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12110079CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD I CON TRUCTOION INC CON I PERMIT NO: 12110079 OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL { 690 GIBRALTAR DR I DATE ISSUED: 04/08/2014 OWNER'S PHONE: 6503441500 LICENSED CONTRACTOR'S DECLA/�RATION j 13 License ClassLic. # " Contractor 0eve'M 6:1--OW,6b- 1,19' 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 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. 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. Signatur Dateoft ❑ 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) 1, 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 penmit 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, I 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. 1 agree to comply with all city and county ordinances and state laws relating- to elatingto 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 time 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 MILPITAS, CA 95035 1 PHONE NO: (408)942-8200 JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL ❑ MAIN STREET CUPERTINO- OFFICE 1- CONSTRUCT OF A NEW FOUR STORY OFFICE BUILDING SHELL 129,898 SQ FT DEFERRED #1 CURTAIN WALL, SHOP DRAWINGS AND STRUCTRUAL CALCS, AMERICAN STEEL & STAIR, RAILS AND FRAMING PLAN- ISSD 9/29/2014 Sq. Ft Floor Area: I Valuation: $18048000 APN Number: 31620109 19339 1 Occupancy Type: PERMITT E 1 4 IFIS NOT STARTED WITHIN 180 AYS Ori T ISSUANCE OR 180 DAYS FR LAST LED INS/P}ECTT�IOlN.. Issued by: Date: (• /, /`7 a 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 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, 2555533, and 25534. Owner or authorized agent: hr'Date: �' 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO rM--,7 FEE ESTIMATOR — BUILDING DIVISION iaADDRESS: 19339 SCB QTY/FEE DATE: 07/08/2014 REVIEWED BY: Mendez i-fe., APN: BP#: 169, *VALUATION: Iso PERMIT TYPE: Building Permit Suppl. PC Fee:) Reg. 0 OT PLAN CHECK TY E: Tenant Improvement PRIMARY Commercial Building USE: Ir:'.S'E). `..: pIiu b. h,,1". r., e., PENTAMATION 1GENCOM PERMIT TYPE: A WORK Deferred #1 curtain wall shop drawings and structrual calcs american steel & stair, rails and framing SCOPE plan $0.00 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 into. FEE ITEMS (Fee Resolution 11-053 &.. 7/1113) 4 ,1 QTY/FEE Phim.6, Plan Chu6 l 1_'7i;(:' Phan i-fe., Vnfn (). PGt mll pe..c. I :r.':f'. permit 0i1)hl _`!> {:tf'C, %'trt.:77?°; .�'�i'r7 E�irli'i' % tC't.. 1115/1. Suppl. PC Fee:) Reg. 0 OT 0.0 1 hrs Ir:'.S'E). `..: pIiu b. h,,1". r., e., 1,s ., --c'. insp. :(': 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 into. FEE ITEMS (Fee Resolution 11-053 &.. 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 # $572.00 Deferred Submittal IDEFSUBM A Suppl. PC Fee:) 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 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes(No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G) 0 7'In<;°el t`?r)r.:r.=Ji'fetpfufioll Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 o- i SUBTOTALS $0.00 $572.00 °1°"TO�ALFEE $572.00 Revised: 07/07/2014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD CONTRACTOR: DEVCON PERMIT NO: 12110079 CONSTRUCTION INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 690 GIBRALTAR DR DATE ISSUED: 04/08/2014 OWNER'S PHONE: 6503441500 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LPA LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL EJ COMMERCIAL 0 ,5 C1 ` MAIN STREET CUPERTINO- OFFICE 1- CONSTRUCT OF A q Licnse Class Lic. # (� NEW FOUR STORY OFFICE BUILDING SHELL 129,898 S Contractor �Cc7 GI �GN rj Date ` 1 S FT REVISION #I- MINOR MODIFICATION TO RESTROOMS & SHOWER I hereby affirm that I am licensed under the provisions of Chapter 9 ROOMS - ISSUED 6/4/2015 (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: $18048000 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 APN Number: 31620109 19339 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 WORD IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITIIIN 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 S FROM LAST CALLED INSP CT ON. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the LO �f r4 Ll�"�-"D Issued by: Date: IBJ• granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: 9 18. !/"/ ��A Signature Date b 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(x) 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, 25533, anA 25534. Section 3700 of the Labor Code, for the performance of the work for which this r� ��lr%�te: Owner or authorized agent: permit is issued. 1 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 1 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 (See. 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD CONTRACTOR: DEVCON PERMIT NO: 12110079 CONSTRUCTION INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 690 GIBRALTAR DR DATE ISSUED: 04/08/2014 OWNER'S PHONE: 6503441500 MILPITAS, CA 95035 PHONE NO: (408)942-8200 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E] ❑ LICENSED CONTRACTOR'S DECLARATION MAIN STREET CUPERTINO- OFFICE I- CONSTRUCT OF A 163 NEW FOUR STORY OFFICE BUILDING SHELL 129,898 SQ License Class__ Lic. 4 NytoK (oo-44' I^ `' Date FT Contractor I hereby affirm that I am licensed under the provisions of Chapter 9 9/25/2014- DEFERRED #3- TRASH ENCLOSURE- ISSD 1/30/2015 (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 Valuation: $18048000 performance of the work for which this permit is issued. Sq. Ft Floor Area: 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: 31620109 19339 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 WORD 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 180 DAYS FRO CALLED INSPECTION. 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 1 Date: granting of this permit. Additionally, the applicant understands and will comply Issued by: with all non -point source regulations 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 Signatur�Date 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, do the work, and the structure is not intended or offered for sale (Sec.7044, will 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 compliance with the Cupertino Municipal Code, Chapter 9.12 and performance of the work for which this permit is issued. will maintain & Safety aety Code, Sections 25505,25533, and 25534. the Health f I have and will maintain Worker's Compensation Insurance, as provided for by for this �OM�IIODi�4 I' YO. is Section 3700 of the Labor Code, for the performance of the work which Owner or authorized agent: M Date: 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, must work's for which this permit is issued (See. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. 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 CITE' OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION 19 ADDRESS: 19339 SCB QTY/FEE DATE: 04/24/2015 REVIEWED BY: SEAN Plan Check Fee: APN: 1 4XBP#: `VALUATION: $0 *PERMIT TYPE: Building Permit A I PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building hrs Civil / Religious activities in BQ zone? 0 Yes • No PENTAMATION PERMIT TYPE: � WORK /-7G7)- cS SCOPE Permit Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, Sc/tool Di.vtrirt. otr.)_ These fees are hated an the nreliminary information availahle and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Lff. 711,113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structufe or Element of a Building A Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.(D Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONST.9XC $0.00 Adinirtistrative Fee: 0 G) Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 i True -el Doc,ulnentation Fees: Strong Motion Fee: $0.00 # $0.00 Revisions 1REVCOMNEW Commercial New Bldg Stds Commission Fee: $0.00 SI71gOTAIS : ,��t.... , . $0.00 $0.00 IOTAI. FEE $0.00 Revised: 04/01/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD CONTRACTOR: DEVCON PERMIT NO: 12110079 CONSTRUCTION INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 690 GIBRALTAR DR DATE ISSUED: 04/08/2014 OWNER'S PHONE: 6503441500 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LPA LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL EJ COMMERCIAL 0 ,5 C1 ` MAIN STREET CUPERTINO- OFFICE 1- CONSTRUCT OF A q Licnse Class Lic. # (� NEW FOUR STORY OFFICE BUILDING SHELL 129,898 S Contractor �Cc7 GI �GN rj Date ` 1 S FT REVISION #I- MINOR MODIFICATION TO RESTROOMS & SHOWER I hereby affirm that I am licensed under the provisions of Chapter 9 ROOMS - ISSUED 6/4/2015 (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: $18048000 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 APN Number: 31620109 19339 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 WORD IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITIIIN 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 S FROM LAST CALLED INSP CT ON. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the LO �f r4 Ll�"�-"D Issued by: Date: IBJ• granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: 9 18. !/"/ ��A Signature Date b 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(x) 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, 25533, anA 25534. Section 3700 of the Labor Code, for the performance of the work for which this r� ��lr%�te: Owner or authorized agent: permit is issued. 1 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 1 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 (See. 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 CITE' OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION 19 ADDRESS: 19339 SCB QTY/FEE DATE: 04/24/2015 REVIEWED BY: SEAN Plan Check Fee: APN: 1 4XBP#: `VALUATION: $0 *PERMIT TYPE: Building Permit A I PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building hrs Civil / Religious activities in BQ zone? 0 Yes • No PENTAMATION PERMIT TYPE: � WORK /-7G7)- cS SCOPE Permit Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, Sc/tool Di.vtrirt. otr.)_ These fees are hated an the nreliminary information availahle and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Lff. 711,113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structufe or Element of a Building A Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.(D Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONST.9XC $0.00 Adinirtistrative Fee: 0 G) Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 i True -el Doc,ulnentation Fees: Strong Motion Fee: $0.00 # $0.00 Revisions 1REVCOMNEW Commercial New Bldg Stds Commission Fee: $0.00 SI71gOTAIS : ,��t.... , . $0.00 $0.00 IOTAI. FEE $0.00 Revised: 04/01/2015 CITY OF CUPERTINO IPM FEE ESTIMATOR - BUILDING DIVISION \2 1AADDRESS: Main Street Cupertino DATE: 10/02/2012 REVIENVED BY: A. Salvador PC FEE ID APN: BP#: ZZ/*VALUATION: Shell Bldgs 1$18,048,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE: Commercial Building Civil / Religious activities in B zone? 0 Yes (j)No PENTAMATION PERMIT TYPE: 1SHELLBLD WORK New TVpe ll -B Office B Occu anc Shell Bldg Office 1 - 129,898 s.f. SCOPE F0.0 1 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA (s.f.) PC FEES PC FEE ID BP FEES BP FEE ID Shell Bldgs II-B,III-B,IV,V-B 129,898 $32,136.26 IOSPLNCK $59,664.07 IOSINSP Permit Fee: $59,664.07 Suppl. Insp. Fee:Q Reg. Q OT F0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXCT-7- 353,322.56 Ad€ i,iisirt Mire F'ee 0 ) Work Without Permit? 0 Yes (DNo $0.00 TOTALS: 129,898 $32,136.26$59,664.07 'I'M vel Dtsr°!anentarion Fees: ` ,3 {f C.'%'s..�er'7} h .. ee. ! dwr Irsp. Mef:lt. 00,i e r„,? ai,b Irzsp, Phail?bz I sr.” Fee: Isle .Ilan Check F_.!ec, fleni?ZiFlffi: 0,1her Eklc. Irt.tFt. .Sift'. his+T. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Dich4rt otr_ )_ Thoce fees are hacpd nn flip nreliminary infnrmafimi availahlo and arp molt' an PcHrnnty_ rnratnrf Nap Dont fnr nddn'1 infn_ FEE ITEMS (Fee Resolution 11-053 E . 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $32,136.26 Select a NEsc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. O OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $59,664.07 Suppl. Insp. Fee:Q Reg. Q OT F0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXCT-7- 353,322.56 Ad€ i,iisirt Mire F'ee 0 ) Work Without Permit? 0 Yes (DNo $0.00 Advanced Planning Fee: IPLLONGC $33,773.48 Select a Non -Residential Building or Structure 0 'I'M vel Dtsr°!anentarion Fees: Strong? Motion Fee: IBSEISMICO $3,790.08 Select an Administrative Item Bldg Stds Conunission Fee: IBCBSC $722.00 SUBTOTALS83 �,..�,.._ ,. .,.......��.4::r 408.45 $0.00 TOTAL FEE $483 408.45 , Revised: 10/01/2012 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD CONTRACTOR: DEVCON PERMIT NO: 12110079 CONSTRUCTION INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 690 GIBRALTAR DR DATE ISSUED: 04/08/2014 OWNER'S PHONE: 6503441500 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL D ��� l MAIN STREET CUPERTINO- OFFICE 1- CONSTRUCT OF A License Class Lic. # NEW FOUR STORY OFFICE BUILDING SHELL 129,898 SQ `s ` r ! )� � Co n j zi- ( —1 FT Contractor �.1 V Date _$ I hereby affirm that I am licensed under the provisions of Chapter 9 7/9/2014- DEFERRED #2- TRUSS CALCS- ISSD OTC 9/28/2014 (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: $18048000 erformance of the work for which this permit is issued. 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: 31620109 19339 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 tocomply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives this city to enter WITHIN 180 OF PERMIT ISSUANCE OR of upon the above mentioned property for inspection purposes. (We) agree to save �YS 180 DAYS FAST CALLED INSP T -ON. indemnify and keep hamiless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued granting of this permit. Additionally, the applicant understands and will comply by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. ) ( I RE -ROOFS: r Signature �V� Date V l � 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. ❑ ONAINER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Lawfor 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 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 `lam Owner or authorized agent: Date: I OI 1 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, 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 pen -nit 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 FEE ESTIMATOR — BUILDING DIVISION F ADDRESS: 19339 SCB DATE: 07/09/2014 REVIEWED BY: Mendez I MISC ITEMS APN: BP#: 12110083 *VALUATION: $0 *PERAiIIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? 0 Yes •. No PENTAIVIATION PERMIT TYPE: 1 GENCOM WORK �- Truss Calcs SCOPE �Office flt ech. I'c'rmir Fee: h2sf. Ll Meci.% Inst. Fee: 1'i:�srz%J. 1"IzLit (ff£.':cti I'r'e. 3p... E7.,.. pl," t Check 1':'ec. l "Sp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Y►'orks, Fire, Sanitary Sewer District, School District, etc.). These.fees are based on the preliminary information available and are only an estimate. Contact the Dept_tor addn'l into. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1113) FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 0 # Deferred Submittal $572.00 IDEFSUBM Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 Ai.Ytnir.;s,m tiv,e F6'e: O 0 Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential 0 Building or Structure 0 StronLy Motion Fee: $0.00 Select an Administrative Item Blda Stds Commission Fee: $0.00 Sl{TSTOTALS $0 00 $572 00 TOTALgFEE 00 $572.00 Revised: 07/08/2014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD CONTRACTOR: DEVCON PERMIT NO: 12110079 CONSTRUCTION INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 690 GIBRALTAR DR DATE ISSUED: 04/08/2014 OWNER'S PHONE: 6503441500 MILPITAS, CA 95035 PHONE NO: (408)942-8200 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E] ❑ LICENSED CONTRACTOR'S DECLARATION MAIN STREET CUPERTINO- OFFICE I- CONSTRUCT OF A 163 NEW FOUR STORY OFFICE BUILDING SHELL 129,898 SQ License Class__ Lic. 4 NytoK (oo-44' I^ `' Date FT Contractor I hereby affirm that I am licensed under the provisions of Chapter 9 9/25/2014- DEFERRED #3- TRASH ENCLOSURE- ISSD 1/30/2015 (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 Valuation: $18048000 performance of the work for which this permit is issued. Sq. Ft Floor Area: 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: 31620109 19339 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 WORD 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 180 DAYS FRO CALLED INSPECTION. 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 1 Date: granting of this permit. Additionally, the applicant understands and will comply Issued by: with all non -point source regulations 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 Signatur�Date 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, do the work, and the structure is not intended or offered for sale (Sec.7044, will 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 compliance with the Cupertino Municipal Code, Chapter 9.12 and performance of the work for which this permit is issued. will maintain & Safety aety Code, Sections 25505,25533, and 25534. the Health f I have and will maintain Worker's Compensation Insurance, as provided for by for this �OM�IIODi�4 I' YO. is Section 3700 of the Labor Code, for the performance of the work which Owner or authorized agent: M Date: 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, must work's for which this permit is issued (See. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD CONTRACTOR: DEVCON PERMIT NO: 12110079 CONSTRUCTION INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 690 GIBRALTAR DR DATE ISSUED: 04/08/2014 OWNER'S PHONE: 6503441500 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL MAIN STREET CUPERTINO- OFFICE 1- CONSTRUCT OF A License Class/Licc.. #^�+3� (fir NEW FOUR STORY OFFICE BUILDING SHELL Contractal,, }(}C.O�/ tJC.r+3 \ • Date I hereby affirm that I am licensed under the provisions of Ch pter 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: $18048000 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 APN Number: 31620109 19339 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 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 -80 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, 180 DAY �F OM LA T LLED INSPEC I N. costs, and expenses which may accrue against said City in consequence of the Date: granting of this permit. Additionally, the applicant understands and will comply Issued by: -�� r with all non -point source regulations er the Cupe ino Municipal Code, Section 9.18. r� RE -ROOFS: Signat Date b 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(x) 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 perfonnance of the work for �vhich this permit is issued. will maintain compliance with the Cupertino Municifial Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, io s 25505, 25533, Vd 255 4 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized a Date: yq I certify that in ;;ie 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 IPM FEE ESTIMATOR - BUILDING DIVISION \2 1AADDRESS: Main Street Cupertino DATE: 10/02/2012 REVIENVED BY: A. Salvador PC FEE ID APN: BP#: ZZ/*VALUATION: Shell Bldgs 1$18,048,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE: Commercial Building Civil / Religious activities in B zone? 0 Yes (j)No PENTAMATION PERMIT TYPE: 1SHELLBLD WORK New TVpe ll -B Office B Occu anc Shell Bldg Office 1 - 129,898 s.f. SCOPE F0.0 1 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA (s.f.) PC FEES PC FEE ID BP FEES BP FEE ID Shell Bldgs II-B,III-B,IV,V-B 129,898 $32,136.26 IOSPLNCK $59,664.07 IOSINSP Permit Fee: $59,664.07 Suppl. Insp. Fee:Q Reg. Q OT F0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXCT-7- 353,322.56 Ad€ i,iisirt Mire F'ee 0 ) Work Without Permit? 0 Yes (DNo $0.00 TOTALS: 129,898 $32,136.26$59,664.07 'I'M vel Dtsr°!anentarion Fees: ` ,3 {f C.'%'s..�er'7} h .. ee. ! dwr Irsp. Mef:lt. 00,i e r„,? ai,b Irzsp, Phail?bz I sr.” Fee: Isle .Ilan Check F_.!ec, fleni?ZiFlffi: 0,1her Eklc. Irt.tFt. .Sift'. his+T. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Dich4rt otr_ )_ Thoce fees are hacpd nn flip nreliminary infnrmafimi availahlo and arp molt' an PcHrnnty_ rnratnrf Nap Dont fnr nddn'1 infn_ FEE ITEMS (Fee Resolution 11-053 E . 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $32,136.26 Select a NEsc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. O OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $59,664.07 Suppl. Insp. Fee:Q Reg. Q OT F0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXCT-7- 353,322.56 Ad€ i,iisirt Mire F'ee 0 ) Work Without Permit? 0 Yes (DNo $0.00 Advanced Planning Fee: IPLLONGC $33,773.48 Select a Non -Residential Building or Structure 0 'I'M vel Dtsr°!anentarion Fees: Strong? Motion Fee: IBSEISMICO $3,790.08 Select an Administrative Item Bldg Stds Conunission Fee: IBCBSC $722.00 SUBTOTALS83 �,..�,.._ ,. .,.......��.4::r 408.45 $0.00 TOTAL FEE $483 408.45 , Revised: 10/01/2012 I CITY OF CUPERTINO BUILDING PERMIT I IBUILDING ADDRESS: 19339 STEVENS CREEK BLVD I CONTRAC TOIO: DE CON I PERMIT NO: 12110079INC I I OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR 1 690 GIBRALTAR DR I DATE ISSUED: 04/08/2014 I OWNER'S PHONE: 6503441500 1 MILPITAS, CA 95035 1 PHONE NO: (408)942-8200 P LICENSED CONTRACTOR'S DECLARATION License Class 5 Li,. # r�7 cte,t F a 1 3 Contractor f)ey&,Pi `OHS' , #1C Date /0 --2 _1 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: 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 9 performance of the work for which this permit is issued. e. 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. 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 regulation_s,peFJhSCupertino Municipal Code, Section 9.18. Signature Date to —2 2 —(5 ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 1, 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. 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 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, 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 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ MAIN STREET CUPERTINO- OFFICE I- CONSTRUCT OF A NEW FOUR STORY OFFICE BUILDING SHELL 129,898 SQ FT REV # 2 - RFPS - ISSUED 10/22/15 Sq. Ft Floor Area: I Valuation: $18048000 APN Number: 31620109.19339 1 Occupancy "type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FRO INSPECTION. ��ED »ars -z < �/ .0e_ � RE -ROOFS: All roofs shAll be insp ed 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 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. agent: /0-2 . Date: 0 - -(5 I 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional -� CITY OF CUPERTINO 11?/f I FEE ESTIMATOR - BUILDING DIVISION r ADDRESS: 19339 SCB DATE: 08/13/2015 REVIEWED BY: MELISSA b , ;t Fee: APN: BP#: 12110079 `VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: $0.00 PENTAMATION 1 GENCOM PERMIT TYPE: 19 WORK REV # 2 - RFI'S SCOPE O.0 NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Dictrirt etr_ k Thece tees are haced an the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7/1113) hfech. Mao Check 4jnb. Pion MISC ITEMS b , ;t Fee: i'/Ionn. i'r iv— Other c+fb'.G:. ,.1D7_ t.).di'0" i�!7N3t1> IttSi3.LJ L t7trYPi'.�:, tr.Y', IYLS, $0.00 PME Plan Check: $0.00 NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School Dictrirt etr_ k Thece tees are haced an the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (F) No $0.00 5 hours Plan Check, Hourly 5715.00 ISTPLNCK Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -C) Reg. Q OT O.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consrru tion T"(X: f E) Work Without Permit? © Yes (D No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential O Building or Structure 0 A li G,�ei 13r�c rrtnertrrrti?>n .F-E::�t: Strong Motion Fee: $0.00 Select an Administrative Item 1 Bldg Stds Commission Fee: $0.001 SUBTOTALS: $0.00 $715.00 __F_ TOTAL FEE: $715.00 Revised: 07/02/2015