07030348 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10123 N WOLFE RD CONTRACTOR:TBD-TO BE PERMIT NO:07030348
DETERMINED
OWNER'S NAME: ORBIT RESOURCES DATE ISSUED:06/09/2011
OWNER'S PHONE: PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
REVISION-2 HR SEPARATION FOR EXITING REVISION
License Class Lic.# EAST(NON-STRUCTURAL)ORGINAL PERMIT#05110089-DPR
IS NOT CONTRACTOR.WE NEED CONTR INFO.
Contractor Date
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: Sq.Ft Floor Area: Valuation:$0
1. 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
performance of the work for which this permit is issued. APN Number:31620037.00 Occupancy Type:
2. 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.
PERMIT EXPIRES IF WORK IS NOT STARTED
APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR
I certify that I have read this application and state that the above information is
correct.1 agree to comply with all city and county ordinances and state laws relating 180 DAYS FROM LAST CALLED INSPECTION.
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, Issued by: Date:
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. RE-ROOFS:
Signature Date 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
the following two reasons:
1. 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 HAZARDOUS MATERIALS DISCLOSURE
sale(Sec.7044,Business&Professions Code)
2. 1,as owner of the property,am exclusively contracting with licensed contractors to I have read the hazardous materials requirements under Chapter 6.95 of the
construct the project(Sec.7044,Business&Professions Code). California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I hereby affirm under penalty of perjury one of the following three declarations: Safety Code,Section 25532(a)should I store or handle hazardous material.
1. 1 have and will maintain a Certificate of Consent to self-.insure for Worker's Additionally,should I use equipment or devices which emit hazardous air
Compensation,as provided for by Section 3700 of the Labor Code,for the 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
performance of the work for which this permit is issued. Health&Safety Code,Sections 25505,25533,and 25534.
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 Owner or authorized agent:
permit is issued. Date:
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 CONSTRUCTION LENDING AGENCY
Compensation laws of California. If,after making this certificate of exemption,I I hereby affirm that there is a construction lending agency for the performance of work's
become subject to the Worker's Compensation provisions of the Labor Code,I for which this permit is issued(Sec.3097,Civ C.)
must forthwith comply with such provisions or this permit shall be deemed Lender's Name
revoked.
Lender's Address
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is ARCHITECT'S DECLARATION
correct.I agree to comply with all city and county ordinances and state laws relating I understand my plans shall be used as public records.
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save Licensed Professional
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
CITY OF CUPERTINO
cvRTaNO PERMIT APPLICATION FORM
0' 30 34�
APN# Date:
g '0 O- 3-
Building A dress: Mailing Address (if different from building address):
1ocz
Owner's Name: Phone#: -777, 308'
PRCR:2u P's
Contractor: License#:
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Contact: Phone: 7-7 7-5346) Cupertino Business License#:
Fax: Z-ZS- O ?J�OoZJ
Building Permit Info:
Bldg W Elect ❑ Plumb ❑ Mech ❑
Job Description: Z b4R Sept%&,1W c--,q�z ISG tj t(4 Cl 1 S 10
Residential ❑ Commercial ❑
Sq.Ft. Floor Area: Sq.Ft.:
Cost of Project: Occupancy Group:
Type of Construction: Please check this box if the project is a
P second-story addition:
Project Size: Standard ElLarge El Major El
Quantity Fee ID Fee Description Fee Group
BAPPLOTHER Other Appliances MECHANICAL
BBOILERI Boiler<= 100,000 Btu MECHANICAL
BBOILER2 Boiler> 100K to 500K Btu MECHANICAL
BBOILER3 Boiler>500K to IM Btu MECHANICAL
BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL
BBOILER5 Boiler> 1.75M Btu MECHANICAL
BCONSTAX Construction Tax BUILDING
BCONSTAX Ind/Off/Comm/Quasi BUILDING
BCONSTAXBQ Con. Tax for BQ Zone BUILDING
BCONSTAXH Hotel and Motel BUILDING
BCONSTAXR Constax-Resi/Mobile BUILDING
BELEC1000 Elec 600V<= 1000A ELECTRICAL
BELEC1001 Elec 600V> 1000A ELECTRICAL
BELEC200 Elec Svcs 600V<=200A ELECTRICAL
BENERGY Energy BUILDING
BENERGYADD Energy Add Multi - - BUILDING
BINVESTIGA Investigation fee BUILDING
1 of 3
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CITY OF CUPERTINO
PERMIT APPLICATION FORM
CUNO
Quantity Fee ID Fee Description Fee Group
BMISCELL Miscellaneous Fee BUILDING
BMITIGATC Comm.Housing Mit. Fee BUILDING
BNUCOMME New Comm Electric ELECTRICAL
BNUCOMMM New Comm Mechanical MECHANICAL
BNUCOMMP New Comm Plumb PLUMBING
BOVERTIME Inspection Overtime BUILDING
BPBACKFLOW Atmospheric Vacuum PLUMBING
BPCESSPOOL Cesspool PLUMBING
BPERMFEE Bldg Permit Fees BUILDING
BPFIXTURE Pblg Fixture PLUMBING
BPGAS Gas Piping System Fee PLUMBING
BPINTERCEP Ind Waste Interceptor PLUMBING
BPLANCHK Plan Check Fee BUILDING
BPLANCKADD Plan Check Add Multi BUILDING
BPLANCKREP Plan Check Repeat Fee BUILDING
BPREPIPE Re i e Of Fixtures PLUMBING
BPSEWAGE Sewage Disposal PLUMBING
BPSEWER Sewers PLUMBING
BPSPRINK Lawn SprinklerBackflo PLUMBING
BPSTORM Storm/Rain Water PLUMBING
BPTRAP Kitchen Trap PLUMBING
BPVENT Alt of Drain &Vent PLUMBING
BPWATER Install/Alter Water Pie PLUMBING
BPWHEATER Water Heater/Vent PLUMBING
BPWSVCS Main Water Service PLUMBING
BREINSPECT Reinspection Fee BUILDING
BREMACOVER A/C Unit> 10,000 cfm MECHANICAL
BREN AIRHAN A/C Units<= 10,000 cfm MECHANICAL
BREMAPPLI Appliance Install MECHANICAL
BREMBUSWAY Remodel Busways ELECTRICAL
BREMFIXT Lighting Fixtures ELECTRICAL
BREMFURN Relocation of Furnace MECHANICAL
BREMFURNOV Relo Furnace> l OK btu MECHANICAL
BREMHEAT Heater Installation MECHANICAL
BREMINHOOD Installation of Hood MECHANICAL
BREMMISC Misc Apparatus ELECTRICAL
BREMNRAPP Rem Non-Res Appliance ELECTRICAL
BREMPOLE Pole/Platform Fixture ELECTRICAL
BREMPOWER Power Device/Apparatus ELECTRICAL
BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL
BREMRELOCA Relocation of Hood MECHANICAL
BREMREPALT Repair/Alter Heating MECHANICAL
BREMRESAPP Remodel Res Appliance ELECTRICAL
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From: Ron Bernhardt
Sent: Fri 4/13/2007 1:20 PM
To: Mike Rohde; 'Greg Casteel'
Cc: bayareaconst_mgmt@sbcglobal.net; 'Dirk Mattern (E-mail)'
Subject: Vallco Fashion Park-2HR Separation Submittal
Greg,
I am submitting the requested 2-HR separation information as a full submittal today as part of the Shell Package. The
sheets being submitted are for work specifically related to the work requested during your recent walk-through of the
facility in anticipation of issuance of a Temporary Certificate of Occupancy (TCO).
A brief description of the sheets and what is included follows:
TS-1: Title sheet identifies sheets being issued under this submittal (Bulletin 20). Most notably are an entire package of
the photometric plans for the west and east entry areas as requested by SCFD and previously sent via email PDF.
A100.3: Adds 90 minute doors on magnetic hold open hardware along the west side with additional layers of gypsum
board required at the clouded walls common to the exterior.
A100.6: Same as A100.3 above except for the east side.
A421: Added details 3, 8 and 11 addressing fire protection issues for the areas in question. A500.3, A500.6 and A500.8:
Reflected ceiling plans for the areas addressed on A100.3 and A100.6. Noted spray-on fireproofing of the exposed steel
beams above the driveline.
A906: Added 90 minute doors to the door schedule for the doors shown on A100.3 and A100.6.
M111: Mechanical changes required to accommodate doors on west side.
E111: An 8-1/2"x 11" plan of this area is included for electrical changes on the west side doors.
E114: Electrical changes for doors on east side.
E211: Lighting modifications for doors (west).
E214: Lighting modifications for doors (east).
E703: Panel Schedules revised to accommodate the doors.
E900's: Normal and emergency exit lighting photometric plans.
Ronald E. Bernhardt, AIA
Senior Associate _
Perkowitz+ Ruth Architects zFCEWED 971
600 Anton Boulevard, 16th Floor
Costa Mesa, CA 92626 ; 'L�bi
[714] 850-3400 phone ax
[714] 850-3499 fax
mailto: rernhardt@prarchitects.com
www.prarchitects.com
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