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15020159 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21220 HOMESTEAD RD CONTRACTOR:POWERHOUSE RETAIL PERMIT NO: 15020159 SERVICES LLC OWNER'S NAME: 7-ELEVEN 812 S CROWLEY RD STE A DATE ISSUED:02/27/2015 OWNER'S PHONE: 9728287011 CROWLEY,TX 76036 PHONE NO:(817)297-8575 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL 7-11;INSTALL(5)ELECTRICAL OUTLETS AT POINT OF License Class C jul Lic.# 01—1 t-1 Z l 1 SALE Contractor. Date 2- 1Z 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. Sq.Ft Floor Area: Valuation:$1500 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 APN Number:32605086.00 Occupancy Type: permit is issued. 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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR to 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 T CALLED INSPE TION. 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 pe it. Additionally,the applicant understands and will comply Issued by: Date: with all non-points urce regulations per the Cupertino Municipal Code,Section 918. 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 I hereby affirm that I 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, 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I 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 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: Z Z l 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 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I 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 per the Cupertino Municipal Code,Section Licensed Professional 918. Signature Date CONSTRUCTION PERMIT APPLICATION 121 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O, 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CURERTINQ (408)777-3228•FAX(408)777-3333•buildinga-cupertino.org 1� ❑NEW CONSTRUCTION ❑ ADDITION ® ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECTADDRESS 21220 Homestead Rd APN# 2LO 675-684v60 OWNER NAME 7-Eleven Inc PHONE 972-828-7011 E-MAIL STREET ADDRESS 1722 Routh St, #1000 CITY,STATE,ZIP Dallas, TX 75201 FAX CONTACT NAME Adam Szaruga PHONE 770-433-0169 E-MAIL adams@uspermit.net STREETADDRESS 117 HurtDr SE CITY,STATE,ZIP Smyrna, GA 30082 FAX 1-888-316-0919 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT 19 CONTRACTOR 1.3 CONTRACTOR ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME Powerhouse Retail Services LICENSE NUMBER 974217 lj CE(C.;i�frPE BUS.LIC# 34601 COMPANY NAME Powerhouse Retail Services E-MAIL ((JJ FAX 817-297-8576 STREETADDRESS 812 S Crowley Rd, Suite A CITY,STATE,ZIP Crowley,TX 76036 PHONE 817-297-8575 ARCHITECT/ENGINEER NAME NSA LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK Installing 5 electrical outlets at point of sale area of existing 7-Eleven store. Branching off of existing circuits. EXISTING USE PROPOSED USE M CONSYPE #STO ��j USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA Retail M 200 1,500 BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA 200sf PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ATTACH #DWELLING UNITS: IS A SECOND UNrr ❑YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? [:]NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY TOTAL VALUATION: PLANNINGAPPL# []NO PLANNING APPROVAL LETTER EICHLERHOME? 0 N $1,500 By my signature below,I certify to each of th 11 1 g: I am the property owner or authorized agent to nth perty owner's behalf. I have read this application and the information I have pro ' i t. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buil n on. I authorize resentatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: 2/20/2015 SUPPLEMENTAL ORMKTIVN REQUIRED cHECKTYPE ROUTINGSLIP _New SFD or Multifamily dwellings: Apply for demolition permit for ovER z couNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ ERPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to 11 MAJOR F-1SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 21220 homestead rd DATE: 02/27/20157REVIEWED BY: mendez APN: BP#: "VALUATION: $1,500 RPERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY Commercial BuildingPENTAMATION 10EAP10 USE: PERMIT TYPE: WORK 7-11; install 5 electrical outlets at point of sale SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Recep/Switch/Outlets 1 BREMRECEP 5 # $48 NO TOTALS: $48.00 q ;z Xh,ch. Plum Check Phimb. Plan Check Elec.Plan Check 0.0 hrs $0.00 ech. Permit Fee: Plumb. Permit Fee: Elec.Permit Fee: 1EPERMIT {)rher A4ech. Ins>>. Other Plumb Insp. Other Elec.Insp. 0.0 hrs 1$48.00 M11ech, Insp. Fee: Plumb. Insp. Tee: Llec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). These fiW are based on the prelimina information available and are only an estimate. Contact the Dept for addn I info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check 1 ire: Slippl. .TC'hee PME Plan Check: $0.00 Permit Fee: 5"tcpl, Irrp Pt:e PME Unit Fee: $48.00 PME Permit Fee: $48.00 Construction Tax: Administrative Fee: IADMIN $45.00 Work Without Permit? ®Yes (E) No $0.00 Advanced Planning P'ees: Travel Documentation Fee: 1TRAVDOC $48.00 Strong Motion Fee: IBSEISMICO $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 MENEM $190.501 $0.00 �U7L�EE: $190.50 Revised: 02/14/2015 a UN15EX RESTROOM 5HLVE5 OISTORAGE COOLER I I OPEN AIR OPEN AIR GD I 53 ?HP G CASE CASE I z" sLURr 9wRPre gI, MICRO "` is^ ® ®® vs 7P.51MN.. L————G� -- ----- } BEVERAGE BAR 43" 46" 49" FIRV --- `) I I rF� 79" LO I I 2er�loA-FLxG� cheese O 49" Z N N ? LF- N I COFFEE 15LAND I a® r 0 T � I I 72" I o cc BACKROOM i i 60" f EXG ic) 0 W I I Q '� O Q WALK-IN 1 I 78" REIAOVE LLJ —J Q ) Tu— w U COMMUNITY DEVELOPMENT DEPARThI!EldT ic '° � EXG (n � � 54" Z O 0 BUILDING CIVI510N -CURERTINO r COOLER �� w RErlove xG cD z APPROVED =a =� o~C W � � N � � 76" -T- N This set of plans and specifications MUST be kept at th 0 W N w job site during construction. It is unlawful to make a W i d Lo I o N CL N changes or alterations on same, or to deviate L_ _ U therefrom, without approval from the Building Official 8s° The Stamping of this plan and specifications SHALL N01 54" be held to par . Phyy an approval of the vial;`'ion ----------------� of any pro sio City Ordinance or State Lnw. I NEWSPAPER ELEC. FOR: BY HOTFOODS DATE7 1z DRAWN BY: W PErwiT NO._ 1�G.. TBB MGR. ICE VAULT SCALE= 1 OFFICE ' -0 ""M��;.,� 3/16 ., ,,.,e; DATE � 12-18-14 1 le— GENERAL NOTES: _ SHEET 1) ALL EQUIPMENT NOTED IN EQUIPMENT SCHEDULE MAY NOT BE 1 OF 2 APPLICABLE TO THI5 STORE. J llJ i�•lam 2)SOLID DOOR FREEZER TO BE DETERMINED BY OWNER/CONTRACTOP., v4f'�j AND WILL BE SUPPLIED AT THE TIME OF HF EQUIPMENT INSTALLATION. IF SUPPLIED,SOLID DOOR FREEZER WILL BE PLACED IN BACK OF HOUSE REVlEW� A.ONCE AREA OF 50LLIID DOOR FREER OUT D ER A51BEN DETERMINED,TE IN A STORAGE PCONTRACTOR WILL R�V1eWed By SET UP FREEZER BY AN AVAILABLE OUTLET. IF NO OUTLETS ARE E V�R DETERMINED AVAILABLE BY CONTRACTOR,AN OUTLET WILL BE INSTALLED BY CONTRACTOR. 3)REFER TO SPECIFICATION SHEETS FOR FULL EQUIPMENT DETAILS. 4)ALL FIELD DIMENSIONS TO BE FIELD VERIFIED BY CONTRACTOR. STORE # 5)ANY NEW EQUIPMENT/MATERIAL5 APART FROM HOT FOODS EQUIPMENT C EXISTING FLOOR PLAN SHALL BE LABELED ACCORDINLY UNLESS NOTED OTHERWISE. 1 4320 GENERAL NOTE5: 1) ALL EQUIPMENT NOTED IN EQUIPMENT SCHEDULE MAY NOT BE APPLICABLE TO THI5 STORE. 2)SOLID DOOR FREEZER TO BE DETERMINED BY OWNER/CONTRACTOR, AND WILL BE SUPPLIED AT THE TIME OF HF EQUIPMENT IN5TALLATION. IF SUPPLIED,SOLID DOOR FREEZER WILL BE PLACED IN BACK OF HOUSE AREA,OR OUT CUSTOMER'S 51TE IN A STORAGE AREA.ONCE AREA OF 50LID DOOR FREEZER HAS BEEN DETERMINED,CONTRACTOR WILL SET UP FREEZER BY AN AVAILABLE OUTLET. IF NO OUTLETS ARE DETERMINED AVAILABLE BY CONTRACTOR,AN OUTLET WILL BE INSTALLED BY CONTRACTOR. 3)REFER TO 5PECIFICATION 5HEET5 FOR FULL EQUIPMENT DETAIL5. 4)ALL FIELD DIMEN51ON5 TO BE FIELD VERIFIED BY CONTRACTOR. 5)ANY NEW EQUIPMENT/MATERIALS APART FROM HOT FOOD5 EQUIPMENT ! SHALL BE LABELED ACCORDINLY UNLE55 NOTED OTHERWI5E. J, REVISION DOVE J/ Y 71 I tXGREV DATE W IL rtL- 3 �:. MOVE EYG 4" d X I. , r 4 ;r o 5 _ N MOVE EXG N �� Z o n N C b r �� I � 1 _..__. 0 0 W _ to f- ` ) 0 _, MEW 2T'Y,30' z �'�I I VVTTII _ D � it uj coMD.C.T. ° _ I LL 3 ?X X x ° X ' 1 �, n _ L) VV I 'K-IN i ' .__ 1 24' N _( ."VIEW 24 X 3G" Q W V X m N N N to N I %�/i ! C. ��1_L T-. I.� ` I I DBL 51DED N lel POS C.T. :.i,:. W O O i vJ U n n r d N - r N X X X X X X i I f _.. .. _— L GONDOLA �� M 0 2 Z X I Arw I �,i �. r _-a Ur C1 I _ N m m = w y _ -&'CIG 0 0Y NCC N — I I I 2A"OTT' ? LN L^LJ N m m r` > p, m jL.V r L.L m a Q - o l 11 ._:_. -::: ��, !,� I MovE �i 14 I a a �y LOT70 h N O L_ k \ EXG U Lu ' N C6 O tr1 p p I \ I MOVE J Lp O 1 EXG ° N L> lt' > O U - ( r---� ---------N EZ — LLJN O I I NEWSPAPER ` I ELEC. FOR: ------------------ Lu z lu JI HOT FOODS O p p Q j ..� ri `y f DRAWN BY: z � Z 11J � co � � 3 UL w I N N z I [ ICE VAULT I TBB L M(7, CL U D tY l� ro I SCALE u 00 Oz g oz ne ozg O 3/16" = V-O" N o a dco � DATE z N 0 o p U a- IL U IV W a S g lz o N `r r r, SHEET 12-18-14 p _ u o p - ° o N, o o = o o - N o W Q ��, Goop� 2 OF 2 LLJ t L ° ° > w �' r,Op� A „f� a m 0 0 0 0 0 0 o J F z Q, v_.Rl w > 3 3 > w w v z a a o a g u � R �e,�e o LLJ N � v ■■cc tt 9 0 n In E �/ O N 0 w ELLVL�R Q REVIEWED LPPROVED O O O O O c ® By TLC at 10:09 am, Jan 02, 2015 O PROPOSED FLOOR PLAN 12/30/14 STORE # 143201