ❑1,o owrwr of dee pmpeny.a my moplvyma with wages u Ne'u sok compewtion, will do the work.and the,suuctum is not intended or offered for sale(Sec.7046,Businw and Profevdom Cnec The Convacor's Liana Law does Out appy to an owom of Required Inspections pmprnywkleiIdaorimpmvn'Ncre .andwhadmssuchwarthimselforthroughhu ownemploycrs,provided thatsuch improvements tie not imeMed moffered for.ule.If. however,the building or improvement is sold within one year of completion.the owner. buiMer will new:the hundred of proving Nat k did tet Will or improve:for puryase of sale.). ❑1.as owner of the property am exclusively conuudin6 wide Band comrurors in construct the project(Sec.7044.Bn'inw and Professions Cade:)The Consacuses U. . «n law docs not apply to an owner of property who Wilds or improves;themen.and. who m deacts fee sols projects witha cnntracmr(s)Imensed pursuant to the ConuxmYs Licen Law. ❑Iamuemprundm See ,B&PCfmt1us.. Owne Dam WORKER'S COMPENSATION DECLARATION I bomb,affirm under Ponalty of perjuryone of Ne following dcclaradnnc 1 have and will maintain a Certificate of Coruem to self-alum fa Wmkela Compen. worm, provided fpe Section 3700 of Ile Vkr Code.for dte pcnormenm of dee work for which this permit is issued. ❑1 lout ared will maintain Worker's Compereation Insurance,as required by Section 3700 of the Labor once.fm Ne performance of Ne work for which this permit u i..& My Wo/rk�e�rrswCompens�ativion l�uursnce curia and Paltry n mak,ace: GrtierlZ�t�r'^� Porky No.:�W CERTIFlCA OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Inc;aim need Out k completed if the permit is froom,hundred on llas(SI00) less.) 1 certify that in the performance of to am*for which this permit u issued.I shall not employ any Person in any manner se u m bceeme subject to the Waken'Compersafion Laws of California.Data Applicant NOTICE TO APPLICANT.If,after making this Cenifieam of Exemption you skald become subject In Its,Woherb Compensation provisions of the Labor Code,you most .,O foMwide comply with such provisions m Nu permit shall k domed revoked. 'Z 55 CONSTRUCTION LENDING AGENCY `� [—i Ikr which mllWtilCRtssed(So.3M. ing agenry fm dte per(mmatRe of �i the work far which Our permit V issued(Sec.7091,Civ.CJ (t)G lendch Name M z Lender's Address U Q 1 cudfy,that I hale mass this application W sum that the anew information 1, Iy ^. cmwmtt I agree 0 comply with all city and county oNinanos eche sum laws rtlatin{m .Q rl^J Wilding construction,and hembyauNanae roprosentiws of Nu city o mtmugm 0e a W.-menned tioproperty nspect fm iion pmpna F ped,' (We)agree to save,indemnify and trap homeless the City of Cupcnino against rn liabilities,judgments.costa and esp.which may k any way scene against cold City uenod of the grauding of this VZ in APPLICANT UNDERSTAND_AND WILL COMPLY WITH ALL -POINT Issued by:— S * Date SOUR ULATIO �� Re-roofs Sib plicanVConu Dam r HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will Ne applicant or future Wilding oreopeotsom m harmlc haurdous material as,dcMml by the,Cupertino Municipal C APmr 9.13.and me Halt,and Safety Code.Section 25332(a)7 ❑Yet All roofs shall be inspected prior to any roofing material being installed. o If a roof is installed without first obtaining an inspection,I Will the applicant or future building occupant use equipment or devices which g agree to remove P .telt hosrdnu air cmumirunu u Jeri 'Ne Bay Arta Air Quality Management all new materials for inspection. ' D uclT ❑Yes u I have mad the husndon'msedalsoequimments under Chapkr6.95ofthe adifor- nuHcalde&SafmyCade,SatiomnS(IS,25533 am1255M.I uMrrsund Nslf dee Wilding dos nut,wwraly have a teuanr that it is my msponsihility o notify Ne occuput of the aqui nts which muss W metr�Vor m issoaac of a Cenlficam ofOcm Signature Of Applicant Date ow armtharundagmr n All roof coverings to be Class'n!t'or better CITY OF CUPERTINO . • 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 31605051 . 02 DATE ISSUED. . . . . . . : 05/01/2008 RECEIPT # . . . . . . . . . : BS000004639 REFERENCE ID # . . . : 08050019 SITE ADDRESS . . . . . : 10983 N. WOLFE RD SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER KIMCO REALTY CORP ADDRESS . . . . . . . . . . : 2490 ARNOLD INDUSTRIAL WY STE CITY/STATE/ZIP . . . : CONCORD, CA 94520 RECEIVED FROM . . . . : ZACHARY R RING CONTRACTOR . . . . . . . : BSM, INC LIC # 29868 COMPANY BSM„ INC BUILDING SERVICES/SYS ADDRESS . . . . . . . . . . : 2490 ARNOLD INDUSTRIAL WAY CITY/STATE/ZIP . . . : CONCORD, CA 94520 TELEPHONE . . . . . . . . : (925) 688-1234 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICO VALUATION 1, 500 . 00 0 . 63 0. 00 0 . 63 0. 00 1STPLNCK HOURS 1. 00 122 .00 0. 00 122 . 00 0. 00 ITRAVDOC FLAT RATE 1 . 00 40.79 0 . 00 40.79 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 163 . 42 0. 00 163 .42 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 163 .42 VISA --------------- TOTAL RECEIPT 163 . 42 • og05 DO (9 SWIM CITY OF CUPERTINO • CUPEYOF RTINO GENERAL BUILDING PERMIT APPLICATION FORM APN # Date: 1/-6 Building Address: 3 Q W Mailing Address (if different from building address): Owner's Name: Phone#: Gl6 5�3C� -ZSZG Contracto�r: Phone: C� 6aa _IZ3y Fax: qts-$ 1 -1 Z3 Contractor License#: (a� O Cupertino Business License#: Q p �y • Contact: (%r i5 k rt`e� 6 jf Phone: C+25— —9 ri Fax: Residential Commercial 93 Job Description: ( berms �l n9 d �7 Q,tahitl7 Is the project in the Wildland- Urban Interface Fire Area? Yes ❑ No ®f Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1-A, 11-B ❑ 11, 111, V-A ❑ 11, 111, 1V V-B ./ 13 Valuation: Square Footage: S t) Project Size: Standard Lar e ❑ Major ❑ Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it • to the application or if applicable, include in plan set& the sheet index. Points Achieved: For help, contact Build it Green at www.buildit%!reeL.org `�--Tm CITY OF CUPERTINO CITYCUPE(,TINO GENERAL BUILDING PERMIT APPLICATION FORM Quantity/Sf Fee ID . Fee Description Fee Permit Type Group IGENRES or 1GENCOM 1 BTEMPPER Temporary Building Permit (good for B 30 days) l BBOILERI For the installation or relocation of ea M boiler/compressor to & including 3 horsepower, or ea absorption sys to & incl 100,000 Btu/h (29.3kw) 1 BBOILER2 Installation/relocation of ea M boiler/compressor over 3 horsepower to &incl 15 horsepower, or ea absorption ss over 100,000 Btu/h 1 BBOILER3 Installation/relocation of ea M boiler/compressor over 15 horsepower to & incl 30 horsepower, or ea absorption sys over 500,000 Btu/h to • & incl 1,000,000 Btu/h 1BBOILER4 Installation/relocation of ea M boiler/compressor over 30 hosepower to &incl 50 horsepower, or for ea absorption sys over 1,000,000 Btu/h to &incl 1,750,000 Btu/h 1 BBOILER5 Installation/relocation of ea boiler or M refrigeration compressor over 50 horsepower, or ea absorption sys over 1,750,000 Btu/h 1 BAPPLOTH For ea appliance or piece of equip M regulated by this Code but not classed in other appliance categories, or for which no other fee is listed in this code. 1 ELECINSP Other Electrical Inspections (per hour) E IMECHINSP Other Mechanical Inspections (per M hour) 1PLMBINSP Other Plumbing & Gas Inspections P er hour 1MEETINGIHR Application Meeting B CG CITY OF CUPERTINO CITY Of GENERAL BUILDING APPLICATION CUPEkTINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM ACOUSTICAL REVIEW IACOUSFDW SFDWL/Duplex New B IACOUSRESAD SFDWL/Duplex-Addition/Alteration B IACOUSCOM Multi-Family/Commercial B CHIMNEY'S 1CHIMNEY Chimney B 1CHIMNEYR Chimney Repair B FENCES IMF 1 FENCE>6FT Non-masonry, over 6"ft in height B 1 FENCEMAS>6 Masonry, over 6 ft in height B FIREPLACES 1FIREPLMAS Fireplace Masonry B 1FIREPLFAB Fireplace Pre-Fabricated/Metal B 1 FLAGPOL>20 Flag pole (over 20 ft in height) B 1MODUSTRU Modular Structures B FOUNDATIONS IFOUNDREP Foundation Repair B 1PILECAST Pile Foundation Cast in place concrete B 1PILEDRIV Pile Foundation Driven (steel, pre- B stressed concrete 3 of 5 SM CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION CUPEI�TINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM RETAINING WALL(CONCRETE OR MASONRY 1RETSTN Standard (up to 50 ft) B IRETSP310 Special Design, 3-10' high (up to 50 `) B 1RETSPI0 Special Design, over 10' high (up to B 50') 1RETCRB< Gravity/Crib Wall, 0-1O'high (up to B 50 ft 1RETCRB> Gravity/Crib Wall over 10' high (up to B 50 ft SIDING 1SIDESTBK Siding, Stone & Brick Veneer B (interior/exterior 1 SIDEOTHER Siding all other B SKYLIGHTS 1SKYL<10 SF Skylight less than 10 sf B 1 SKYL>IOSF Skylight greater than 10 sf or B structural 1STAIRS Stairs-first flight/ea addt'l B STORAGE RACKS 1SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B 1 SRACKS>8 Storage Racks over 8' high (up to 100 B st) 1STUCOAP Stucco Applications (up to 400 sf) B additional stucco application 4of5 CITY OF CUPERTINO CITY OF GENERAL BUILDING APPLICATION • CUPEkTINO FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Permit Type Group 1GENRES or 1GENCOM 1 WINREP Replacement windows/sliding glass B door (ea 8 windows) 1 WINMEWSTR New Window-structural shear B wall/masonry (includes plan ck fee lEPERMITFEE Electrical Permit Fee E 1MPERMITFEE Mechanical Permit Fee M 1 PPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M 1 PLMPLNCK Stand Alone Plumbing Pln Ck (hrly) P 1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B when not over counter) hourly-stand alone 1BSEISMICR Seismic Residential B 1BSEISMICO Seismic Commercial B 1TRAVDOC Travel & Documentation B 1BUSLIC Business License B • 5of5 LU LU w EL v a 2 LU Ww g LL o zv �_ � �' Q = N jw m U- 0 s C U u W N a Q O U Z_ - Z , is U W Z o m O I L w ¢ J (7 Z ♦— Q Q U1 V ¢ O r` r m Z W W Y N m ¢ .,5+� J Z W� Z w w / 1 LL a m E WN � N } aQ w 00 w 0 � w I Q w < m o w U poor o ,- 0�y/ c O O ? 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Wolfe Rd, Retail Building Roof Repair Dear Mr. Squarcia: I visited the site today as requested regarding the above project. I found the framing work to be substantially complete and conforming to the intent of the drawing which I prepared. Please call or email if you require further information. . Best regards, Rob McKie, Archit ct cc(via email only): ' Doug Fisher, Kimco Realty Corp, Owner Chris Krieg, Project Manager, BSM Construction