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09120055CITY OF CUPERTINO BUILDING PERMIT J BUILDING ADDRESS: 10050 N WOLFE RD SUITE SWI -100 I CONTRACTOR: TBD - TO BE DETERMINED I PERMIT NO: 09120055 I I OWNER'S NAME: CUPERTINO FINANCL CTR PARTNRS LLC I I DATE ISSUED: 02/01/2010 TER'S PHONE: 6503882761 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. # Contractor 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 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 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 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, •ind expenses which may accrue against said City in consequence of the �. ng of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per th Cupertino Municipal Code, Section 9.18. Signatur Date PHONE NO: BUILDING PERMIT INFO: BLDG F_ ELECT r— PLUMB r MECH r RESIDENTIAL r- COMMERCIAL r— JOB DESCRIPTION: PROJECT IMPLEMENTS AN INTERIOR BARRIER -FREE REMOEL OF AN EXISTING KAISER FACILITIES -UPGRADE ACCESSIBILITY FEATURES. Sq. Ft Floor Area: Valuation: $35000 APN Number: 31620086.CRTNFNCL I 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: Z�_ ) — t v 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(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. . R 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 CITY OF CUP INO TENANT I OVEMEN CUPEkTINO PERMIT PLICATION FORM 0qI_oo:�5 APN # �F (� �2OC>� Date: Building Address: J 1 dmf 0 Mailing Address (if different from building address): Afnd-E) 146 Tenant (If tenant please provide a letter from the building owner approving the tenant improvement.) Building Owneri?:-11N C L-1-6 Are Hazardous Materials being used as part of this project? Yes LJ No Tenant/ uilding Owner's Name: A: � ai—1 ql\VAKZ�:LleN Phone #: ��> � � _ -7r, 7 r Contractor:Phone #: 1 2 Fax #. p 5 _0( Contractor License #: Cupertino Business License #: Contact:-rdN G STI L LSU fiE�� Phone #: (41 -1-1-7 . Fax #: (44 50 'i -T-1 - IAP6H Alternate Contact: Phone #: Fax #: Valuation (cost of project): ODO Job Description (be specific): 7 TIT Tenant Improvement Includes Re -Roof. Yes ❑ No If yes, number of squares Tenant Improvement Includes Structural Yes ❑ No Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ I III B IV -HT, V -B Z 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 07/06/09 CITY OF CUPERTINO TENANT IMPROVEMENT FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type IATINSP Tenant Improvement B 1A TI Inspection IATIPLNCK Tenant Improvement Plan B Check 1BTIINSP Tenant improvement B 1B TI Inspection 1 BTIPLNCK Tenant Improvement Plan B Check 1ETIINSP Tenant Improvement B IE TI Inspection -Preschool IETIPLNCK Tenant Improvement Plan B Check -Preschool 1FTIINSP Tenant Improvement B IF TI Inspection-Factory/Indust 1 FTIPLNCK Tenant Improvement Plan B Check-Factory/Indust 1HTIINSP Tenant Improvement B 1H TI Inspection -Hazardous 1HTIPLNCK Tenant Improvement Plan B Check -Hazardous I ITIINSP Tenant Improvement B 11 TI Inspection -Institutional I ITIPLNCK Tenant Improvement Plan B Check -Institutional 1MTIINSP Tenant Improvement B 1M TI Inspection -Merchandise 1MTIPLNCK Tenant Improvement Plan B Check -Merchandise 1 STIINSP Tenant Improvement B 1S TI Inspection -Parking Garag 1 STIPLNCK Tenant Improvement Plan B Check -Parking Garage 1REROOFCOM Re -Roof Commercial B 1 BCBSC Cal Bldg Standards B ALL PERMIT TYPES Commission Fee 1BSEISMICO Seismic Commercial B 1BUS LIC Business License B -71Z,,q L'S'O rl 1k _' 2 of 2 s F Ic FE MENLO EQUITIES MANAGEMENT COMPANY Lyn Barshay MENLO EQUITIES Vice President, Property Manager 2901 Tasman Drive, Suite 220 • Santa Clara, California 950541136 Phone: (408) 567-9900 ext 2002 • Mobile: (408) 221-9305 • Fax: (408) 567-9339 Email: barshay@menloequities.com • www.menloequities.com December 8, 2009 Tony Castillo Project Manager Lionakis 101 New Montgomery Street, Sixth Floor San Francisco, CA 94105 Re: Minor Remodel oLExL9ILng Ka' Facilit 050N. olfe Road, Suite SW 1-100 upe Tony: Please use this letter as Landlord approval to do the work as designated in plans dated 12-3-09 for the above referenced address. Menlo Equities is the controlling entity of Cupertino Financial Center Partners LLC, the owner of the property. Sincerely, Menlo Equities for Cupertino Financial Center Partners LLC 2vl � ect� Lyn Barshay Vice President