09080243CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10050 N WOLFE WOLFE RD FLOOR] -3 CONTRACTOR: OPI COMMERCIAL PERMIT NO: 09080243
BUILDERS
"" 'R'S NAME: MENLO EQUITIES 1445 LEIGH AVE DATE ISSUED: 10/06/2009 I
r _ .*'NER'S PHONE: 4085679900 LOS GATOS, CA 95032 PHONE NO: (408)3774800
❑ LICENSED CONTRACTOR'S DTCLARATION
License Class Lic. # 4F !
Contractor Date (/ "
1 hereby affirm that 1 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
1 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 tions per the Cupertino Municipal Code, Section
9.18. �f
Cc;• Date �—C
❑ 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
constrict 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, 1 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 1 ---ding construction, and hereby authorize representatives of this city to enter
e above mentioned property for inspection purposes. (We) agree to save
:nify 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
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
MECH f— RESIDENTIAL r COMMERCIAL F_
JOB DESCRIPTION: INTERIOR CORRIDOR & LOBBY
IMPROVEMENTS.ADA
COMPLIANT RESTROOMS @1 ST AND 2ND FLOOR; NEW DOORS
CEILING T -BAR, CARPET, DUCT REGISTER RELOCATION &
Sq. Ft Floor Area: Valuation: $283000
APN Number: 31620086.FLI-3 I 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, 1 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 Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Owo- itho ' d agent: Date(/ �y _
CO
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
1 understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO BUILDING PERMITDATE
BUILDING ADDRESS: 10050 N WOLFE RD FLOOR I-3 CONTRACTOR: OPI COMMERCIAL PERMIT NO: 09080243
BUILDERS
OWNER'S NAME: MENLO EQUITIES 1 445 LEIGH AVE I DATE ISSUED: 10/06/2009 1
OWNER'S PHONE: 4085679900 1 LOS GATOS, CA 95032 1 PHONE NO: (408)3774800 1
❑ LICENSED CONTRACTOR -A DECLARATION
License Class Lic.# ( 6 Z'�`
Contractor I Date ' _)r
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 Date
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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)
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.
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. l 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 sour gulations per the Cupertino Municipal Code, Section
9.18. J ✓�
Signature Date
JOB DESCRIPTION: RESIDENTIAL
INTERIOR CORRIDOR & LOBBY IMPROVEMENTS.ADA
COMPLIANT RESTROOMS @1ST AND 2ND FLOOR; NEW
DOORS
CEILING T-BAR, CARPET, DUCT REGISTER RELOCATION
REVISION #1 REPLACE FINISHES IN 2 BATHROOMS
Sq. Ft Floor Area: I Valuation: $283000
APN Number: 31620086.FLI-3 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DA",9 FR"M LAST CALLED INSPECTION.
Issued by" — Date:
i
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 Management District I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Section , 25533, and 25534.
r �(u
Owner or authorized agent: 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
I understand my plans shall be used as public records.
Licensed Professional
o�
ro
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10050 N WOLFE RD FLOORI-3
CONTRACTOR: OPI COMMERCIAL
PERMIT NO: 09080243
BUILDERS
OWNER'S NAME: MENLO EQUITIES
445 LEIGH AVE
DATE ISSUED: 10/06/2009
OWNER'S PHONE: 4085679900
LOS GATOS, CA 95032
PHONE NO: (408)3774800
❑ LICENSED CONTRACTOR'S DECLAggRATION
r ELECT r PLUMB r
5
BUILDING PERMIT INFO: BLDG
License Class Lic. #^� lr,
r r �
/'
Contractor�ll Date ,1641
MECH RESIDENTIAL COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: INTERIOR CORRIDOR & LOBBY IMPROVEMENTS.ADA
(commencing with Section 7000) of Division 3 of the Business & Professions
COMPLIANT RESTROOMS @I ST AND 2ND FLOOR; NEW DOORS
Code and that my license is in full force and effect.
CEILING T-BAR, CARPET, DUCT REGISTER RELOCATION &
8/5/10 - REV# 2 - RESPONSE TO FIRE INSPECTION COMMENTS FOR DE -
I hereby affirm under penalty of perjury one of the following two declarations:
BATING OF ALL TENANT CORRIDOR DOORS-REV#2 ISS'D 9/16/10
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.
l 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
Sq. Ft Floor Area:
Valuation: $283000
permit is issued.
APPLICANT CERTIFICATION
APN Number: 31620086.FLI-3
Occupancy Type:
l 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,
PERMIT EXPIRES IF WORK IS NOT STARTED
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non -point source regulations per the Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18.
'
Signature lam- Date
Issued by /— Date:
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
RE -ROOFS:
the following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
I, as owner of the property, or my employees with wages as their sole compensation,
installed without first obtaining an inspection, I agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec.7044,
inspection.
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain
Section 3700 of the Labor Code, for the performance of the work for which this
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
permit is issued.
Additionally, should I use equipment or devices which emit hazardous air
l certify that in the performance of the work for which this permit is issued, l shall
contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Compensation laws of California. If, after making this certificate of exemption, l
Health & Safety Code, Sections 25505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, 1 must
Owner or agent:
forthwith comply with such provisions or this permit shall be deemed revoked.
Date: _�
gl
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
I certify that l 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
1 hereby affirm that there is a construction lending agency for the performance of work's
to building construction, and hereby authorize representatives of this city to enter
for which this permit is issued (Sec. 3097, Civ C.)
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Lender's Address
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
ARCHITECT'S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
Yr l FEE ESTIMATOR - BUILDING DIVISION
ADDRESS:
DATE:
REVIEWED BY:
APN:
BP#:
'VALUATION:
$100
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
„' < ".
APPLICATION
TYPE:
1B TI
MYECHANICAL Q Yes •' No
PLUMBING Q Yes Q No
ELECTRICAL
Q Yes O No
wW
a
cc
3U
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s .ft.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
II-B,III-B,IV,V-B
0
$0.00
$0.00
TOTALS:
0
$0.00
$0.00
7r rlr. bur
C ..
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 09-05I Eff' 7/I/09)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: E) Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:0 Reg.
0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Acoustical Fee:
Q Yes Q No
$0.00
0
0
Work Without Permit? Q Yes Q No
$0.00
Plannin Fee:
$0.00
Select a Non -Residential
Building or Structure
0
�
1 ruU�•f lJrx•rrr+rc•rrtcrart�: � ; � .
Strong Motion Fee:
IBSEISMICO
$0.50
2.0 hrs
$252.00
Revision
ISUPPKFEE Over the Counter
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
1 $1.50
$252.00
TOTAL FEE:
$253.50
Revised: 7/28/2010