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10120125I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10080 N WOLFE RD STE SW3-350 OWNER'S NAME: CUPERTINO FINANCIAL CTR PARTS LLC OWNER'S PHONE: 4085679900 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # 7 ?D G Date 7� ✓ Contractor _/� (✓' / 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 f -Date ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that I am exempt from (he Contractor's License Law for one of the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, wil I 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). 1 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. CONTRACTOR: APPLIED CONSTRUCTION PERMIT NO: 10120125 TECH 1230 OAKMEAD PKWY DATE ISSUED: 03/03/2011 SUNNYVALE, CA 94085 PHONE NO: (408)252-9990 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: COMM'L TI- DRYWALL,DOORS,PAINT;INTERIOR EXPANSION OF ONE SERVER ROOM(I071SQFT);EXTERIOR,BUILD A ROOF PLATFORM W/ROOF SCREEN & INSTALL 20 TON CHILLER Sq. Ft Floor Area: I Valuation: $150000 APN Number: 31620086.3350 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: 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. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(s) 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 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner horize "ant: 4 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 Address ARCHITECT'S DECLARATION Date I understand my plans shall be used as public records. I CITY OF CUPERTINO BUILDING PERMIT _...,ct� 4,- In ✓ UJ-0 I BUILDING ADDRESS: 10080 N WOLFE RD STE SW3-350 OWNER'S NAME: CUPERTINO FINANCIAL CTR PARTS LLC OWNER'S PHONE: 4085679900 ❑ LICENSED CONTRACTOR'S DECLARATION License Class_ Lic. # Contractort'' A5 ko J07 6CM5� I Date 12 �i f 20 Z 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 th Cupertino Municipal Code, Section Sign. /� //)� Signature ��' I �C( Date ' i ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 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. 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 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. CONTRACTOR: APPLIED glAtIOTT NO: 10120125 CONSTRUCTION TECH pp►� 1230 OAKMEAD PKWY DATE ISSUED:03/03/2011 SUNNYVALE, CA 94085 PHONE NO: (408)252-9990 JOB DESCRIPTION: RESIDENTIAL u COMMERCIAL COMM'L TI- DRYWALL,DOORS,PAINT;INTERIOR EXPANSION OF ONE SERVER ROOM(1071SQFT);EXTERIOR,BUILD A ROOF PLATFORM W/ROOF SCREEN & INSTALL 20 TON CHILLER 5/17/2011 - DEFR'D#1 - 880SQFT SERVER ROOM ANCHORAGE- ISSD 8/5/2011 Sq. Ft Floor Area: I Valuation: $150000 APN Number: 31620086.3350 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Yanagement District I will maintain compliance with the Cupertino unicip ode, Chapter 9.12 and the Health & Safety Code, Sections 2 05,116 a 5534. Owner or authorized agent Date: Q$ OS�f1 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 Signature, Date Fm_� CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION imiADDRESS: 10080 n. wolfe rd. DATE: 05/17/2011 REVIEWED BY: bobs. APN: BP#: 10120125 *VALUATION: j$10,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION 1DS PERMIT TYPE: WORK 1880 sci ft server room anchorage. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID Deferred Submittal (Not R-3) II-B,III-B,Iv,v-B 0 $0.00 $0.00 TOTALS: 1 0 $0.00 $0.00 MECH, HOURLY ()Yes (E) No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No r ti,j.., ,,,e•. , �' >Ll NOTE: These fees are based on the Preliminary information available and are onlv an estimate. Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 09-051 Eff' 711110) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes O No $0.00 ® hours $504.00 Plan Check, Hourly ISTPGNCK Suppl. PC Fee: E) Reg. 0 OT rcolhrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.e Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (. (>iItE7'itc'tf!siF 1(:,i Acoustical Fee: 0 Yes (F) No $0.00 0 Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 i F I as c' �7C�C11111t:f7FGft.+(�±! 1 E, �. Strong Motion Fee: IBSEISMICO $2.10 2.0 J hrs $252.00 Inspections IINSPMIS Standard Inspections Bldg; Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $3.10 $756.00 TOTAL FEE: $759.10 Revised: 04/29/2011 CITY OF CUPERTINO IM-7, FEE ESTIMATOR - BUILDING DIVISION ADDRESS: p DATE: REVIEWED BY: APN: BP#: EVALUATION: 1$150,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: g TOl �L FLOOR .�RF,a: PENTAMATION 1 B TI PERMIT TYPE: WORK U. commercial offices ace expand one server room build roof platform, install 20 ton chiller, SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 1,071 $1,893.28 IBTIPLNCK $1,004.08 IBTIINSP TOTALS: 1,071 1 $1,893.28 1 1 $1,004.08 MECH, HOURLY 0 'lees Q No PLUMB, HOURLY 0 Yes Q No ELEC, :HOURLY Q Yes Q do Mech. Plan Check 0.0 hrs $0.00 f>hrurh. P(crn �ierk Plan Ch<<ck Mech. Permit Fee: IMPERMIT Pomit r-Cc. Gtzx. P�wnw Fc' Other Mech. Insp. 0.0 hrs $42.00 1 Oilier Numb i;l : Li 0/"I, r [-.A'<. Ire r HCCh. Ilt.�h. ANC IF1sl1. I' F'i'.: I;ICc. Insp. FCC. NOTE. These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addh7 info. FEE ITEMS (Fee Resolution 09-051 Eff 7/1/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,893.28 4 hours $504.00 Plan Check, ISTPLNCK Hourly Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 0 # $126.00 Mechanical IMCRAA Cooling Unit Permit Fee: $1,004.08 Suppl. Insp. Fee10 Reg. 0 OT 0.0 1 hrs $0.00 0 s.f. Re -roof $348.00 IREROOFCOM PME Unit Fee: $0.00 PME Permit Fee: $42.00 Constl action Tar Acoustical Fee: 0 Yes (E) No $0.00 0 0 Work Without Permit? 0 Yes E) No -°$0.00 Planninp- Fee: PLLONGRNGC $0.00 0 0 i Travel Documentation Fee: ITRAVDOC $42.00 Strong Motion Fee: 1BSEISMICO $31.50 LLO hrs $252.00 IINSPMIS Inspections Standard Inspections Bldg; Stds Commission Fee: IBCBSC $6.00 SUBTOTALS: $3,018.86 $1,230.00 TOTAL FEE: 1 $4,248.86 Revised: 12/07/2010