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15120121CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120'121 10700 CLUB HOUSE LN CUPERTINO CA 95014 (356 05 003) (S L M DEVELOPMENT INC) BELMONT, CA 94002 OWNER'S NAME: (AIKINS:SONYAETRUSTEE) BATE ISSUED: 02/08/2016 OWNER'S PHONE: 415-945-9984 PHONE NO: 650-288-7399 LLCENSED CONTRACTOR'S DE LAR TION BUILDING PERMIT INFO: License Class B Lie. # 48 1898 Contractor (S L M DEVELOPM15NT INC) Date 02/08/2016 —BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing. _ MECH — RESIDENTIAL COMMERCIAL _ with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: IJ ACCESSIBILITY UPGRADE AT (E) RESTROOMS AND PARKING I hereby affirm under penalty ofperjury one of the following two declarations: SPACES (ADD1 VAN ACCESSIBLE PARKING) 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. Sq. Ft Floor Area: Valuation: $42000.00 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 APN Number: Occupancy Type: ordinances and state laws relating to building construction, and hereby 356 05 003 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 PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will WITHIN 180 DAYS OF PERMIT ISSUANCE OR comply with all non -point source regulations per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION. Code, Section 9.1 r� Issued by: ABBYAYENDE Signature% Date 02/08/2016 Date: 02/08/2016 LVt RE -ROOFS: OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.. If a roof is following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for 1. I, as owner of the property, or my employees with wages as their sole inspection. compensation, will do the work, and the structure is not intended or offered for sale (Sce.7044, Business & Professions Code) Signature of Applicant: 2. I, as owner of the property, am exclusively contracting with licensed Date: 02/08/2016 contractors to construct the project(Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance, as provided for California Health & Safety Code, Sections 25505, 25533, and 25534. I will by Section 3700 of the Labor Code, for the performance of the work for which maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the this permit is issued. Health & Safety Code, Section 25532(a) should I store or handle hazardous s. I certify that in the performance of the work for which this permit is issued, I material Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I '„ will maintain compliance with the Cupe , un%cipal Code, Chapter 9.12 and Worker's Compensation laws of California. If, after making this certificate of the Health & Safety Code, ctions 505, 25533, and 25534. 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 Owner or authorized agent:,.,'- be deemed revoked. Date: 02/08/2016 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Civ C.). relating to building construction, and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant ARCHITECT'S DECLARATION understands and will comply with all non -point source regulations per the I understand my plans shall be used as public records. Cupertino Municipal Code, Section 9.18. Licensed Signature Date 02/08/2016 Professional CUPERTINO n NF'W ['OMRTRI ir' CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408)) 777-3228 • FAX (408) 777.3333 • building G0cuperlino.org M CIIVJ f € Anni'i'inM A i T'L"b A I`I —.I — i }' 1 6C-5I2C(0�—� PROJECT ADDRESS j/ys�,. v� /' t", -. AN#�06- "'C✓ OWNER NAI �/► �j��/"� /ISO -�E-^Iv�EA�1L�� f y� / �-,,,J _ f �U }l4-/ 6) J � �i STREE�'R1"5, /��( /J C�nY, 57 TE,Z F Y CONTACT AM& ,1 tit ✓iXX' P ST tA t OWNER © OWNER ❑ OWNER -BUILDER OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ T-ENANT CONTRACTOR NAME. 4 4 LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME &MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE AKCHITECTJENGINEER NAME LICENSE NUMBER BUS, LIC 4 COMPANY NAME &kpt qV ISG? c� B im^ e t q Vl,l� FAX STREET ADDRESS t7 ,., f I `' / o �r t�I, tel' Z /� /wpl CITY, STATE, ZIP �T� O CA _`. ) t PRONE DESCRIPTION OF WORK DI,l� �i` � G✓�, t/I Y�//r/ lN✓" �s v` EXISTING USE PROPOSED USE CONSTR. TYPE U„ a fl STORIES - USE TYPE OCC, SQ.FT. - - VALUATION {$) EXISTG AREA NEW FLOOR AREA DEMO TOTAL AREA NET AREA L�j/� _����f Re; I o °.�I 000. ��� A-2 3� �-yy�"� 0) mo BATHROOM - REMODEL AREA KITCHEN REMODEL AREA OTHER REMODEL AREAj%/t .i/ (��1t f _ ... 2 S 00 PORCH AREA DECK AREA TOTAL DECKJPORC€I ARCA GARAGE AREA: DETACH. - 0 ATTACH H DWELLTNG UNITS: 1S A SECOND UNIT , ❑YES SECOND STORY [DYES BEINGADDEO? ❑NO ADDITION? ©NO PRE -APPLICATION DYES IF YES, PROVIDE COPY OF PLANNING ADPL # D NO PLANNING APPROVAL LETTER 7S THE BLDG AN ❑ YES EICHLER nOR1E? ❑ NO REGEi:15BX " ""' z::::35?-" =:^=^.`';' .:;y ris asc :5?i: '_ iiF; .uvz TOT VALUATION: - 7 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 tris application and the information I have provided is 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 COnstruction. author a representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: —!---- Date: SUPPLEMENTAL INFORMATION REQUIRED _ New SFD or Multifamily dwellin S: Applyfor demolition litionP r permit existing 1sulldmg(s). Demolition permit is required prior to Issuance ofbulldlmg UtsTCE ..:»_ :;; - -.. .....: :��uu p)I G,I•�i�riti�vi��v�':��'' ......<.•.. _ :...._, for o new permitnbuilding., ...:...,: _...:,-._,. _.,..,.._ _ Commercial Bldgs.- Provide acompleted Hamdous Materials Disclosure -in _ _.. -- _ _ - Tor if am Hazardous Materials are being art a thispro project. - - _- Copyof Planning Approval Letter or Meeting wit]p Planning prior to - r - - SA �urtArTc-o submttlaI ofButldm Permit application. Bldgrlpp_ZOI J.doc revised 06/21111 CITY OF CUPERTINO FM --7 FEE ESTIMATOR — BUILDING DIVNION iADDRESS: 10700 Club House Ln a-1 FEE DATE: 12/14/2015 REVIEWED BY: Phuong APN: 356-05-003 BP#a $0.00 'VALUATION: 1$42,000 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE. Commercial Building hrs PENTAMATION 1GENCOM I PERMIT TYPE: WORK Accessibility upgrade ate restrooms and parking spaces (add 1 van accessible parking) SCOPE Permit Fee: Hourly Only? C) Yes (F) No A�feeh 1�10'n A,",4,uA Plat (,'heck .Avk"'ch, A."rtniz I I Phwnb� I I PIH.Wb, fnsp� y Fee" NOTE.• This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are hated on the nrP.fim;nary infnrinafinn availahle and are nnh) an avfimatp- Cantart th,, vont fnr addn'l ;nfn FEE ITEMS C],ee Resolution 1.1-053 Ljj 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 . S. $503,00 Remodel, Other - F11;M RESOTH Suppl. PC Fee: Reg. 0 0T= G) hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? C) Yes (F) No $0.00 Suppl. Insp. Fee.(@ Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 1 0'0: Work Without Permit? 0 Yes (F) No $0.00 Advanced PlqnnjngjFge: $0.00 2 hours $286.001 Inspections ISTINSP Inspection, Hourly 7)WM' Strong Motion Fee: I BSEISMIC0 $1176 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.001 VffTOTALS: $13.76$789.0 0[ TOTAL FEE $802.7 J 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: lo?q6 C 1jw.,4a O1'- PERMIT # / / 20 / Z OWNER'S NAME: PHONE # —? 9 GENERAL CONTRACTOR: d.( ✓.e t-c� Z --f, BUSINESS LICENSE # ADDRESS: 16 / ,4 61 CITY/ZIPCODE: Cr coo *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCC UP SPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL S CONT CTO HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: ignatur Date Please check applicable subcontractors and complete the following information: (S— f / Contractor Signature Datc SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile (S— f / Contractor Signature Datc Adaptive Architecture 20111 Stevens Creek Blvd, Suite 270 Cupertino, CA 95014 MEMORANDUM February 17, 2016 RE: Rebuilding (E) Shear Wall Deep Cliff Clubhouse - Restroom Remodel 10700 Clubhouse Ln Cupertino, CA 95014 To Whom It May Concern: Tel: (408) 865-1089 Email: info(&adaotivearch.us ,s12o►Z( Due to extensive water damage and dry -rot discovered in the Women's Restroom exterior wall, the full length of the wall shall be removed and re -constructed. The new wall shall be constructed of 2x4 wood studs at 16" o.c., with (2) 2x4 sill plates anchored to the existing foundation with 5/8" diameter holdown bolts at 4'-0" o.c. Anchor bolts to be set in Simpson SET -XP epoxy with a minimum embedment depth of 12". On the exterior side of wall, attach 1/2" plywood sheathing fastened to studs with 10d nails at 12" o.c. in field and 6" o.c. at edges. Wall finish to be 7/8" cement plaster over lath and building paper to match existing conditions. Please contact me with any questions or comments. Sincerely, V v , Janice Yeh, AIA Principal Architect (408) 865-1089 janicePadaltivearch.us