10110141CITY OF CUPERTINO BUILDING PERMIT 9EVISION #
BUILDING ADDRESS: 20400 STEVENS CREEK BOULEVARD BLVD, 4TH
CONTRACTOR: NOVO CONSTRUCT
-PE
FLOOR
OWNER'S NAME: CUPERTINO CITY CENTER BUILDINGS
4025 BOHANNON DR
DATE ISSUED: 12/21/2010
OWNER'S PHONE: 6173749500
MENLO PARK. CA 94025
PHONE NO: (650)701-1500
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
-1C1 ( (72.Z.
T.I. BLDG 3, 4TH FLOOR, NEW PARTITION AND DOORS @
License Class Lic. a
Contractor � R vU'ItH
N�7 Date ^ � i_
(�I> l /� jS
CORRIDOR AND RELATED MECHANICAL WORK. (6,053')
1 hereby affirm that I am licensed under the provisions of Chapter
1/7/11 REVISION til -REVISED FLOOR PLAN FOR NEW
(commencing with Section 7000) of Division 3 of the Business & Professions
OFFICES, CORRIDOR CEILING CHANGED TO SYP.BD.
Code and that my license is in full force and effect.
FROM UPDATED ELECTRICAL LAYOUTS,DEMO OF (E)
1 hereby affirm under penalty of perjury one of the following two declarations:
LIGHTS, REVISED POWER PLAN. -ISSUED 1/27/11
1 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
Sq. Ft Floor Area:
Valuation: $200000
performance of the work for which this permit is issued.
1 have and will maintain Worker's Compensation Insurance, as provided for by
wor oV
Section 3700 of the Labor Code, for the performance of ther which this
permit is issued.
f
APN Number: 36901028.FLR4
Occupancy Type:
APPLICANT CERTIFICATION
1 certify that I have read this application and stale that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
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
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
upon the above mentioned property for inspection purposes- (We) agree to save
180 DAYS FROM LAST CALLED INSPECTION.
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 perm(. Additionally, the applicant understands and will comply
Issued by:
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
. Date
RF. -ROOFS:
Signature
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
❑ OWNER -BUILDER DECLARATION
inspection.
hereby affirm that I am exempt from The Contractor's License Law for one of
Signature of Applicant: Date
the following two reasons:
I, as owner of the property, or my employees with wages as their sole compensation,
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
IIA'LARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
I hereby affirm under penalty of perjury one of the following three
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
declarations:
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
I have and will maintain a Certificate of Consent to self -insure for Worker's
Ilealth & Safety Code, Section 25532(1) should 1 store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District 1
performance of the work for which this permit is issued.
will maintain compliance with he Cuperlino Municipal Code, Chapter 9.12 and
I have and will maintain Workers Compensation Insurance, as provided for by
the Health & Safely Code, Se
Date:LI
permit is issued.
or authorized
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 Cali fomia. If, alter making this certificate of exemption, I
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, 1 must
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked,
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
APPLICANT CERTIFICATION
I certify that 1 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,
ARCHITECT'S DECLARATION
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit, Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code. Section
_
Licensed Professional
9A&
Signature Date
CITY OF CUPERTINO BUILDING PERMIT r le
BUILDING ADDRESS: 20400 STEVENS CREEK BOULEVARD BLVD, • CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 10 110 141
4'rl l FLOOR
OWNER'S NAME: CUPERTINO CITY CENTER BUILDINGS 4025 BONANNON DR DATE ISSUED: 1221/2010
OWNER'S PHONE: 6173749500 MENLO PARK, CA 94025 PHONE NO: (650)701-1500
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL. ❑ COMMERCIAL ❑
T.I. BLDG 3, 4TI I FLOOR NEW PARTITION AND DOORS (✓u
CORRIDOR AND RELATED MECHANICAL WORK. (6,053')
License Class Lic.p
Contractor Date
1 hereby affirm that l 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.
1 hereby affirm under penalty of perjury one of the following two declarations:
r. 1 have and will maintain a certificate of wnsenl 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,
2. 1 have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the [.shot Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and slate that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building concoction, 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.
OWNER -BUILDER DECLARATION
I hereby affirm that l am exempt from the Contractor's License Law for one of
the following two reasons:
t. 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)
2. I, as owner of the property, am exclusively contracting with licensedcon eto" to
construct the project (See 7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three declarations:
t. 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.
2. 1 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
permil is issued.
3. 1 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 Cali fomia. If, after making this certificale of exemption, 1
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. /,-01
APPLICANT CERTIFICATION
1 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 regul t s e upertino Municipal/Code, Section 9.18.
Signature DateL�- /C)
Sq. Ft Floor Area: I Valuation: $200000
APN Number: 36901028.FI.R4 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued Date: /2—
RF.-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
AL1. ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Ileallh & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Ileallh &
Safety Code, Section 25532(x) should 1 store or handle hazardous material.
Additionally, should 1 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
Ileallh & Safety Cod a fi ns 25505, 25533, and 25534.
O
Date: /Z • 7f � Z'N/ O
CONSTRUM. ON LENDING AGENCY
1 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
ARCIIITECT'S DECLARATION
1 understand my plans shall be used as public records.
Licensed
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
1wADDRESS:
20400,stvns,crk-blvd DATE: 11/19/2010
APN: BP#:
REVIEWED BY: bob s.
'VALUATION: $200,000
*PERMITTYPE: Building Permit
PC FEE ID
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
TOT -IL
/'LOOK 4Rliil:
PENTAMATION 1B TI
PERMITTYPE:
WORK
$2,204.80
IBTIPLNCK
SCOPE
1BTIINSP
tiler. lnyr. tier:
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
II-B,111-B,IV,V1B
6,053
$2,204.80
IBTIPLNCK
$4,523.06
1BTIINSP
tiler. lnyr. tier:
PME Plan Check:
$0.00
Permit Fee:
$4,523.06
Suppl. Insp. Fee:O Reg.
O OT
0'.0
hrs
$0:00
PME Unit Fee:
$0.00
PME Permit Fee:
TOTALS:
6,053
$2,204.80
1 $4,523.06
MECH, HOURLY O Yes O' No
PLUMB, HOURLY O Yes Q No
ELEC, HOURLY O Yes ONO
,L/rch. 1'1un Check
Plnnrh. Plan C/" c"
h,'/ a:. Plon Ch, ck
rllrch. Peep B Fee;
Plumh. Permit Fee:
tiler. Tennis Fre:
f
01/w, Me, h. tail'.
Odmr Plumb.lnsp.
Usher 1"Ie., harp. Li I
Jlech. hnp. Frc:
Phnnh. htrp. Fee:
tiler. lnyr. tier:
NOTE: These fees are based on the preliminary information available and are oniv an estimate. Contact the Dew for addn'I info
FEE ITEMS (Fee Resahaiat 09-051 EB" 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,204.80
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 0 Reg. O OT0.0.
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$4,523.06
Suppl. Insp. Fee:O Reg.
O OT
0'.0
hrs
$0:00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Consnvrmion Tax
Acoustical Fee:
O Yes E) No
$0.00
O
O
Work Without Permit? O Yes; O No -1
- $0.00
Planning Pee:
PLLONGRNGC
$0.00
Select a Non -Residential
Building or Structure
0
O
i
Travel Doctumeniatinrt Fees:
Strong Motion Pee:
IBSBISAHCO •
$42.00
Select an Administrative Item
Bldg Suis Commission Fee: IBCBSC
$8.00
SUBTOTALS:
,$6,777.86
$0.001
TOTAL FEE:
1 $6,777.86
Revised: 11/08/2010
�/� CITY OF CUPERTINO
IfD' FEE ESTIMATOR — BUILDING DIVISION
NOTE: These fees are based on the prellminarp information available and are on1V an estimate. Contact the Dept for addn'/ info.
FEE ITEMS (Fee Resolution 09-05/ Elf 711110)
ADDRESS: 20400 stuns crk blvd 4th floor DATE: 01/07/2011
APN: BPH:
REVIEWED BY: bobs.
'VALUATION: $45,000
PERMITTYPE: Building Permit
PLANCHECKTYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
IJ,;c. N;;'rnir l�i":
PENTAMATION
PERMIT TYPE:
WORK revise floor plan for offices corridor ceiling, update electrical and power plan.
SCOPE
NOTE: These fees are based on the prellminarp information available and are on1V an estimate. Contact the Dept for addn'/ info.
FEE ITEMS (Fee Resolution 09-05/ Elf 711110)
AI„'lr. N ... I (.'h, A
Plumb Pl0o Check
17rrc. Phm Chrrk
,16',-11. l'rnui� her:
Plump. l§:rnril li, �:
IJ,;c. N;;'rnir l�i":
U,hvr .l lrch. lncµ
Olhrr 1'1....21, Imp.
older /ihx�. /n<p_
J ldrh. Imp. l-r.'r
Phnuh hop. Fri;
1.Ic'. /,,,,p./z,
NOTE: These fees are based on the prellminarp information available and are on1V an estimate. Contact the Dept for addn'/ info.
FEE ITEMS (Fee Resolution 09-05/ Elf 711110)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 0 Reg. O OT
FO.0
Thrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feed Reg. O OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
l_•onsll'll,ltion 7"tl.1' .
Acoustical Fee: 0 Yes 0 No
$0.00
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Planninc Pce:
$0.00
0
O
i
7)mocl Doumnewation Fuer:
Stron MMotion I'ce: 1BSEISMICO
$9.45
1 #
$760.00
Revision
IREI'COMTI Tenant Improvement
Blde, Suis Commission Fee: IBCBSC
$2.00
SUBTOTALS:
$11.45
$760.001
TOTAL FEE:
$771.45
Revised: 12/07/2010