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15060032
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10057 SAICH WAY CONTRACTOR: SILICON X PERMIT NO: 15060032 CONSTRUCTION INC OWNER'S NAME: DIANA TAYLOR TRUSTEE 2051 JUNCTION AVE DATE ISSUED: 07/27/2015 OWNER'S PHONE: 4084530477 SAN JOSE, CA 95131 PHONE NO: (408) 418-0099 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL F] /� License Class , ? _ Lic.# 1B SAICH STATION - CODER SCHOOL - BUILD OUT SHELL FOR Contractor �� , �• � X Ccg,,�V-ZIi&A - �� - [ B OCCUPANCY (988 S.F.) 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: $65000 ave 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: 3263204 L 10057 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 PERMIT EXPIRES IF WORK IS NOT STARTED 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 YS FROM LAST C4LLED INSPE TIO indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the . r granting of this permit. Additionally, the applicant understands and will comply Issued by: Y Date: with all non -point source r gulations per the Cupertino Municipal Code, Section 9.18. '7 7_ f" Signature Date J any 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. 13OWNE - UILDER 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: I, as owner of the property, or my employees with wages as their sole compensation, ALL 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 & PFofessions 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 Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance 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 & Safety Code, Section 25532(a) should I store or handle hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the material. Additionally, should I use equipment or devices which emit hazardous 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 -Z T/ permit is issued. 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 Califomia. If, after making this certificate of exemption, I CONSTRUCT 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 Address 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 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT a BUILDING DIVISION 10300 TORRE AVENUE o CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building ar )cupertino.o9 -5-C 6 vV L NEW CONSTRUCTION ❑ ADDITION 0 ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10057 Saich Way APN # 326-32-041. t U U OWNERNAME Saich Way Station LLC PHONE (408) 453-4700 E-MAIL tarry@borelli.com STREETADDRESs 20551 Junction Ave., Suite 100 CITY, STATE,ZIP San Jose, CA 95131 FAX (408) 453-5636 CONTACT NAME Robert Bearden PHONE (925) 678.2033 EMAIL bob@fcgainc.com STREET ADDRESS 301 Martz Ave., Suite 213 CITY, STATE, ZIP Danville, CA 94526 1 FAX (925) 820-5858 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ® ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME Tony Gonzalez LICENSENUMBER 983292 LICENSE TYPE B BUS. LIC # COMPANYNAME SiliconX Construction &MAIL tony@siliconxconstruction.com FAX. (408) 453-5636 STREETADDRESS 2051 Junction Ave., Suite 100 CITY,STATE,ZIP San Jose, CA 95131 PHONE (408) 418-0099 ARCHITECT/ENGINEERNAME Cedric Craig LICENSENUMBER C-15490 BUS. LIC# COMPANY NAME FCGA architecture E-MAIL ric@fcgainc.com FAX (925) 820-5858 STREETADDRESS 301 Hartz Ave., Suite 213 CITY,STATE,ZIP Danville, CA 94526 PHONE (925) 820-7585 DESCRIPTION OF WORK Landlordlowner improvements to existing vacant tenant space in new building: demising wall, interior partitions with gypsum board finish, no paint, restroom, HVAC system, suspended acoustic panel ceiling with lighting, subpanel and electrical outlets. EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES Mercantile Business* V -B 1 USE TYPE I OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA 988 AREA 0 AREA 0 NET AREA 988 Business* V -B I Tu my 988 $65,000 BaTrmooM KITCHENoTItER *Business -After Jul 1, 2015 in accordance with CBC Section REMODELAREA REMODELAREA REMODELAREA 304.1; July 1, 2015 Supplement PORCH AREA I DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: DETACH LJ ATTACH # DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY []YES BEINGADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION M YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES TOTAL VALUATION: PLANNING APPL # NO PLANNING APPROVAL LETTER EICHLERHOME? ❑NO'•,. $65,000 By my signature below, I certify to each of the following: I am the property owner or authorize t'to act operty owner's behalf. a read this application and the information I have provi ed is correct. I7hav read the Description of Work and ve ' s accurate. I agree to comply with all applicable local ordinances and state laws relating to it tr ction.r e reoresentatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: 06.01.2015 SUPPLkMENTAL INFORMATION QUIRED PLAN cHEcx TYPE xizlrizl+tG s rn New SED or Multifamily dwellings: Apply for demolition permit for ❑ ❑ existing building(s). Demolition permit is required prior to issuance of building . OYER THE COUNTER BUII DING PLAN REVIEW permit for new building. p❑ EXPRESS ©, PLANNriVG PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sANnnxiiz " ❑ PUBLrc WORKS form if any Hazardous Materials are being used as part of this project. a ❑ LARGE ❑FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑MAJOR j] SAl11TARYSEWERDISTRICT x ❑ ..ENVIA0NI4IENTAL iIFALTH. BldgApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FM'_1 FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 10057 SAICH WAY DATE: 06/04/2015 REVIEWED BY: MELISSA PC FEE ID APN: 32632041.10057 BP#: 56 c:2— *VALUATION: 1$65,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building $1,066.52 PENTAMATION PERMIT TYPE: 1 B TA WORK SAICH STATION - CODER SCHOOL - BUILD OUT SHELL FOR B OCCUPANCY 988 S.F. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,111-B,IV,V-B 988 $2,133.82 1BTIPLNCK $1,066.52 IBTIINSP Elec. Imp. Fee: $0.00 Permit Fee: $1,066.52 Suppl. Insp. Fee -(F) Reg. C) OT 10.01hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: TOTALS: 988 $2,133.82 -;` $1,066.52 == - MECH, HOURLY Yss �.No PLUMS, HOURLY. Yes,, No. ELEC, IkOYIRLY; Yes Q No :Tech. Plum Check Phunb. Plan Check- 1i7ec. Plan Check ;Lt111h. Permit Fee: Phrmb. Permit Fee: rie:c. Permir !gee: Other it lech. Insp. Other Plunib Inst. Other Elec. Insp. ;llech, buy.). hen.: Plrunb. hasp. Fee: Elec. Imp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Aictriet otr 1_ Thovo foot aro havod an tho nroliminanr infnrmadnn availahlo and are anly an evdinate- Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11-053 Ef. 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,133.82 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. 0 OT 0,0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,066.52 Suppl. Insp. Fee -(F) Reg. C) OT 10.01hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: 0 G Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 Trm:el Uoc�utnentation Fees: Strong Motion. Fee: IBSEISMICO $18.20 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $3.00 - SUBTOTALS` $3,221.54 $0.00 TOTALFEE 4 $3,221.54 Revised: 05/07/2015 (' Building Department � City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 C O P E RT I N O t. Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: DOS'? PERMIT # d b Z OWNER'S NAME: A, PHONE # #6 oc - S — FT L � GENERAL CONTRACTOR: , �, BUSINESS LICENSE # VP 3 2 - .ADDRESS: Zc j' ,q-v� CITY/ZIPCODE: C -t - *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: Signature Please check applicable subcontractors and complete the following information: Date Date 2 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing v-rElectrical v c_ Z T , Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Ll Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper rb Paving Plastering ✓ Plumbing �ffSo G a-7er> l•�► Roofing Septic Tank Sheet Metal Sheet Rock Tile Date 2