10020127CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20745 STEVENS CREEK BLVD
CONTRACTOR: TBD - TO BE DETERMINED
PERMIT NO: 10020127
OV'NER'S NAME: TARGET CORP
DATE ISSUED: 05/07/2010
C ER'S PHONE: 6127612432
PHONE NO:
kLICENSED CONTRACTOR'S DECLARATION
[— ELECT r— PLUMB
License Class i6 Lic. # .� 1110 7
BUDDING PERMIT INFO: BLDG
I- F- I-
MECH RESIDENTIAL COMMERCIAL
Contractor WH rtif+G-'"ruANEK Date 5
1 hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: T.1 REMODEL 7584 SQ FT TO EXPANSION OF GROCERY
(commencing with Section 7000) of Division 3 of the Business & Professions
AREY` INCLUDING THE ADDITION OF REFRIGERATED CASES
AT SALES FLOOR, WALK IN FREEZER/COOLER AND DRY
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.
1 have and will maintain Worker's Compensation Insurance, as provided for by
Sq. Ft Floor Area:
Valuation: $750000
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APN Number: 32632054.00
Occupancy Type:
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
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
1.80 DAYS FROM LAST CALLED INSPECTION.
with all non -point sourc eguI do per the Cupertino Municipal Code, Section
9.18.
Issued by: '��".� Date:. 7 LG
Date T I
Signature
❑ OWNER -BUILDER DECLARATION
RE -ROOFS:
I 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, I agree to remove all 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)
Sigm.ture of Applicant: Date:
I, 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 hate read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued.
Calilornia 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.
Additionally, should I use equipment or devices which emit hazardous air
permit is issued.
contaminants as defined by the Bay Area Air Quality Management District I 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
Heal % & Safety Code, Sections 25505, 25533, and 25534.
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.
Owner or a d a �t:
Date: /I/510
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
I herby 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 Ahich this permit is issued (Sec. 3097, Civ C.)
to building construction, and hereby authorize representatives of this city to enter
Lent er's Name
urs^ the above mentioned property for inspection purposes. (We) agree to save
i iify and keep harmless the City of Cupertino against liabilities, judgments,
Lent er's Address
cu_ .., 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 -points re ation per the Cupertino Municipal Code, Section
9.18.
///
1 understand my plans shall be used as public records.
Signature Date 54 l
Licensed Professional
11 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20745 STEVENS CREEK BLVD
OWNER'S NAME: TARGET CORP
OWNER'S PHONE: 6127612432
❑ LICENSED CONTRACTOR'S DECLARATION
License Class.
5 Lic. # 3 { 0 7
�
ContractorU tZ 30 (r 7U & A Date t -)
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 under penalty of perjury one of the following two declarations:
t. 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.
2. 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 forich is
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 thKp-Nnit. Additionally, the applicant understands and will comply with
all non-pointur fat' ns er a Cupertino Municipal Code, Section 9.18.
Signature Dateo
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
t. 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)
2. 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:
t. 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.
2. 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
permit is issued.
s. 1 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
ndemnify and keep harmless the City of Cupertino against liabilities, judgments,
)sts, and expenses which may accrue against said City in consequence of the
anting of this permit. Additionally, the applicant understands and will comply with
non -point source regulations per the Cupertino Municipal Code, Section 9.18.
ature Date
CONTRACTOR: WHITING - TURNER PERMIT NO: 10020127
CONTRACTING CO
7011 KOLL CENTER PKWY STE 160 DATE ISSUED: 05/07/2010
PLEASANTON, CA 94519 PHONE NO: (925) 485-0800
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
T.1 REMODEL 7584 SQ FT TO EXPANSION OF GROCERY
AREA INCLUDING THE ADDITION OF REFRIGERATED CASES
AT SALES FLOOR, WALK IN FREEZER/COOLER AND DRY
09-07-2010 - REV# 1 REVIEW FIRE RATING AT CORRIDOR, REVIEW STEEL BEAM
SPLICE, ELIMINATE HORN/STROBE, REVIEW EXITS.I.GlIREVISION #I ISSUED
9/14/10.
I
Sq. Ft Floor Area: I Valuation: $750000
APN Number: 32632054.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by. Date:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(x) should I store or handle hazardous material.
Additionally, should I use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Healt fe Code, ns 25505, 25533, and 25534.
Owner a h$�en
f✓ 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
I understand my plans shall be used as public records.
Licensed Professional