15080179CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10050 N WOLFE RD
CONTRACTOR: C & J CONTRACTING PERMIT NO: 15080179
INC.
OWNER'S NAME: I&G DIRECT REAL ESTATE 27 LP
331 COMMERCIAL ST DATE ISSUED: 08/25/2015
OWNER'S PHONE: 3108607171
SAN JOSE, CA 95112 PHONE NO: (408)374-6025
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
LICENSED CONTRACTOR'S DECLARATION
STE 260 - T.I. PREP FOR 5,021 S.F.
License Class Lie. # ll1'0
Contractor t-C. Date
I hereby affirm that I am licensed W der the provisions of 6hapter 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
I.Cominensation, as provided for by Section 3700 of the Labor Code, for the
ance of the work for which this permit is issued.
Sq. Ft Floor Area:
Valuation: $10000
re nd will maintain Worker's Compensation Insurance, as provided for by
APN Number: 31620086.00
Occupancy Type:
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
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN RMIT.ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
AYS 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
Iss Date: ? J�
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.
RE-ROOFS:
Signature Date P/7,157-
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. 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(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
defined by the Bay Area Air Quality Management District I
Compensation, as provided for by Section 3700 of the Labor Code, for the
of the work for which this permit is issued.
air contaminants as
will maintain compliance with the Cupertino Mun' ipal Code, Chapter 9.12 and
performance
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
the Health & Safety Code, Sections 255 , nd 25534.
Owner or authorized age Date: Z5 ,
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 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, I must
work's for which this,permit is issued (Sec. 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
CUPERTINO
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 . FAX (408) 777-3333 • building(aD-cuoertino.org / ��
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS 9 /e /d, S T
APN # /� v 0 �% �
�
/O0 5-0
(/V
OWNERNAME 1'
PHONE
E-MAIL
3/ • �� J
STRF.FT AT)T)1ZF.CC � � � �.
CTT SATE, ZIP � ��� r�
S
FAx
CONTACT NAME
PHONE
E-MAIL
T&5c—vl L4—
310 < H
04gv-n.Ca.���da
STREET ADDRESS/�
CITY, STATE, ZIP
FAX
e� 'L1 � (J
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRA ORN/AME /
LICENSE NUMBER
LICENSETYPE
BUS. LIC 9
6 !'e ?'9 /iZ
COMPTY NAME
E-MAIL
FAX
r
C'51 ddL .
STREETADD SS
CITY STATE ZIP/a pp
CA I
{P'HONE
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aa
1
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ARCHTTECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC H
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
EXISTING USE
PROPOSED USE CONSTR
TYPE
1 # STORIES
USE .TYPE OCC.
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KrrCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: El DETACH
I
E] ATTACH
I
R D WELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? NO
ADDITION? ANO
PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF
IS THE BLDG AN❑YES REC :.:
`
TOU,(,TION:
PLANNING ADPL k ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO :. }
By my signature below, I certify to each of the following: I am t ��operty owner or authoriz t±o-a owner's behalf. I have read this
application and the information I have provided is c ect. I r7the Description with all applicable local
z
ordinances and state laws relating to buildi ructio . au I e resent a ernn a ove-' entifie rope rty for inspection purposes.
Signature of Applicant/Agent: Date:
TALO
,y.,
t
.IN
cisP} F, `. `SUPPLEME
New SFD or Multifamily dwellings: Apply for demolition permit for
Q OVER THE COUNTER'r
SUILDINGPLANREVIEW r '
_
existing building(s). Demolition permit is required prior to issuance of building
y
,
permit for new bui]ding.
❑ EXPIRE,ss $
PLANIVIIVGPLANREVIEW r c
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
sTaNnARD �'
❑' P LICWORKSs'
UB
_
form if any Hazardous Materials are being used as part of this project.
J
Copy of Planning Approval Letter or Meeting with Planning prior to
a x
❑ "sArlTAiiY sEWERDISTRrcT
_
submittal of Building Permit application.
mAroR
�
..��.EPIVIROIYMENTAI;"HEALTli�?,•
BldgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
T7 -TT TCYrin A Tl1D 112TT1r1r 717N(-' "FVTCTLIN
Check _
l9e<;lr. Non _
. Plrrrrrh. 1'larra f.:hc:ck Elee. Platt Check
L1eclr. 1'errni[ tee: F'Irrmh. Per nut Fee. filzc-. Permit Fee.
Other Alech. Irash.
id er.h. lash. l ee:
Other Plumb lrarr.
Phmrb. 1wq). Fee:
other Elec. Ins r. L J
Elec. Imp. Fee:
Cl -..--
NOTE.
-
NOTE: This estimate does not include fees due to other uepartments ti.e. nunncng, ,Uuucec rrvnn, c, —•--- _ _-__ ___, _ -- -
- - .. .. -----`-'---_._ n,.s....* #I.- nnnf f—nt%rtN'/,n n_
District, eta). Theseees are basea on the reanuna
FEE ITEMS (Fee Resolution 11-053 Ef. 7/f 1/13)
Al J i •.,AJ 1 t
u.cu �.�
QTY/FEE
�••• �•- ��--•-___� _________ ___
MISC ITEMS
Plan Check Fee:
ADDRESS: 10050 N WOLFE RD
DATE: 08/25/2015
REVIEWED BY: MELISSA
0.0
APN: 316 20 086
BP#: /27
*VALUATION:
$10,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY
Commercial Building
Civil / Religious activities
0 Yes (F) No
PENTAMATION 1TIPREP
PERMIT TYPE: i
USE:
in BQ zone?
PME Unit Fee:
$0.00
WORK
STE 260 - T.I. PREP FOR 5,021 S.F.
Construction Tax: 1BCONSTAXC
SCOPE
Check _
l9e<;lr. Non _
. Plrrrrrh. 1'larra f.:hc:ck Elee. Platt Check
L1eclr. 1'errni[ tee: F'Irrmh. Per nut Fee. filzc-. Permit Fee.
Other Alech. Irash.
id er.h. lash. l ee:
Other Plumb lrarr.
Phmrb. 1wq). Fee:
other Elec. Ins r. L J
Elec. Imp. Fee:
Cl -..--
NOTE.
-
NOTE: This estimate does not include fees due to other uepartments ti.e. nunncng, ,Uuucec rrvnn, c, —•--- _ _-__ ___, _ -- -
- - .. .. -----`-'---_._ n,.s....* #I.- nnnf f—nt%rtN'/,n n_
District, eta). Theseees are basea on the reanuna
FEE ITEMS (Fee Resolution 11-053 Ef. 7/f 1/13)
in ormacwrc uvuuuuca
FEE
u.cu �.�
QTY/FEE
�••• �•- ��--•-___� _________ ___
MISC ITEMS
Plan Check Fee:
$0.00
L— ! J # Tenant Improvement Prep
$417.00 ITIPREP
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Supp/. Insp. Feer Reg. Q OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BCONSTAXC
$0.00
.2t:lministr7tive Fee:
0
Work Without Permit? 0 Yes (F) No
$0.00
Advanced PlanninFee
g
$0.00
Select a Non -Residential
Building or Structure C)
A
Trtwivel Documentation Fees:
Strong Motion Fee: 1BSEISMICO
$2.80
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTdTALS
_. .
$3.80
$417.00 TQ;TAL $420.80
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10050 N WOLFE RD
CONTRACTOR: C & J CONTRACTING
PERMIT NO: 15080179
INC
OWNER'S NAME: I&G DIRECT REAL ESTATE 27 LP
331 COMMERCIAL ST
DATE ISSUED: 08/25/2015
OWNER'S PHONE: 3108607171
SAN JOSE, CA 95112
PHONE NO: (408)374-6025
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
STE 260 - T.I. PREP FOR 5,321 S.F.
License Class_ Lic. 4 L/ 6 -?' /0 !�(
/ �� / ��Q 9
J Cs�rscrh^r, 2S'
( /t/ U /U
Contractor 1'NC. Date /
I hereby affirm that I am licensed Udr 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: $10000
armance of the work for which this permit is issued.
ve and will maintain Worker's Compensation Insurance, as provided for by
rNect
ion 3700 of the Labor Code, for the performance of the work for which this
APN Number: 31620086.00
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 Iaws relating
WITHIN RMIT 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
AYS FRO_ 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
/
VS,)
granting of this permit. Additionally, the applicant understands and will comply
Iss Date:
with all non-point source regulations ger the Cupertino Municipal Code, Section
9.18.
RE-ROOFS:
Signature Date N45 /
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's
material. Additionally, should I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Muipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 255 , oil 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
'
Owner or authorized age 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, 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