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11090088CITY OF CUPERTINO BUILDING PERMIT fit 11 DING .ADDRESS: 10080 N WOLFF RD OWNER'S NAME: CUPERTINO FINANCIAL CFR PARTS LLC' FIR'S PHONE: 4085679900 0 LICENSED CONTRACTOR'S DECLARATION I cense Class l�" I,ic. H onlractor r,, i ? ice', "> 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 ('ode and that my license is in full force and effect. CONTRACTOR: PERMIT NO: 11090088 r V j ✓�%(),�r�^t i��� DATE ISSUED: 09/14/2011 BUILDING PERMIT INFO: BLDG F— ELECT f PLUMB MECII r— RESIDENTIAL COMMERCIAL JOB DESCRIPTION: SUGAR CRM - COMMERICAL TENANT IMPROVEMEN"f PREP OFFICE SPACE (460SQFT) 1 hereby affirm under penalty of perjury one of the following two declarations: have and will maintain a certificate of consent to self -insure for Worker's ompensauon, as provided for by Section 3700 of the Labor Code, for the pertonnance of the work for which this permit is issued. I have and w ill maintain Worker's Compensation Insurance, as provided for by Secuon 3700 of the Labor Code, for the performance of the work for which this permit is issued Sq. Ft Floor Area: APPLICANT CERTIFICATION I :ertit\ 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 budding construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes (We) agree to save uidemnifv and keep harmless the City of Cupertino against liabilities, judgments, eosts, and expenses which may accrue against said City in consequence of the ,ranting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the 'upertino Municipal Code, Section Q 18 _Date OWNER -BUILDER DECLARATION 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 riot intended or offered for sale (Sec.7044, liusmess & Professions Code) I as ownci 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 ('on ipensation. as provided for by Section 3700 of the Labor Code, for the perlimnance 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 certily 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, atter making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forihwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certilN 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 In building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save lndCllllllkr and keep harmless the City of Cupertino against liabilities, judgments, and expenses which may accrue against said City in consequence of the i,,, of this permit .Additionally, the applicant understands and will comply ;ell nnn-pone source regulations per the Cupertino Municipal Code, Section "I�,nautre Date Valuation: $2500 APN Number: 31620086.10080 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: / Z7 l / 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 fbr inspection. Signature of ApplicanC Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 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 & Safetv ('ode, Section 25532(x) should 1 store or handle hazardous material. Additionally, should 1 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. O origent: i-- 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 Add ARCHITEC'T'S DECLARATION understand my plans shall be used as public records. Licensed Professional COVER SHEET 11090088-D 10080 N WOLFE RD PERMIT # DATE PROJECT .;,Lr - ADDRESS APPLICANT Sass�n �c�drem.rr� z- c OWNER APN# �� �_ 2G—UrP RES. (LVNG) (GARAGE) comm. SQ. FT. (NEVi) .� . P E/�J RES. REMODEL CONTACT' __C6_ JSc-t'� ldre'vm-L; PHONB# % 9 PAX Gt VALUATION (Cost of Project) NOTES: READ. PAID CONSTRUCTION TAX (Y) (N) SCHOOL FEES (Y) (N) HOUSING NMG (Y) (I) HEART OF THE CITY (Y) (N) ISSUED BY - ''::_-? DATE �' 4 / TOTAL FEES cF CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10080 N WOLFE RD CONTRACTOR: T. PERMIT NO: 11090088 OWNER'S NAME: CUPERTINO FINANCIAL CTR PARTS LLC `' V i el O Ji tAA( DATE ISSUED: 09/14/2011 OWNER'S PHONE: 4085679900 ( l r wQ- i HONE NO: LICENSED CONTRACTOR'S DECLARATION F ELECT r— PLUMB 1/5111515 � -7Z), 3 BUILDING PERMIT INFO: BLDG License Class Lic. it o MECH RESIDENTIAL COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: SUGAR CRM - COMMERICAL TENANT IMPROVEMENT (commencing with Section 7000) of Division 3 of the Business & Professions PREP OFFICE SPACE (460SQFT) 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. 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 Sq. Ft Floor Area: Valuation: $2500 permit is issued. APPLICANT CERTIFICATION APN Number: 31620086.10080 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 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 th upertino Municipal Code, Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signature Date— Issued Date: �� t1 0 ❑ OWNER -BUILDER DECLARATION I hereby affirm that I aro 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 1, 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 wil I 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 I certify that in the performance of the work for which this permit is issued, I 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, I become subject to the Worker's Compensation provisions of the Labor Code, I must Health & Safety Code, Sectio 25505, 25533, and 25534. Ow agent: forthwith comply with such provisions or.this permit shall be deemed revoked. i` Date: !i APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that 1 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 I hereby affirm that there is a construction lending agency for the performance of Hork'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. I understand my plans shall be used as public records. Signature Date Licensed Professional CUPERTINO It Oq 0 agk DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (..41108) 777-3228 • FAX (408) 777-3333 • building(Dcupertino.org PROJECT ADDRESS 10 0 8 0No l f e road APN # 316-20-086 OWNER NAME PHONE 408.567.9900 E-MAIL EXT. 13 STR.EETADDRESS 2901 TASMAN DRIVE, CITY, STATE,ZIP SANTA CLARA, CA FAX 408.221.9304 SUITE 220 CONTACT NAME Sassan Pedramrazi PHONE E-MAIL spedramrazi@aaidesign.co 4082978899 STREETADDRESS 1036 The Alameda CITY,STATE. ZIP Sari Jose, Ca 95126 ��]FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ® ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ERIC EISEN LICENSENUMBER 870431 LICENSE TYPE BUS. LIC# COMPANYNAME EISEN ENVIRONMENTAL & E-MAIL ERICEISEN@EECSERVICES.ORG FAX (925) 723-0122 CONSTRUCTION SERVICES. STREETADDRESS 210 BERRELLESA ST., SUITE B CITY, STATE, ZIP MARTINEZ, CA 94553 PHONE (925) 723-0120 DESCRIPTION OF WORK DEMOLITION OF (E) CEILING SYSTEM, DEMOLITION OF(E)NON-BEARING PARTITION, DEMOLITION OF(E)LIGHTING DEMOLITION OF (E) FINISHE DEMOLITION OF (E) COUNTER TOP, SINK & PLUMBING LINES DEMOLITION WILL NOT EFFECT EXIT PAT OF TRAVEL AS WELL AS ADJACENT OCCUPANCY RESIDENTIAL # DWELLING OFFICE USE ONLY USE occ TYPE SO. Fr. VALUATION FLOOR AREA UMTS COMMERCIAL 460 s . f . f fi, off r1 � ) �/,�7 �/l 4d,5 6 I Q U FLOOR AREA - TYPE OF CONSTRUCTION I I - B # STORIES 3 / AQMD JOB NUMBER RECEIVED BY: TOTAL VALUATION: By my signature below, I certify to each o ing: I am the property owner or authorized agent to act on the property owner's behalf. I have read this Qdis application and the information 1 have provirrect. I have read the Description ofWork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildinctio I thorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: 09-12-11 SUPPLEMENTAL I­NFORMATIOAED PRIOR TO ISSUANCE OF DEMOLITION PERMIT OFFICE USE ONLY PLAN CHECK TYPE Provide Job Number from Bay Area Air Quality Management District www.baagmd.org Q@% 415-749-4762. H t ®TC _ Provide three copies of a site plan showing protection for any trees 10" in diameter or more at 3' above grade. ss ❑ STANDARD _ Provide letter from PG&E (408-725-3325) stating all gas and electric has been disconnected. ❑ LARGE Provide a letter of inspection, tests, and abatement ofany Hazardous Materials. Letter to be initiated by person(s) certified in asbestos, mercury and/or hazardous material examination. ❑ MAJOR Planning Dept clearance to verify building is not considered an historical landmark. Allow 10 business days. Provide letter of clearance of all vermin from a licensed pestcontrol contractor. Applicant shall call the Public Works Department at 408-777-3104 and schedule a "habitable dwelling" inspection. Provide signed Debris Bin and Recyclable Materials form. Commercial Buildings Only: Provide Fire Dept clearance for fire suppression / alarm system review. Den:oApp_2011.doc revised 03/16/11