13010112 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10023 S DE ANZA.BLVD CONTRACTOR:WAYNE PERRY INC PERMIT NO:13010112
OWNER'S NAME: MARDESICH CO.CROSSROADS,LLC. 8281 COMMON WEALTH AVE DATE ISSUED:01/22/2013
OWN 'S PHONE: 7148260352 - BUENA PARK,CA 90621 PHONE NO:(714)826-0352
LICENSEDCONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL
License Class � 3 LIC:# A CZ� � �(� Lbs _bqo CHEVRON-VOLUNTARY BARRIER REMOVALS
Contractor. �W�,q lx ?_a t1(�bIate ( Z Z " t Int
hereby affirm that.I am licensed ander the provisions of Chapter 9
(commencing with Section 7000)ofDivision3 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. Sq.Ft Floor Area: Valuation:$9000
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:35908019.00 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 180 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 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 Issued b ��.^7 /V r��
granting of this permit, Aoa no ally,the applicant understands and will comply Y: Date:
with all on-p int source r Iat ns per the Cupertino Muni 'pal Co e,Section
9.18.
qRE-ROOFS:
Signature Date ZU/ , 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:
I hereby affirm that I 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. I 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 wi h th Caper o unicipal Code,Chapm 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,S do s 255 , 5 ,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this \ 7j7/ X27
permit is issued. Owner or authorized agent: �Td�°s Date:
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 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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City,of Cupertino against liabilities,judgments,
costs,and expenses which may accme 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
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION V;11
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255Y
CUPERTINO (408) 777-3228• FAX(408)777-3333•buildinGCEDcuoertino.ora `,�
60
❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROSECTADDRESS I O v Z��. E ^ , 'ZA W'\ APN# 2 sq O � Ole
OWNERNAME C.\�Ev Qo1J- I.,��rdES7cy ""7E /44 �n�OJ�J�t E-MAIL
STREET ADDRESS C IJ F> CITY, STATE.ZIP I s ,, GT, t,„�, ( 1 C A FAX
CONTACT NAME F PHONE J'N\+ '4JiJ"\ N MAIL l`
TJM ` '�c\�\� �t4 32.E 1961 -rr`I�c e� wl )Ae_CCA4
STREET ADDRESS ^.�j�q ' ! AAMO. 1` '� �T, CITY,STATE, ZIP-y�. 1� -�Rpt cA nor2` FAX
R
❑OWNER ❑ OWNER-BUFR l f❑1 OWNER` IVAGEENT 131CONTRACTOR ❑CONTRACTOR AGENT ❑ 4ARCHITECT ❑1 ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME \6M \TLatr LICENSE NUhffi LICENSE �Ncz BUS.LIC#^ J9) C
COMPANY NAME \� 1A oI� 7Mn \ E-MAIL �r1 y_IG�\e ^ .���,. �� FAX G J
STREET ADDRESS !���F" I�N� T,'�13A1 CITY,STATE,Z[&., -I �A �(�� 1 VL`n q��2, PHOye7 325 Iq 6 1
ARCHITECT/ENGINEER NAME LICENSE NUMBE �S r` BUS.LIC#
COMPANY NAME MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
v oLVnJ'MR �A�Rt 4Mp! S
IDUSTING USE PROPOSED USE CONSFR TYPE I #STORMS
USE TYPE OCC. SQ.FT. VALUATION(I)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECKAREA TOTAL DECKIPORCH AREA I GARAGEARBA: LIDErACH
❑ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECONDSTORY OYES
BEING ADDED? ONO ADDITION? ONO
PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN OYES CE - ,.. TOTAL ALUATION:
PLANNINGAPPL# ONO PLANNING APPROVAL LETTER EICHLER HOME? ONO
By my signature below,I certify o each of the following: am a property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I ve provi d is correct hav ead the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating ulldi cons ion rite representatives of Cupertino to enter the above identifi d property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED "
_New SFD or Multifamily dwellings: Apply for demolition permit for ar_,..VER-TaE<` ou "- ND .REvt>;,,,existing building(s). Demolition permit is required prior to issuance of building
permit for new building.Commercial Bldgs: Provide a completed Hazardous Materials Disclosureform if any Hazardous Materials are being used as part of this project.Copy of Planning Approval Letter or Meeting with Planning prior tona R tisubmittal of Building Permit application. ,L 'Air
Bldgvlpp_2011.doe revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10023 S DE ANZA BLVD DATE: 01/22/2013 REVIEWED BY: MENDEZ
APN: BP#: *VALUATION: 1$9,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY PENTAMATION 1GENCOM
USE: Commercial Building PERMIT TYPE:
WORK I VOLUNTARY BARRIER REMOVALS
SCOPE
e w ,
gv
:Nech.Plan Check Plumb. Plan Check Elec..Plan Ch,rk
jkfeeA Perriiil Fee:- - Plumb.Peimiv Fee: Elec. Permit Fee: -
Other;tlech..Insp. Oilier Plumb 7n.sp. Other Elec.lump.
A,fech.Insp.Fe=e. � � Plurub. hap.Fee_' Elec.Insp.Fee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District etc). These ees are based on therelimfna in ormaiion available and are only an estimate. Contact the Dept for addn7 info.
FEE ITEMS (Fee Resolution 11-053 I . 7111121 FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? O Yes Q No $0.00 = hours Plan Check,Hourly
Suppl. PC Fee: Q Reg. 0.OT 10.0 1 hrs $0.00 $133.001 1STPLNCIf
PME Plan Check: $0.00
Permit Fee: Hourly Only? ®Yes Q No $0.00
Suppl. Insp.Fee-.0 Reg. O OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Convivction Tax:
Administrative Fce:
Work Without Permit? ® Yes Q No $0.00
Advanced Planning Fee: $0.00 1 hours Inspections
Travel Documentation Fees: $133.00 1STINSP Inspection,Hourly o
Strone Motion Fee: IBSEI5MICo $1.89 Select an Administrative Item
Bide Stds Commission Fee: IBCBSC $1.00
i $2.89 $266.00 _ . TOPAIFLE; $268.89
Revised: 10/01/2012
i
SITE INFORMATION
OWNER:CHEVRON.INC.-CHEVRON FACILITY NUMBER 95954 OCCUPANCY:M0DIRECTIONAL CSTOREMINIMART
CODE REFERENCE DATA:2010 CALIFORNIA BUILDING CODE CONSSCOPE OF WORK STEVENS CREEK BLVD. VOLUNTARY BARRIER REMOVAVMAIMENANCE PROJECT:INSTALL DIRECTIONALSIGNAGE TO ACCESSIBLE EXTERIOR UPGRADES:ROUTEPROVIDE COMPLIANT NTER OF POSTING. AT EXISTING ACCESSIBLESIGNAGE AT 2]"TO CENTER OF POSTING.
S 8Y 58'UO E -BSJI'- ^ CREDIT
cur, 3 PROVIDE "HONK FORASSISATED DOMES
ATBU CARD DECALS
IBLEENRANCISLANDS.
X11' 3 INSTALL 30 SO FT OF TRUNCATED DOMES AT BUILDING ACCESSIBLE ENTRANCE
i31 Idir omftfne
X11 )T INTERIOR UPGRADES:
11 RELOCATE AND INSTALL NEW INTERIOR DOOR(WOMEN'S RESTROOM),INSTALLATION OF ADA
013 COMPLIANT RESTROOM SIGNS AND ADJUSTMENT OF DOOR TO COMPLIANT OPERATING PRESSURE.
INSTALL(6)HONK DECALS �ex� �`�/)C
WTHNEWCREDITCARD ® \ 1C'AN�'PY 1 F�LVIL`�VLL�F� "� E CONSTRUCTION NOTES
DECALS AT EACH DISPENSER I+1 p� d,9 pp
O
♦ (�EVfi:{��U ' SALL HALL MEET CURRENT 201 COMPLY WITHBUILDING
STATE AND FEDERAL REGULATION AND
p SHALL MEET CURRENT 2010 CALIFORNIA BUILDING CODE.
NRI WATER UNIT / \ 1 OQ
•
of INDEX OF DRAWINGS
u
SITEPLAN.............................................................................................. .........................SHEET 1
/ 4 m
S FLOOR PLAN.......................................................................................................................................................SHEET 2
/ Zg
Z EXTERIOR CONSTRUCTION DETAILS..............................................................................................................SHEET 3
Z EXTERIOR CONSTRUCTION DETAILS................................................................................................... .........SHEET
as
INSTALL(2) W 0
TRUNCATED DOMES AT ¢ < ® COP,BUILDING ENTRANCE N -
C v1MUNH T DEvELOPMENTD"PARTNIEivT LEGEND yI
\ % / CO goo BUILDING DIVISION-CJPi2H T iNO
✓ s INSTALL CHEVRON PROVIDED"HONK FOR
P. ROVE- ASSISTANCE"DECAL AT FUELING ISLAND
• goo CO o This set of plans and speancations MUST boke 01 INSTALL TRUNCATED DOMES
® O - -E)
oo =� Job site during construction. It is un!aivful to
changes or alterations on same,or to ot,
® therefrom,Without approval from the Building:ilf`::J'. a FURNISH AND INSTALL ACCESSIBLE ROUTE
541 DIRECTIONAL SIGNAGE
— The stamping this plan and Specifications S a
. O ,
behold to permit or to bean inoproroval al o.tl,=
N W 5e 0D . IMM — sDo'— of any provisions of any City Ordinance or S ,..,C
RESTRIPE COMPLIANT ACCESSIBLE WALKWAY(MIN 48"WDT16t1i1 ' -••^�•^-^' -•'
MAX CROSS HATCH AT 36"O.C.)WALKWAY TO BEA MAXIMUM 5%
RUNNING SLOPE WITH CROSS SLOPE NOT TO EXCEED 2% DATE �/ y/ ��a^'-•"- - -
PERMIT N0.
SITE PLAN
SCALE:1'=30'i! i
N rSMH
SHEETTITLE FIGURE NO.
WE /04/201$ SITE PLAN
5 OWNERSITE LOCATION
s ICHEVRON FACILITY NO.9-5954
10023 SOUTH DE ANZA BOULEVARD PROJECT NO.
0 15' 70' CUPERTINO,CALIFORNIA 12.489
X:\ENC-9n\CMaon ADA\..Stu A+mdM b WWv959%-1 W21 SwM W NUP 9N.CUV�5R.�9.595!_DN Pak.9.- m9
DOOR SCHEDULE
FLOOR PLAN SIZE DOOR TYPE THICKNESS I MATERIAL I STYLE FINISH FRAME TWE I HARDWARE CLOSER NOTES
SCALE.11W-I'-0'
3'-0" X 6'-8" 'A' 1-3/4" I HOLLOW METAL SWWG FACTORY 'A' LATCH AND LOCK ADA -
REMOVE OLD DOOR AND CLOSE UP OPENING WITH 3-5/8" 25
GA. METAL STUDS PATCH BACK DRYWALL TO MATCH EXISTING.
rer^�F�tlw•r[p.��2■� snDOOR TYPE 'A' FRAME TYPE 'A'
F"
&.1idirg 09W.vient
2.
yy 2-
MEN MEN
24-3" + y a n 1
2 2 2013
`3�� 1O'-0"
VdOMENS HALLWAY 1 E �I
X6• f2�Vi�iU �JFOi C9 OURIAM
R Aevnd By:
._6.
5
w e t INSTALL NEW 3'-0" X W-8" DOOR
`
4)1@ AT NON LOAD BEARING WALL.
DOOR NOTES:
MERCHANDISING
AREA 1. ALL EXIT DOORS SHALL BE PIVOTED OR SIDE HINGED SWINGING TYPE
2. THE MINIMUM SIZE FOR ANY DOOR SHALL BE S-0" X 6'-8" AND SHALL HAVE A MINIMUM OF 32" CLEAR
37'-6' 3. ALL DOORS SHALL HAVE A LEVEL FLOOR LANDING ON EACH SIDE OF THE DOOR NOT EXCEEDMI
4. A MINIMUM BOTTOM RAIL OF SOLID FLAT SURFACE SHALL BE A MINIMUM OF 10" (NO GLAZING PERMITTED
5. DOUBLE DOOR WIDTH SHALL BE S-O" NOMINAL OPENING (ACTIVE LEAF).
6. NO REVOLVING DOOR ALLOWED FOR ACCESSIBLE DOORS
CASHIER 7. CONTRACTOR SHALL FIELD VERIFY ALL DIMENSIONS
AREA
® DOOR HARDWARE NOTES:
1. DOORS SHALL BE OPERABLE FROM SINGLE EFFORT, NO GRASPING OR WRIST MOVEMENT USING LEVERS.
OFFICE 2. LATCHING AND LOCKING DOORS THAT ARE HAND OPERATED AND WHICH ARE IN A PATH OF TRAVEL ARE OPERABLE
BY LEVER TYPE, PANIC BARS, PUSH-PULL ACTIVATING BARS. U-SHAPED HANDLES OR OTHER HARDWARE DESIGNED
TO PROVIDE PASSAGE. LOCKED EXIT DOORS SHALL OPERATE AS ABOVE IN EGRESS DIRECTION
3. HARDWARE SHALL BE MOUNTED AT 38" -44" HIGH.
4. DOOR CLOSERS SHALL PROVIDE A MINIMUM OF 3 SECONDS TO MOVE FROM A 70 DEGREE OPEN POSITION TO A
POINT 3" FROM THE LATCH.
EFFORT TO OPERATE DOORS:
37'-6" 23'-3" INTERIOR DOORS = 5 POUNDS
• EXTERIOR DOORS - 5 POUNDS
FIRE DOORS = 15 POUNDS
NSMH
DRAw.v SHEETTIRE FIGURE NO.
_ovo4i2ot3 FLOOR PLAN
W E MIA
�.
� REVOt OWNER91TE LOCATION
S CHEVRON FACILITY NO.9-5954
REvw 10023 SOUTH DE ANZA BOULEVARD RRwscT No.
CUPERTINO,CALIFORNIA 12,489
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