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14040061CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19550 VALLCO PKWY CONTRACTOR: SOUTH BAY PERMIT NO: 14040061 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR 1711 DELL AVE DATE ISSUED: 07/17/2015 OWNER'S PHONE: 6503441500 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DEISCRIPTION: RESIDENTIAL ❑ COMMERCIAL E] TEMPORARY SHORING FOR MAIN STREET LOFTS & License Class_ Lic. # 33(o BELOW GRADE PARKING STRUCTURE Contractor Date �� 3 �� 8/11/15 - REV # 1 - REMOVE SLOPE CUTS, REVISE PILES & I hereby affirm that I am license un er the provisions of Chapter 9 TIE -BACKS AND ADD SHORING. ISSUED 8-31-15. (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 erformance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $535000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 31620085.19550 Occupancy Type: 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 I 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 1180 DAYS FROM LAST CALLED INSPECTION. 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 Issued Iby: /�l�/ `� �6� Date: l/C granting of this permit. tionally, the applicant understands and will comply d with all non -point rce re ulations per the Cupertino Municipal Code, Section 9.18. Date O� 3 u l I RE -ROOFS: All be inspected to any roofing material being installed. If a roof is Signature roofs shall prior 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 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 j 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. 1 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: Healthl & 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 as defined by the Bay Area Air Quality Management District I Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. air contaminants will maintain compliance with the no Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the for which this the Health & Safety Code, Sect' s 25505, 5533, and 25534. 3!- Section 3700 of the Labor Code, for the performance of work Owne or authorized agent: Dater 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 CONSTRUCTION LENDING AGENCY 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 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 9.18. Signature Date CITY OF CUPERTINO BUI DING PERMIT BUILDING ADDRESS: 19550 VALLCO PKWY CONTRA TOR: SOUTH BAY PERMIT NO: 14040061 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 1711 DEL AVE DATE ISSUED: 07/17/2015 OWNER'S PHONE: 6503441500 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL y-� TEMPORARY SHORING FOR MAIN STREET LOFTS & License Class_ Lic. # 6 BELOW Contractors bA—i t 1r GRADE PARKING STRUCTURE 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 Sq. Ft Floo Area: Valuation: $535000 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 permit is issued. APN Numb r: 31620085.19550 Occupancy Type: APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PE T 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 WI. BIN 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save indemnify 180 AYS.ROM`L�� D INSPECTION. 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 co Issued by: Date: with all non -point s urce regu tions r t up e o Municipal Code, Section 9.18. / Signature a, C Date / J''f `` (S' RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed wit out first obtaining an inspection, I agree to remove all new materials for inspection. ElOWNER-BUILDERDECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, A L ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 I hereby affirm under penalty of perjury one of the following three California maintain co ealth & Safety Code, Sections 25505, 25533, and 25534. I will npliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Health & & fety Code, Section 25532(a) should I store or handle hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the material. A air contamb Iditionally, should I use equipment or devices which emit hazardous iants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintai it compliance with the C pertino Municipal apter 9.12 and 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 the Health & Owner or Safety Code, Sect' is 505, nd 3 v thorized agent: J'P1/ Date: f '7 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 Lender's A dress 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand ny 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 Pro essional 9.18. Signature Date CUPERTINO I F-1 TT1711/1'n M QTD T rrTTnXT CONSTRUCTION PERMIT APPI LICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 950114-3255 ; „ (408) 777-3228 - FAX (408) 777-3333 e build in cu pertino.or nn A A T1r1rTTnNT AT TVP ATTnN / Tio- RFvlcl�t� nF.FF.RRF.D ORIGINAL PERMIT # NCA L1 C`I U()(01 PROJECT ADDRESS5® \&I Co L r( ✓ c) q6'®d41 APN OWNERN ME �ir_r'c (2 g. Hip® T- 'd:. �.�17 Lt�,l® PCG e,3 ql 4 " [ 5o® HONE E -MAIL -A e -A S I`1 e- /-I \��. CO/11 STITC t p P� 7 CITY, t� ZI (/ C d g ®�®� FAX CONTACT N®MF BUS. # COMPANY NAME F� Fd pHi:'.N,r. E -MATT . . STRHFT;ADDRT9,Sy` pp nn qqt pg, PHONE is 3 3 � -��- C/ITyY,STATE]}(�ZI9P9 CA, ct FAX n nn,wmo n nv,wrcn nnnnco n MiTTPD Ao➢ m Int (YINTRACTnR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME �� LICENSE NUMBER � LICENSES E BUS. LIC # COMPANY NAME Sem E-MAIL C.. FAX STREET ADDRESSAl Q �� CITY, Sa_,, Z ,1 ®/q V �3 PHONE909 'LIC ARCHITECT/ENGINEERNAME �e l LICENSE NUMBER ZZ 9 ( BUS. # COMPANY NAME F� Fd E-MAIL �y �®��. l� � est t tl �•�' ' � FAX STREET ADDRESSCITY, a�� .5 APs e �I� �l° STATE, ZIP �IV;^� �a ►� PHONE is 3 3 � -��- ESCRIPTION OF WOP n� P,�,y p� !� J®Pe_ C" « � � � � � 5L,0 1- L t i6c1..GC`��,� 'EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (i) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER. REMODELAREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA DECK/;PORCH GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEINGADDED? ADDITION? ❑NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN 11YESVALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? []NO - By my signature below, 1 certify to eac f the to lowmg: I am the property owner or aumo ' �, u.� I' -F ..y �.._.�• ��••�- - •• • - • ___ _.___ application and the information I ha provided i correct. 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 building c strucrion. I authorize representatives of Cupertino to enter the above-ide/ntified property for inspection purposes. Signature of Applicant/Agent: Date:—I f� SUPPLEMENTALRFORMATION REQUIRED _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑' OVER' -THE -COUNTER ❑ EXPRESS ❑ .STANDARD LARGE' ❑ MAJOR SLIP ❑ BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW El PUBLIC WORKS ❑ FIRE DEPT ❑ SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06/21111 CITY OF CUPERTINO FOMW FFF, FIRTIMATOR - BUILDING DIVISION im,ADDRESS: 19550 VALLCO PKWY DATE: 08/11/2015 REVIEWED BY: MELISSA Afech. Pet'mil Fire: APN: 31620085.19550 BP#: 14040061 "VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CIIECK TYPE: Alteration /Addition/ Repair PRIMARY USE: rxtrer1al Building Civil / Religious activities in BQ zone? Yes No PENTAMATION PERMIT TYPE: d woiQI�EV # J REMOVE SLOPE CUTS REVISE PILES & TIE -BACKS AND ADD SHORING SCOPE ,.5 .. <A 1I ell . r NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public works, rare, JQmaary Jewer JJ15LI ILL, Th bon d th relimina information available and are onl an estimate. Contact the Dept or addn'1 info. "100 1, etc . ese ees are ase e ,/tech. Plan ('heck Phimb. flan (heck Elec. P/an Check Afech. Pet'mil Fire: Plt rrn. Perinit hee: lilec. Par?WT Fee.: Other ,We:ch, lrisp. other Pltmsb /rasp_Li Other Glee. Insp. ;/Tech. lilsp. Fee: t'lunib. hisp. /'eel: 11"1c'C. Inst''). $0.00 Select a Misc Bldg/Structure ® or Ele ent - a Building NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public works, rare, JQmaary Jewer JJ15LI ILL, Th bon d th relimina information available and are onl an estimate. Contact the Dept or addn'1 info. "100 1, etc . ese ees are ase e FEE ITEMS (Fee Resolution 11-053 f f. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure ® or Ele ent - a Building Su 1. PC Fee: Re OT 0.0 PP � g• 0 hrs $0.00 PME Plan Check: $0.00 ' Permit Fee: $0.00 SuPP1. Insp. Fee:(j) Reg. � OT0.0 hrs $0.00 PME Unit Fee: $0.00 /�lif PME Permit Fee: $0.00, Construction Tax: IBCONSTfIXC $0.00 Aclrninistrative Fee: � Work Without Permit? 0 Yes (j) No $0.00` Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 Tnivel Documentation Fees: a Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTAISo $0.00 $0.00 TOTAL FIE $0.00 Revised: 07/02/2015 CUPERTIINQO CONSTRUCTION PERMIT APPICATI®IV COMMUNITY DEVELOPMENT DEPARTMENT • UILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 9501 (408) 777-3228 • FAX (408) 777-3333 • building ® NEW CONSTRUCTION n AT)nMnW n AT TT7A A-rTniv i TT n n-1.1--. ...-, ,,,., Sao — - u ,-..niu�ri. vivvu�rw rniuvut tt PROTECT ADDRESS �J�� ,y. _ ,o'/ APq# OWNER NAME M IN s /I Cy +�7 e{ Nom• PHONE 45-0_./ _1 � /,goo E -r STREET ADDRESS Z03 S�YL CITY, STATE, ZIP F4.,(–o _3/ w _ CONTACT NAME A� wDy twevittom , PHONE �+y� 3 (j' /l EMAIL �v� ac STREET ADDRESS D � � _ � CrrY STATE, ZIP CA 5`0 JFXsv-3YY-06S'2-1 ❑ OWNER ❑ OWNERBUILDER❑ OwNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR A 3ENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME —A LICENSE NUMBER LICENSE TYPE BUS. LIC 9 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT,TNGINEERNAME Roger Heeringa LICENSE NUMBER S453 (California) BUS. LIC 4 91-1403544 cOMPANYNAME DCI Engineers E-MAIL jbeftner@iici-engineers.com FAX jbrink@dc -engineers.com STREET ADDRESS 1 Post Street, Suite 1050 CITY, STATE, ZIP San Francisco, CA 94104 PHONE 415-781-1505 DESCRIPTION OF WORK Temporary shoring for 2 level below -grade concrete parking structure. EXISTING USE PROPOSED USE CONSTR. TYPE #STORIES I USE TYPE OCC. SQ.FI'. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA ,A S �/W p ,5 oG�'•' BATHROOM KITCHEN[ OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA UDETACH ATTACH H DWELLING L=S: IS A SECOND UNIT ❑YES SECOND Y ❑YES BEL\G ADDED? ❑NO ADDIII ? ❑NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY IS LDG '� Q YES PLAN. I1NG APPL ❑ NO PLANNING AP i FrrGa EI H IE? ❑ NO $Y - TOTAL VALUATION: By my signature below, I certify to each of fe fo e p perty owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have prove ed is c hav rea the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building co u oriz representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Apphcant/Agent: Date: �� 0 SUPPLEMENTAL INFO TION RE 7.PI Ali CHECKTYPE ROUTINGSLIP New SFD or Multifamily dwellings: Apply for demolition permit forp Q«1t THE CO[A�TER � BUILDINGPLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. xPRFss ❑ PLANNING PLAIN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure DTAND-A zD ❑ .PUBLIC wOPM form if any Hazardous Materials are being used as part of this project. R GE D FHtE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ OR ❑ submittal of Building Permit application. SANITARY SEWERDISTRICT EN47R6N17ENTAL HEALTH .. BldgApp_201 1. doc revised 06121111 CITY OF CUPERTINO . FEE ESTIMATOR - BUILDINGD DIVISION LIMA MAIN STREET (LOFTS) DATE: 04/10/2014 REVIEWED BY: MELISSA APN: 31620 085 BP#: *VALUATION: $535,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: 0.0 1 PENTAMATION PERMIT TYPE: 1 GENCO i WORK TEMPORARY SHORING FOR MAIN STREET LOFTS & BELOW GRADE PARKING STRUCTURE SCOPE fvviC: 1 nis estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the Dreliminary information availahlp and arp nr,h, FEE ITEMS Lee Resolution 11-0�3 Lff.' 7,%1113) •iPt°% ��. i.tie 6Yte'L"n' ,Pho';"'. Noll L',/tc Nk MISC ITEMS > t:;l:: i7i:.. rE;'r`ii 1`z'c. Y Z; l o l l hours $8 4.00 Plan Check, Hourly ISTPLNCK Of ?.'r 1,1 ,P...:n:;p t"f."" -. �t':ti„ 0.0 1 7 f`. fvviC: 1 nis estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the Dreliminary information availahlp and arp nr,h, FEE ITEMS Lee Resolution 11-0�3 Lff.' 7,%1113) FEE QTYIFEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (2) No $0.00 l o l l hours $8 4.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: (j) Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes (F) No $0.00 Suppl. Insp. Feer Reg. 0 OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 .t ` C.'(:'.; 0 Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure • l vu;';: % 1:3„r:r rrf ,rir.:�rr.,,; 1 :�:• . Strong Motion .Fee: IBSEISMICO $112.35 6.0 hrs $824.00 Inspections ISTINSP Inspection, Hourly .Bldg Stds Commission Fee: IBCBSC $22.00 SUBTOTALS: $134.35 $1,668.00 TOTAL FEE: $1, 802.35 Revised: 04/01/2014