Loading...
10090201-EXPIRED CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10301 VISTA DR CONTRACTOR:CUPERTINO UNION PERMIT NO: 10090201 SCHOOL DISTRICT OWNER'S NAME: CUPERTINO UNION SCHOOL DISTRICT 10301 VISTA DRIVE DATE ISSUED:01/18/2011 ER'S PHONE: 4082523000 CUPERTINO,CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:INSTALL A NEW OUTDOOR RATED WALK-IN COOLER& (commencing with Section 7000)of Division 3 of the Business&Professions FREEZER AT THE DISTRICT'S MAIN WAREHOUSE.MEASURES Code and that my license is in full force and effect. 25'X 65'X I THIGH,WITH THE COOLER&FREEZER DOORS 1 hereby affirm under penalty of perjury one of the following two 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. 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:5400000 permit is issued. APPLICANT CERTIFICATION APN Number:31622019.00 Occupancy Type: 1 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 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 this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature Date Issued b_ Date: r/ d"—�// Mani. with a I OWNER-BUILDER DECLARATION RE-ROOFS: 1 hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,1 agree to remove all new materials for 1,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: I,as owner of the property,am exclusively contracting with licensed cprgrtctors to construct the project(Sec.7044,Business&Professions Code). !X�— ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 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. 1 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(a)should I store or handle hazardous material. permit is issued. Additionally,should 1 use equipment or devices which emit hazardous air 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,1 shall maintain compliance wit 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 Health&Safety Code, ec'ons 25505,25533,and 553 . 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 Owner o o ized a r f forthwith comply with such provisions or this permit shall be deemed revoke -Date: l CJ'l APPLICANT CERTIFICATION 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 work'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 ind-nnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address c nd expenses which may accrue against said City in consequence of the gT certg of this permit.Additionally,the applicant understands and will comply with all non-point source regatr s per the Cupertino Municipal Code,S tion ARCHITECT'S DECLARATION 9.18. 1 understand my plans shall be used as public records. Signature'—� Date �� Licensed Professional CITY OF CUPERTINO BUILDING PERMIT RE111$IQN BUILDING ADDRESS: 10301 VISTA DR CONTRACTOR: CUPERTINO UNION : 10090201 SCHOOL DISTRICT OWNER'S NAME: CUPERTINO UNION SCHOOL DISTRICT 10301 VISTA DRIVE DATE ISSUED: 01/18/201 1 OWNER'S PHONE: 4082523000 CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION F_ I— F_ BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic. # I— j- MECH RESIDENTIAL COMMERCIAL Contractor Date 1 hereby affirm that i am licensed under the provisions of Chapter 9 JOB DESCRIPTION: INSTALL A NEW OUTDOOR RATED WALK-IN COOLER & (commencing with Section 7000) of Division 3 of the Business & Professions FREEZER AT THE DISTRICT'S MAIN WAREHOUSE.MEASURES 25'X 65'X I THIGH, WITH THE COOLER & FREEZER DOORS Code and that my license is in full force and effect. 1 hereby affirm under penalty of perjury one of the following two declarations: 6/30/11 REVISION # I- REVISE ELECTRICAL EXTERIOR CONDUIT I have and will maintain a certificate of consent to self -insure for Worker's LAYOUT AND WIRE SIZE-ISSD 6/30/11 Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $400000 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 permit is issued. APN Number: 31622019.00 Occupancy Type: APPLICANT CERTIFICATION I certify 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 to building construction, and hereby authorize representatives of this city to enter WITHIN SOF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DA CALLED INSPECTI N. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Date: �� 1 granting of this permit. Additionally, the applicant understands and will comply Issued by: / with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date 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. OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code).' —7�- have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I 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 Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I 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 Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 2553".d 25534. Section 3700 of the Labor Code, for the performance of the work for which this / permit is issued. Owner or authorized agent: Date: L 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 I hereby affirm that there is a construction lending agency for the performance of forthwith 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the 1 understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations e Cupertino Municipal de, Section Licensed Professional 9.18. �— Signature Date �! YM -7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: FLR AREA s.f. DATE: REVIEWED BY: BP FEES APN: BP#: *VALUATION: 1$400,000 *PERMIT TYPE: Building Permit $0.00 PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building Other Mech. Insp. 1 2.0 1 hrs TUT.4L FLOOR -AREA. PENTAMATION 1 S1 PERMIT TYPE: WORK 0/hc, Clo My Lj Mech. Insp. Fee: IMECHINSP SCOPE Plumb. Insp. Fee: IPLMBINSP $252.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID S-1 (Moderate -Hazard) II-B,111-B,IV,V-B 0 $0.00 IPLMBLNC Plumb, Permit Fee: IPPERMIT $0.00 Other Mech. Insp. 1 2.0 1 hrs $42.00 Other Plumb Insp. 2.0 hrs $42.00 0/hc, Clo My Lj Mech. Insp. Fee: IMECHINSP $252.00 Plumb. Insp. Fee: IPLMBINSP $252.00 E[ec. lrrsp. i e $0.00 Suppl, Insp. Fee -0 Reg, 0 OT FO.0 hrs $0.00 1� $126.00 Mechanical IMCRAA Refrigeration Unit PME Unit Fee: $0.00 PME Permit Fee: TOTALS: 0 $0.00 $0.00 MECH, HOURLY ® Yves Q No PLUMB, HOURLY0 Yes Q No ELEC, HOLTIR,LY 0 Yes O No Mech. Plan Check"20 $252.00 Plumb. Plan Check 2.0 hrs $252.00 E/cv P/ar Ch, k IMECPLNC FMech. Permit Fee: IMPERMIT IPLMBLNC Plumb, Permit Fee: IPPERMIT T'ce Other Mech. Insp. 1 2.0 1 hrs $42.00 Other Plumb Insp. 2.0 hrs $42.00 0/hc, Clo My Lj Mech. Insp. Fee: IMECHINSP $252.00 Plumb. Insp. Fee: IPLMBINSP $252.00 E[ec. lrrsp. i e NOTE: These /fees are based on the Dreliminary information available and are onlv an estimate. Contact the DeDt for addn'l info. FEE ITEMS (Fee Resolution 09-051 Eff 7/1/10) FEE QTY/FEE MISC IT ,M Plan Check Fee: $0.00 1 # $42.00 Plumbic' 1 IPRREPIPE Piping, Condensate Suppl. PC Fee: :) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $504.00 0 # $42.00 b i n g IPRREPIPE Piping, Drainage Permit Fee: $0.00 Suppl, Insp. Fee -0 Reg, 0 OT FO.0 hrs $0.00 1� $126.00 Mechanical IMCRAA Refrigeration Unit PME Unit Fee: $0.00 PME Permit Fee: 88.00! Construction Tax Acoustical Fee: 0 Yes E) No $0.00 Q d Work Without Permit? © Yes 0 No $0.00 Planning, Fee: $0.00 Select a Non -Residential Building or Structure G i Travel Documentation Fee: ITRA VDOC $42.00 Strong Motion Fee: IBSEISMICO $84.00 Select an Administrative Item $210.00 TOTAL FEE: 1 $1,444.00 Bldg Stds Commission Fee: IBCBSC SUBTOTALS:. $16.00 $1,234.00 Revised: 9/14/2010 N(P22 bte1 CITY OF CUPERTINO FM --7 FEE ESTIMATOR - BUILDING DIVISION a ADDRESS: 10301 vista dr. 1APN: DATE: 06/29/2011 REVIEWED BY: bobs. Plan Check Fee: BPP: 'VALUATION: $100 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building PENTAMATION PERMIT TYPE: CD WORK electrical exterior conduit layout and wire size. SCOPE �revisin NOTE: These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Tee Resolution 09-05I EfY' 7,110) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: d Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.e Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes 0 No $0.00 0 Work Without Permit? 0 Yes Q No $0.00 Planning Fee: $0.00 Select a Non -Residential Building or Structure Q 0 A Strong Motion Fee: IBSEISMICo $0.50 2.0 hrs $252.00IINSPMIS Inspections Standard Inspections Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $252.00 TOTAL FEE: 1 $253.50 Revised: 04/29/2011