The URL can be used to link to this page

11050114 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20730 STEVENS CREEK BLVD CONTRACTOR:W L BUTLER INC PERMIT NO: 11050114 i OWNER'S NAME: BYER PROPERTIES 204 FRANKLIN ST DATE ISSUED:07/05/2011 OWNER'S PHONE: 4156262937 REDWOOD CITY,CA 94063 PHONE NO:(650)361-1270 ❑ LICENSED CONTRACTOR'S DECLARATION rBUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# .��J MECH RESIDENTIAL COMMERCIAL Contractor W1, `gJ ILIA C'00>`(V.Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: COMMERCIAL DEMO OF EXISTING LOADING DOCK 2400', DEMO WALL FOR 2 NEW OPENINGS 1000'. (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. Sq.Ft Flour Area: Valuation:$500000 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:35908020.20730 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 PEiMIT 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 M .. ( P fr ; granting of this permit. Additionally,the applicant understands and will comply Issued by. Date f with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. b 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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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) 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(x)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 the Health&Safety Code,Sect'oks 25505,255 and 25534. Section 3700 of the Labor Code,for the performance of the work for which this _ ( ��J permit is issued. Owner or authorized agent: 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 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. I Signature Date I I I CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 B i CUPERT1t� O (408)777-3228 • FAX;7TERATION/TI x/77-3333 •building aC�cupertino.org lla5 // i ❑NEW CONSTRUCTION ❑ ADDITION ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS r. ar' I APN# a p k� OWNER NAME PHO , E-MAIL t STREET ADDRES CI STA FAX ' t. CONTACT NAM -� , pI}O E-MA 1 __ c�. STREET ADDRESS �V CVTATE,ZIP FAX �. ❑OWNER ElOWNER-BUILDER ❑ OWNERAGENT 11 CONTRACTOR ❑CONTRACTOR AGENT ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME ..,. ,f� LICENSE NUMBER LICENSE TYPE BUS.LIC# COMP ANY NAME E-MAB FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME V LICENSE NUMBER �� r °• BUS.LIC# kw: etCOMPANYNANM g E-MAIL FAX STREET ADDRESS a STATE,ZIP HONE' e DESCRIPTION OF WORK 1�✓ a EXISTINGUSfi PROPOSED USE CO TYpE #STOIjiS "OFFICUVSEONLY yW�" ®�`/ 'QCC- 'TYPB .bESCRTPTIONS .Fr_ _= YALUA'r[ON - EXIST NEW FLOOR DEMO. TOTAL �"$p - AREA NET AREeC'/ AREA ARE c ( •- �� r 1 �` BATHROOM KITCHEN - OTHER - REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA:❑ DETACH - ❑ ATTACH - - - q DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDTTION2 ❑NO - PRE-APPLICATION ❑ YES IF YES,PROVIDE COPYOF PLANNER'S NAME: RECEIVED$Y ,'AI;ifA.Tf PLANNING APPL k ❑NO PLANNING APPROVAL I.EFTER By my signature below,I ce��Itob �e ppilowing: I amt property owner or authorized agent to act on the property owner's behalf. I have read this application and the inforr�Intioded 4s co ct I hav read the Description of Work and verify it is accurate. I agr to comply with all applicable local ordinances and state laws relatg c nstru Io Iau orize representatives of Cupertino to enter the abov identifed property for inspection purposes. Signature of Applicant/�geTlt: /`° Date: 7 11 SUPPLEMENT INFORMA'T'ION REQUIRED = TLAN Cis : "E ROIialrlc sL>p New SFD or Multifamil dwellings: Apply for demolition permit for ❑ ,ovER TcGIJNTEx CJII DHZG PLALV zp viEW existing building(s). Demo Ion permit is required prior to issuance of building permit for new building. Q.I xpREss YLANNINGELe11YHEYTEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Q'sxArmAxn ❑ rus lCVoxxs" form if any Hazardous Materials are being used as part of this project. zAxc> _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑�hrAaoR " �]:sANITARx sEvvi R DrsTiucr 'ENuixoivlp Tk LTH i i Bld APP_2011.doc revised 03/16/11 g 1 DEMOLITION CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION F DRESS: 20730 stvns crk blvd. DATE: 05/13/2011 REVIEWED BY: bobs. BP#: VALUATION: $500,000 N: C� �-U � �t/ J �� *PERMIT TYPE: Demolition Permith3 tl,'�� _�� L T'-PE- PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1 COMMLDEM WORK commercial demo of 2,400 sq ft at existing loading dock demo wall for 2 new openings. SCOPE FEE ID FLR AREA s.f. 1DEMOCOM 3,400 30'e,-h. itr3t i .j, I'iall C- .,J; ,i-,,:,:. tF.ri'I'7�t;ati;fIt;?z. l+r r.:1 j�.i< pdit.yj,r, Ll ifi, NOTE: These,fees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 in o. FEE ITEMS (Fee Resolution 09-051 E'. 7/1/10) FEE QTY/FEE MISC ITEMS 21 7TJ j, PC `e c Permit Fee: $760.00 Suppl.Insp.Feer Reg. 0 OT0.0 hrs $0.00 t 1'a3 e/..F:),,II6t'7?'t'1Iall;C>It I Strong Motion Fee: 1BSEISMICO $105.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $20.00 i SUBTOTALS: 1 $885.00 $0.00 TOTAL FEE: $885.00 Revised: 04/29/2011 -0 . LfG'QJ51 1� '.5