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08110099CITY OF CUPERTINO eAta,•f-x';o:'f °� -� '' t-i.g ^. NTRACTORIIV"LW4- TION BUILDING DIVISION PERMIT ,C, BUILDING ADDRESS: PERMIT NO. 10741 N WOLFE RD FLR 1 SAN J R'S NAME: PERMIT ISSUE DATE PHONE: '2868 SA CONTROL NO. ARCHITECTIENGiNEER: BUILDING PERMITINFO BLDG ELECT PLUMB MECH TEMP PERMIT FOR COMMERCIAL O O O O LICENSED CONTRACTOR'S DECLARATION T.I DOES NOT INCLUDE Job Description 1 hereby affirm Nal 1 am liberated under provisions of Clupter 9 (commencing with Section 7")of Division 3 ofthe BWnm and Prefeuiana Code.md my Beenseu "' "' """'""----- "in fuforce aM ertett til 7 Liccirrre 0+yl � g Dau /// /W i—CanlrxlorRATION (f Cr— C�fJ'✓) �O f ARCHITECTS DECLA 1 understand my pia shall he umd u Public ucords - Licemed Prol.W... I OWNER-BUMMER DECLARATION I knotty affect that I am exempt from NC Connactora Uccrow Law for the following reason. (Section 703 L5, BoAmess and Pmfeusions Code: My city or county . which roqulms a pormit a mcuroel, alar. Improve. dcmnlim. our repair any mommon Ninr m ba iSilYMe. a err; Duties the applimnl for such Permit In file. elgRd aliLL'menl Convector's Lacnae law(Clsptm9 Sq. Ft. Floor Area Valuation Thu he is licensed punmentIO the pmvisimu of the (cunmcncing with Section 7") MDivision 3 mlthe, Businmand Pmfeuiona Code)or - 1 that he Is exempt Uumfrom and the but$ far the alleged exemption. Any violation of APN Number Occupancy Type Section 7031.5 by my applicent for a permit subjects the applicant to a civil penalty of not moa than five hundred dolius (M). 1, u name of the, property, or my wploy en with In As their .1. mmpenu0on. will out the work and the structure, t$ rout rounded or offered for We (SOC. 70,14, Busittm Required Inspections (1 Am Pmfesvom Code: The Conumars l.ian¢ law does oro appy a an vane, of P property who builds Or improves thereon, and who does such work himself or through but awn employers, provided that such imprmemenu arc not intended or offered for We, if. however. the building or improvement In aid within one year of cumpktion. the owar- Wilder will haw the burden of proving that he did not Mid or Improve fu p nimme of . Wo.). ❑ I. u owoer a the property. arm eaclusrvely coeuamint with liarued aonvacars a couwct the project (Sec Tufa. B Wnm AM Profmions Crock:) The Convacafs U- oom law doca not apply to an owner of prmPeny who builds or improves themon. and who contmcu for such projects with a contractor(s) licensed Putman, to the Convutar's Lteeue Law. ❑ Iamaermprundm See .B&PCfm Ws. Due WORKER'S COMPENSATION DECLARATION I hereby afro under penalty of perjury one of Ne following dedmationac ❑ I have and will maintain a Cemfiose of Consent an self-Inure for Worker's Compen- - amon, As provided for by Section 3700 of the labor Code. for the performance of the ark for which this permit is issued 1 have um will maintain Worker's Compewtian Inmranm. as acquired by SOW. 371)(1of the tabu CMB. for dse performance.f tlm work for which this permit In luund My Worla/c7e. Compensation hem. carrier and Policy number am: , L Cartier./�4LfYfr LKlI'CGHCI//Y Policy No.: ' I CERTIFICATEOF EX EM EXEMPTION MOM WORKERS' COMPENSATION INSURANCE (This seNm need aathecompleud Btbe permit t$ faanehunmed dollar (5100) nr leas) I certify that in Ne performance of the wart for which Ni. permit a issued. I shall out employ my perm r in my manner an u an become subject to the Workers Compwadon Laws of California. Data AppLtnt NOTICE TO APPLICANT: If, a/ur making Nu Caniacam of Exgnp ran. you should barnme subject a Ota Wmkm's Compeneatimn provisions of the lahm Code. you mut forthwith comply, with such providom or this permit shall be doomed rewieed. r CONS RUCDONLENDINGAGENCY 1 hereby Mr. than Vert I,. couvucdorr Iemi.g.Fnc, our the p ufamawrtt of y Ne work for which this permit is Wood (Sec. 3097. Civ. C.) - Lemm'sName Lmdefs Addmu 1 aulify that I have read Ni. application end auto that ted above information It entero I agree m comply with all city and county ordinmces And Auto I.W. relatiag It, building convection. and hereby mthodm representatives of this city a enter upon the ahove-mendoned property for inspection puryorzs (We) ague a am indemnify and keep herealm Ile City of Caperton .taint Iiabilitie.. jedgrec un. east And expuuu which may in my way exotic against mid Cry i in conteyuenae of the treating of this permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date SOUR EGULATT Re-roofs � - Type of Roof � --��gnuum mrof Applitn✓C�—onvacar Dau HAZARDOUS MATERIALS DISCLOSURE Will the appllont or future Wilding cecupant more or handle hruNous material ' JAL.deficand! by tic Cupem. an Murticipal Cuk. Cbzpter 9.12 and One Health and Safety a .ction zss3zp)7 All roofs shall be inspected prior to any roofing material being installed. ❑Y �Na If a roof is installed without first obtaining an inspection, I agree to remove Will thea 1 rant or future Wildingocam am um equipment err maw which emit hmvMn err <mnuminnu u dcfioeby Ne Bay ArnAir Quality Management all new materials for inspection. Dieu C17 ❑Yrs CQNo I have road the lwardrws materials rophemonu under C7upw 6.95 of Lou Cmifor- ni.tkc "Safety Code.Sectiom2 M5.M533a 25534.1unde.dNuirft building Jae not currently have a memo Nat h u my teoponibilily m anory the occupmt of Ne reyviremcn 'chmuebemet "rarer r.cenr0muearaapartey. Signature of Applicant Date All roof coverings to be Class'W' or better ower m,mNan wagent , w+Mw,+M✓r.w,w 'ROJECT kDDKESS �PPJJCANT - .�::.` �'—�r �" o„ ' OWNER � AGENCY IN RN'!"iJRN Status Wt IN REI URN Status [nit iPi RETURN Status hdt MILDING ) UTSIDE ~- �LANNINCr All 1 'UBLIG -777 WORKS V, .e. we WAMON00010" i ANITARY � - - ---- 1001) 4EALTH - j NSS£SSOR r RFS. (LVNG) (CIARAGE `OMM. S FI: 4 T.I. S FT '� ' 't% Q. (NEW) .�..... SQ.FT. RES. RENAUUEI, 'UNTACT _ C' ?. C10 PHONE#�.�_." �. ��� FAX 'ALUATION (Cost of Project) ,� �.�._.._._.._...- R�',QIS, PAID 47E,S:. .. C ONSTIRUCTION TAX (Y) (N) HOUSING iv mG (Y) (N) -- _,..._ . _._. ...,,....� HEART OF THE CM (Y) (N) ' s: r. SSLTED B DATE ,' G✓ TOTAL FEES 6 o File Edit Actions Deta4s Links Favorites Heb " 5R i 4. a.. - moi`- I { t % i -:+�c :.. �� L- -- F'w.rrrri; Er�f+Stm,�hon i_cr_.. t ar Infarrnation Permit Numi mi " 08110099 : ; j Address " 1Q741 N WOLFE RD FLR 1 r�OK Status F `T Crty/SWe/Z i CUPERTINCi EPA 95914 - 4* Back t Master Numtiot Notes 0; APN ;iIS45Q1tiFLR1 Project Unit , ( Contractors Apply Date" 1 1I2&/20Q8 Operator: Syl'naM 0vner fn61y Intoimation JWFees Permit Issue Date 11/26/1008 Qperatrx SylvreM - (owner Name " `80 LJNGINETTI - Plan Reviews Certificate Issued 412/30/20DO Operator Uso �Default Certificate TType_. , _ ...._:._ __ _:. : Inspections Addova 'Business -10741 N WOLFE Ria IST FLR Certificate NurnberAm Print Permits City/State/Zip CJPERTIN41 CA - 9014 Adjustments Permit' Property Zoning Applicant Contractor " DefinedFields Hoids {' Permit Details Purpose/Special Conditions i+ Copy F1;; rt Permit Type' 1B TItc j, TEMP PEP11IT FOR COHMERCiAL T. I fHILTUN! DOES NOT : TENANT IMPROVEMENT ; INCLUDE (M,P) ELECTRICAL WORK IS INCLXJDED-GOOD FOP, 3 $ Close P�rrrut Usages GiasS _ ll/IIIN �1 DAYS-NO_INSPECTION3 AFTER 12/26/0$. NO FINALS ON THI Overrides PERMIT ORIC PERYtIT 08090082 ff/ItlNpNEvV Y SuppfemontafFietds AprAedValut" 100; 01/1Z/09 NO BORE INsPECTIC)NS ON THMP PEAMIY. NO _ . FINALS ON TXMP PERMIT. THRY NEED To GET ORIGINAL SQUARE FT. 4 PRAMTT #08090082 APPROVED STILL IN PLAN CK SURV, CrgfcculatulValue Q RErAXED COMMENTS TO PETE B. jAltachmmrus US C-404 Type :437 } ALT: NON -RES, NOWHSKPG Permit Form " AUTOPERM -PERMIT Owner -ship I - Private `- Project Size COUN TER • OVER THE COUNTER v Add Dof3uk Text { Enter permit status .� ��th��t Infc�trr��,ircr, Pard Number E08110099 Stat ws 'Ctated APN 31645-015.FLR1 ; Address ! 10741 N WOLFE RD FI -A 1 , Owner Name ±BB LQNGINETTI Review Stop Revision Datc In Due Data Date out Status Time Raviami Notes Contraetoi ID lr iMs Plan Reymw tr,tormativn - _ Plan F fv%,v,, , N;-te- Review Strip , COUNTER OVER THE COUNTER REVIEW :No notes Havision 1 ';. Reviewer !Bog S Status l+4 Sta'as Dots Dake In 111728/06 Time In #'rpjact Size LIN `Go _.. .. _ . _..._, Default Days 1 Due Date ,11/2712009 Date taut [111261'09- Time Out Time Spent ! 0 QO } Cuntractor ID Sent To Sent B 4 7 INSPECTION WORK LOG - ONE PER PAGE DETAIL FORMAT PRINTED ON 01./24/11 PAGE-001 PERMIT NUMBER: 08110099 PERMIT TYPE: 10741 N WO LFF RD FILR 1 CUPERTINO 1B TI USAGE CLASS. II/III/V- TENANT IMPROVENENT II/III/V-A NEW SPECIAL :TEMP PERMIT FOR COMMERCIAL T.I (HILTON) DOCS NOT PERMIT :INCLUDE (M,`P) ELECTRICAL WORK Is INCLUDED-GOOD FOR CONDITIONS:30 DAYS-NO INSPECTIONS AFTER 12/26/08. NO FINALS AND NOTES :ON THIS PERMIT ORIG PERMIT 08090082 PARCEL_ ID: 3164501.5 , FLR1 LOT: BLOCK SUBDIVISION: OWNER NAME: BOB LONCINETTI OWNER ADDRESS: 10741 N WOLFE RD IST F'LR CONTRACTOR ID- 20047 CONTRACTOR NAME: JOHN DIMANTO CONTRACTOR PHONE: (408)986-8711 INSPECTION TYPE: 314 T-BAR CEILING INSPECTION AREAS SCHED .DATE: 12/16/08 INSPECT TIME: CONTACT 'INFO INSPECTOR: LS ,QUARC::A, LARRY INSTRUCTIONS: REQ AM V41vx 590.5651 COMMENTS RESULTS: PASS- FAIL CANCEL RE-FEE FAIL CODE, NOTES: PRIOR INSPECTION RESULTS: 115 ELECTRICAL UNDERGROU 12/02/08 P 3.15 ELECTRICAL UNDERGR.OU 12/01/08 P CONDUIT ' LOBBY LS TS 304 ROUGH ELECTRICAL 305 12/01/08 P WALLS AS MARKED ON PLANS LS FRAME 12/15/08 I 305 FRAME 12/02/08 P ATG L5 3U5 FRAME, 12/01/08 P SEE NOTES 308 SHEETROCK 1'2/02/08 P I S 314 T-BAR CEILING 12/:16/0€3 P 314 T-BAR CEILING 12/15/08 F LS 317 MECHANICL ABOVE CEIL 12/16/06 P JG LS 317 MECHANICL ABOVE; CEIL 12/15/08 I LS 318 ELECTRICAL ABOVE CEI 12/16/08 P J 319 ELECTRICAL ABOVE CEI 12/15/08 1 LS UIT —V0 FOU-NUFff W— 77777=77. EVIL Iavc DIVISION PERHAT ` 40- tOsrt`.` HA I0'7d1 N WOLtFF ' OwPtis I NAMB P6REIQY» Ri1B _ . MAN N1tCiriS[ICrtttliQiY&BRt BUILDIMi'R�11T IWO •••_ • •• ••�• - TEMP PERMIT FOR COMMERCIAZ, rj' . DOES NOTINCLUDE Description 41GBN3EiA (XiMRACIM% [7K ARATM r >+�� tw y i am lka wd andor pttoritfons air cupu V (Cmw aacint wide S dw 7tlM d DivIdoa 3 Of 60 Satdnw nwd Prokullow Clado, ad my MOW Is M ..lob • • , • , « � • ^ •, •• •• .. . ,, in ILU lorw &W WOO (i -Lie.4COM lowr �rla Yrr<'1�7�/7'P t dt ARCHi17tGT3 S?PIA.ASiAOifC� u,rirruaW ety plana tad be RAW a p Wk Heath u OWMIX-BUILDUR 1W;C:t.UATKM I b=4 444M tbu I *A wernpt man Ileo Cwt,anor'a I k nw Law for dm G Ptlknvint mawn. (300100?030, #W*z.0 and P`mkukaa Cade: Avy ehy w cu"y MbJI'i �1 a ptsmit w CarlliWq, altar. ImjIfS3V{4. thmdiA, a mp* 66y attl �^. pr(ar ur 1u asuaraao, tdw mquim tla Awlaw raw 30th poamll to Ilk a sitaod auara,tra/ AN hr k Bcataoad pytwant I- N pr-iwnoa of tba CutVmWt [ ww [Uw (C ktpwr 9 - - -••- » « Sq, Vit. Ploor Ares Valuation I tcwwaaoardrt with Sunil, 7CtOQ} of Dtrision 3 of lbe RWNU ana FeaieW m (:(da) or dttw he k IlAwdew ad 64 bash &a the atiattsi ampdua My vM&0il4 of 3e01aa 106ISTY for "" ••' " �. toy rrtnram a FwM t wlTjr;lf aha BW&XM to a CKpo" at aaa twon Apt M. bwthod 4dLn (SMAPN Number OcCtzpaney jrpc Q L a utvf+ar o(tM rjoty, or my twaplaym w" wrAu dull Iota ass/pet m,^ will da Iba wrxi. tmttkw tt�acu�ta b aotlrttattda! rxasie 7tM<. w ttrrasd t&ee, «1d IrorwAm CoU •tom Coatm&Wa I'- Law t� � � � awns or required inspections mup" *'Ito W)" cc imp"" t wom and Oviedo" rotb wsab Or gfro* hk carr etagtola+aa, ptvv%w tlw =* hapmvWwrwa wa Hat wataod or MITUM torSole, it 6onrova, ata b4W1a= w itngmetamt y told withht ON low of 00OVk4um. 0w oaaan hallaw WM bare ft bw*0 of FeWat>fat to alf4 wait wu air beptaa W lowpeea of C3 4 as owror of lie praprrtX am r=JWv* coMwilAt wilt Ik"w" eatwa &w ta O&W010 dm pt*d (Stu. AW4, sosl" Rod Pt Awk w Catch:) She CORUWAw's W. aemtM Law lista ea M4a1y r, as twatr of pmprrty wAw hawk a t>atPto+oe tdwalaaa, and . v�ro oatwrRata rw t� ptttjlae rilralxnaao>'x(al} ueaKled pwewaMln Aa Ct>taraaot'a Uwaft k", 0 1 ea —I* wow Bea WoMMS COMi 6Nt1ATIM 0KYA1LtTM I Meeby d&M wAtt penalty rr Parjoty Cava of do k"Vo ttj datsr Mkerc �] I have ud WW towfliala a cwwkui' orcot�oralt w wit-WON ra wa to't Cas G. udaw, as p wAda4 for by Swil w SM d Ibe Lcbw Cada, fir aAr pdormnts d ft Moet for tvbkh *k p mk u b0oa ❑ 1 have and will malteala Worbs411 Com pbustlon lftVAwas. au rtq*H by Swim 37mor ata Usha Cafe, for Aa loww"aaea 0(ft *aft f rveAch rapt Mu a tread, My CompaatlowInawom)e�atrierprad�Pftyntwab�e.;tfyam uLW Fit0MW0RK9LV COMP$NsOUM INSURANCE MVweds.nod,.wbecomphuedlruapa vellUtop 4"AWAWdate�.($sae, Car low►, I sxntij' uaal u *o pwfonoi" td We Waite lar vjhkh tW W1011 is MrXef, i shin oa �p(dr Ney Dra7ar #n arty etarnar>a ae to bttttaae ta>itJtrS to dte'4i wial' Ctt (lpowaa8aa ' Leave N CaNfatda Dur __ ., N�'}Sz13 APt'1JCAM! if. itler mtklnb tda Ce+wkw of RUMOW, you �uM > beeaaa apb¢xt n dae Wostm'a Cotupeasuler ptoviamns at dais I W+vr t:urlp yoe sepal roKhwkh a iARW wllb ant luavid" a rah p MU trail k, drpavai tevalNtl CON3'tS X nON LBNDING A©8NCY y r>r E ltuoby trfum Ibat than h a twralnuthnl la YnS a rot lie ptwfr waW af a wail fW wtkr lhh MMII la Wool (Sm 3W77. Car. GI 1 agtlly 9W I Mw rtyd tbk app!kanw and a/ak: Art dte airw mWmttt4ua b j eartoet l WW w Cwtoy wW> wi chy sled tnwKy OtC5Mn= Nut ow Wn rclat!at b btdiR}et amwwuwm "a wmby awworlta tep,usawtadvta of"oily w altar Vpaa tit w a m&, taiatda> 4 WaPO ty (or kspatdou pu perms. y { ! ►tme w acre IndarwAry low lags hwa lea vas Cky tK COW609 apdael @ 1labiudtu jatlPx a te, cwm Rod t opera WWA OWW 1A Myavay tramtia WARAC W4 Ody i A ecu of 0 't=T NDS AY WILL COMPLY V/ITH ALL Iv*i.PE3INT A1�7CA7if tIWDgRffiY Issued Date // air €fAZARRUC)UtMAS13RrAC.,4Dt3C1.QSU1Rit 1 °ff$ o ��pe e:1a Roof Sattls iia +l ;,,swim hum W0414oatom tr Nw& bawdww taap W as 40dowd by On Cuwum hlaninptr Codn9.71. and an Ikatdt WA 5aiay Coda, seal" ""U7 0-ft brto All mors shall be inswted prior to any roofing material being instant WW as ,pp $wt a r fuwm hwid"S Owuptta a;0acralpmwi or dw4m 9M bizardaw WrcwKman if a sof is installed without first obtaining an inspection, I agree to remove &w aytMairywitA*OwAi w all new materials for inspection. ❑ IM Cara E brra nrtl ua:lrrxdau: tnrv,iaia>pgakamccxl uudar CANtttxa97 d dta t3dltan , ads S M"A k 3&("y Cade. SOWAM i 0.13333 Md 255]14.! umtratarw lucIf #tai a vw a WA% ow a it my teslaxWbahy a rainy dais ucxppan' of iht be eta w b neery �-- Signature of Applicant Date All roof coverings to be Classy ",�}" or better isri•gym ly„0 , d ! t � CUPERTINO CITY OF CUPERTINO TENANT IMPROVEMENT PERMIT APPLICATION_ FORM AIyN # pate: Building Address: 107411 Al. 1 Mailing Address (if different, from building address), Tenant (If tenant pleases pmvide a letter from the building; owner approving the tenant improvement.) Building Owner Tenant/Building Owner's Name: Phone #: Contractor' Phone #; Fax Contractor Liccue #: Cu ertino Business License #: Contact: Flione #' r> lav ��el Fax #: 0 z Alternate Contact: Phone..#• rl Valuation (cost of project),{ tob Description (bespecific): S[� 4-r"I.'•)�'���Ar �rj�'�r ��`�j` �':(���r�'f.1 �%Lr ri''�<'� a- iYi� 4/€�-..'�3' ^/f �r? �'•' CC-,. �'t✓T�./{,a+O V 1�t+�i�.✓/� Tenant Improvement Includes Ike -Roof 'YesNo If yes, number of squares Tenant'Improvenient Includes Structural Yes Na Type of Construction (Usage Class): Occupancy Type: 1-A, I -B IVIII/V-A (5 111111 B, IV -HT, V -B FJ Project Size: Express Standard Larg+ eMaid Green Building: Please complete Leed for commercial Interiors checklist & attach It to the application or if applicable, include in plans & sheet Index LEEU Points Achieved I i *** For Offfce Use Only*** Over The Counter 0 Revised 810$,148 CITY OF CUPERTINO 2 ITEMS OF ,2; PERMIT RECEIPT OPERATOR: SylviaM COPY 1 Sec: Twp Rng: Sub: Blk: Lot: APN . , , .. .: 31.64501.5,FLR1 DATE ISSUED........ 11,126/2008 RECEIPT C .......... BS00000670 _REFERENCE _.ID # . .: 0811009 SITE ADDRESS .....: 10741 N WOLFE RIS FLR 1 SUBDIVISION ......: CITY .............: CUPERTINO IMPACT AREA ......: OWNEF. ............. BOB LONGINETTI ADDRESS ............ 10741 N WOLFE RD IST FLR CITY/STATE/ZIP ...: CUPERTINO, C.N 95014 RECEIVED FROM ....: SAN JOSE CONSTRUC CONTRACTOR .... ..:,J©HN DIMANTO LIC # 20047 COMPANY ...:......: SAN JOSE CONSTRUCTION ADDRESS . 1210 COLEMAN AVE CITY/STATE/ZIP ...: SANTA CZ,AIRA, CA 35050 TELEPHONE . ... ... (408} 98+6-8711 FEE ID UNIT QUANTITY AMOUNT PA--TO-DT THIS REC NEW BAL IBSEISMICO VALUATION 100.00 0.63 0.00 T �--- 0.63 0.00 LSTIINSP SQ77ARR FEET 20, 994.00 366.00 0.00 366.00 0.0`0 TOTAL PERMIT - 366.63 0.010 ---------- - 366.63 0.07 METHOD OF PAYMENT A14OUNT REFERENCE NUMBER CREDIT CARD 366.63 - visa TOTAL RECEIPT 366.63 i