10120088CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20300 STEVENS CREEK BLVD CONTRACTOR: BAY AREA BUILDERS INC I PERMIT NO: 10120088
I -1IOWNER'S NAME: WW DASC OWNER LLC 318 MARTIN AVE (DATE ISSUED: 01/13/2011
'NER'S PHONE: 6508380100
❑ LICENSED CONTRACTOR'S DECLARATION
License Class tT Lic. #
Contractor 6 a ✓ �l t I � P'r s Date I3 ^�
1 hereby affirm t tat 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.
1 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. 1_�
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
correct. 1 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
ign
ature^ Date ��
Sign
OWNER -BUILDER DECLARATION
1 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
construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
declarations:
1 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, 1
become subject to the Worker's Compensation provisions of the Labor Code, 1 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. 1 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,
-sts, and expenses which may accrue against said City in consequence of the
Ming of this permit. Additionally, the applicant understands and will comply
..rth all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
Signature Date
SANTA CLARA, CA 95050
PHONE NO: (408) 648-4500
BUILDING PERMIT INFO: BLDG r ELECT r— PLUMB r
MECH r RESIDENTIAL I— COMMERCIAL r
JOB DESCRIPTION: INSTALL A GLASS AWNING AT THE MAIN BUILDING
ENTRANCE
Sq. Ft Floor Area:
Valuation: $87780
APN Number: 36901019.00 I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180';DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issue - Dater
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.
Owner thorized ent:
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
understand my plans shall be used as public records.
Licensed Professional
CITY OF
CITY OF CUPERTINO /)00 Q6
TENANT IMPROVEMENT
CUPERTINOPERMIT APPLICATION
', FORM
APN #
Date:
Building Address: ,
O-300 si-evens, (reek 131kld
Mailing Address (if different from building address):
Tenant ❑ (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 ❑ Nop,
Tenant/Building Owner's Name:.
r a4e (-)art ri-er / �� � � � ��
Phone #:
650_ 9 __0100
Contractor: (� E' 1±1 V� 1 G� Y , ,' (1
Fao #• #. C i 05f,4 fi
Cupertino Business License: State Contractor License #:
Ll of L� q
Contact:
` 1 (4 Vie'_ tt C �l t� a
Phone #: Lf 0�� 614 0 10 5 t-
Fax #: Ll 0 1
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated areas):IV "
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 Tye ❑ Water Budget
Job Description (be specific):
e y- -C r 1, 0 V— G� �( ; i.� 1lt/ 61 t rt cj. C I/Vt 11 1 0 -i 0 + V t 11 C 'e
Tenant Improvement Includes Re -Roof: Yes ElNo If yes, number of squares
I
Tenant Improvement Includes Structural Yes ❑ No LDA
Type of Construction (Usage Class):
Occupancy Type:
1-A, 1-B M II/III/V-A ❑ II/III B, N711T, V -B ❑
Valuation: 9-71, s o ' c
Project Size: Express ❑ Standard ❑/ Large ❑ 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*** Over The Counter ❑ Revised 05/18/10
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: PERMIT # '`�� 06-) ';� <IS-
OWNER'S NAME: L a C, r'+ n e r- PHONE # L( 10SC
GENERAL CONTRACTOR: 13 cs y 14 (1 e a 9 tik ,' 161 e f'5 BUSINESS LICENSE #
ADDRESS: '3 1 8' v, a r 'r k► A ✓ -e CITY/ZIPCODE: 5; avi,4-4 C IQ 1-4, 6A, 1505 b
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors: Z
Signature Date
Please check applicable subcontractors and complete the following information:
4�z --- / 'Z —1 Ll
caner / Contractor Signature Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
G51
Heating
Insulation
Landscaping
Lathing
Masorny
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
5�-e-e I
f ricu��a��
4�z --- / 'Z —1 Ll
caner / Contractor Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
v.
ADDRESS: 20300 stevens creek blvd
DATE: 12/14/2010
REVIEWED BY:
APN:
BP#: , O, ®010
VALUATION: 1$87,780
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY
USE: Commercial Building
TOT -IL
FLOOR .IREA:
PENTAMATION 1 GENCOM
PERMIT TYPE: A
WORK
exterior glass awning at main entrance of existing commercial bldg.
SCOPE
$0.00
NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'1 into.
FEE ITEMS (Fee Resohdion 09-051 E '. 7/UIO�
Xlech. Plan Check
Plumb, Mal Uheel,
Dec. flan Check
lfech. Permil Fee"Phan!).
Permit Fee:
Flew. Permit Fce:
ether Alech. tr vp.
Olher Plumb ht,Vp.
07her Dec. Insp.
Al ch. hasp. Fee:
Plumb. Insp. hese:
Dec. Insp. Fee:
NOTE: These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'1 into.
FEE ITEMS (Fee Resohdion 09-051 E '. 7/UIO�
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
1 hours
$126.00
Plan Check, Hourly
1STPLNCx
i
Suppl. PC Fee: G Reg. 0 OT0.0
hrs
$0.00
PME Plan Check:
$0.001=
#
$317.00
Awning / Canopy (Support'd by Bldg)
IAWNATTBLD Canopy
Permit Fee:
$0.00
Suppl. Insp. Feer Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Couvritcllon Tax
Acoustical Fee: 0 Yes G No
$0.00
0
Work Without Permit? 0 Yes G No
$0.00
Plamiiiig Fee:
$0.00
G
Tnwel DocinnGntolion Fees:
Strong Motion Fee: IBSEISMICO
$18.43
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$4.00
SUBTOTALS:
$22.43
$443.00
TOTAL FEE:
$465.43
Revised: 12/07/2010
CAPEX ENGINEERING INC,
PO BOX 14198, FREMONT, CA 94539
Tel:(510)668-1815 Faxe:(510)490-8690
Project No. 6797
August 20, 2011
Building Department
City of Cupertino
10300 Torre Ave,
Cupertino, CA 95014-3202
Subject: Office Building New Glass/Steel Awning (Rear Entrance) at
20300 Stevens Creek Blvd.
Cupertino, CA
(Permit No. 10 120088) 30
SPECIAL INSPECTION SERVICES FINAL AFFIDAVIT
Dear Sir:
CAPEX ENGINEERING INC, has provided testing and special inspection services at
the subject site in accordance with section 1701 of the California Building Code (2010
Edition) as listed below:
• Steel welding on glass/steel awning frame
[Fillet welds on (8) 1" stainless plate to existing TS beam]
Personnel under the general supervision of a registered Civil Engineer performed
this inspection. Based on the inspections performed and upon our substantiating
reports that the inspected work was performed, to the best of our knowledge, in
conformance with the approved plans and specifications and the applicable
workmanship provisions of the California Building Code.
Sincerely,
CAPEX ENGINEERING INC,,
p�yy
r }
Gary SU, P,E
Principal
4k4 y a C J