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15060151 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6 RESULTS WAY CONTRACTOR:SC BUILDERS INC PERMIT NO: 15060151 OWNER'S NAME: BVK PERIMETER SQUARE RETAIL LLC ET 910 THOMPSON PL DATE ISSUED:06/23/2015 OWNER'S PHONE: 6509067350 SUNNYVALE,CA 94085 PHONE NO:(408)328-0688 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL APPLE-T.I.TO INSTALL 3(N)DOORS WITH 3(N) License Class Lic.# ?4 l 4 CARD READERS(1ST FLOOR ONLY) Contractor Date D aI.;,3 b s-- 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:$48000 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 APN Number:35720041.6 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK OT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAY + 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 DA 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 theZ3 granting of this permit. Additionally,the applicant understands and will comply Date: with all non-point source regulations per the Cupertino Municipal Code,Secti 918. RE-ROOFS: Signature 9 Date Mal 2-7 I I/' Ali 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. El 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 ' al Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se ' rs 255 , nd 5534. Section 3700 of the Labor Code,for the performance of the work for which this . permit is issued. Owner or authorized agent: Date: �S 7 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 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 - CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT e BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 _ CUPERTINO, (408)777-3228• FAX(408)777.3333•building 2cupertino.orcl NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT g ` PROJECT ADDRESS 6 n �Sv LT� l� APN n _ Z-® _ 0 [J p OWNERNAME `'j� 7 �V i� �•�r�/�1Q�� PHONE E-1vL0.IL c' �dAua_—'\VILA,r �a'o>�LE STREET ADDRESS C „ 'a rE.�y / A � FAX CONTACT NAME rs (/ L 0�1`ESwl1� �� E-� US-0 Ls Im •CI l(R 4 JP_f1-r SC.3\3 1 Li3c�iP3L.�J�j STREET ADDRESS CITY,STATE,ZIP FAX S .ate :f n't,� C d'a OWNER OWNER-BUILDER ❑OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGWPER ❑ 'DEVELOPER ❑ TENANT CONTRACTOR NAME ' LICENSE NUMBER LICENSE TYPE BUS.LIC 4 COMPANY NAME a E-MAIL —� FAX IJ\1 i X225 �L J�1"" tS f�F1 baSLY>\ \dam �S1A9C�. Loi STREET ADDRESS CITY,STATE,ZIP PHONE lel iiso �J i�1c� I Sur+s� �{ tt CA C)qabi ARCHITECT/ENGINEER NAME LICENSE NUhMER I BUS.LIC R C_ s0i COMPANY NAME E-MAIL CFAX Sive eiS i,�� S�vpS• G®� STREET ADDRESS CITY,STATE,ZIP PHONE 1a4��az'S� est« Sia ►�c�CiS[ CA ggI-Ds LA 6 3°t8- "1S'IS_ DES F EXISTING USE 'PROPOSED USE CONSTR TYPE 'STORIES 0 ry,( Cj r I[ L' I I 1 USE TYPE OCC. I SQ.FT. I VALUATION(S) EXISTG NEWFLOOR, DEMO TOTAL AREA ✓`''Q AREA AREA NET AREA 3�Q _ j� •� p ✓'-' „kms �x"� Y¢� BATHROOM. KITCHEN. OTHER, t�L� `j' C70 4 REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ATTACH . R DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN J,�. - �-� - �'-s. « TOTAL PLANNING APPL ❑NO' PLANNING APPROVAL LETTER EICHLER HOAIE? ❑NO -- � - �- � fir. ION: By my signature below,I certify to each of the following' a e property owner o orize a_e o act on th er y owner's behalf. I have read this \ application and the information I have provided is have r d the Description of-Work vericcurate. I agree to comply with all applicable local ordinances and state laNvs relating t ilding c struc io . uthor' a representatives of Cupe I nter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: 3Q}�1E, • �d 1ST SUPPLEMENTAL INF N REQUIRED _ ' HE rPLMOW CK3IPi073T33aGSLIEsEON Ij. New SFD or Multifamily d«,ellings: Apply for demolition permit for 4_ DU1tTER r❑'BLaDI1�GPL REYIEii, .existing building(s). Demolition permit is required prior to issuance of building -�� `D'—RTHPlC� �s �t� .� '�.�.� �- �-�• permit for new building. mrwn �XPBEssF xARIIIVGYLAIr REyTEW a _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure FKIRE§ 9t � PIIcoRTcs form if any Hazardous Materials are being used as part of this project. ` iffit- LARGErp �TEPT r k" _Copy of Planning Approval Letter or Meeting with Planningrior toS �gog ¢Y4 a P submittal of Building Permit application. .��`. MA�OR- i-E 'rlA'R.XrSIS ER R \ . 1 �" y��,� kms...` -'t��t.� 4 -c �'��a�_..�..�Y='�� .�'a.,.�t• Bldg4pp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 6 RESULTS WAY DATE: 06/23/2015 REVIEWED BY: MELISSA APN: 357 20 041 BP#: (� *VALUATION: 1$48,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1 B TI USE: PERMIT TYPE: WORK APPLE-T.I. TO INSTALL 3 N DOORS WITH 3 N CARD READERS 1ST FLOOR ONLY SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B (Tenant Improvements) II-B,III-B,IV,V-B 300 $2,097.00 IBTIPLNCK $588.00 IBTIINSP TOTALS: 300 $2,097.00 " $588.00 MECII,,HOURLY �O Yes-__�_No PLIJMB�.HOURLY i� No. Yes No ,ELE.C,IiO.URL Q:_Yes Alech. flan Check Plumb.Plan Check Elec.Plan Check ;Ltecth. Permil Few: Plumb. Permit Fee: Islec. Permir Tee: Ober Alech. Insp. Ocher Plumb Insp. Other Elec.Imp. Lj ;ldech.112sp. Fee: Phanrb. In p, fee: Glec.Insp,Fee: NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,097.00 Select a Misc Bldg/Structure Suppl.PC Fee: Reg. 0 OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $588.00 Suppl. Insp.Feer Reg. 0 OT0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 construction Tax: .46bninifrativa Fee: 0 Work Without Permit? 0 Yes (2) No $0.00 E) Advanced Planning Fee. $0.00 Select a Non-Residential Building or Structure 0 7i�ut�c>l 1:�ocuine�ntatioy� F'ccrs: � Strong Motion.Fee: IBSEISMICO $13.44 Select an Administrative Item Blda Stds Commission Fee: IBCBSC $2.00 = SUBT:OTALS $2,700.44 $0.00 TOTAL FEE $2,700.44 Revised: 05/07/2015