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11060043 CITY OF CUPERTINO BUILDING PERMIT BFILDING ADDRESS: 20735 STEVENS CREEK BLVD CONTRACTOR:TM!!f_'`f't)FtE PERMIT NO: 11060043 i F'Tr'R'17111Ct'r ONNNFR'SNAME: HK INVESTMENT'S � / DATE ISSUED:09/02/2011 A'VER'S PHONE: 4082053496 Mt' PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL, COMMERCIAL 11 License Class_2 Lic.# '9C VERIZON WIRELESS- COMMERCIAL TENANT IMPROVEMENT Contractor �lPn�rnSk.�. ��ny1��/ _ (2910SQFT) NON-STRUCTURAL INCLUDES MECHANICAL, hereby affirm that I am licensed under the provisions of Chapter 9 ELECTRIC,PLUMBING,DRYWALL& FRAMING. (commencing with Section 7000)of Division 3 of the Business&Professions ('ode and that my license is in full force and effect. hereby affirm under penalty of perjury one of the following two declarations: I lime 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 perlorniance of-the work for which this permit is issued Sq.Ft Floor Area: Valuation:$175000 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the I-abor Code,for the performance of the work for which this APN Number:32632054.00 Occupancy Type: permit is issued i- APPLICANT CERTIFICATION I :crlill 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 PERMIT ISSUANCE OR t,,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. utdcnutify 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 Issued b � Date: with all non-point source regulations per the Cupertino Municipal Code,Section r) 18 RE-ROOFS: gnature___ DateAll roof's 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 1 hereby affirm that 1 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, %+!.I do the work.and the structure is not intended or offered for sale(See.7044, f3usmCSS& Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE constrtet the project(Sec 7044,Business&Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will 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(a)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 C ompcnsation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District 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 W'orker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agent: Dater 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 1 hereby affirm that there is a construction lending agency for the performance of forUhwlth 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 ARCHITECT'S DECLARATION indemnity'and keep harmless the City of Cupertino against liabilities,judgments, ,ts,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. .WiTIV of thre permit Additionally the applicant understands and will comply th all non-point Source regulations per the Cupertino Municipal Code_Section Licensed Professional 18 —— Signature Date REVII�IVr'4 IP CITY OF CUPERTINO BUILDING PERMIT DATE _ BUILDING ADDRESS: 20735 STEVENS CREEK BLVD CONTRACTOR:MENFMSHA PERMIT NO: 11060043 DEVELOPMENT O" R'S NAME: HK INVESTMENTS 4950 W 145TH ST DATE; ISSUED:09/02/2011 0N4,. 'S PHONE: 4082053496 HAWTHORNE,CA 90250 PHONE NO:(818)212-4958 LIC TRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB Lich, lass Lic ti Lt' ) r _ MEC" ' RESIDENTIAL ' COMMERCIAL Con�affirnl�hat DateGIensed under the provisiq s of hapter 9 JOB DESCRIPTION: VE R170N WIRFI.F.SS COMMFRCIAI.TTiNAN L (commencing with Section 7000)of Division 3 of the Business& Professions IMPROVEMENT (2910SQFT)NON-STRl1CTURAL.INCLUDES MFCtIANICAL, Code and that my license is in full force and effect. ELECTRIC,PLUMBING,DRYWALI.&FRAMING 1 hereby affirm under penalty of perjury one of the following two declarations: ;, ,. _ I f 4+i t v 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 Sq.Ft Floor Area: Valuation:$175000 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:32632054.00 Occupancy Type: 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 expense's whih ma cy ccrue against said City in consequence of the granting of this permit. Addnally,the applicant undo ds and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR wStir all non-point sourc gulations per the Cupe o Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. Signature A Date (U Issued by; Date: d OWNER-BUILDER DECLARATION �1 hereby affirm that I am exempt from the C'ontractor'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). — 1 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 pennit is issued. 1 have read the hazardous materials requirements tinder Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety(lode,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(x)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 file performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District 1 will not employ any person in any manner so as to become subject to the Worker's 'stain-Colti�liance yvtth-t#t"e C upertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,atter making this certificate of exempt io 1'� Health&Safety Code,Section� 5505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code, must forthwith comply with such provisions or this permit shall be deemed revoked. Own r or aut agent: ate: Z4/ lT APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above informati ts/ 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,uxk'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 VT ify and keep harmless the City of Cupertino against liabilities,judgments, cr nd 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 9.18. ARCHITECT'S DECLARATION — I understand my plans shall be used as public records. Signature Date Licensed Professional I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 20735 STEVENS CREEK BLVD I CONTRACTOR: - I PERMIT NO: 11060043 OWNER'S NAME: HK INVESTMENTS I K A e;-A I il-AA � HA I DATE ISSUED: 09/02/2011 1 OWNER'S PHONE: 4082053496 PHONE NO: LICENSED CONTRACTOR'S DECLARATION License Class! Lie. #�,, Contractor Pi 12�I1t 5�s. CON 5 r Irate 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 tinder 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 2�61 ❑ 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) I, 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. 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. JOB DESCRIPTION: RESIDENTIAL VERIZON WIRELESS - COMMERCIAL TENANT IMPROVEMENT (2910SQFT) NON-STRUCTURAL INCLUDES MECHANICAL, ELECTRIC,PLUMBING,DRYWALL & FRAMING. Sq. Ft Floor Area: Valuation: $175000 APN Number: 32632054.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued b 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 ofAppl Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements wader 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. 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional Date 1 CITY OF CUPERTINO BUILDING PERMIT DAT,F BUILDING ADDRESS: 20735 STEVENS CREEK BLVD CONTRACTOR: MENEMSHA PERMIT NO: 11060043 DEVELOPMENT OWNER'S NAME: HK INVESTMENTS 4950 W 145TH ST DATE ISSUED: 09/02/2011 OWN�2'S PHONE: 4082053496 HAWTHORNS, CA 90250 PHONE NO: (818) 212-4958 i Lice lass Lic.# Contra�hat Date 0 1 ered under the provisi9 s of hapter 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 expensCagainst said City in consequence of the grant�g 6I Yhis permit. Add' nally, the applicant unde ds and will comply w�i Ir""all non -point sourc gulations per the Cupe o Municipal Code, Section 9.18. Signature_ OWNER -BUILDER DECLARATION BUILDING PERMIT INFO: BLDG r ELECT ._ PLUMB f— MECH ' RESIDENTIAL COMMERCIAL yW JOB DESCRIPTION: VERIZON WIRELESS - COMMERCIAL TENANT IMPROVEMENT (2910SQFT) NON-STRUCTURAL INCLUDES MECHANICAL, ELECTRIC,PLUMBING,DRYWALL & FRAMING. e c' 6 E~ 'i ;`fir gL e 4.`Ei3/ t Sq. Ft Floor Area: I Valuation: $175000 APN Number: 32632054.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. o � o I Issued by: 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) I, 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 exemptio�, 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 informati 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. Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material beiig 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- onflp-Rince with-the_Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section�)15505, 25533, and 25534. or autt n iz0 agent: M CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of Nwrk'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. Signature Date Licensed Professional __ _ CITY OF CUPERTINO rw—FFF FNTIMATOR - BUILDING DIVISION ADDRESS: 20735 stvns crk blvd. DATE: 06/06/2011 REVIEWED BY: bobs. APN: BP#: *VALUATION: 1$175,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building PENTAMATION 1 M TI PERMIT TYPE: WORK t.i. commercial business space non structural include M E Ps. SCOPE OCCUPANCY TYPE: CONSTRR. TYPE . s.f.FLR AREA �C FEES C FEE ID BP FEES BP FEE ID M (Tenant Improvements) II-B,III-B,IV,V-B 2,910 $2,887.40 MTIPLNCK $2,260.05 IMTIINSP TOTALS: 2,910 $2,887.40 1 $2,260.05 MECH, HOURLY 0 Yes G No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No F El 7VnWP- Thom inns nra h—ad n» ilia nraiif»i"ary irrMminlinn nvailahlo and nrP nn1v an estininte. Contact the Dent for i/ddh I info. FEE ITEMS (Fee Resohition 09-051 Eff. 711110) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,887.40 Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: G Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,260.05 Suppl. Insp. Fee:0 Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 F71 Acoustical Fee: 0 Yes (j) No $0.00 0 0 Work Without Permit? 0 Yes (j) No $0.00 Planning Fee. $0.00 Select a Non -Residential Building or Structure 0 0 _ T -,,,' Strong Motion Fee: IBSEKSMKCO $36.75 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $7.00 SUBTOTALS: $5,191.20 $0.00 TOTAL FEE: 1 $5,191.20 Revised: 04/29/2011 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION G ADDRESS: 20735 stvns crk blvd. DATE: 09/20/2011 REVIEWED BY: bobs. APN: 7jS / BP#:lL%� xVALUATION: $100 YPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: PENTAMATION 1GENCOM I PERMIT TYPE: WORK revise floor plan layout due to soffit revision also omit parapet SCOPE }'L'tar/j r_<.. �. 17Er(>}; � f.E.'..�'a'!r d � .,<.0 . f'l;t}. r' t f ,.n di'f:'iy. i t.. ;<rM < �P .i�r( �''6,(I, r�E,�f ;.i°tt'.'}".:1IL'i`17, i::Sj?, {�r'.r'},�i' f°lit:}t%; i}7:'i — (.}7?t£:}' t_,,. <.. f?r'::•jJ, NOTE. This estimate does not include fees due to other Depts (i.e. Public Works, Sanitary Seaver District, School District, etc.). These fees are based on the Preliminary in ormation available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resohrtion 11-053 EJf Z I,/111 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: � Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:G Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 �•70'7 "I 'Ilf.°iiw? T C+A i�rli72 pt i:>IF'r1°tt rE.' f"`E!?'. 0 G Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 lllalwl Drx,',, 7i7f: r7t:#I'10H Fc 5: Sty Motion Fee: IBSEISMICO $0.50 # $783.00 Revision IREVCOMTI Tenant Improvement Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $783.00 TOTAL FEE:. $784.50 Revised: 09/02/2011