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15070135CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20525 MARIANI AVE CONTRACTOR: DEVCON PERMIT NO: 15070135 CONSTRUCTION INC OWNER'S NAME: 20525 MARIANI DRIVE LP 690 GIBRALTAR DR DATE ISSUED: 08/05/2015 OWNER'S PHONE: 4084121275 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ License Classf��, Lic. # 3�!i' APPLE - T.I., IST FLR, EAST WING (8,672 S.F.) TO RECONFIGURE (E) OFFICE SPACE Contractor ,/�,!et>ADateLC ( 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: $750000 performance of the woik 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: 32656001.20525 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 D YS FROM LAST CALLED INSP C ION. 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 by: r—�/ J"� �4 Date: granting of this permit. Additionally, the applicant understands and will comply with all non -points urce regulations per the Cupertino Municipal Code, Section 9.18. RE-ROOFS: Signatur 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: 1, 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 & 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 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, Secti 505, 25533, nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized age t: Date:e/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 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 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 Iunderstand 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 CUP€RTINO ❑ NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - building@cuper ino.ora is �����.� El ADDITION %ALTERATION 1-1 / TI REVISION /DEFERRED ORIGINAL PERMIT # PROTECT ADDRESS � Zt l y, � APN A p5 OWNER NAME PHONE E-MAIL S7REETADDRESS J CITY, STATE, ZIP C � � Cpl G[rz)f3 FAX CONTACT NAME PHONE yIS E-MAIL STREETADDRESS CITY, STATE, 'LIP . ClP 9 L( 101 FAX ❑ OWNER ❑ 01krNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTR ACTOR AGENT A ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT ONTRACTOR NAME G LICENSE NUMBER pl 3 `� tt�� LICENSE TYPE BUS. LIC # [STREET OMPANY NAME E-MAIL FAX ADDRESS 0 - CITY, STATE, ZIP Qj PHONE N� L'1? 1 crus S �3� -lot - sly a 05 &+-5 ARCHITECT/ENGINEER NAME L' U ult--t � Pi i LICENSE NUMBER/ -ry l.-�'}�� f �C\ BUS. LIC # COMPANY NAME Bb 1G. `l l Kt li� E-MAIL (v&e-kk9 ,e{C�1L;Dr+ FAX 1S`S3%'�200) STREET ADDRESS -31.x CITY, STATE. Z P V)U- C -)sI C PHONE DESCRIPTION OF WOR 6P EXISTING USE t�� 1 Cr 14� PROPOSED USE CONSTI (St) C4i L P,� . TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ` l I I ($) EXISTG AREA NEW FLOOR AREA DEMOr AREA 10��- TOTAL NETAREA BATHROOM REMODEL AREA KITCHEN REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH #DWELLING UNITS: IS A SECOND LtNIT ❑YES SECONDSTORY []YES BEING ADDED? ❑NO ADDITION? ❑NO v A- PRE APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ' ❑ NO PLANNING APPROVAL. LETTER IS THE BLDG AN ❑ YE EICHLER HOME? (�EV$�j $y x c. .t >� ` -^`""i ,, ': TOTAL VALUATION: By my signature below, I certify to each of the following: I am the property owner or author' edge �.ttie property ovmer's behalf. I have read this application and the information 1 have k provided is correct. I have read the Description ado a verifyrit is accura a -i agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cilpertino to enter-Ehe above -identified property for inspection purposes. Signature of Applicant/Agent: Date: 7-,F-6-15 SUPPLEMENTAIAi FORMATION REQUIRED PLAN,. ; WK TYPF RQti'TJNG SI M ❑ i _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building OVER T' COIIriTER © BLAiDh1GFi ANREV.iEW permit for new building.' ❑.., EXPRESS `- ❑ kANI•INGPLANAkiU'" , Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑, sTA1�DAR� ❑ PL?SLIC form if any Hazardous Materials are being used as part of this project. WORhS ; _ Copy of Planning Approval Letter or Meeting with Planning prior to _' � ❑ FIRE D>,P1F-.; submittal of Building Permit application. ❑ MAJOR =f ❑ 51VTTARYSEWER_DISTRICT ❑ ENVIRONMENTAL HEALTH B1dgApp 2011.doc revised 0612V/ I CITY OF CUPERTINO F. M-7, FEE ESTIMATOR - BUILDING DIVIRION OCCUPANCY TYPE: ADDRESS: 20525 MARIANI AVE DATE: 07/20/2015 REVIEWED BY: MELISSA PC FEE ID APN: 326 56 001 BP#: �� *VALUATION: 1$750,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement URSIEMARY Commercial Building IBTIPLNCK PENTAMATION 1 B TI PERMIT TYPE: A WORK APPLE - T.I. 1ST FLR EAST WING (8,672 S.F. TO RECONFIGURE E OFFICE SPACE SCOPE $0.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,11[-B,IV,V-B 8,672 $2,632.34 IBTIPLNCK $6,081.45 1BTIINSP ble.c. Insp, Fee: $0.00 Permit Fee: $6,081.45 Suppl. Insp. Fee. -(E) Reg. Cl OT 0,0 hrs $0.00 PME Unit Fee: '$0.00 PME Permit Fee: $0.00 Construction 1'c7x: TOTALS: 8,672 $2,632.34 = $6,08145 MECIIHOURLY: Yes .No - # PLUMB, IOURLY Yes No . ELIC; HOURLY.: �; Yes :.0 No i Ah?c11. Plan {'h<<ch 1'11w1b. 1'lcrn Check Isletc..Plun Olec/c ;L9eclr. reri17i1 f=ee! 1'hwnh. Pennii Fee: flee. Permh Fee: 0dier Alech, friss. l)7he. Plunttr hr,rp.ET-1- 011"er here. Insp. E3 �!<lC:f.'k Fee: Phiwb. Iws1,. Fc.,e: ble.c. Insp, Fee: AUM 1 his estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These fees are hued an the nreliminary information"availahlo and aro anly nn octimato_ Cnntart tho Wont far addn'l info_ FEE ITEMS (Fee Resolution 11-053 Eff. 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,632.34 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Reg. 0 OT 0.0 hes $0.00 PME Plan Check: $0.00 Permit Fee: $6,081.45 Suppl. Insp. Fee. -(E) Reg. Cl OT 0,0 hrs $0.00 PME Unit Fee: '$0.00 PME Permit Fee: $0.00 Construction 1'c7x: AdininistrG7five P-ee: 0 E) Work Without Permit? 0 Yes 0 No $0.00 .Advanced Plannin Fee: $0.00 Select a Non -Residential Building or Structure G 0 � 7i-erre/ I�r,c�tiincs�alaiicn� T'e'as; Strong Motion Fee: IBSEISMICO $210.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $30.00 SUBTOTALS, : $8,953.79 $0.00 ' TO AL FEE" $8,953.79 Revised: 07/02/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20525 MARIANI AVE CONTRACTOR: DEVCON PERMIT NO: 15070135 CONSTRUCTION INC OWNER'S NAME: 20525 MARIANI DRIVE LP 690 GIBRALTAR DR DATE ISSUED: 08/05/2015 OWNER'S PHONE: 4084721275 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ APPLE - T.I., IST FLR, EAST WING (8,672 S.F.) TO License Class—a Lic. # 3011 1 (D 3 RECONFIGURE (E) OFFICE SPACE Contractor DemCa'o - Date it /a-5 REVISION #1: TEMPORARY EQUIPMENT RELOCATION 1 hereby affirm that I am licensed under the provisions of Chapter 9 FOR PHASING OF PROJECT WITH MINOR ELECTRICAL (commencing with Section 7000) of Division 3 of the Business & Professions AND MECHANICAL REVISIONS. ISSUED 11-25-15. 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 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: $750000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by ection 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 32656001.20525 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 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 FROM LAST CALLED 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„� j Issued by: Date: Z �5 - granting of this permit. Additionally, the applicant understands and will comply /���f�CI with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. C i j/� Signature Date < l S 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. ❑ 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 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 1 performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 a ud I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2550 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this G Owner ' R15 /I S permit is issued. or authorized agent: ate:. 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15070135 20525 N ARIANI AVE CUPERTINO CA 95014 (326 56 00 1) OWNER'S NAME: 20525 MARIANI DRIVE LP DATE ISSUED: 08/05/2015 OWNER'S PHONE: PHONE NO: I TCFNSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic. 48_3q9 ( (P3 Contractor Date I / 13 � � (o _BLDG _ELECT _PLUMB MECH RESIDENTIAL _ COMMERCIAL 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: APPLE - T.I., 1ST FLR, EAST WING (8,672 S.F.) TO I hereby affirm under penalty of perjury one of the following two declarations: RECONFIGURE (E) OFFICE SPACE i. 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 TCO GOOD TILL 2/16/16 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for DEF # 1 - INSTALL HIGH DENSITY STORAGE RACKS IN 3 — S Sv by Section 3700 of the Labor Code, for the performance of the work for which ROOMS & ELECTRICAL TRANSFORMER ANCHORAGE this permit is issued. APPLICANT CERTIFICATION **BIN A-3.5** 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 REVISION #1: TEMPORARY EQUIPMENT RELOCATION FOR ordinances and state laws relating to building construction, and hereby PHASING OF PROJECT WITH MINOR ELECTRICAL AND authorize representatives of this city to enter upon the above mentioned MECHANICAL REVISIONS. ISSUED 11-25-15. property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and Sq. Ft Floor Area: Valuation: $750000.00 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 APN Number: Occupancy Type: Code, Section 9.18. 326 56 001 SignatureDate PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYPERMIT ISSUANCE OR OWNER -BUILDER DECLARATION DA CALLED INSPECTION. I hereby affirm that I am exempt from the Contractor's License Law for one of the L180 No following two reasons: t. I, as owner of the property, or my employees with wages as their sole y: - compensation, will do the work, and the structure is not intended or offered Date: 3 6 for sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed RF. -ROOFS: contractors to construct the project (Sec.7044, Business & Professions Code). All roofs shall be inspected prior to any roofing material being installed. If a roof is I hereby affirm under penalty of perjury one of the following three declarations: installed without first obtaining an inspection, I agree to remove all new materials for 1. I have and will maintain a Certificate of Consent to self -insure for Worker's inspection. Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Applicant: z. I have and will maintain Worker's Compensation Insurance, as provided for Date: by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER a. 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 HAZARDOUS MATERIALS DISCLOSURE Worker's Compensation laws of California. If, after making this certificate of I have read the hazardous materials requirements under Chapter 6.95 of the exemption, I become subject to the Worker's Compensation provisions of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will Labor Code, I must forthwith comply with such provisions or this permit shall maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the be deemed revoked. Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous APPLICANT CERTIFICATION air contaminants as defined by the Bay Area Air Quality Management District I I certify that I have read this application and state that the above information is will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and correct. I agree to comply with all city and county ordinances and state laws the Health &Safety Code, Sections 25505, 25533, and 25534. relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree /� (/►O to save indemnify and keep harmless the City of Cupertino against liabilities, Owner or authorized agent: /" I` /I judgments, costs, and expenses which may accrue against said City in Date: (3 consequence of the granting of this permit. Additionally, the applicant CONSTRUCTION LENDING AGENCY understands and will comply with all non -point source regulations per the I hereby affirm that there is a construction lending agency for the performance Cupertino Municipal Code, Section 9.18. of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Signature Date Lender's Address CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BURE pRWN # / 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(@cupertino.org 1 1 NFW CONSTRUCTION I I ADDITION ❑ ALTERATION /T1 REVISION /DEFERRED ORIGINAL PERMIT # IM] PROJECT ADDRESS a0 5 g5 M(3.f�Q� � APN # J�q� (� OWNERNAME 1 1 PHONE 1 _ . ZE-MAIL STREE ADDRESS CITY, STATE, ZIP FA Q CONTACT NAME PHONE E-VAIL vss � - a - - STREET ADDRESS CITY, STATE, ZIP FAX C ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENAN I CONT ORNAME LICENSE NUMBER LICENSE TYPE BUS. LIC # 3 COMPANY ME E-MAIL ' S FAX • STREET ADDRESS to Y, 1 CITY, STATE, ZIP PHONE „ _ 61 (•� ^ _ ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC - COMPANY NAME E-MAIL'' nn I.NJ�� FAX 1 Q 1 - 8� STREET ADDRESS bVsAA i) lam CITY, STATE, ZIP PHONE, 5' Ci 1 DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE 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 DECKIPORCH AREA GARAGE AREA: DETACH [TOTALAREA ❑ ATTACH # DWELLING UNITS: Is A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ONO ADDITION? ONO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIV / TOTAL PLANNING APPL # F1 NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO � A / � JATION: 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. I have read this application and the information 1 have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local erty for inspection purposes. ordinances and state laws relating to building construction. I authorize epresentatives of Cupertino to enter the abov7�n Signature of Applicant/Agent: Date: SUPPLEMEN L INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP OVER-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. ❑ ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 06/21/11 CONSTRUCTION PERMIT APPLICATION COV 0UNI I Y DEVELOP1JiENT DEPARTA4ENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 35014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building cuoerti711)=) ❑ NEW CONSTRUCTION ❑ ADDITION . ❑ ALTERATION / TI -NiREVISIO ORIGINAL PERMIT # /,Z-7013 PROWr ADDRESS J �A\,� ,Pte ' l e�u APN I PHONE . � ` t� E-MAIL ` OV'NERNAME ���,`% �� �i 1G., • f "'--'C 119 STREET ADDRESSCITY, STATE, zgS alr'1 I FAX C c� a CONTACT NAME QI PHONE�ISyQ,E-N°IL�f40" `1 1 STREET ADDRESSC STATE, ITY, , dGa-t��-+c,s ►D C'A dl �� l t)BJ FAX "' =R Q owmm•Buimmt ❑ owNER AGENT ❑ CONTRACTOR ❑ CONIRACTOR AGENT (4.ARC=-CT ❑ ENGINEM ❑ DEVELOPER ❑ TENAi r CONTRACTORNAME �Au LICENSENUMBER,Q,91.- I LICENSETYPE BUS. LIC CObffANYNAD.�E (1�_ E-MAIL C/dSL�Cf STREET ADDRESS Co9b G���n.LtPr�' �vL- CITY, STA ZIP M�►,P�cAs GA gSa3S PHONE YAa-S)q •OSLIS ARCHITECT/EIvG iER N?�✓E LICENSE NUMBER O �� J I Fa�-►� �i�A�l A�CC1 BUS. LIC # COMPANY NAME cH w LA11--Csc G��+�-• E-MAIL �,�1�' Hca-orc�, FAX �l�s-X31-8Go STP.EET ADDRESS CITY, STA P PHONE yl S •931 '��t�` DESCRIPTION OF WORK �'ua �. t �cI► t. Lai-.�WZc►,ac` I.r<c %LA LIE Ea7STING USE PROPOSED USE CONSTR. TYPE 4 STORIES i 1 USE TYPE OCC. SQFT. 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 4 D\VTLLINGUN7rS: IS A SECOND UNrr ❑ YES SECOND STORY []ITS - BEINGADDED? NO ADDITION? ❑NO I I PPIP- PPLICATION ❑YES IF YES, PROVIDE COPY OF ISTHE BLDG AN ❑ YES EICHLER C,$I�% '$jf'+ � ;"d }' I< '`"" ` OTAL VALUATION: PLA' KING ADPL R ❑ NO PLANNING APPROVAL LETTER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agejnt to act on ther erty owner's behalf. I have 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 relatingg( to buil ' o ruct'o ..% I1 authorize represe trves -of Cupertino to enter the above-iddeentified property for inspection purposes. SignatureofApplicant/Agent: ?' LZz(A sem—C�4�� Date: 11 �Ot /I 1F5 SUPPLEMENTAL INFORMATION REQUIREDp New SFD or Multifamily d -Wellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. c _ 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. °`'�� " ' 1.wR'`.... 2�:W'NiEI�T4L kiE:AL BIdgApp_Ml.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION - ADDRESS: 20525 Mariani Ave DATE: 11/24/2015 REVIEWED BY: Phuong APN: 326-56-001 BP#: 15070135 "VALUATION: 1$45,000 'PERMITTYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: f%t'Pi'1 (..-C.:Pii'j.:.Ll PENTAMATION 1GENCOM PERMIT TYPE: WORK Def # 1 - Install high density storage rack SCOPE PME Plan Check: NOTE: This 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 preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Pee Resolution 11-053 Fff 7/1/13) Ifec z. Ptan Check Plwnh. Phan C.'heek t:c. Plar; ;; Phorb. Pei mii 1,ee: $0.00 ... Other Pluto& lrnp f%t'Pi'1 (..-C.:Pii'j.:.Ll Suppl. PC Fee: 0 Reg. 0 OT Phinib. ImP. I; 1 hrs NOTE: This 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 preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Pee Resolution 11-053 Fff 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # $286.00 Deferred Submittal IDEFSUBM 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. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (.'o;1sirlietion 744 Administrative .I`L'L': G Work Without Permit? ® Yes (F) No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential Building or Structure 0 i Travel Documentation 1"ec.s_ Strong Motion Fee: 1BSEISMICO $12.60 Select an Administrative Item BldgStds Commission Fee: 1BCBSC $2.00 SUBTOTALS: 1 $14.60 $286.00 TOTAL FEE: $300.60 Revised: 10/01/2015 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION t ADDRESS: 20525 Mariani Ave DATE: 11/25/2015 REVIEWED BY: Sean APN: BP#: "VALUATION: Iso 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: hrs PENTAMATION 1GENRES PERMIT TYPE: WORK REVISION #1: TEMPORARY EQUIPMENT RELOCATION FOR PHASING OF PROJECT WITH SCOPE MINOR ELECTRICAL AND MECHANICAL REVISIONS. NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These fees are haled nn the nretiminary infnrmntintt nvailahlo and ara nmly nn actimata f'nntapt iho Wont fnr addn'1 infn FEE ITEMS (Fec Resolution II -053 Eft: 7;'1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Yes (F) No $0.00 2 hours Plan Check, Hourly $286.00 ISTPL Suppl. PC Fee: (F) Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. 0 OT r 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 G Work Without Permit? Yes (F) No $0.00 Advanced. Planning Fee: $0.00 Select a Non -Residential G Building or Structure Strong Motion Fee: $0.00 Select an Administrative Item BId Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE: $286.00 Revised: 10/01/2015 08/12/2015 09:57 (FAX) CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST P.0011001 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: ;k 0 615 tro-ria-ol ,A,t e PERMIT # � S 0 —7 0 1 3 5 OWNER'S NAME: A e p kG c_ PHONE # C,0t0047L—S100 GENERAL CONTRACTOR: j[a e_v co BUSINESS LICENSE # 1 O ADDRESS: lays CITY/ZIPCODE: rn11 l+ -as &P, 4A'.5: a3 *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 Date Please check applicable subcontractors and complete the following information: Owner / Contractor Slgnrture Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating 2� Insulation Landscaping Lathing Masonry Painting/ Wallpaper -'t Paving Plastering Plumbing Roofing Septic Tank Sheet Metal pC. Sheet Rock u✓V'\ Tile Owner / Contractor Slgnrture Date