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15100208CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100208 20450 STEVENS CREEK BLVD CUPERTINO CA 95014 (369 01 027) DPR CONSTRUCTION A GENERAL PARTNERSHIP REDWOOD CITY, CA 94063 OWNER'S NAME: (CUPERTINO CITY CENTER BUILDINGS) I I DATE ISSUED: 02/03/2016 1 OWNER'S PHONE: (650) 931-3400 I I PHONE NO: (650) 474-1450 I LICENSED CONTRACTOR'S DECLARATION License Class B Lic. #953749 Contractor DPR CONSTRUCTION A GENERAL PARTNERSHIP Date 10/31/2018 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. )/' 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. 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 API--" / / Date 02-16-2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 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 BUILDING PERMIT INFO: —BLDG —ELECT —PLUMB _ MECH _ RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: AMAZON - TI - 7TH FLOOR (21,793 S.F.) (TI PREP IS 100206) REVISION #1 - RFI'S; FIELD CHANGES; ARCHITECTURAL AND STRUCTURAL CHANGES; MEP'S; NEW CARD READERS - ISSUED 10/12/16 REVISION #2 - DESIGN REVISIONS TO ARCHITECTURAL, STRUCTURAL AND MECHANICAL -ISSUED 11/08/16 DEFERRAL #1 - CUSTOM METAL SCREEN PANELS & OPERABLE PARTITION AT AV CONFERENCE ROOM - ISSUE 02/16/2017 Sq. Ft Floor Area: I Valuation: $40b0000.00 "N Number: Occupancy Type: 369 01 027 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued 2 L ga _01_6 Kkl� �, Date: 02/03/2016 V � � 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. performance of the work for which this permit is issued. Signature of Applicant: 2. I have and will maintain Worker's Compensation Insurance, as provided for by Date: 02-16-2017 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ALL ROOF s. 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 02-16-2017 BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &.Safety Code, Sections X25505, 25533, and 25534. Owner or authorized agent: Date: 02-16-2017 CONSTRUC ON LENDI'AGENCY I hereby affirm that there is a construction lefiding agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name CONSTRUCT€ail- PERMIT APPLICATION 002® COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 r% #B (408) 777-3228 • FAX (408) 777-3333 • buildinoti)DEFERRED cupertino.org L1 NEW CONSTRUCTION 71 A.DT)TTTnN FI AT TFU dTtn1`T I TT Nfi ar,-1-11 — - iLr L.nrct� � VRSUlI\:iL YrKlVlil rr PROJECT ADDRESS %04 6-0a'r6v",6 y1�-, 2 vi S60) � 2- OVINERN 4 AB C, , ` �f 6er � n 4/ I PHONE 6 n q3 I 4 0 0 I E-lxLaIL ' STREET.aDDP ESS M ®o (" ` l o?, <�t•,LvVwv-q CITY; STATE; Z P `"'�� J 90! f V ►a M P!" 1 Ci•$ •" R"T "1 ®� FAX CONTACT NAMEr B� T� "-� PHONE E-MLaIL 1'tlrtiIn��0 6-P 60 STREET ADDRESS 14n 1V t G n , V j C- ��v� CITY. STATE, ZIP •R�o�D CA -q4 063 FAX �s ❑ ONT'ER ElOv,�N�-B:. --RR EDOV NZER AGE:T 1 > 1171 ACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGL=-R ❑ DEVELOPER❑ TENA\TT CONTRACTOR NAME , e �LICEN"SE 1,7UMIBER I LICENSE TYPE BUS. LIC COIN12ANTXAIx4E t 1.�� \v ��v l��'•O , V E -h SSL I SAY-' � �'' (('�-y� I FAX STREET ADDRESS i LV5D y CI R^ k CITY, STATE; ZIP `� V �1\tC9O1� eVL0000 Cr�t"" - g�ioG3 PHO'N'E � iu% 512 629 �t ARCHJTF-CT,TNGNNEER NA!,,IE I LICENSEXUBER BUS. LIC COl4PANTXAh4E E-MAIL FAX — STREET ADDRESS I CITY, STATE. ZIP I PHONE DESCRIPTION OF WORK /L%�??�� ►�W�' ' � " � 2 a p , ar / ✓/ !Ad �u G ok # 2 Rexiahe 6440-a A&W "40L rar4 gm"�a�Iti ab oy-e f'WO> <f,PP-MA127,Vs EXISTING USE PROPOSED USE CONST& TYPE -.-.STORMS I USE I TYPE OCC. SQ.FT. VALUATION (S) EXISTG NZEPI FLOOR DE,10 TOTAL — A-REA AREA AREA NET AREA I BA 00M I:rfCHEN OTHER . REA40DEL.=AEA I RFx4oDELAP-rA REMODELAREA I PORCHAREA DECKPREA TOTALDECICPORCH.aRE:4 GARAGEAREA: Ej DETACH " ❑ ATTACH I DVi`ELLLNG LN -1-1 S: IS A SECOND UNIT ❑ Y'ES SECOND STORY ❑ Yt5 BELNGADDED? E] \-O ADDITION? El NO PRE-.2,M]CATION ❑ YES IF Y=S, PROVIDE COPY OF n PLAI.A"t�G.-..PL' ❑?:'0 PLi\'\'12NG APPROVAL LETTER IS THE BLDG AN YES ❑ EICHLERHOn1E? ❑?:0 PECEIVEDEYS€is'>,;`'<'s= ; :;-• TOTAL - LVALLATIO\: By My signature below, I certify to each oftbe follow,-ine: I am the property owner or authorized agent to act on the property CAper`s behalf. I have read this application and the information I have provided is correct. I have read the Description of "Mork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build' ction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. SionatureofApplicant%Agent: Date: ; RIN4.A T?\T REQLT -'1RtD ,I :\FO SUPPLEI\6El\TALI ; i\ j......__ ...,._ .R,0:U.T..I._NPL ✓ _he\\- SFD or Multlfamlly d\a•ellmgs. Apply for demolition penult for "-..".:-ar":-=;;;c;r.>>;.,rt3+>:..:.t..::..:. ...:::. ,.... ,.. ____.. _. _. ..___- .. ,..-.... _.._.-.. - •-`�`' -` �""-' `"' pyx;=;...„.: .-., _::�.<e,a::.:: :.__ :"... .•-...:�._;`:;'.e::--._s.,.<.<..�.�:::5'_:ia°::e sir:!.:`.';'?�: �:;�,,;. exison2buildiWs). Demolition errnrt Is reoulr a rnr to Iss lance or -. bu.ldl_ O\ _R - _. _.” .:."RE\'iETV;.,::,,°:�';'�t: :.:...:::.....:....:_,.._.... • ernut for new building. _Commercial Bldgs. Provide a completed Hazardous 'Materials Disclosure 'M�terr2.n � ST DaRD ❑ PLTLICS\ORhS` ern IIa Haz<rd,u are fan_Q sed as art o1 this project. >-_•;. DEPT'`; Copy of Planning Approval Letter or l\leetn?Q \\'Ith Planningnor to -- submittal of Building Pe on. nnit application. r licati : _>.::,:;.;:>.•:; ::.,.:;.;"-::: -_:, ;. ;:: ;,:::.,=:_::" .. :..:.:::::., \rTARYSE�iERDI_TRICT, F rN UROMNIE1T`ALHEALTH .;'. B ldglpp_2 0 11. do c 7 -ev1.7ed 0 612 1/11 C0.^fr" CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: 15100208 20450 STEVENS CREEK BLVD CUPERTINO CA 95014 (369 01 027) DPR CONSTRUCTION A GENERAL PARTNERSHIP REDWOOD CITY, CA 94063 OWNER'S NAME: (CUPERTINO CITY CENTER BUILDINGS) DATE ISSUED: 02/03/2016 OWNER'S PHONE: (650) 931-3400 PRONE NO: (650) 474-1450 LICENSED ONT A TOR' DECLARATION BUILDING PERMIT INFO: License Class GENERAL ENGINEERING CONTRACTOR Lic. #9 74 Contractor DPR CONSTRUCTION A GENERAL PARTNERSHIP Date 10/31/2018 _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'. AMAZON - TI - 7TH FLOOR (21,793 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: (TI PREP 15100206) 1. I have and will maintain a certificate of consent to self -insure for Worker's REV # 2 (10/12/16) DESIGN REVISIONS TO ARCHITECTURAL, Compensation, as provided for by Section 3700 of the Labor Code, for the STRUCTURAL & MECH performance of the work for which this permit is issued. **BINA-5 * * * I have and will maintain Worker's Compensation Insurance, as provided for by REVISION #1 - RFI'S; FIELD CHANGES; ARCHITECTURAL AND P-% Section 3700 of the Labor Code, for the performance of the work for which this STRUCTURAL CHANGES; MEP'S; NEW CARD READERS - ISSUED permit is issued. 10/12/16 APPLICANT CERTIFICATION REVISION #2 - DESIGN REVISIONS TO ARCHITECTURAL, I certify that I have read this application and state that the above STRUCTURAL AND MECHANICAL 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 Sq. Ft Floor Area: Valuation: $4000000.00 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 APN Number: Occupancy Type: source regulation per the Cupertino Municipal Code, Section 9.18, 369 01 027 Signature Date 11/8/2016 f PERMIT EXPIRES IF WORK IS NOT STARTED OWNER -BUILDER DEGI;ARATION WITHIN 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: ABBY AYENDE- sale (Sec.7044, Business & Professions Code) Date: 02/03/2016 2. 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. 2. 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: 11/8/2016 permit is issued. 3. 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 ofthe 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 California Health & Safety Code, Sections 25505, 25533, and 25534. I will be deemed revoked. 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 certify that I have read this application and state that the above information is material. Additionally, should I use equipment or devices which emit hazardous correct. I agree to comply with all city and county ordinances and state laws air contaminants as defined by the Bay Area Air Quality Management District I relating to building construction, and hereby authorize representatives of this city will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and `the to enter upon the above mentioned property for inspection purposes. (We) agree Health & Safety Code, Stions 25505, 25533, and 25534. to save indemnify and keep harmless the City of Cupertino against liabilities, = 1AA 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: 11 /8/2016 1 and will comply with all non -point source regulations per the Cupertino Municipal 'CONSTRUCTION LEND 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 11/8/2016 Lender's Name .,.E CUPERTItaiO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIO 10300 T ORRE AVENUE CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 buildina(Dcupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ As.LTERATION / TI ❑ REV ISION / DEFERRED ORIGIN? AL PERMIT 6 ci PROJECT ADDRESS Ow-NER I AA4E Uli\Ti O Cr�Y C&v „VPHONE STREET ADDRFSS o fn /' oR f r CITY; STATE. Z /t �y FAX V J 1 ®% ! t `A l �t1 CONTACT N124E j �) L PiO EC.fl �Fpay :J�Y e-zr STREET ADDRESS CITY, STATE, ZIP FAX e cJ n OW\TR ❑ OWAEIR-BUl? DER ❑ 0 -MI -ERA G EN'T ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGL\'EER ❑ DEVELOPER 11 TENANT i CONTRACTOR I\AME, L CENSE NTLMBER LICENSE TYPE BUS. LIC r COMPANYN:AME I E-MAIL FAX STREET ADDRESS p � lvlur j � �s 'J �,` CITY, STATE; ZIP I PHONE I e ogv c5 .RCHITECT/ENGINTE NARIE LICE SE UT43ER BUS. LIC-4�( COMPANY NA1,4E E-MAIL FAX STREET ADDRESS CITY, STATE, 7IP I PHONE DESCRIPTION OF WORK AynA—zQ„r — "r KNI,-'I ftJ 2 4 5 1 ►V `�Y � � � � � �j�1� � 4V EXISTING USE PROPOSED USE CONSTR T]PE _ STORIES USE TYPE OCC. I SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA ATEA I. AREA NET AREA BATHROOM -KITCHEN - OTHER - REMODEL AREA REMODEL AREA RE1\40DEL AREA PORCH. REA DECK AREA TOTAL DECK•PORCHAREA G.ARAGEAREA: ❑DETACH I ❑ ATTACH ._.-..--------a-- D]lELLLNG UNITS: IS A SECOND UIN ❑ 1'-S SECOND STORY ❑YE5 - BEINGADDED? ENO ADDITION? ❑NO PRE -..APPLICATION ❑ YES IF ITS, PROVIDE COPY OF IS THE BLDG A.N ❑ ] CEiVE - .,� TOTAL VALUATION: , PL.A.NT'LNG.ADPL:: ❑NO PL.4NNL':GAPPROVAL.LETTER I EICHLERHO'.3E? El?� a By my signature below, I certif}� to each of the folloveing: 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 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 built -construction. I authorize representatives of Cupertino to enter the aybove-identified/property for inspection purposes. �/�`-"'G1 Date: lo)� r k? SianatureofApplicant/Agent: SUPPLEMENTAL INFORMATION REQUIRED PLA. CE[ECI�TYPE. >° ROUTINGSLIP.•. New SFD or Multifamily dwellings: Apply for demolition permit for � o] ER THF cot .TER Ll BLTILDI\G PL4 � RP ]TER existing building(s). Demolition permit is required prior to issuance ofbuilding permit for new building. ElPRESS � � PLA \L�GPLAn RE] IEI� P � Bldgs: Provide a completed Hazardous Materials Disclosure L sr3ND�RD fl PLBiict�oRl.s _Commercial form if any Hazardous Materials are being used as part of this project. f LARGE FIRE DEPT _ Copy of Planning Approval Letter or ]Fleeting with Planning prior to s❑ ALA TOR � I� sA �rr�R] sERERDI�TRICT � submittal of Building Permit application. B1dgApp_2011.doc revised 06121111 M, CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100208 20450 STEVENS CREEK BLVD CUPERTINO CA 95014 (369 01027) DPR CONSTRUCTION A GENERAL PARTNERSHIP REDWOOD CITY, CA 94063 OWNER'S NAME: (CUPERTINO CITY CENTER BUILDINGS) DATE ISSUED: 02/03/2016 OWNER'S PHONE: (650) 931-3400 PHONE NO: (650)474-1450 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL ENGINEERING CONTRACTOR Lic. #9.5374 Contractor DPR CONSTRUCTION A GENERAL PARTNERSHIPDate 10/31/2018 _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: AMAZON - TI - 7TH FLOOR (21,793 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: (TI PREP 15 100206) t. 1 have and will maintain a certificate of consent to self -insure for Worker's REV # 2 (10/12/16) DESIGN REVISIONS TO ARCHITECTURAL, Compensation, as provided for by Section 3700 of the Labor Code, for the STRUCTURAL & MECH 'performance of the work for which this permit is issued. **BIN A-5*** 2 F " I have and will maintain Worker's Compensation Insurance, as provided for by REVISION #1 - RFI'S; FIELD CHANGES; ARCHITECTURAL AND Section 3700 of the Labor Code, for the performance of the work for which this STRUCTURAL CHANGES' MEP'S• NEW CARD READERS - ISSUED permit is issued. 10/12/16 APPLICANT CERTIFICATION REVISION #2 - DESIGN REVISIONS TO ARCHITECTURAL, I certify that I have read this application and state that the above STRUCTURAL AND MECHANICAL 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 Sq, Ft Floor Area: Valuation: $4000000.00 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 APN Number: Occupancy Type: source regulations per the Cupertino Municipal Code, Section 9.18. 369 01 027 re Date 11/8/2016 Signature PERMIT EXPIRES IF WORK IS NOT STARTED DWNF_,R-BUI DER DECLARATION WITHIN 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: ABBY AYENDE sale (Sec.7044, Business & Professions Code) Date 02/03/2016 2. 1, 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. 2. 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: 11/812016 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 I have read the hazardous materials requirements under Chapter 6:95 of the Labor Code, I must forthwith comply with such provisions or this permit shall California Health & Safety Code, Sections 25505, 25533, and 25534. I will be deemed revoked. 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 material. Additionally, should I use equipment or devices which emit hazardous Correct. I agree to comply with all city and county ordinances and state laws air contaminants as defined by the Bay Area Air Quality Management District I relating to building construction, and hereby authorize representatives of this city will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and to enter upon the above mentioned property for inspection purposes. (We) agree the Health &Safety Code, Se tions 25505 25533 a d 25534. to save indemnify and keep harmless the City of Cupertino against liabilities, r 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: 11 /8/2016 ° and will comply with all non -point source regulations per the Cupertino Municipal CONSTRUCTIONAGENCY Code, Section 9.18. 1 hereby affirm that there is a construction l nding agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Signature Date 11/8/2016 CONSTRUCTION PERMIT APPLICATION COMIdiUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION LQ— . 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255. � `'�'�� w (4'08) 777-3228 • FAX (408) 777-3333 • buildingcugeriino.or E _ CUPERTIHO• NEW CONSTRUCTION ❑ ADDITION . ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT 4 PROJECT ADDRESS 2 64 5e -4 f s � � �� I APN n 369 o' OWNER NAIL P �.+ Pi30NE t -MAIL STREET ADDRESS 16.M � 4 CITY, STATE, ZIP ��Q � � ��¢ fuSo FAX 1 CONTACT N,WE SW / Dg S 1 j iPA' jW_ I PHONE 1461 -4 to STREET ADDRESS 337 e:U—yPtF- i So J 2B7) CITY, STATE, ZIP O&V I -AW FAX of Z 6 t E3 OWNER 11 OWNER-BuIIAER ❑ OWNMAGENT E3 CONTRACTOR ❑ CONTRACTOR AGENT ve ARCHITECT El ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME :S I LICMIIISE NU S R3 7 LICENSE TYPE ` ,. _ �( BUS. LIC R _ COMPAtv-YN'AJS P E-MAIL FAX STREETADDRESS 1450 \%Q T. F� e,(Atj CITY, STATE, ZIP �4 PHONE �✓�(��_�21 �� ARCHITECT/ENGINEFRNP.ME I LICENSENIUM,BER Bus.LICm COMPANY NANS E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK C IS ION_ 1 m V C"AtZCAItS Gt11�,- (-%t� —; - 1�V mevi CPRI) EXISTLNGUSE PROPOSED USE CONSTR. TYPE A'STORIES USE. ) TYPE I OCC. I SQ.FT. I VALUATIOhI (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA L AREA NIST AREA BATHROOM KITCHEN OTTMR--_..-- y REMODEL AREA RE1,40DEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH P.REA -GARAGE AREA: Lj DETACH El ATTACH - ( - IDWELLINGUINIITS: - IS A SECOND UNIT El YES SECOND STORY AYES BEING ADDED? ElNo ADDITION? [3NO ( I. PRE•APPLICATION QYcS IF YES, PROVIDE COPY OF PLAAT�GAPPROVAL LTrER I IS THE BLDG AN ❑ YES_ EICHLERHOME? NO ii' s ;_ - T TAL VALUATION: PLANI�IINGAPPLR nNO E] By my signature below, I certify to each of the foil owing: I am the property owner or authorize -A agent to act on the property 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 accurate. I agree to comply with all applicable local of Cupertino to enter the abot �- �� +;fPa ^^'rty for inspection purposes. ordinances and state laws relating to bund; _'Const ction, Al authorize representatives '•^ - Sismature of Applicant/Agent: Date: SUPPLEMENTAL INOF N REQ UIRED `¢ , New Multifamilyn permit for R� � ng building(s). cion�pelrmit isrequ rply equiredpriorto issuance of building 1- - exis p permit for new building. s`� �a.G eLfir _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure fiDA72B 1 � nUBI� Yea form if any Hazardous Materials are being used as part of this project. {, — Copy of Planning Approval Letter or Meeting with Planning prior to sx�Tsr submittal of Building Permit application. - Bldg11pp_2011.doc revised 06121/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100208 20450 STEVENS CREEK BLVD CUPERTINO CA 95014 (369 01027) (DPR CONSTRUCTION A GENERAL PARTNERSHIP) REDWOOD CITY, CA 94063 OWNER'S NAME: (CUPERTINO CITY CENTER BUILDINGS) DATE ISSUED: 02/03/2016 OWNER'S PHONE: 650-931-3400 PHONE NO: 408-421-4368 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #953749 Contractor (DPR CONSTRUCTION A GENERAL PARTNERSHIP) Date —BLDG —ELECT _ PLUMB _ MECH _ RESIDENTIAL— COMMERCIAL 02/03/2096 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 JOB DESCRIPTIONS license is in full force and effect. AMAZON - TI - 7TH FLOOR (21,793 S.F.) (TI PREP 15 100206) 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. 2. I have and will maintain Worker's Compensation Insurance, as provided for Sq. Ft Floor Area: Valuation: $4000000.00 by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county 36901 027 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 PERMIT EXPIRES IF WORK IS NOT STARTED harmless the City of Cupertino against liabilities, judgments, costs, and WITHIN 180 DAYS OF PERMIT ISSUANCE OR expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will 180 DAYS FROM LAST CALLED INSPECTION. comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Issued by: le" Date: 02/03/2016 Signature Date 02/03/2016 RE -ROOFS: OWNER -BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed. If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of the installed without first obtaining an inspection, I agree to remove all new materials for following two reasons: inspection. 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 Signature of Applicant: for sale (Sec.7044, Business & Professions Code) Date: 02/03/2016 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: L I have and will maintain a Certificate of Consent to self -insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation, as provided for by Section 3700 of the Labor Code, for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued, California Health & Safety Code, Sections 25505, 25533, and 25534. I will 2. I have and will maintain Worker's Compensation Insurance, as provided for maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the by Section 3700 of the Labor Code, for the performance of the work for which Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous this permit is issued. air contaminants as defined by the Bay Area Air Quality Management District I 3. I certify that in the performance of the work for which this permit is issued, I Will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and shall not employ any person in any manner so as to become subject to the the Health &Safety Code,,Secfions 25505, 25$33, and 25534. r's Compensation of a. this certificate f 1Worker'slComeensl hog r 11 exemetion, I become subject the provisions of th P J p p V ' 11 Labor Code, I must forthwith comply with such provisions or this permit she Owner 2/ authorized agent: Date: 2! 1 be deemed revoked. CONSTRUCTION LENDING ENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance certify that I have read this application and state that the above information is of work's for which this permit is issued (Sec. 3097, Civ C.) correct. I agree to comply with all city and county ordinances and state laws Lender's Name relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Address to save indemnify and keep harmless the City of Cupertino against liabilities, ARCHITECT'S DECLARATION judgments, costs, and expenses which may accrue against said City in be a I understand my plans shall be used as public records. 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. Licensed /11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100208 20450 STEVENS CREEK BLVD CUPERTINO CA 95014 (369 01 027) DPR CONSTRUCTION A GENERAL PARTNERSHIP REDWOOD CITY, CA 94063 OWNER'S NAME: (CUPERTINO CITY CENTER BUILDINGS) DATE ISSUED: 10/12/2016 OWNER'S PHONE: (650) 931-3400 PHONE NO: (650) 474-1450 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL ENGINEERING CONTRACTOR Lic. #953749 Contractor DPR CONSTRUCTION A GENERAL PARTNERSHIP Date 10/31/2016 _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: AMAZON - TI - 7TH FLOOR (21,793 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: (TI PREP 15100206) 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 REVISION #1 - RFI'S; FIELD CHANGES; ARCHITECTURAL AND performance of the work for which this permit is issued. STRUCTURAL CHANGES; MEP'S; NEW CARD READERS - ISSUED a 2. I have and will maintain Worker's Compensation Insurance, as provided for by 10/12/16 V Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPL.ICA_NT 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 Sq. Ft Floor Area: Valuation: $4000000.00 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 against liabilities, judgments, costs, and expenses which 369 01 027 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. PERMIT EXPIRES IF WORK IS NOT STARTED %' WITHIN 180 DAYS OF PERMIT I NCE OR Signature �✓� /%" Date 10/12/2016 180 DAYS FRO CTION. OWNER -B LD .R DECLARATION Issued by: MELI NAME I hereby affirm that I am exempt from the Contractor's License Law for one of the Date: 10/12/2016 following two reasons: t. 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 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is sale (Sec.7044, Business &Professions Code) installed without first obtaining an inspection, I agree to remove all new materials for 2. I, as owner of the property, am exclusively contracting with licensed inspection. contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: Signature of Applicant: t. I have and will maintain a Certificate of Consent to self -insure for Worker's Date: 10/12/2016 Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the shall not employ any person in any manner so as to become subject to the 25533, and ter 9.1 I will California Health &Safety Code, Sections Municipal maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Worker's Compensation laws of California. If, after making this certificate of Health & Safety Code, Section 25532(a) should I store or handle hazardous exemption, I become subject to the Worker's Compensation provisions of the material. Additionally, should I use equipment or devices which emit hazardous Labor Code, I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Area Air Quality Management District I be deemed revoked. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sec ons 25505, 25533, and 25534. 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 Owner or authorized agent: relating to building construction, and hereby authorize representatives of this city Date: 10/12/2016 to enter upon the above mentioned property for inspection purposes. (We) agree CONSTRUCTION LENDING AGENCY to save indemnify and keep harmless the City of Cupertino against liabilities, I hereby affirm that there is a construction lending agency for the performance judgments, costs, and expenses which may accrue against said City in of work's for which this permit is issued (Sec. 3097, Civ C.) consequence of the granting of this permit. Additionally, the applicant understands Lender's Name and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Lender's Address Signature Date 10/12/2016 ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. CCUPERTINO I I N\�W ('0NC7RTTC'7TC1N CONSTRUCTION PERMIT APPLICATION 151 ,r . SLEWOW COMMiUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 two (408) 777-3228 FAX �(408) 777-3333 • building(va -cubettino.or F-1 ATITITTT(lN 1 714TTFDGTTn-KT/Tin T 1 1 D=-,rTC7(1TT/TILDCD*DCn nDT/'-Ti.TAT n—,.mru PROJECT ADDRESS OVNERNAIVM f4 IPHONEb) IE-VAII 'Cqf��`° STREET ADDRESS _ `' gyp@ / p� r I CITY, STATE, ZIP p� FAX - s . v1na p� p CONTACT NAME �� i✓L�i=��IP lam I PHONE 110 -4 0 ^�p /��I E-MA�L ) V STREET ADDRESS ' 1 1 � � f ' (� CITY, STATE, ZIP 0" 'rA-%/%f lam!✓ FAX E3 OFVNER D: OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT tx ARCHIr-CT ❑. ENGREFR ❑ DEVELOPER. ❑ TENANT CONTRACTORNAME S V A -y %f LICENSE'NW _fI LICENSE TYPE BUS, LIC COMPANY NAhS E-M.A.IL FAX �J ��f^ �� Q STREET ADDRESS ��'Q v1 th t"' PI � CITY, STATE, ZIP � p a,,,�,o_._J � srf. PHONE 1 I ? b ARCMTECT/ENGINEFRNAME LICENSE NUMBER BUS: LIC_TvU COMPANY NAME EMAIL FAX - STREET P:DDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK �}7� B�1 .r t m pp -c &-A r c -F. -' -th rler-.!-M 6tp. i It EXISTLNG USE - PROPOSED USE CONSTR. TYPE 4 STORIES I I USE TYPE OCC. SQ.FT. I. VALUATION (S) AREA AREANET NEW FLOOR AREA DEMO ( AREA - AREA - .., / y /ofof BATHROOM - KITCHEN 0ThER REMODEL AREA REMODEL AREA REMODEL AREA - PORCH AREA DECK AREA TOTAL DECKJ?ORCH U-T:A GARAGE AREA: DETACH - _ ❑ ATTACH n DV,'ELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES - - - - BEING ADDED? E] NO ADDITION? []NO PREAPPLICATION ❑1r.S IF YES, PROVIDE COPY OF PLANINMIGAPPLR NT APPROVAL NO PLANNG IS THE BLDG AN ❑ TES EICHLERHOE? NO M - -_ - - �. _ ` -T TAL Vp.LUATION' ___ By my signature below, I certify to each of the following: I am the property owner or authorizea agent to act on the property 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 accurate. I agree to comply with all applicable local ordinances and state laws relating to building c struction. I authorize representatives Cupertino to enter the above -identified for inspection purposes. Iroperty SignatureofApp] icantlAgent: Date: Ed 1, s SUPPLEMENTAL Il\TFOK MATION REQUIRED — �� :�PLAA;CHECK�•1PE _ �,_ 1- �__�;.r�OU"TZNG-SLIP: = , a,._�_: ❑ of Rra coT ITER BITIID GPL4NREiI£Si` New SFD or Multifamily d%vellings: Apply for demolition permit for existing buildincr s). Demolition permit is required prior to issuance of building permit for new building. .EXPA£SS" - -� PL_'iLRGPL REV -LEFT' Bldg: Provide a completed Hazardous Materials Disclosure _ CC] cr4NDaTzn= PIc�oRrs _Commercial form if any Hazardous Materials are beingused as part of this project. Copy of Planning Approval Letter or Meeting with Planning prior to RIOT _ submittal of Building Permit application. iin7 R s �Aa�R SY2�Is = z Bldgt4pp_2011.doc revised 06121111 I CITY OF CUPERTINO 009p$f FEE ESTIMATOR — BUILDING DIVISION iAlADDRESS: 20450 Stevens Creek Blvd DATE: 10/26/2015 APN: 369 01 027 BP#: REVIEWED BY: PAUL *VALUATION: 1$4,000,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building Plan Check Fee: PENTAMATION PERMIT TYPE: 1 B T� WORK TI - 7TH FLOOR (21,793 S.F. SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. (s.f.) B (Tenant Improvements) I-A,I-B 21,793 $4,756.12 IBTIPLNCK $15,143.88 1BTIINSP I TOTALS: I 21,793 I $4,756.12 $15,143.88 _ I Mech. Play. Check I IPl wjb. Plarr Check I IElec—Pion Check _llecr. Perratif Fee: Plumb. I'ermzr Fee: El". Permit Fee: Other Alech. Insp. Odie. Plymb Insp.Ea-L- Other Llec. Imp, Mecz, Insp, Fee: 11haiA hisp. fee: Elec. Insp. Fee: NnTF.: Thiv estimate does not include fees due to other Departments (i.e. Planning. Public Works. Fire. Sanitary Sewer District, District, etc.). These_fees are based on the preliminary information available and are only an estimate. Contact the Deptfor addn'l info. FEE ITEMS (Fee Resolution 11-053 Elf. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,756.12 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $15,143.88 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C'onstruction Tier: Administrative Fee. 0 E) Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) i Travel Documentation I"e>s: Strong Motion Fee: IBsEISMICo $1,120.00 Select an Administrative Item Blda Stds Commission Fee: 1BCBSC $160.00 SU13T 21,180.00 $0.00 _ -TAZ FES $21,180.00 Revised: 10/01/2015