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15080021I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20672 HOMESTEAD RD I CONTRACTOR: CHRIS CONSTRUCTION I PERMIT NO: 15080021 1 [ OWNER'S NAME: SOBRATO CONSTRUCTION CORP 18425 TRAGUS WAY I DATE ISSUED: 08/04/2015 1 I OWNER'S PHONE: 4084460700 1 ELK GROVE, CA 95624 1 PHONE NO: (916) 832 -8898 1 W LICENSED CONTRACTOR'S DECLARATION License Class Lic. g Contractor _ � ` �c 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. JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALLATION OF DEMISING WALL (64 L.F.). 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: 1- -Iihve 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. 1 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. r Signature Date 11 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, 1 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, 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 Valuation: $8000 APN Number: 32610066.20672 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by:"J�(v 44F2:& Date: z5 - i!5 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 1 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, Sectio rs 25%,505, 25513, and 25534.1 Owner or authorized agent: ° (� Date: 'J CONSTRUCTION LENDING AGENCY 1 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 Add ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Profess CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408)777-3228- FAX (408)777-3333- buildingna.cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT tl PROrECTADDR,SS 20672 HOMESTEAD ROAD APN# 326 -10 -066 OWNERNAME THE SOBRATO ORGANIZATION PHONE 408-446-0700 E -MAIL RTRUEMPLER @SOBRATO.COM RICH TRUEMPLER STREET ADDRESS CITY, STATE, ZIP CUPERTINO, CA. 95014 FAX 408 - 866 -6638 10600 N. DE ANZA BLVD. CONTACT NAME JEFF OPAROWSKI PHONE 408- 496 -0676 EMAIL JOPAROWSKI @ARCTEC INC. COM STREET ADDRESS 99 ALMADEN BLVD., SUITE 840 CITY, STATE, ZIP SAN JOSE, CA 95113 __FFAX 408- 496 -1121 ❑ OWNER ❑ OWNER - BUILDER ❑ OIANERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ® ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME CHRIS CHEN LICENSE NUMBER 922 316 LICENSE TYPE B BUS. LIC # COMPANYNAME CHRIS CONSTRUCTION EMAIL MINGMINGNG2006 @YAHOO.COM FAX STREETADDRESS 8425 TRAGUS WAY CITY,STATE,ZIP ELK GROVE, CA 95624 PHONE (916) 832 -8898 ARCHITECT/ENGINEERNAME JEFF OPAROWSKI, AIA LICENSENUMBER C -21289 BUS. LICH COMPANYNAME ARC TEC INC. E -MAIL JOPAROWSKI @ARCTECINC.COM FAX 408- 496 -1121 STREET ADDRESS 99 ALMADEN BLVD. CITY, STATE, ZIP SAN JOSE, CA 95113 PHONE 408- 496 -0676 DESCRIPTION OF WORK A NEW DEMISING WALL. EXISTING USE PROPOSED USE CONSTR. TYPE M STORIES OFFICE USE Y NONE RETAIL V -B ONE V6LIUATION (3) EXISTG NEW FLOOR DEMO TOTAL 6,112 - AREA 6 ' 112 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 IDWELLINGUNITS 19A SECOND UNIT [:]YES SECONDSTORY ❑ YES BEINGADDED? ❑ No ADDITION? ❑ NO PRE - APPLICATION ❑ YES IFYES, PROVIDE COPY OF PLANNER 'SN IIE B TOT VALUAT ON, PLANNNG APPL , ❑ NO PLANNING APPROVAL LETTER ' By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf 1 lAve 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 all applicable local ordinances and state laws relating to building cons tion. uthorize r resentatives of Cupertino to enter the above - identified property for inspection purposes. I Signature of Applicant/Agent: Date: I-W 'Ilq SUPPLEMENTAL INFO ON RE UIRED PLAN CHECK TYPE ROUTENG841P ❑ ouFe- THE - COUNTER ❑ BUILDING PLAN REVIEW, 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. ❑ EXPRESS ❑ 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 ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. CJ ENVIRONMENTAL HEALTH BldgApp_20 / L doc re vised 0311611 1 /J (0e 0'1 ili /" CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etch These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Ef � 7111132 ADDRESS: 20672 Homestead Rd DATE: 08/04 /2015 REVIEWED BY: Sean APN: BP#: *VALUATION: $8,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building Tin Civil / Religious activities BQ zone? Yes Q No PENTAMATION PERMIT TYPE: 1 GENCOM WORK Installation of demising wall 64 L.F. . SCOPE $0.00 NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etch These fees are based on the nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Ef � 7111132 FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 = l.f. Interior Partitions $717.00 IpART1Comm Suppl, PC Fee: Q Reg. 0 OT FO 0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 0 Work Without Permit? 0 Yes No $0.00 Advanced PlanningFee: $0.00 Select a Non-Residential Building or Structure 0 y F`u;Yq'('C d,RS €:P� "6' �tQ,lt�ir1 /''a.x�.,� Strong Motion Fee: 1BSEISMICO $2.24 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 BTITALS:, $3.24 $717.00 TUTA FEET $720.24 Revised: 07/02/2015 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408- 777 -3228 Fax: 408- 777 -3333 JOB ADDRESS: `2 © 2 PERMIT # OWNER'S NAME: � � PHONE # � GENERAL CONTRACTOR: Cabinets & Millwork BUSINESS LICENSE # ADDRESS: IV044 CITY /ZIPCODE: *Our municipal code requires all bus mosses 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 SUBCONT CTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Date 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