13120166CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19550 VALLCO PKWY
CONTRACTOR: SOUTH BAY
PERMIT NO: 13120166
CONSTRUCTION, INC
OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR
1711 DELL AVE
DATE ISSUED: 09/21/2015
OWNER'S PHONE: 6503441500
CAMPBELL, CA 95008
PHONE NO: (408)379-5500
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
IB3���
LOFT APARTMENTS- CONSTRUCT 120 RESIDENTIAL
DWELLING UNITS 163,405 SQ FT & LEASING OFFICE
License Class_ Lic. #
2,075 SQ FT
Contractor S C,,, //ff "L Date — Z r
I hereby affirm that I am lice 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:
Sq. Ft Floor Area:
Valuation: $182070000
�. 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
APN Number: 31620085.19550
Occupancy Type:
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.
PERMIT EXPIRES IF WORK IS NOT STARTED
APPLICANT CERTIFICATION
WITHIN 180 D SSUANCE OR
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
180 SPECTION.
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 e City of Cupertino against liabilities, judgments,
2/
Issue y: Date:712-
costs, and expenses whi may ccme against said City inconsequence of the
costs,
granting of this perm' . Ad ' nally, the icant understands and will comply with
all non -point sour a per th upertino Municipal Code, Sectio//n 9.18.
RE -ROOFS:
Signature Date _ fs
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
a. I, as owner of the property, or my employees with wages as their sole
HAZARDOUS MATERIALS DISCLOSURE
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
I have read the hazardous materials requirements under Chapter 6.95 of the
construct the project (Sec.7044, Business & Professions Code).
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
I hereby affirm under penalty of perjury one of the following three declarations:
Safety Code, Section 25532(a) should I store or handle hazardous material.
�. I have and will maintain a Certificate of Consent to self -insure for Worker's
Additionally, should I use equipment or devices which emit hazardous air
Compensation, as provided for by Section 3700 of the Labor Code, for the
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
performance of the work for which this permit is issued.
Health &Saf e, Sections 25505, 25533, and 25534.
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
Owner o authori a n
permit is issued.
�Z
Date: 1
3. 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 work's
become subject to the Worker's Compensation provisions of the Labor Code, I
for which this permit is issued (Sec. 3097, Civ C.)
must forthwith comply with such provisions or this permit shall be deemed
Lender's Name
revoked.
Lender's Address
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
ARCHITECT'S DECLARATION
correct. I agree to comply with all city and county ordinances and state laws relating
I understand my plans shall be used as public records.
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
Licensed Professional
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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
19550 VALLCO PKWY (316 20 116)
OWNER'S NAME: MAIN STREET AGGREGATE
OWNER'S PHONE: 650-344-1500
LICENSED CONTRACTOR'S DECLARATION
License Class a Lic. #336974
Contractor SOUTHBAY CONSTRUCTION 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:
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 4t
(� 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. 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, thea plicant understands d will comply with all non -point
source regul ' ns er the Cuperti unicipal Code, Section 9.18.
Signature Date 09/21/2016
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. 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)
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:
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
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.
3. 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 09/21/2016
CONTRACTOR: PERMIT NO: 13120166
SOUTHBAY
CONSTRUCTION
DATE ISSUED: 09/21/2015
PHONE NO: 408-379-5500
BUILDING PERMIT INFO:
BLDG —ELECT _ PLUMB
MECH _ RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
LOFT APARTMENTS- CONSTRUCT 120 RESIDENTIAL
UNITS 163,405 SQ FT & LEASING OFFICE 2,075 SQ FT
DEF # 18/19/2016 - SHRINKAGE COMPENSATING TIE -DOWN
SYSTEM (TDS) - ISSUED 9/21/16
DEF # 2 8/19/2016 - SIMPSON STRONG FRAME SPECIAL MOMENT
STING FRAME (SMRF) - ISSUED 9/21/16
# 1 - RFI REVIEWS (OPEN TILL FINAL)
Sq. Ft Floor Area: I Valuation: $18207000.00
APN Number: Occupancy Type:
316 20 116
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST C-ALLERJNSPECTION.
Issued by: MELISSA NAMES
Date: 09/21/2015
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: 09/21/2016
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 Cu unicipal Code, Chapter 9.12 and
the Health & Safety Co , Sections 5505, 25533, and 25534.
Owner or authorized agent:
Date: 0912112016
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 Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
FIA�_ .A0 -o7_
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 13120166
19550 VALLCO PKWY (316 20 116)
SOUTHBAY
CONSTRUCTION
OWNER'S NAME: MAIN STREET AGGREGATE
DATE ISSUED: 09/21/2015
OWNER'S PHONE: 650-344-1500
PHONE NO: 408-379-5500
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class a Lic. #336974
Contractor SOUTHBAY CONSTRUCTION Date
_ BLDG _ ELECT _ PLUMB
MECH RESIDENTIAL COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
LOFT APARTMENTS- CONSTRUCT 120 RESIDENTIAL
I hereby affirm under penalty of perjury one of the following two declarations:
DWELLING UNITS 163,405 SQ FT & LEASING OFFICE 2,075 SQ FT
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
DEF # 18/19/2016 - SHRINKAGE COMPENSATING TIE -DOWN
performance of the work for which this permit is issued.SYSTEM
2. I have and will maintain Worker's Compensation Insurance, as provided by
(TDS) - ISSUED 9/21/16
DEF # 2 8/19/2016 - SIMPSON STRONG FRAME SPECIAL MOMENT
Section 3700 of the Labor Code, for the performance of the work for which this
RESISTING FRAME (SMRF) - ISSUED 9/21/16
permit is issued.
REV # 1 - RFI REVIEWS (OPEN TILL FINAL)
APPLICANT CERTIFICATION
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
Sq. Ft Floor Area:
Valuation: $18207000.00
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
APN Number:
Occupancy Type:
City of Cupertino a ' st liabilities, judgments, costs, and expenses which
may accrue against sai City in consequence of the granting of this permit.
316 20 116
Additionally, tpe applica t understands,2nnd will comply with all non -point
source reg tions per he Cuperti u Municipal Code, Section 9.18.
PERMIT EXPIRES IF WORK IS NOT STARTED
Signature Date 09/21/2016
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
OWNE ER DE LARATI N
I hereby affirm that I am exempt from the Contractor's License Law for one of the
Issued by: MELIRSA NAMES . L
following two reasons:
Date: 09/21/2015
r. 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)
RE -ROOFS:
2. I, as owner of the property, am exclusively contracting with licensed
All roofs shall be inspected prior to any roofing material being installed. If a roof is
contractors to construct the project (Sec.7044, Business & Professions Code).
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
I hereby affirm under penalty of perjury one of the following three declarations:
1. I have and will maintain a Certificate of Consent to self -insure for Worker's
Signature of Applicant:
Compensation, as provided for by Section 3700 of the Labor Code, for the
Date: 09/21/2016
performance of the work for which this permit is issued.
2. I have and will maintain Worker's Compensation Insurance, as provided for by
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
3. I certify that in the performance of the work for which this permit is issued, I
HAZARDOUS MATERIALS DISCLOSURE
shall not employ any person in any manner so as to become subject to the
I have read the hazardous materials requirements under Chapter 6.95 of the
Worker's Compensation laws of California. If, after making this certificate of
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
exemption, I become subject to the Worker's Compensation provisions of the
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
Labor Code, I must forthwith comply with such provisions or this permit shall
evices which emit hazardous
material. Additionally, should I uQBaye
be deemed revoked.
air contaminants as defined by thality Management District I
APPLICANT CERTIFICATION
will maintain compliance with theipal Code, Chapter 9.12 and
certify that I have read this application and state that the above information is
the Health & Safety Cod, 25533, and 25534.
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
Owner or authorized agent:
to enter upon the above mentioned property for inspection purposes. (We) agree
Date: 09/21/2016
to save indemnify and keep harmless the City of Cupertino against liabilities,
CONSTRUCTI& NDING A E Y
judgments, costs, and expenses which may accrue against said City in
I hereby affirm that there is a cons tion lending agency for the performance
consequence of the granting of this permit. Additionally, the applicant understands
of work's for which this permit is issued (Sec. 3097, Civ C.)
and will comply with all non -point source regulations per the Cupertino Municipal
Lender's Name
Code, Section 9.18.
Lender's Address
Signature Date 09/21/2016
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
RA:, -_e3
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: EMPBELL,CA95008
NTRACTOR: PERMIT NO: 13120166
19550 VALLCO PKWY (316 20 116) C C INC
OWNER'S NAME:
OWNER'S PHONE:
License Class ]a Lic. #336974
Contractor S B C C INC Date 03/31/2018
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. 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
DATE ISSUED: 09/21/2015
PHONE NO: (408) 379-5500
PERMIT INFO:
BLDG _ ELECT _ PLUMB
MECH _ RESIDENTIAL _ COMMERCL4,L
JOB DESCRIPTION:
LOFT APARTMENTS- CONSTRUCT 120 RESIDENTIAL
DWELLING UNITS 163,405 SQ FT & LEASING OFFICE 2,075 SQ FT
DEF # 5 - EXIT STAIR 1 & 2 - ISSUED 5/12/2017
DEF # 1 - SHRINKAGE COMPENSATING TIE -DOWN SYSTEM (TDS)
performance of the work for which this permit is issued. I - ISSUED 9/21/16
2. I have and will maintain Worker's Compensation Insurance, as provided for by I DEF # 2 - SIMPSON STRONG FRAME SPECIAL MOMENT
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
certify that I have read this application and state that the above
information is correct. I agree to comply with all city and county ordinance$
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, thgeeNlicant understands and will comply with all non -point
source regulptions &er the Cupertino Municipal Code, Section 9.18.
Signature DatefZt2
E -BVDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
i. 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)
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.
3. 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.
Sig
Date
RESISTING FRAME (SMRF) - ISSUED 9/21/16
DEF # 3 (10/27/16) - ELEVATORS 1 & 2 - ISSUED 6/29/2017
DEF # 4 - 4TH FLR, (STAIR 3) EXIT STAIRS TO COURTYARD -
ISSUED 3/27/2017
Sq. Ft Floor Area: Valuation: $18207000.00
APN Number: Occupancy Type:
31620 118
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Leeacv
Date: 09/21/2015
RE -ROOFS -
All roofs shall be inspected prior to any roofing material being installed. If a of is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature ofApplicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A"
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 Ar Quality Management District I
will maintain compliance with the C rtino nicipal Code, Chapter 9.12 and
the Health & Safety Co ;Sections 05, 25533, and 25534.
Owner or aytho iz agent:
Date: tvF/z
C STRUCTION 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 Address
ARCHITECT'S DECLARATION
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 13120166
19550 VALLCO PKWY (316 20 116)
S B C C INC
CAMPBELL, CA 95008
OWNER'S NAME:
DATE ISSUED: 09/21/2015
OWNER'S PHONE:
PHONE NO: (408) 379-5500
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class B Lic. #338974
Contractor S B C C INC Date 03/31/2018
— BLDG —ELECT —PLUMB
MECH RESIDENTIAL COMMERCIAL
I hereby.affirm that I am licensed under the provisions of Chapter 9 (commencing
— — —
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
LOFT APARTMENTS- CONSTRUCT 120 RESIDENTIAL
I hereby affirm under penalty of perjury one of the following two declarations:
DWELLING UNITS 163,405 SQ FT & LEASING OFFICE 2,075 SQ FT
1. I have and will maintain a certificate of consent to self -insure for Worker's
DEF # 1 - SERINKAGE COMPENSATING TIE -DOWN SYSTEM (TDS)
Compensation, as provided for by Section 3700 of the Labor Code, for the
- ISSUED 9/21/16
`' performance of the work for which this permit is issued.
DEF # 2 - SIMPSON STRONG FRAME SPECIAL MOMENT
2 2. I have and will maintain Worker's Compensation Insurance, as provided for by
eRESISTING
FRAME (SMRF) -ISSUED 9/21/16
Section 3700 of the Labor Code, for the performance of the work for which thi
DEF # 3 (10/27/16) - ELEVATORS 1 & 2
permit is issued.
DEF # 4 - 4TH FLR, (STAIR 3) EXIT STAIRS TO COURT YARD -
�^�
APPLICANT CERTIFICATION /
ISSUED 3/27/2017
I certify that I have read this application and state that the above
***BIN A-2***
information is correct. I agree to comply with all city and county ordinances
REV # 1 - RFI REVIEWS (OPEN TILL FINAL)
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
Sq. Ft Floor Area:
Valuation: $18207000.00
City of Cupertino against liabilities, judgments, costs, and expenses which
may accrue against ity in consequence of the granting of this permit.
Additionally, the lica understands and will comply with all non -point
APN Number:
Occupancy Type:
source regular' s per a Cupertino Municipal Code, Section 9.18.
316 20 116
Signatu Date 03/28/2017
PERMIT EXPIRES IF WORK IS NOT STARTED
R -B ER DE LARATI
OWNEWITHIN
180 DAYS OF PERMIT ISSUANCE OR
I hereby affirm that I am exempt from the Contractor's License Law for one of the
180 DAYS FROM LAST CALLED INSPECTION.
following two reasons:
1. 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
Issued by MEIA
sale (Sec.7044, Business & Professions Code)
Date: DgG".� srrtvvi�-- 3
z. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
RE -ROOFS:
I hereby affirm under penalty of perjury one of the following three declarations:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. I have and will maintain a Certificate of Consent to self -insure for Worker's
installed without first obtaining an inspection, I agree to remove all new materials for
Compensation, as provided for by Section 3700 of the Labor Code, for the
inspection.
performance of the work for which this permit is issued.
z. I have and will maintain Worker's Compensation Insurance, as provided for by
Signature of Applicant:
Section 3700 of the Labor Code, for the performance of the work for which this
Date: 03/28/2017
permit is issued.
s. I certify that in the performance of the work for which this permit is issued, I
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
HAZARDOUS MATERIALS DISCLOSURE
Labor Code, I must forthwith comply with such provisions or this permit shall
I have read the hazardous materials requirements under Chapter 6.95 of the
be deemed revoked.
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
APPLICANT CERTIFICATION
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I certify that I have read this application and state that the above information is
ipm devices which emit hazardous
material. Additionally, should I usjertino
correct. I agree to comply with all city and county ordinances and state laws
air contaminants as defined by the ea Air ality Management District I
relating to building construction, and hereby authorize representatives of this city
will maintain compliance with the Munm ipal Code, Chapter 9.12 and
to enter upon the above mentioned property for inspection purposes. (We) agree
the Health & Safety Co e, Sections 2550 , 25533, and 25534.
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Owner or authorized agent:
consequence of the granting of this permit. Additionally, the applicant understands
Date: 03/28/2017
and will comply with all non -point source regulations per the Cupertino Municipal
CON TR AGENCY
Code, Section 9.18.
1 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.)
Signature Date 03/28/2017
Lender's Name
Lender's Address
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 13120166
19550 VALLCO PKWY (316 20 116) S B C C INC
CAMPBELL, CA 95008
OWNER'S NAME:
OWNER'S PHONE:
LICENSED CONTRACTOR'S DECLARATION
License Class GENERAL BUILDING CONTRACTOR Lia #336974
Contractor S B C C INC Date 03/31/2018
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:
r. 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.
z. 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 thi:
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 s ' City in consequence of the granting of this permit.
Additionally, the a ica understands and will comply with all non -point
source regulatio s pert Cupertino Municipal Code, Section 9.18.
Signature Date
OWNER -BUILDER DECLARATION DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
r. 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)
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:
r. 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.
z. 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.
3. 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
ISSUED: 09/21/2015
NO: (408) 379-5500
BUILDING PERMIT INFO:
BLDG _ ELECT _ PLUMB
MECH RESIDENTIAL COMMERCLAL
JOB DESCRIPTION:
LOFT APARTMENTS- CONSTRUCT 120 RESIDENTIAL
DWELLING UNITS 163,405 SQ FT & LEASING OFFICE 2,075 SQ FT
DEF # 1 - SHRINKAGE COMPENSATING TIE -DOWN SYSTEM (TDS)
- ISSUED 9/21/16
DEF # 2 - SIMPSON STRONG FRAME SPECIAL MOMENT
RESISTING FRAME (SMRF) - ISSUED 9/21/16
DEF # 3 ELEVATOR - ISSUED 11/22/2016
DEF # 4 (11/08/16) - 4TH FLR, (STAIR 3) EXIT STAIRS TO COURT
YARD
***BIN A-2***
REV # 1 - RFI REVIEWS (OPEN TILL FINAL)
Sq. Ft Floor Area: I Valuation: $18207000.00
APN Number: Occupancy Type:
31620 116
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: ABBY AYENDE
Date: 09/21/2015
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:
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 Cgper�ino Municipal Code, Chapter 9.12 and
C
the Health & Safetyd ; Sec ons 25505, 25533, and 25534.
Owner or authorized agent:
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 Address
rlr _ t5
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 13120166
19550 VALLCO PKWY (316 20 116)
S B C C INC
CAMPBELL, CA 95008
OWNER'S NAME: SAND HILL CONSTRUCTION
DATE ISSUED: 09/21/2015
OWNER'S PHONE: 650-344-1500
PHONE NO: (408) 379-5500
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class a Lic. #336974
Contractor S B C C INC Date 03/31/2018
—BLDG —ELECT _ PLUMB
MECH RESIDENTIAL COMMERCLAL
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
LOFT APARTMENTS- CONSTRUCT 120 RESIDENTIAL
I hereby affirm under penalty of perjury one of the following two declarations:
DWELLING UNITS 163,405 SQ FT & LEASING OFFICE 2,075 SQ FT
1. I have and will maintain a certificate of consent to self -insure for Worker's
DEF # 5 - EXIT STAIR 1 & 2 - ISSUED 5/12/2017
Compensation, as provided for by Section 3700 of the Labor Code, for the
l•
DEF # 1 - SEIUNKAGE COMPENSATING TIE -DOWN SYSTEM (TDS)
performance of the work for which this permit is issued.
- ISSUED 9/21/16
2. I have and will maintain Worker's Compensation Insurance, as provided for by
DEF # 2 - SIMPSON STRONG FRAME SPECIAL MOMENT
Section 3700 of the Labor Code, for the performance of the work for which this
RESISTING FRAME (SMRF) - ISSUED 9/21/16
permit is issued.
DEF # 3 (10/27/16) - ELEVATORS 1 & 2
APPLICANT CERTIFICATION
DEF # 4 - 4TH FLR, (STAIR 3) EXIT STAIRS TO COURT YARD -
I certify that I have read this application and state that the above
ISSUED 3/27/2017
information is correct. I agree to comply with all city and county ordinances
***BIN A-2***
and state laws relating to building construction, and hereby authorize
REV # 1 - RFI REVIEWS (OPEN TILL FINAL)
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.
Sq. Ft Floor Area:
Valuation: $18207000.00
Additionally, the pWicant understands and will comply with all non -point
source regulations pe � the Cupertino Municipal Code, Section 9.18.
APN Number:
Occupancy Type:
f
Signature / Date 5/12/2017
316 20 116
OVVMR-HI�EltDECLARATION
PERMIT EXPIRES IF WORK IS NOT STARTED
I hereby affirm that I am exempt from the Contractor's License Law for one of the
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
180 DAYS FROM LAST CALLED INSPECTION.
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
Issued by ABBY AYENDE
2. I, as owner of the property, am exclusively contracting with licensed
Date' 09/21/2015
contractors to construct the project(Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
RE -ROOFS:
t. I have and will maintain a Certificate of Consent to self -insure for Worker's
All roofs shall be inspected prior to any roofing material being installed. If a roof is
Compensation, as provided for by Section 3700 of the Labor Code, for the
installed without first obtaining an inspection, I agree to remove all new materials for
performance of the work for which this permit is issued.
inspection.
z. 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
Signature of Applicant:
permit is issued.
Date: 5/12/2017
3. 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
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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
HAZARDOUS MATERIALS DISCLOSURE
be deemed revoked.
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
APPLICANT CERTIFICATION
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
I certify that I have read this application and state that the above information is
Health & Safety Code, Section 25532(a) should I store or handle hazardous
correct. I agree to comply with all city and county ordinances and state laws
material. Additionally, should I use equipment or devices which emit hazardous
relating to building construction, and hereby authorize representatives of this city
air contaminants as defined by the Bay Area Air Quality Management District I
to enter upon the above mentioned property for inspection purposes. (We) agree
will maintain compliance with the Cuygrtino Municipal Code, Chapter 9.12 and
to save indemnify and keep harmless the City of Cupertino against liabilities,
the Health & Safety C�de;_Sechpns 25505, 25533, and 25534.
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
Owner or authh
authorized agent:
and will comply with all non -point source regulations per the Cupertino Municipal
Date:5/12/201
Code, Section 9.18.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
Signature Date 5/12/2017
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: 13120166
19550 VALLCO PKWY (316 20 116)
S B C C INC
CAMPBELL, CA 95008
OWNER'S NAME:
DATE ISSUED: 09/21/2015
OWNER'S PHONE:
PHONE NO: (408) 379-5500
LICF.N ED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic. #338974
Contractor S B C C INC Date 03/31/2018
— BLDG —ELECT _PLUMB
MECH RESIDENTIAL COMMERCIAL
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— —
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
LOFT APARTMENTS- CONSTRUCT 120 RESIDENTIAL
I hereby affirm under penalty of perjury one of the following two declarations:
DWELLING UNITS 163,405 SQ FT & LEASING OFFICE 2,075 SQ FT
1. I have and will maintain a certificate of consent to self -insure for Worker's
DEF # 6 - LOFTS FALL PROTECTION - ISSUED 8/2/2017
pensation, as provided for by Section 3700 of the Labor Code, for the
DEF # 5 - EXIT STAIR 1 & 2 - ISSUED 5/12/2017
performance of the work for which this permit is issued.
DEF # 1 - SHRINKAGE COMPENSATING TIE -DOWN SYSTEM (TDS)
I have and will maintain Worker's Compensation Insurance, as provided for by
- ISSUED 9/21/16
Section 3700 of the Labor Code, for the performance of the work for which this
DEF # 2 - SIMPSON STRONG FRAME SPECIAL MOMENT
permit is issued. (/,; C,
RESISTING FRAME (SMRF) -ISSUED 9/21/16
APPLICANT CERTIFICATION
DEF # 3 (10/27/16) - ELEVATORS 1 & 2 - ISSUED 6/29/2017
I certify that I have read this application and state that the above
DEF # 4 - 4TH FLR, (STAIR 3) EXIT STAIRS TO, COURT YARD -
information is correct. I agree to comply with all city and county ordinances
ISSUED 3/27/2017
and state laws relating to building construction, and hereby authorize
***BINA***
representatives of this city to enter upon the above mentioned property for
REV # 1 - RFI REVIEWS (OPEN TILL FINAL)
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 consequehce,of the granting of this permit.
Additionally, the applicant understands and will comply with all non -point
Sq. Ft Floor Area:
Valuation: $18207000.00
source regulations pertheCupertino Municipal Code, Section 9.18.
APN Number:
Occupancy Type:
S/ne' Date 8/2/2017
316
316 20 118
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
PERMIT EXPIRES IF WORK IS NOT STARTED
following two reasons: I
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
r. I, asiowner of the property, or my employees with wages as their sole
180 DAYS FROM LAST CALLED INSPECTION.
compensation, will do the work, and the structure is not intended or offered for
sale !(Sec.7044, Business &Professions Code)
z. I, as owner,of the property, am exclusively contracting with licensed
Issued by: Legacy
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 09/21/2015
I hereby affirm under penalty of perjury one of the following three declarations:
1. I have and will maintain a Certificate of Consent to self -insure for Worker's
RE -ROOFS:
Compensation, as provided for by Section 3700 of the Labor Code, for the
All roofs shall be inspected prior to any roofing material being installed. If a roof is
performance of the work for which this permit is issued.
installed without first obtaining an inspection, I agree to remove all new materials for
2. I have and will maintain Worker's Compensation Insurance, as provided for by
inspection.
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
Si a ofApplicant:
3. I certify that in the, performance of the work for which this permit is issued, I
; g 2 201
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
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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.
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
APPLICANT CERTIFICATION
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I certify that I have read this application and state that the above information is
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
correct. I agree to comply with all city and county ordinances and state laws
Health & Safety Code, Section 25532(a) should I store or handle hazardous
relating to building construction, and hereby authorize representatives of this city
material. Additionally, should I use equipment or devices which emit hazardous
to enter upon the above mentioned property for inspection purposes. (We) agree
air contaminants as defined by the Bay Area Air Quality Management District I
to save indemnify and keep harmless the City of Cupertino against liabilities,
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
judgments, costs, and expenses which may accrue against said City in
the Health & Safety Code, Sections 25505, 25533, and 25534.
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
Owner or authorized agent:
Code, Section 9.18.
Date: 8/2/201
CONSTRUCTION LENDING AGENCY
Signature Date 8/2/2017
1 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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 13120166
19550 VALLCO PKWY (316 20 116) S B C C INC
CAMPBELL, CA 95008
OWNER'S NAME: ( MAIN STREET CUPERTINO AGGREGATOR LLC) DATE ISSUED: 09/21/2015
OWNER'S PHONE: 1 1PHONE NO: (408) 379-5500
License Class GENERAL BUILDING CONTRACTOR Lic. #336974
Contractor S B C C INC Date 03/31/2018
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
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. 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 2/28/2018
\"LARATION
OWNE BE
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. 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)
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:
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
performance of the work for which this permit is issued.
z. 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.
3. 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,
aL�- �f'�•If'�tjl�3
BUILDING PERMIT INFO:
—BLDG —ELECT —PLUMB
_ MECH _ RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
LOFT APARTMENTS- CONSTRUCT 120 RESIDENTIAL
DWELLING UNITS 163,405 SQ FT & LEASING OFFICE 2,075 SQ FT
DEF # 7 -SECURITY ACCESS CONTROL -_55kXed
DEF # 6 - LOFTS FALL PROTECTION - ISSUED 8/2/2017
DEF # 5 - EXIT STAIR 1 & 2 - ISSUED 5/12/2017
DEF # 1 - SHRINKAGE COMPENSATING TIE -DOWN SYSTEM (TDS)
- ISSUED 9/21/16
DEF # 2 - SIMPSON STRONG FRAME SPECIAL MOMENT
RESISTING FRAME (SMRF) - ISSUED 9/21/16
DEF # 3 (10/27/16) - ELEVATORS 1 & 2 - ISSUED 6/29/2017
DEF # 4 - 4TH FLR, (STAIR 3) EXIT STAIRS TO COURT YARD -
ISSUED 3/27/2017
***BIN A*•*
REV # 1 - RFI REVIEWS (OPEN TILL FINAL)
Sq. Ft Floor Area: I Valuation: $18207000.00
APN Number: Occupancy Type:
316 20 118
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: ABBY AYENDE
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: 2/28/2018
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 Cupprtfn Municipal Code, Chapter 9.12 and
the Health & Safety Code Section 25505, 25533, and 25534.
Owner or authorized agent:
Date: 2/28/2018
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.)
CITY OF CUPERTINO
W -M FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: Main St- Apartments
DATE: 12/16/2013
REVIEWED BY: Sylvia
PC FEE ID
APN:
BP#:i
*VALUATION: 1$18,207,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY __7Multi-Family Dwelling
USE:
Buildina is
>3 Stories E) Yes O No
PENTAMATION 1 R2
PERMIT TYPE:
WORK
construct 120 residential dwelling units 4t&m 1 l;�l
SCOPE
'
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.)
PC FEES
PC FEE ID
BP FEES
BP FEE ID
R-2 (Apartment)
II-A,111-A,V-A
163,405
$22,862.30
IR2PLNCK
$54,738.80
1R2INSP
Permit Fee:
$54,738.80
Suppl. Insp. Fee:Q Reg. O OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BCONSTAXR120
# new
units
$78,100.80
F?,dyninistrafiiTC'
0
L E)
Work Without Permit? O Yes (E) No
$0.00
TOTALS:
163,405
$22,862.30
7 Favel 1.)oC:t?r)if nzarion Fees:
$54,738.80
K
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, sanitaryFewer vistrict, Mnooi
Mcirfri om 1 Theca faac nvo hacod "" rho preliminary information available and are only an estimate. Contact the Dept for addii'1 into.
FEE ITEMS (Fee Resolution 11-053 E . 7/1113)
Plan C�f2eCX
� hind;T. �3£fiT:
Jt£?i's £.:''iL'Ci�
Afe h. Permit f-ee,
$22,862.30
Pery?li° Fee:
zs...:
00,iC1"Pit?TPii: hZs(1,
0i72E'P'Etf?<'. Insp.
MeFA I??.4p. i'°t e':
1°iIa?i:1?. LY:'.s�:-, i`ee:
1�fec. Ins'.iT. F'ee:
Permit Fee:
$54,738.80
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, sanitaryFewer vistrict, Mnooi
Mcirfri om 1 Theca faac nvo hacod "" rho preliminary information available and are only an estimate. Contact the Dept for addii'1 into.
FEE ITEMS (Fee Resolution 11-053 E . 7/1113)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$22,862.30
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 1@ Reg. O OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$54,738.80
Suppl. Insp. Fee:Q Reg. O OT
0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: 1BCONSTAXR120
# new
units
$78,100.80
F?,dyninistrafiiTC'
0
L E)
Work Without Permit? O Yes (E) No
$0.00
Advanced Planning Fee: 1PLLONGC
$45,753.40
Select a Non -Residential 0
Building or Structure O
7 Favel 1.)oC:t?r)if nzarion Fees:
Strong Motion Fee: 1BsEisMico
$3,823.47
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$729.00
}SUBTOTALS
06,007.77
$0.00 TOTAL FEES'
$206,007.77
Revised: 10/01/2013
CITY OF CUPERTINO
FEE ESTIMATOR — BiALDING DIVISION
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
(s.f.)
PC FEES
PC FEE ID
Main St- Retail space
DATE: 12/16/2013
REVIEWED BY: Sylvia
I&ADDRESS:
PN:
BP#:
*VALUATION:
$1,293,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: New Construction
PRIMARY
Commercial BuildinginBQ
Civil / Religious activities
CI Yes � No
rPENTAMATIONUSE:
NIIT TYPE: 1 M
IBOPLNCK
zone?
IBOINSP
.WORK
construct retails ace & leasing office
PME Permit Fee:
$0.00
SCOPE
Construction Tax: IBCONSTAXC
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
(s.f.)
PC FEES
PC FEE ID
BP FEES
BP FEE II)
M (Mercantile)
II-B,111-B,IV,V-B
10,081
$4,844.85
IMPLNCK
$5,229.34
IMINSP
B (Offices)
II-B,111-B,IV,V-B
2,075
$5,853.18
IBOPLNCK
$2,450.14
IBOINSP
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXC
$34,279.92
Work Without Permit? C) Yes (H) No
$0.00
TOTALS:
12,156
$10,698.03
?'i'f vel D{;('1:D7i£•:iEiY%trion Fees:
$7,679.48
� F
< ply C Cris' a" : T r" $" y L , .{ it'6 �' 1 4 S ✓ L �`. .� °^ _ f F . ti /'
�/ ash lw F k? $
"5�` w f>fE 3 ,� y .,,. C i
�, FX v„ - f)
�l'C��•z• �' ... .. ./r."<b' .. vf.�� iii.. .f .. ,. �. f ......� :k S.'^�'✓•`�'f,. .v \✓,aa', �. �.s ''� Y.. '�"-::� ..l n.r.
} ,,.',Y l.a .,
Mech. l�;fsY:. Check.
ah °'
l:iL: £:. I''iti7i �.IiL:£: �'
Plan Check Fee:
$10,698.03
Select a Misc Bldg/Structure
T-7-71 or Element of a Building
Ala'£: , Perm!" 1'e£:,
plalub, 1't>�"P? h F' ?e':
EG'e '. Pe.>-mir Fee:
P: "he le"h, lam
i iherPhar,,b Insp,
0,her_' ec•. 1r. Fs.
,,Wecht lay. t''t't':
Pli? nb, Irsp. z'e'e:
7IC. sIS?1.
Suppl. Insp. Feer Reg. Q OT
0,0
V:..,. 0-4 c,,,,,.,r rl;atrrit Rehnal
NOTE: This estimate does not include fees due to other Departments (Le. running, ruunc rr urna, I is c, uw„oe.r. y .,..... - - _• _-- ----- - -
-- _ -- - .. ,. .-- __--- '_-�•--.----...•___ ......a,.J./.....,d __ _Y., m, actin,nfo_ i1nntact the Dept for add t'l into.
District, etc.). These ees are basea on the reamuzur
FEE ITEMS (Fee Resolution 11-053 E . 7f� 11113)
tra urrauuvrt UVW—u—
FEE
w,. w, ..
QTY/FEE
-,_r ..
NHSC ITEMS
Plan Check Fee:
$10,698.03
Select a Misc Bldg/Structure
T-7-71 or Element of a Building
Suppl. PC Fee: Reg. OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$7,679.48
Suppl. Insp. Feer Reg. Q OT
0,0
hrs
$0.00
T_=
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax: IBCONSTAXC
$34,279.92
Work Without Permit? C) Yes (H) No
$0.00
Advanced Planning Fee: 1PLLONGC
$3,403.68
Select a Non -Residential E)
Building or Structure Cl
I-==- A
?'i'f vel D{;('1:D7i£•:iEiY%trion Fees:
Strong Motion Fee: IBSEISMICO
$271.53
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$52.00
56,384.64
$0.00 s r TO)rAI� FEE $56,384.64
Revised: -iulwlzui3