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15080163CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10627 BANDLEY DR CONTRACTOR: SC BUILDERS INC PERMIT NO: 15080163 OWNER'S NAME: SI 30 LLC 910 THOMPSON PL DATE ISSUED: 08/24/2015 OWNER'S PHONE: 4084460700 SUNNYVALE, CA 94085 PHONE NO: (408)328-0688 ly LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL APPLE - T.I. TO RECONFIGURE (E) OFFICE SPACE TO License Class Lic. #� ., `7 CREATE TWO (N) MASSAGE ROOMS (400 S.F.) Contractor �� v. ' e�5 Date r 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: $192000 performance of the work for which this permit is issued. I 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: 32610047.00 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 DAYS FROM L SPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, -- costs, and expenses which may a rue ainst said Ci p y City in consequence of the _ -� granting of this.permit. tion y, applicant understands and will comply Issued b Date: yh with all non- int s ur a re ulati s the Cupertino Municipal Code, Section 9.18. Signatur Date 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 /OWNER-BUILDERDECLARATION inspection. E] I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, 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 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 Cupertio unicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25 , 55 , and 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized agent Date: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSRUCTION 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 CUPERTINO ❑ NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 o buildingacupertino.org / ❑ ADDITION 1r 1 ALTERATION / TT I I RF.VISTCTN / DEFRRRFT) nRTrTNAT. PFRMTT A PROJECT ADDRESS 10627 Bandley Drive APN# 326-10-047 OWNERNAME Sobrato Interests PHONE (408) 446-0700 (408) 446-0700 STREETADDRESS 10600 N. De Anza Blvd., Suite 200 CITY, STATE,z>P Cupertino, CA 95014 FAX CONTACT NAME Carl Bacon <"� PHONE 408-783-1712 EMAIL carlbacon@apple.com STREET ADDRESS 1050 Arques Avenue cITY,STATE, zIP Sunnyvale, CA 94085 T;A; ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER VKTENANT CONTRACTOR NAME Michael Soik LICENSE NUMBER CSLB # 767196, Class B BUS. LIC# Cupertino # 24074 COMPANYNAME SC Builders Inc. E MAtI msoik@scbuildersinc.com FAX STREET ADDRESS 910 Thompson Place CITY, STATE,z>P Sunnyvale, CA 94085 PHONES ;,� 9O 73�® F�# ARCHITECT/ENGINEERNAME Howard Kwok LICENSE NUMBER C-31576 BUS. LIC COMPANYNAME DES Architects + Engineers E-MAIL hkwok@des-ae.com FAX (650) 364-2618 STREET ADDRESS 399 Bradford Street CITY, STATE, zip Redwood City, CA PHONE (650) 364-6453 DESCRIPTION OF WORK 400 square feet Interior renovation project (T.I.) at the Apple Fitness Center. The scope is to renovate a conference room and office area into 2 massage rooms with a hallway. No exterior and site work in this project scope. Project valuation is $192,000 (< Cal Green $200,000 min. threshold) EXISTING USE Fitness Center PROPOSED USECONSTR Fitness Center TYPE 3B # STORIES One USE TYPE OCC. SQ.FT. VALUATION($) EXISTG AREA 15,100 sf NEW FLOOR AREA 0 DEMO AREA 0 TOTAL NETAPEfio change - K0 0 M Z®D BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH I ❑ ATTACH I # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEINGADDED? NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES 'RECEIVED BY: ^• - TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? []NO - • " X19 ZP®o 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 I have provided i correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building c struction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicant/4gent: Date: SUPPLEMENTAL INFO ON REQUIRED PLAN CBECK TYPE ` ; ' ROUTING SLIP ❑'° OvER-TIiE COUNTER,' 0 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. El EXPRESS 0 -PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARn ❑ PUBLIC WORTS form if any Hazardous Materials are being used as part of this project. ❑ .LARGE; " ❑. "FIREDEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ° ❑;. DISTRICT submittal of Building Permit application. MAJOR'+ SANrfARY S PWER ❑ ENVIRONMENTALHEALTB - B1dgApp_2011.doc revised 06/21111 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10627 BANDLEY DR CONTRACTOR: SC BUILDERS INC PERMIT NO: 15080163 OWNER'S NAME:, SI 30 LLC . 910 THOMPSON PL DATE ISSUED: 08/24/2015 OWNER'S PHONE: 4084460700 SUNNYVALE, CA 94085 PHONE NO: (408)328-0688 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL APPLE - T.I. TO RECONFIGURE (E) OFFICE SPACE TO License Class_ Lic. # 710-1 tel (0/ CREATE TWO (N) MASSAGE ROOMS (400 S.F.) Contractor,C::;1'-_ i I l�P IIJ� Date 1!:')D I hereby affirm that I am liccused under the provisions of Chapter 9 REV # 1 - REVISE CEILING DESIGN, DOOR TYPE & OTHER MINOR (commencing with Section 7000) of Division 3 of the Business & Professions CASEWORK UPDATES - ISSUED 11/30/15 Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: 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 Sy. Ft Floor Area: Valuation: S19-1000 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: 32610047.00 Occu pancc "rN pc: 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 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 Date: granting of this permit. Additionally, the applicant understands and will comply Issued by: with all non -point source regulpiTs per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature 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 Signature of Applicant: Date: I hcreby affirm that 1 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) 1, 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. 1 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 nicipal Code, Chapter 9.12 and I have and.will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 2 33, nd 34. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: 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 Compensation laws of California. If, after making this certificate of exemption, [ 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 indemni.fy!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: 10627 BANDLEY DR CONTRACTOR: SC BUILDERS INC PERMIT NO: 15080163 OWNER'S NAME: SI 30 LLC 910 THOMPSON PL DATE ISSUED: 08/24/2015 OWNER'S PHONE: 4084460700 SUNNYVALE, CA 94085 PHONE NO: (408)328-0688 LICEED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL E] APPLE - T.I. TO RECONFIGURE (E) OFFICE SPACE TO License Class Lic. # e CREATE TWO (N) MASSAGE ROOMS (400 S.F.) L i Contractor J L J 1 n- Date ( I 7— Z 0 DEF#1 - SITE AND RESTROOMS ACCESSIBILITY - ISSUED 1 hereby affirm that I am licensed under the provisions of Chapter 9 11/23/15 (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 as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $192000 7tion, ce 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: 32610047.00 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 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 Z3 (oty( Issued by: Date: S_ granting of this permit. Additionally, the applicant understands and will comply with/non-pt source re tions p the Cupertino Municipal Code, Section 9.18 L 2- 20/ RE -ROOFS: Sign 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 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 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) 1, 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, 255339 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 Are it Quality Management District I performance of the work for which this permit is issued. will maintain compliance with t Cuperti o unicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sec ns 25505 2 53 nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this Date: Z3 n permit is issued. Owner or authorized age GG 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ` CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • buildin cu ertino.or F I NFw CONSTRICTION Il ADDITION ION / TIREVISION DEFERRED 1, a6 o) �3 V, ORIGINAL PERMIT # PROJECT ADDRESS 10627 Bandley Drive APN # 326-10-047 OWNER NAME Sobrato Interests PHONE (408) 446-0700 (408) 446-0700 STREET ADDRESS 10600 N. De Anza Blvd., Suite 200 CITY, STATE,ZIP Cupertino, CA 95014 FAX CONTACT NAME Carl Bacon PHONE 408-783-1712 E-MAIL carlbacon@apple.com STREET ADDRESS 1050 Arques Avenue CITY, STATE, ZIP Sunnyvale, CA 94085 FAX ❑ OWNFR ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER TENANT CONTRACTOR NAME Michael Soik LICENSE NUMBER CSLB # 767196, Class B BUS. LIC # % Cupertino # 24074 COMPANY NAME SC Builders Inc. E-MAIL msoik@scbuildersinc.com FAX STREET ADDRESS 910 Thompson Place CITY, STATE, zrP Sunnyvale, CA 94085 PHONE Carl Bacon ARCHITECT/ENGINEER NAME Howard Kwok LICENSE NUMBER C-31576 BUS. LIC # COMPANY NAME DES Architects + Engineers E-MAIL hkwok@des-ae.com FAX (650) 364-2618 STREET ADDRESS 399 Bradford Street CITY, STATE, ZIP Redwood City, CA PHONE (650) 364-6453 DESCRIPTION OF WORK— t'� RSVISF!�_ CS w3c_n 'OMQ C�4 r Z) RE?1S£ 'E;4—Z' C -T 'Dc7QR_ S 4G_ t c. 37 1 - EXISTING USF PROPOSED USE CONSTR. TYPE # STORIES Fitness Center Fitness Center 3B One USE TYPE70cc. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA 15,100 sf AREA 0 AREA 0 NETAREMO change BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH I ❑ ATTACH I # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? []NO PRE -APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIV , TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property 9A"9—01.a o 'z nt to act 1 er's behalf. I ave Tea application and the information I have provided is correct. I have read the Descriptio ork and ve ' acct agree to comply with all applicable local ordinances and state laws relating to building cons coon. I authorize representatives o erti Bte Lne above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATIO EQUIRED PLAN CHECK TNPEif ROUTING SLIP ❑ ❑ New SFD or Multifamily dwellings: Apply for demolition permit for _ existing building(s). Demolition permit is required prior to issuance of building OVER-THE-COUNTER BUILDING PLAN REVIEW 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 ❑ ❑ submittal of Building Permit application. MAJOR SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21111 U CUPERTINO CONST RUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISIO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 . (408) 777-3228 - FAX (408) 777-3333 - buildinciecupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION . ❑ ALTERATION / TI 42rM Q — ORIGINAL PERMIT n X 500 4114 3 PROJECT ADDRESS I APN ° 0 6 4'� LLE too 3`Z(- 19 j6 �A- ©ND IPp �I FAx �CT or" fJ CONTACT NAV Nn U G HOAT- S o A)�RESS (,�� FAX 13 OA`),M ❑. OWIZER•BUILDER OV'1\-rL Ac-r-lv'T ❑ CONTRACTOR ❑ CONTRACTOR AGDvT ❑ ARciirm T ❑ ENraa t'�7a t ❑ DEv 1 OPzz ❑ TENAh? C7 (c� - 6 LICENSETYPE(J( u"`sEN""BER J/�71 /.-- (�FAx L OI t a� ': • � Thi T ' V 40 S PHO AR ITU ➢�'rER NAM, _ q l �E h 1 , Q 3L' C # 4 C FAX STRZET A.DDRFS o C ST 7E ZIP k49e'136 G ! Dd 4-- 7,61 DESCRIP ON 0 WORK' EXISTING USE PROPOSED USE CONSTR. TYPE M STORIES USE iYP-- OCC. SQ.cT. VALUATION(S) EXISTAREAG NARREAOOR DEMO TOTAL AREA I NFr AREA I 7-1 ©(✓ + BATHROOM KITCHE 4 OTYrR REMODEL AREA RTTSODEL AREA RELiODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AY.EA GARAGE Al2-A:LJ DETACH ❑ ATTACH I 4 D'AMI.INGUNITS: IS ASECOND UNIT 0 SECOND STORY YES BEING ADDED? []NO ADDITION? ❑NO i PRr-AP?IICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YrS{�C ]A R TOTAL VALUATION: PLANNINGAPPLA ❑NO PLANNM,r,APPROVALLETTER I ETCHLERHOME? ❑NO M. A& By my signature below, I certify to each of the fallowing: I am the property owner or authorized agent to act on the Op- r 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 act agree to comply with 211 applicable local ordinances and state laws relating to building construction. I authorize representatives Df Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL ATFORMATION REQUIRED New SFD or Multifamily dvNrellipgs: Apply for demolition permit for s existing building(s). Demolition permit is required prior to issuance of building permit for new, building. - _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. t � r�.D L BIJC_R o - 01,11 Im 4. c _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. "' } BldgApp_2011.doc revised 06/21/11 1� in CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION im,ADDRESS: 10627 BANDLEY DR Plumb. Plan t'lt e'i DATE: 11/30/2015 REVIEWED BY: MELISSA Pturrrn. 1 APN: 32610 047 BP#: 15080163 `VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: $0.00 PME Plan Check: PENTAMATION 1GENCOM PERMIT TYPE: WORK REV # 1 - REVISE CEILING DESIGN DOOR TYPE & OTHER MINOR CASEWORK UPDATES - SCOPE ISSUED 11/30/15 Suppl. Insp. Fee:Q Reg. Q OT NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Fewer District, school mgr;rt otr 1 T4ese foac aro bawd on the nre iminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution I1-053 Eff. 7/1/131 FEE Plumb. Plan t'lt e'i l iec. flan Check le 'r. ?': Pturrrn. 1 Elec, Pentre I'r'e (;r.p. 0ther.Plunib Inst. t>, rer r'":iec. t,rsp. 11cclr:rsrz ; ; .. Plumb..lusp. ; :.:iec. tarp. Fee: NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Fewer District, school mgr;rt otr 1 T4ese foac aro bawd on the nre iminary information available and are onlv an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution I1-053 Eff. 7/1/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? © Yes (F) No $0.00 1 hours Plan Check, Hourly $143.00 ISTPLNCK Suppl. PC Fee: Q Reg. OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT O p hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 .e,r�.�arucarurr 1�rx: Irlrninislrcrtire 1�'e: G Work Without Permit? © Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 A 1i'u} c'% I )rjct�t;rc ntr�riurz I 'ec�.s. Strong Motion Fee: $0.00 Select an Administrative Item .Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $143.00 TOTAL FEE: $143.00 Revised: 10/01/2015 CITY OF CUPERTINO EM -M FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: 10627 BANDLEY DR DATE: 08/24/2015 REVIEWED BY: MELISSA IlaADDRESS: APN: 32610 047 BP#: *VALUATION: 1$192,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: g IATIPLNCK PENTAMATION PERMIT TYPE: 1A T� WORK APPLE - T.I. TO RECONFIGURE E OFFICE SPACE TO CREATE TWO N MASSAGE ROOMS SCOPE (400 S.F.) OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.L PC FEES PC FEE ID BP FEES BP FEE ID A (Tenant Improvements) II-B,11[-B,IV,V-B 400 $2,437.00 IATIPLNCK $592.00 ]ATHNSP Laec. Ir+s1 . Eee: $0.00 Permit Fee: $592.00 Suppl. Insp. Fee:e) Reg. Q OT O p hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 i.'012S17'6lction Tax: TOTALS: 400 $2,437.00 Achnirustralive I,ee: $592.00 ; MECH, TOURIY Yes No' PLUMB, HOITRLY Q YesJ9, Q"Nio �ELEC, HOURLY:: ®.'Yes lYo ;19ei:h. Plcrr� <'het.k t'lrrnth. Platt {'hec•k itlr>c..1'liu� C."/u>clr biec/% Perntil fete: 1'lwmb. 1'e:rmit Feta: 1>l<ec. Permir Fee: Olrher Mcch. IrtsT. Ober 11hon r Insp.Ll I Orlter 1. lec•. 1nsj,r. E3__L_ ;:140ch. lnspN Fee., 1'lunrh. Irrsp. Fee: Laec. Ir+s1 . Eee: NUM This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are haled nn the Oroliminary infnrmatinn availahlo nand Oro nnhr nn octimnto rnn/Ont tho Tlant int ndda �l infn FEE ITEMS (Fee Resolution 11-053 E f 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,437.00 Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: Reg. 0OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $592.00 Suppl. Insp. Fee:e) Reg. Q OT O p hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 i.'012S17'6lction Tax: Achnirustralive I,ee: 0 G Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning, Fee: $0.00 Select a Non -Residential Building or Structure 0 � Travel1_?oc°ttrrrcyt2taliurr f'e�e.i•: Strong Motion Fee: . 1BSEISMICO _$53.76 Select an Administrative Item Bldg, Stds Commission'.Fee: IBCBSC $8.00 SUBT , . $0.00 TOTAL FEE y` $3,090.76 Revised: 07/02/2015 FE-M-7 �� CITY OF CUPERTINO Iii FF. F. ESTIMATOR —BUILDING DIVISION NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Hire, Sanitary Sewer District, School McMrL etc )_ These foes aro haced on the nreliminary information available and are only an estimate. Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 11-053 Lfif 711113) 10627 Bandley Dr DATE: 11/23/2016 REVIEWED BY: Phuong JimADDRESS: APN: 326-10-047 BP#: -VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: Phin1b. 1,U;:, PENTAMATION 1GENCOM PERMIT TYPE: WORK I Def # 1 - Site and restrooms accessibility SCOPE NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Hire, Sanitary Sewer District, School McMrL etc )_ These foes aro haced on the nreliminary information available and are only an estimate. Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 11-053 Lfif 711113) Tech. Plan Cheek I'Ittdr:ti. /°iri;t Chee 1'Iran c: ;re,;l; Plan Check Fee: :)cher Wech Other t'Irrs:h trst;, tJtl.:c, lilac. Irsl;. lerl� i;xJ1;_ Fe`e': Phin1b. 1,U;:, 0.0 NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Hire, Sanitary Sewer District, School McMrL etc )_ These foes aro haced on the nreliminary information available and are only an estimate. Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 11-053 Lfif 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 =# $286.00 Deferred Submittal 1vE> scant Supp/. PC Fee: Reg. Q Ol 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. 0 OT 0.0 I�rs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consiruction Mk': Aclrninistrolive Pee: 1 0 (2) Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure L I 0 i rxL<;1 Docutrtentalir>rt Fees. Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE: $286.00 Revised: 10/01/2015 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: PERMIT # OWNER'S NAME: PHONE # — GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date Owner / Contractor Signature 1-41110 /If,- Date 2/tb/I- Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & MillworkNN-:;r'-v)053 Cement Finishing Electrical iunG Excavation Fencing Flooring / Carpeting 2� Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper 2/0 Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock C , 210122 Tile Owner / Contractor Signature 1-41110 /If,- Date 2/tb/I- Date