12020009 SICITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20682 STEVENS CREEK BLVD
OWNER'S NAME: BYER PROPERTIES LP
OWNER'S PHONE: 4156262937
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. N 313.5 X53
Contractor�Z Date '{ [! b 12--
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18. }�
Signature Date `'0 (� l I Z
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Date
CONTRACTOR: W.L. BUTLER
CONSTRUCTION, INC
204 FRANKLIN ST
REDWOOD CITY, CA 94063
PERMIT NO: 12020009
DATE ISSUED: 04/16/2012
PHONE NO: (650) 361-1270
BUILDING PERMIT INFO: BLDG T_ ELECT r- PLUMB r
MECH RESIDENTIAL COMMERCIAL r -
JOB DESCRH'TION: CONSTRUCT NEW 8011 SQFT COMMERCIAL SHELL
BUILDING
PAD E INCLUDES ADJACENT FOUNTAIN, AND SITE WORK.
FUTURE TENANTS (20682,20684,20686,20688 STEVENS
Sq. Ft Floor Area: Valuation: $1250000
APN Number: 35908020.20682 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued b Date1W/_Z_
RE -ROOFS:
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 all new materials for
inspection.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should 1 store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Ow authorized agent: ^ r'Z
`{, Date /
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of work's
for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO BUILDING
BUILDING ADDRESS: 20682 STEVENS CREEK BLVD
OWNER'S NAME: BYER PROPERTIES LP
OWNER'S PHONE: 4156262937
�y LICENSED CONTRACTOR'S DECLARATION
License Class
Contractor b�''
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signa lop
97, �u.ia—
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, 1 must
forthwith comply with such provisions or this permit shall he deemed revoked.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Date
CONTRACTOR: W.L. BUTLER PERMIT NO:1020001 "
CONSTRUCTION, INC
204 FRANKLIN ST DATE ISSUED: 04/16/2012
REDWOOD CITY, CA 94063 PHONE NO: (650) 361-1270
JOB DESCRIPTION: RESIDENTIAL u COMMERCIAL
20682,20684,20686,20688 STEVENS CREEK CONSTRUCT
NEW 8011SQFT COMMERCIAL SHELL BUILDING PAD E
INCLUDES ADJACENT FOUNTAIN, AND SITE WORK
FUTURE
9/28/12- REVISION #1- ENLARGE ELECTRICAL ROOM ,INFILL
PARTIAL STOREFRONT @ N. ELEVATION WITH WALL
DECORATIVE TILE ISSUED @ COUNTER
Sq. Ft Floor Area: Valuation: $1250000
APN Number: 35908020.20682 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
i
Issued by: -A N T Date• 9- 2co'
RE -ROOFS:
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 all new materials for
inspection.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code Sections 25505, 25533, and 534.
Owner or authorized ;' �
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
RFM7
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 20750 stvns crk blvd. bldg E.
DATE: 02/02/2012
REVIEWED BY: bobs.
PC FEE ID
APN: W7 a8 0,0
1 BP#: Da MoD 2
"VALUATION: 1$1,250,000
xPERMIT TYPE: Building Permit
PLAN CHECK TYPE: New
Construction
PRIMARY
USE Commercial Building
Civil / Religious activities
in BQ zone? 0 Yes Q No
PENTAMATION
1'�
PERMIT TYPE:
WORK
construct new 8011 s.f. comm. shell bldq includes adjacent fountain
and site work.
SCOPE
hrs
$0.00
OCCUPANCY TYPE:
TYPE OF
CONSTR.s.f.
FLS AREA
PC FEES
PC FEE ID
BP FEES
BP FEE ID
A-2
II-B,111-B,IV,V-B
8,011
$6,268.27
IA2PLNCK
$8,949.17
IA2INSP
Permit Fee:
$8,949.17
Suppl. Insp. Fee -0 Reg. ® OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXC
$20,107.61
Work Without Permit? (j Yes Q No
$0.00
TOTALS:
8,011
$6,268.27
$8,949.17
Strong Motion Fee: IBSEISMICO
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District etn ). These feet are hated on the nrelininary information availahle and are only an estimate Contact the Dent for addn 11 info.
FEE ITEMS (lee I�esolutiorr 11-05 i E . 7/1%11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$6,268.27
Select a Misc Bldg/Structure
or Element of a Building
77
0.0
ht's
$0.00
PME Plan Check:
$0.00
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District etn ). These feet are hated on the nrelininary information availahle and are only an estimate Contact the Dent for addn 11 info.
FEE ITEMS (lee I�esolutiorr 11-05 i E . 7/1%11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$6,268.27
Select a Misc Bldg/Structure
or Element of a Building
Supp/. PC Fee: Reg. Q OT
0.0
ht's
$0.00
PME Plan Check:
$0.00
Permit Fee:
$8,949.17
Suppl. Insp. Fee -0 Reg. ® OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXC
$20,107.61
Work Without Permit? (j Yes Q No
$0.00
Advanced Planning Fee: PLLONGRNGC
$2,082.86
Select a Non -Residential
Building or Structure'
Strong Motion Fee: IBSEISMICO
$262.50
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$50.00
SUBTOTALS:
$37,720.41
$0.00 TOTAL FEE:
1 $37,720.41
Revised: 111912012