Loading...
15040175ru CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20371 STEVENS CREEK BLD CONTRACTOR: C(VO C0Agleke' '011 PERMIT NO: 15040175 OWNER'S NAME: WDV PROPERTIES DATE ISSUED: 07/27/2015 OWNER'S PHONE: 4152150113 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL F] COMMERCIAL S� �/�� I- SUSHI -T.I. FOR (N) RESTAURANT INTO (E) License Class Lic. # , RESTAURANT SPACE Contractor �� ��N�(fI 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 Floor Area: Valuation: $30000 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. APN Number: 31626090.20371 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 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS LED INSPECTION. 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 Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE- ROOFS: Signature Date Z 7 s All roofs shall be inspected prior to any roofing material being installed. If a roof is r 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, td 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized agent: Date: 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 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 CUPERTINO I (40x8)) 777 -3228 • FAX (� 777 -3333 • building(a)cupertino.org ❑ NEW CONSTRUCTION I I AT)T)T-rT()W AT TFR A- rTnT.T /Tr I—I v=tjroTnwT tncc — - - - - - - -- - u vi...vii.rw rntuvut r� PROJECT ADDRESS APN # OWNERNAME PHONE J E-MAIL STREET ADDRESS 9( O _ h �� , w ' CITY, STATE, 7,LP s FAX N . �C 7 C CONTACT NAME PHO E-MAIL t fCO Ohl STREET ADDRESS ry (Z( � CITY, STATE, ZIP r o ®� Cs FAX ❑ OR'NER ❑. OWNER-BUILDER OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ENGIIAIEEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LICENSE NUMBER LICENSETYPE BUS. LIC# COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER Q BUS. LIC # �) COMPANY NAME E -MAIL � FAX B s tl� l � r � � s �Uc STREET ADDRESS CITY, STATE, ZIP - PHONE -4ck 0 �� , GS 6 DESCRIPTION OF WORK -- EXISTING USE PROPOSED USE CONSTR TYPE # STORIES AI- eS A �n17 USE TYPE OCC. SQ.FT. VALUATIONS) , AREAG ' N,ggq OOR I1� DAREA . TNETAREA � N/5 5 f cl 3dc d BATHROOM KITCHEN ` OTHER REMODEL AREA) 6, REMODEL AREA REMODEL AREA Q� PORCH I A DECK AREA TOTAL DECK/PORCH AREA GARAGE A: DETACH ❑ ATTACH tM(,y( R DVIELLIN UNfrS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES -y `E BEING D? 21SO ADDITION? t ❑NO .: -..- F ' , PRE-APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL R ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO TAL VALUATION' ' By my signature below, I certify to each of the following: I am the property owner or authorized a to act on the properly owner's behal . I h this ave read application and the information I have is provided correct. I have read the Description of Work and verify it is accurate. I agree to comply , th all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above- identi, property foi- inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED prArrc>cx �E, oucsmx _ New SFD or Multifamily dwellings: Apply for demolition permit for _� fl (VERTETrG077ItTER � gk TJILDTNGPLRE existing building(s). Demolition permit is required prior to issuance of buildlnQ s -�� permit for new building.®�� �Ess� rpHPfrt Lararnc PZt�rE�YIE ummg _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure tpc Cl form if any Hazardous Materials are being used as part of this project.ar1�� Cp PY of Planning Approval Letter or Meeting with Plannin g Prior to submittal Building Permit 4%IIIZYSEERDI §�C of application.�,oR�� Bldg4pp_2011.doc revised 06121111 ffim-1, CITY OF CUPERTINO FEE ESTIMATOR - RITTI,DING DIVICION baADDRESS: 20371 STEVENS CREEK BLVD DATE: 04123/2015 REVIEWED BY: MELISSA PC FEE ID APN: 31626090.20371 BP #: *VALUATION: 1$30,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building IBTIPLNCK PENTAMATION 1 B I PERMIT TYPE: T WORK I -SUSHI - T.I. FOR N RESTAURANT INTO E RESTAURANT SPACE SCOPE Suppl. Insp. Fee-(F) Reg. 0 OT OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA S.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II- B,III- B,IV,V -B 1,099 $2,139.08 IBTIPLNCK $1,134.88 IBTIINSP 1 fec. Imp. hee: $1,134.88 Suppl. Insp. Fee-(F) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 cnrstruction Tax: T ,1. {.hninistrative Fee: 0 G Work Without Permit? 0 Yes 0 No $0.00 TOTALS: 1,099 $2,139.08 .; : $1,134.88 Strom Motion Fee: IBSEISMICO MI CHi HOURLY Yes. _ N� PLUMB, H URL :Yes -` Na :' ELE , Il<QURLY, .. I'es Q No Nkch. Plan Check Plrurth. Plan C:'he(-4 1 lec. Plan Check Llei:h. Permit fee: Numh. Permit Fee.: F;lec. Permir Fee: Other A/ewh. Insl). tithe. Plumb lnsn. Other tile:. Insp. tlech. Inch. 1,ee: Phenzb, Gzsp. Fe I.. 1 fec. Imp. hee: MUM I his estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). 77tese fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,139.08 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Reg. 0 OT 0,0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,134.88 Suppl. Insp. Fee-(F) Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 cnrstruction Tax: T ,1. {.hninistrative Fee: 0 G Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential 0 Building or Structure 0 A Travel Docuinenlaiir. n Fees: Strom Motion Fee: IBSEISMICO $8.40 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC $2.00 7. STIBTOTALS.`' $3,284.36 $3,284.36 $0.00 $3,284.36 Revised: 04/01/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20371 STEVENS CREEK BLD CONTRACTOR: '�iT0 Cott ERMIT NO: 15040175 1 OWNER'S NAME: WDV PROPERTIES IW'JA h'iI JW[ 1/l"f Vj.,' I JIU1 � T " •I DATE ISSUED: 07/27/2015 1 OWNER'S PHONE: 4152150113 I MAQUf N } E Gk q j010, I PHONE NO: yl LICENSED CONTRACTOR'S DECLARATION License Clas O. ic. # Contractor `'" t t' ,. "�' ° x ���nDate 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: 1. 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 ph Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION 1 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 re lations 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: 1. 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. 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. 2. 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. s. 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, l must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 1 certify that [ 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 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ I- SUSHI -T.I. FOR (N) RESTAURANT INTO (E) RESTAURANT SPACE Sq. Ft Floor Area: Valuation: $30000 APN Number: 31626090.20371 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSSr C ION� Issued by: Date: —1� � 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 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. O JWJ ner or aut orY�ze a n at _C 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 CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20371 STEVENS CREEK BLD CONTRACTOI, f 01t® „A ,Y ERMIT NO: 15040175 OWNER'S NAME: WDV PROPERTIES aJQLW tom/ W DATE ISSUED: 07/27/2015 OWNER'S PHONE: 4152150113 t KO �,/k % PHONE NO: t LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL [I COMMERCIAL ❑ License Class mnit`,_ #fig I- SUSHI-T.I. FOR (N) RESTAURANT INTO (E) RESTAURANT SPACE OW Contractor �n r` * F 1 F (g "rm Date a Q N; I hereby affirm that Iam 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. Sq. Ft Floor Area: Valuation: $30000 I hereby affirm under penalty of perjury one of the following two declarations: t. I have and will maintain a certificate of consent to self - insure for Worker's APN Number: 31626090.20371 Occupancy Type: 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. PERMIT EXPIRES IF WORK IS NOT STARTED APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR 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 180 DAYS FROM LAST CALLED INSPECTION. to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save Issued by: Date: 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 regul tions per the Cupertino Municipal Code, Section 9.18. RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature I l Date " _ &7 �aZ installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE sale (Sec.7044, Business & Professions Code) I have read the hazardous materials requirements under Chapter 6.95 of the 2. I, as owner of the property, am exclusively contracting with licensed contractors to California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain construct the project (Sec.7044, Business & Professions Code). compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. I hereby affirm under penalty of perjury one of the following three declarations: Additionally, should I use equipment or devices which emit hazardous air t. I have and will maintain a Certificate of Consent to self - insure for Worker's contaminants as defined by the Bay Area Air Quality Management District I will Compensation, as provided for by Section 3700 of the Labor Code, for the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by Owner or auqorized a t: Section 3700 of the Labor Code, for the performance of the work for which this , r� " +a'�9 . , Date: �� "w (' permit is issued. awl s. I certify that in the performance of the work for which this permit is issued, I shall CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is construction lending agency for the performance of work's become subject to the Worker's Compensation provisions of the Labor Code, I a for which this permit is issued (Sec. 3097, Civ C.) Lender's Name must forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Address APPLICANT CERTIFICATION ARCHITEC'T'S DECLARATION I certify that I have read this application and state that the above information is I understand my plans shall be used as public records. 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 Licensed Professional 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 E., IWO CONSTRUCTION PERMIT APPL[CAT[ON fW#1ff=% COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ffo (408) 777 -3228 • FAX (408) 777 -3333 • building 51cupertino.orq ❑ NEW CONSTRUCTION ❑ ADDITION . ❑ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMTT n PROJECT ADDRESS r 5 I APN R O OWNERNAME �WD 0 VV PHONE I — _ D 3 E -MAIL STREETADDRESS CITY, STATE, ZIP FAX i CONTACT NAME PHONE / U E -A4AII v J STREET ADDRESS I CITY, STATE, ZIP ow FAX OWNER ❑. OWNER.BUn-DER ' �T'ER AGENT ❑ CONTRACTOR • ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSETYPE BUS. L1C 9 COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME jj LICENSE NUMBER BUS. LIC R COMPANY N IE E -MAIL FAX �. �� `I o(-'l STREET ADDRES.SJ CITY, STATE, ZIP / PHONE � �/ � � U DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTRTYPE 4 STORIES I USE TYPE I OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA •- BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH m DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? E] NO ADDITION? E] NO , PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑YES UEDBY - i - TOTAL, V ATION: PLANKING APPL: []NO PLANNING APPROVAL LETTER EICHLER HOA1E? I] 1.0 = _ ' �r = By my signature below, I certify to each of the following: I am the property n v, or authoriz d agent to act on the property owner's behalf. I ha read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with alf applicable local ordinances and state laws relating to building construction. I authorize representatives -of Cupertino to enter the above -ide ified property for inspection purposes. SigrlatureofApplicant/Agent: Date: r�I SUPPLEMENTAL INTFOP MATION REQUIRED r> I\Tew SFD or Multifamily dwellings: Apply for demolition permit for existing building s). Demolition permit is required prior to issuance of building OVER THE GOTThTER - = xT z BUILDL�GYL�NREVIE�V permit for new building. ExPxss© r Pz �n�,>?.GPLnNEVLEw _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 1]' sT:DAxn L7 P>aB�tcwoRxS� form if any Hazardous Materials are being used as part of this project. L s Copy of Planning Approval Letter or Meeting with Planning prior to _ submittal of Building Permit application. ©MAoRF�k z �� S4�I�TIARYSE�iER�ISTRICTa Bld,- App_2011. doc revised 06121111 CITY OF CUPERTINO J*20 FEE ESTIMATOR - BUILDING DNISIO imlADDRESS: 20371 Stevens Creek Blvd DATE: 09/21/2015 REVIEWED BY: PAUL rmit Fee: APN: 316 26 090 BP #: *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement . PRIMARY .Commercial Buildin g USE: Elec. Insp. Fee: PENTAMATION 1 GENCOM PERMIT TYPE. WORK Revision #1 - Relocate seating and equipment SCOPE NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the Preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 Ef. 7/1/132 91ech. Plan CH-11LI11111. Plumb. Plan Check Dec. Plan Check rmit Fee: Plumb, Permit Fee: Elec. Permit Fee: Other ,11ech. Insp. Other Pluinh Insp. Other Elec. Insp. Li :blech, Insp. Fee: Plumb. Insp, fee: Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the Preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 Ef. 7/1/132 FEE QTY/FEE MISC ITEMS' Plan Check Fee: Hourly Only? 0 Yes Q No $0..00 0 hours Plan Check, Hourly $143.00 ISTPLNCK Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. 0 OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative. Fee: 0 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee. $0.00 Select a Non - Residential Building or Structure 0 0 Travel Docuinentation Tees: Strong Motion Fee: $0:00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $143.00 .3 TOTAL.FEE: Revised: 07/02/2015 7 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 Fax: 408 - 777 -3333 i JOB ADDRESS: 2,V371 -1917 OWNER'S NAME: S PHONE # - —D 113 GENERAL CONTRACTOR: aj Si- -t0 BUSINESS LICENSE # U4 l ADDRESS:90 "; CITY /ZIPCODE: �406Z) *Our municipal code requires all businesses working in the city to have a City of Cupertino business license NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: nV Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date September 08, 2015 To Whom It May Concern, I, Chea\a4 a „ovriting this letter to inform you that I release Aero Construction from liability as the general Contractor. I will hire and authorize Jaysito Construction Group to represent my property located 20371 Steven Creek Cupertino CA. To act as my general contractor and to obtain permit from the City of Cupertino. Please feel free to contact me if you have any other questions or concerns. Sincerely, I -Sushi 20371 Steven Creek Blvd Cupertino, CA, 95014 415 - 618 -9882 j C IVED SEP 2 zor� k•