11030026 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10201 TORRE AVE CONTRACTOR:DPR CONSTRUCTION INC PERMIT NO: 11030026
OWNER'S NAME: WOODMONT REAL ESTATE MANAGEMENT 1450 VETERANS BLVD DATE ISSUED:04/28/2011
OWNER'S PHONE: 6505923960 REDWOOD CITY,CA 94063 PHONE NO:(650)474-1450
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Class Lic.# �� t/ (j
� MECH r RESIDENTIAL r COMMERCIAL r
Contractor _VP� � 11.1L't1RUL71otc.�Date 4"1 11
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:ADD 1 FUME HOOD IN EXISTING I ST FL ROOM 157,
(commencin with Section 7000)of Division 3 of the Business&Professions INSTALL RATED EXHAUST DUCT TO 3RD FLO ROOF AND NEW
Code at my license is in full force and effect. ROOF MOUNTED EXHAUST FAN
e eby 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 Sq.Ft Floor Area: Valuation:$44360
p Viissueil.
j;�
APPLICANT CERTIFICATION APN Number:36941005.BLDG Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of 's permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION.
with all n -po t source regulations per the Cupertino Municipal Code,Section
9.18.
��°('
Signature Date Issued Date:
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material berg installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove al I new materials for
I,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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 HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)should I store or handle hazardous material.
Additionally,shouId I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's ;HraaN& fety Code,Sec'ons 25505,25533,and 25534.
Compensation laws of California. If,after making this certificate of exemption,Ibecome subject to the Worker's Compensation provisions of the Labor Code,I mu horized agent:
forthwith comply with such provisions or this permit shall be deemed revoked. Date: (C5
APPLICANT CERTIFICATION 7z� CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of Hork's
correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18• 1 understand my plans shall be used as public records.
Signature Date Licensed Professional
CITY OF
is CITY OF CUPERTINO
TENANT IMPROVEMENT
CUPERTINO PERMIT APPLICATION FORM
APN # 4�1, q -4-1 WS-/,Q / Date:
(,,(.J 3/4/11
Building Address: 10201 TORRE AVE.
Mailing Address (if different from building address):
Tenant V (If tenant please provide a letter from the building owner approving the tenant improvement.)
Building Owner ❑
Are Hazardous Materials being used as part of this project? Yes 0 No
Tenant[Building Owner's Name: Phone#: 650-592-3960
PMCF PROPERTIES LLC(OWNER)/WOODMONT REAL ESTATE(AGENT)
Contractor: DPR CONSTRUCTION Phone #: 408-370-2322
Fax#: 408-716-2972
Cupertino Business License: State Contractor License #: 599846
Contact: DEREK JENSEN Phone#: 650-333-8412
Fax/e-mail: 408-716-2972
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated areas):
If 2,500 sq. ft. or less,compliance with the Landscape Water-Efficiency Checklist is required.
If more than 2,500 sq. ft., a complete Landscape Project Submittal is required.
Compliance Method: ❑ Plant Type ❑ Water Budget
Job Description (be specific):
ADD (1) U FUME HOOD IN EXISTING 1ST FLOOR ROOM 157. INSTALL RATED EXHAUST
DUCT TO 3RD FLOOR ROOF AND NEW ROOF MOUNTED EXHAUST FAN.
Tenant Improvement Includes Re-Roof. Yes ❑ No Vu If yes, number of squares
Tenant Improvement Includes Structural Yes V No ❑
Type of Construction (Usage Class): IIA Occupancy Type: B
1-A, 1-B ❑ II/IIl/V-A ❑ I1/III B, IV-HT, V-B Valuation: 44,360
Project Size: Counter ❑ Expres Standard*�_L-
Major ❑
Green Building: Please complete Leed for commercial interiors checklist &attach it to the application
or if applicable, include in plans& sheet index
LEED Points Achieved
*** For Office Use Only*** Revised 12-06-10
«fesWOO�MONT
March 1.1, 2011
Lary Squarcia
Senior Building Inspector
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Re: Torre Plaza, 10201 Torre Ave. Cupertino, CA 95014
Dear Mr. Squarcia,
This letter is to confirm that the building owners of Torre Plaza, 10201 Torre Ave. in Cupertino
California, are aware of and have given Lab 126 permission to construct a fume hood in the
building.
If you have any questions, please contact me anytime.
Sincerely,
Woodmont Real Estate Services
Scott M. PritchettCPM, RPA
Senior Vice President
Cc: Mark Gri co
MAR 14 2011
BY:
2001 Winward Way,Suite 100 1 San Mateo,CA 94404
Tel:650.592.3960 Fax:650.591.4033 1 www.wres.com