12120009CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20400 STEVENS CREEK BLVD
CONTRACTOR: MISSION ELECTRIC
PERMIT NO: 12120009
COMPANY
OWNER'S NAME: CUPERTINO CITY CENTER BUILDINGS
5700 BOSCELL CMN
DATE ISSUED: 12/04/2012
OWNER'S PHONE: 408406517
FREMONT, CA 94538-5111
PHONE NO: (510) 6574460
❑ LICENSED CONTRA'CTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Classc-10 Lic.4 'l/ko --
PROVIDE SEPERATE PANEL FOR REPLACEMENT OF
a�— (
Contractor l'�\ya lON �C6F.� Date �Z 2
ELEVATOR
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.
1 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
Sq. Ft Floor Area:
Valuation: $9500
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
APN Number: 36901028.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state 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
WITHIN 1 0 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
180 DAY M 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
a"
granting of this permit. Additionally, the applicant understands and will comply
Issued by: Date:
with all non -point source regulations per the Cupertino Municipal Code, Section
1-4
9.18.
RE -ROOFS:
Signature Y��� Date Z��v
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.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1, 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
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
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 I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
' n 2 05, 25533, and 25534.
the Health & Safety Code, S��fa�
Section 3700 of the Labor Code, for the performance of the work for which this
'f
�
Owner or authorized agent: f ^' � Date:W`
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
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I 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
APPLICANT CERTIFICATION
Lender's Address
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,
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
9.18.
Signature Date
GUPERTINO
GENERAL PERMIT APPLICATION CA
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DNISION �O�
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 \�
(408) 777-3228 • FAX (408) T77-3333 • buildina(7G cuoertinO.oro
❑PLUMBING ❑MECHANICAL. 9=CTIUCAL ❑MISCELLANEOUS
MEP
MISC
PROIECIADD ' 20400 c, �e� �� � APNN
`+H {�}
OWNERNAMS PHOM E -MAB.
o .sS -410-SI
17TtEETADDRE11
00 uc CRY, STATE, ZP I FAX
r ..w
CONTACT NAME PHONE E-MAII.
r a�. O!f -'1 lo- 6 Si-► rGavtw.u. we
STREETADDRE%*46& eq;geV
CRY,STATE, ZlP �•
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENTWCONTRACTOR ❑ CONTRACTOR AGENT, ❑ ARCt7T -T ❑ ENGINEER ❑ DEVF].OPER ❑ TENANT
CONTRACTORNAME 4w V � S
LICENSENVMBER .I/KJ IM�
ryl0
L1CnT'SE TYPE ^-' U
1.
BUS, UC:
COMPANY NAME
\SSIoIJ EL�TZ\L
E -MAB.
NAaWv�s
FAX
$-0-�-113-51to
Sn=ADDRESS
l w.,,. �
CITY, STATE, ZIP
�rtw CA. �1 nV
PHONE
SI645-1-44Go
ARCHITECTIENGINEEER NAME LICENSE NUNMER.
BUS. LIC i
COMPANY NAME'
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑SFD. DUPLEX ❑ MULT4FAMB.Y
BUILDING: fACONDERCW.
PROJECT IN WLLDLAND ❑ YES PROJECT fN ❑YES
URBAN DTr.WACE AREA NO FLOOD ZONE NO
IDTHE BLDG AN ❑YES
ECHLERAOM O
DESCRIPTION OF WORK
"vs fki av
TOTALVALUATION: SW
RECEIVED BY:
By my signature below, [certify to each of the following: Ism the property owner or authorized agent to act on the prop wner's behalf. I have road this
application and the information I have provided is comet I have t'ead the Description of Work and verify it is accurate. I agregto comply with all applicable local
ordinances and state laws relg t i ag consttnctim I authorize representatives of CupertiDo to enter the above -id tifledpmpe y for inspection pui{ oses.
SignaturoofAnplicant/Agent i ti'-'�'�— Date: 1�� ' �I-L-
SUPPLEMENTAL INFORMATION REQUIRED
OFFICE USE ONLY
w
U
U
❑ OVFR-THE-COUNTER
❑ EXPRESS
❑ STANDARD
❑ LARGE
❑ MAJOR
MEP?fuc 4pp_2011.doc revised 06/21111
40 .CA
(3mv
r��� CITY OF CUPERTINO
m-- I FEE ESTIMATOR — BUILDING DIVISION
NOTE: This estimate does not include fees due to other Departments (I.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.). These fees are based on the Drelindnarv, information available and are only an estimate. Contact the Dent for addn'I info.
FEE ITEMS (Fee Resolution 11-053 Efl 7/1/12)
ADDRESS: 20400 SCB DATE: 1 210412 01 2
APN: BPk:
REVIEWED BY: mendez
*VALUATION: $9,500
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
Plumb. Permit Fee:
PENTAMATION ICEAP2
PERMIT TYPE:
WORK
PROVIDE SEPERATE PANEL TO REPLACEMENT ELEVATOR
SCOPE
:Nech. Insp. Pec:
NOTE: This estimate does not include fees due to other Departments (I.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.). These fees are based on the Drelindnarv, information available and are only an estimate. Contact the Dent for addn'I info.
FEE ITEMS (Fee Resolution 11-053 Efl 7/1/12)
FEE
,Lfv(.h. Plan Check
Plumb. Plan Check
Elec. Plan Check 0.0 hrs $0.00
,Llech, Per/ni( Fee:
Plumb. Permit Fee:
Elec. Permit Fee: IEPERMIT
Other Mech. Insp,
Other Plumb 7n.sp.Li I
Other Elec. Insp. 0.0 1 hrs $45.00
:Nech. Insp. Pec:
Plumb. Insp. Fee:
Elec. Insp, Fees
NOTE: This estimate does not include fees due to other Departments (I.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc.). These fees are based on the Drelindnarv, information available and are only an estimate. Contact the Dent for addn'I info.
FEE ITEMS (Fee Resolution 11-053 Efl 7/1/12)
FEE
QTY/FEE
I
MISC ITEMS
Plan Check Fee:
$0.00
EKI amps Electrical
$45.00 CECT<200 I Services
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -.0 Reg. 0 OT
o
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$45.00
Conshvction Tax:
Administrative Fee: IADMlN
$42.00
O
0
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
A
Travel Documentation Fee: ITRAVDOC
$45.00
Strong Motion Fee: IBSEISMCO
$2.00
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
$135.00
$45.001:TOTAL
FEE:
1 $180.00
Revised: 10/01/2012
COM BUILDING DIVISION E CUPERTINO ENT
�1� �tTY C�i�1T�
UNITY DEVELOPMENT
APPROVED OFFICE COPY
This set of plans and specifications MUST be kept at the C
job site during construction. It is unlawful to viae OD STFvE� J ✓
r to dwia'e 1.1 / v
changes or alterations on same, o - I _
therefrom, without approval from the Building Official.
The stamping of this plan and specifications SHALL NOT
be held to permit or to be an approval of the violation
of any provisions of Spy City Ordinance or State W.
G
— BY la —
TE
RMIT NO.
®z 0 �P 0 Baa JW IZDDA
ZcvAS1WAF ZCO'S Z1bn5 4SA5
L)DDAS
11 2 I'i I °o AF I 40A t
NOT 10 I
=U yS'e
A>'11�rf!a rtas�
MlsS1aN
Llc.# q(01001�7
v6V kte"—�
1E) r.{4 \'JJ --°-sco
100/3 (N)
(�11 1 oOAS i50AF
AAA I N113
Opti
�o�co�ti
IU7480 7r4W12 3:66 PM
COIMNUOUB-LOA4t 126%
.15:26:. KIN
�ISTI�I C�
.162.3 .:
.RECEPTACLELOAD(100XTOR}TRAT
-:O.:KW
-S0LOAD 43AXW -AMPS
165:0
MAIN :400A
2771490
PHASE: 3
WIRE :4
COLOAD-46:3=KW AMPS
PANEL: HG
AID RATING: 65K
-MOUNTING : SURFACE
-ENCLOSURE:NI
-
MOTOR LOAD(12rA-FGWL*RGEST
FED FROM :MAIN -SERVICE
FEEDER :600 MOM
FEED POINT: BOTTOM
LOCATION :ELECTRIC ROOM
CIR_
NO
LI DESCRIPTION
_BREAIO:R
LOAD
MOM
9
-C -`
A -[2.23
-A ._
B -
- C -
A
B -.
C
A
-G
-C .-
-A -
-9 -
- 0 -
-`A -
0 "
C
A
B __
C_
LOAD
(kW)
BREAKER.
AM
DESCRIPTION
P ..
U
CUR
NO.
. i -
3 -
-6 .
C GARAGELTS - -20 ` 1 - 1:58
- 20 1 • GARAGE LTS - G
2 -
-4 -
-6
'C- GARAGE LTS "20 ^ `1 ' 1:82 -
20' 1 - C
-C OARAGEIT3 20 i :.. ..0:98
20.. 1 C.
. _7".II-GARAGE
- 9
11
LTS 20" "1: 0.13
20." 7 C
'8 '.
10'
C ARE - 20- _ 1 " 0.00 _
C" ARE 20" 1 ' - 0.00 - --
20" 1 ARE C-
20 1 GE LTS14CCl
13 -
16
17
C PARE 20� 1 " 0.00 -
20 - 1 ARE
PACE 0.00
0.00 20 1 SPARE
SPACE 0.00
0.00 20 1 SPARE
19 _
21 =
23..M-
M- B1SF 496 _ 30 3 _ 3.79
1:41 30 3 � F 46,47,48
:M- B1SF-485 .= .W! .3 .� .3.79
1.41.- 30. 3 _ EF 46,47,48
81SF 485:30- .:3 .= .3.79
1.41. 30.- 3 .. EF 46,47,48
-26-
27-
29-
G 9KVA TX -15---3 - 0.55 _
6:23- 40- 3 _ SF40 - M-
-�-
28-,
-30-1"
-0-9KVATX = %, 3- -035 -
-5.23- -40- 3 - SF40 1SHP M
fl 0 KVA TX .: I3- -3- :03S .
-5:23 - 40-- 3 -$1:40 - -M
31'
- 33"
36-
"X 9ISF283 ': '40'. " 3 - "379 "
16.21 -100" -3 ' ELEVATOR 'M-
.32 .
34 -
36--
38 �.
40'
42
M SISF 283 40-. 3- 3.79 -
16.21. 100 - 3 ELEVATOR ------ - M
16.21 100 3 `ELEVATOR _--- - M
1.15 70 3 - EF 3,4,7,8,11,12 M
It BISF 283 40" 3-_ 3.79 -
37
39
41
M- F 1,2,5,6 70 3* 8.48
M EF 1,2,5,8 70. 3 8.49
1.15 70 3 .3,4,7,8,11,12 M
N EF 1,2,5,8 .. _. __. _.74." $ ...8.45.
1.15 70 9 EF 3,4,7,8,11,12 M
IU7480 7r4W12 3:66 PM
COIMNUOUB-LOA4t 126%
.15:26:. KIN
AO LOAD -ALO KW . AMPS
.162.3 .:
.RECEPTACLELOAD(100XTOR}TRAT
-:O.:KW
-S0LOAD 43AXW -AMPS
165:0
10i1NAE bO
COLOAD-46:3=KW AMPS
1633
-
MOTOR LOAD(12rA-FGWL*RGEST
-132.3376-RW
-
MOTOR 8100% FOR#HIIAINING
LOAD IDENTIFICATION:
GENERAL LO 106X
- I." i0N -
-C-OONTINOUS LOAD
TOTAL LOAD
-1493x76-KW
D4RECEPTACLELOAD
M4AOTOR LOAD
.TOTAL -AMPS- 277"
180 A
04FNERAI-LOAD
.
• LOCK -ON DEVICE 't
VIA LCC
-13 VIA PHOTOCELL
T GFI BREAKER '
VIA SECURITY CONTROL
IU7480 7r4W12 3:66 PM
1
3
-5
-7
9
11
13
MAIN :400A
2771480
PHASE:3
WIRE :4
1525 =ION
RECEPTACLE-LDAmtft16'}OR'M11ST
01(VAi07G
PANEL: HO
AIC RATING-: 85K
'MOUNTING: SURFACE
ENCL0SURE:N1
TOR LOADt12MMEAROESi
MOTOR-& 10075 POR`RGHIASSNG
'i59:0W5-KW
FED FROM : MAIN SERVICE
FEEDER :500 MCM
FEED POINT: BOTTOM
LOCATION :ELECTRIC ROOM
DESCRIPRON�ANIFAKER.-
jWT
P _
LOAD
-
PHASE
.:IkW►,
-A -
'S
'C "
"A
- B
C
A
B
C�
A :
.� .:1.41_-
` :0 -.
=A -
=H _
-C -
"A -
B _
C
A
a
LOAD
BREAKER
AMP _.._P
DESCRIPTION
=
GARAGE LTS - 20-& 1 1:58 -
1:65- 20 1 GARAGE LTS
GARAGE LTS ' -20 -1 ' 182
1.34- 20 1 ' GARAGE LTS
GARAGE LTS 20= 1- 0:98
1:48- 20- 1 -GARAGE LTS
GARAGE LTS -ID- -1- -0.13
'0:99" --20" 1 " GARAGE LTS
SPARE - 20-� 1 0.00
ARE -20" t '0.00
0.00- 20- 1 SPARE
-223-: 20 1 GARAGE LTS -
ATOR :100. 3 - 12.97
0.00, 20� 1 SPARE
A7DR 100. S :t 12.97
0.00 - 20 . 1 _ PARE
ATOR ='100': 3 : 12&7
0.00. 20, 1 ARE
rBISF4&5 -'-30; 3 3.70
1,41, 30: 3 EF 48.47,48
48,5 .30� `.3 .3.79 -
30. .3 _ EF 48.47:48
4&S -.3D'- .3� .:0.79 "
1.41_:. .30.: .3 _° EF 4847.46
9KVA TX --AS- -'3- -'0:55 "
5.23-- -40-� 3 - SF40
9KVATX - "16-' 1 _ --646 _
3:23-' -.40-" -3 = SF 40 VRP
9KVATX - - .:1 = 777 .:036 -
--5:23- --40- .3 = 40
1SF2&3 ` -AD- '-3' .`3.79
12:87 ..100. ..3.' - ATOR
1SF2&3 .. __40,'. 3"- .. .3.79 �
......:
1297 .100- 3 _ ATOR
S_2&3 _ _ _ 40" 3 � . 3.70. -
F 1,2.5,6 70 - -3 8.48
I&W 100 3 - LEVATOR
1.15 70 _ . 3 EF 3,4,7.8,11.12
EF 1,2,5,8 .:70' .3. - 8.45
1.15. 70: 3 3;4,7.811.12
tlUOUSAMiDr -4875
1525 =ION
RECEPTACLE-LDAmtft16'}OR'M11ST
01(VAi07G
--a-x0111
TOR LOADt12MMEAROESi
MOTOR-& 10075 POR`RGHIASSNG
'i59:0W5-KW
GENERAL LO 16871
-1:98-10N
TOTAL LOAD
-77619!5-ION_
.AL -AMP$ -277/480
-212--A
• LOCK -ON DEVICE
T GFIBREAKER
' VIA SECURITY CONTROL
.:AALOAD _-< KW
SV,LOAD--53.&KW
CO -LOAD 36:OM
C CONTINOUS COAD
.-04tECEPTACLE LOAD
-44410TORLOAD
--Oi-0ENERAL'LOAD
13 VIA PHOTOCELL
AMPS
AMPS
AMPS
NO
2
-4
8..
10'
12'
14
19
18
997A
193.1
199.7
20
22
26
34
38
38
40
3771480 7f2.112012 4:09 PM
FrXI
I�
CUPERTINO
CONTRACTOR / SUBCONTRACTOR LIST
Building Department
City Of Cupertino
10300 Tone Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: 7,04eb 56A&S cr;
PERMIT #
OWNER'S NAME: ,r v- :`
PHONE # SID -"l -q
GENERAL CONTRACTOR::
BUSINESS LICENSE #
ADDRESS:
CITY/ZTPCODE: Q c'SY
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL' -QR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND , SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable�subcontractors'aiid complete the following information:
Owner
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
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner
Signature
Date