B-2016-1380 f
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: - CONTRACTOR: PERMIT NO:B-2016-1380
10261 BUBB RD CUPERTINO,CA 95014-4167(357 20 008) (S C BUILDERS INC)
SUNNYVALE,CA 94085
OWNER'S NAME: BARBARA LLC. DATE ISSUED:02/17/2016
OWNER'S PHONE:650-906-7350 PHONE NO:650-669-9764
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class 5 Lic.#Z67196
Contractor(S C BUILDERS INC)Date 02/17/2016 X BLDG —ELECT _PLUMB
MECH_R:ESIDENTIAL X 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:
Apple Tenant Improvement for(4)telephone rooms(411 sq ft).
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. Sq.Ft Floor Area: Valuation:$190000.00
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 357 20 008 A(Tenant Improvements),B(Tenant Improvements)
authorize representatives of this city to enter upon the above mentioned
property for inspection purposes. (We)agree to save indemnify and keep
harmlessACupertinoupertino agai liabilities,judgments,costs,and PERMIT EXPIRES IF WORK IS NOT STARTED
expenseaccrue agai t aid City in consequence of theWITHIlT 180 DAYS OF PERMIT ISSUANCE OR
granting . Addition a applicant understands and willcomply int s c e ulations per ertino Municipal 180 DAYS FROM LAST CALLED INSPECTION.
Code,SIssued by: 1 ignaturhate 02/17/2016 Date:02/17/2016
OWNER-B DER DECLARATION RE-ROOFS:
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. 1,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(Sec.7044,Business&.Professions Code) Signature of Applicant:
2. I,as owner of the property,am exclusively contracting with licensed Date:02/17/2016
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. 1 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, 1 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
a. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or devices h emit hazardous
air contaminants as defined by the Ba Area Air agement District I
shall not employ any person in any manner so as to become subject to the will maintain compliance with t U o ici e,Chapter 9.12 and
Worker's Compensation laws of California. If,after making this certificate of the Health&Safe ode,Sec` n 5505 ,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: " 17—/(=,
be deemed revoked. Date:02/17/2016
APPLICANT CERTIFICATION N TR TI N LENDING AGENCY
I certify that 1 have read this application and state that the above information is I hereby affirm that there islf 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 ARCHITECT'S DECLARATION
consequence of the granting of this permit. Additionally,the applicant
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
Professional
Signature Date 02/17/20..16 '
1
CONSTRUCTION PERMIT APPLICATION
EM COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION.
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CtJPERTIhtC} (408)777-3228•FAX(408)777-3333•building(akupertino.org tF•c?6)& a 3 v
❑NEW CONSTRUCTION ❑ ADDITION 94 ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT-#
PROJECT ADDRESS o� ` APN#
OWNERNAME `
G� ® PH ®� �.. �� -. E-MAILi
STREETADDRESS G=s CITY,STA•TEE,,ZIP 7F —
CONTACT
NAME PHONE J 1C ,9 �`b(_O� E-MAIL .
1 J �
STREET ADDRESS SmEsx CITY,STATE,ZIP �� FAX6F,cp, !I
❑OWNER ❑ OWNER-BUn,DER t40 OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT vg�ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME& -' LICENSE NUMBER GI,I C t_7 LICENSE TYPE BUS.LIC(#/
COMPANY NAME < E-MAIL r FAX
STREET ADDRESS CITY,STATE,ZIP PHONE( ��,r_��y
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
G�`u Vl �CS G_ 1 a '��
COMPANY NAME E-MAILa FAX
ksGI c` )A 511 `uC6gi;A&�C.,_-CAfC,'ooi M
STREET ADDRESS �� y Ct4 ��O t,ATF' CITY,STAT ,ZIP ��. PHONE
DESCRIPTION OF WORK
,�LE,N�����4J�F
-
EXISTING USE PROPOSED USE CONSTR TYPE #STORIES L.
'(S USE
j USE TYPE OCC. SQ.FT. VALUATION($)
AREA T W NEW FLOOR 1 DEMO )] TOTAL
AREA41119
g
�'ll s� AREA �l l� AREA NET AREA
BATHROOM KITCHEN OTHER -
REMODELAREA REMODELAREA REMODELAREA C..•i
PORCHAR, - DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA; DETACH -
Com"
[]ATTACH
#DWELLINGUNITS: IS A SECOND UNIT ❑YES SECOND STORY E]YES
BEING ADDED? ❑NO ADDITION? ❑NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES C'-E _- � '" t TOTAL VALUATION:
PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑.NO W /901000 0 U0O
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Workand verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: = - Date: /
ko
SUPPLEMENTAL ORMA�T bN REQUIRED .Xt y o N
New SFD or Multifamil wellin s: Apply for demolition permit for
Y g pp Y p
existing building(s). Demolition permit is required prior to issuance of building Y
permit for new building. sx Dr
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
form if any Hazardous Materials are being used as part of this project. EA
_Copy of Planning Approval Letter or Meeting with Planning prior to
p' ANITARySEWEWDYSTRI
submittal of BuildingPermit application.
�� 3
x,# 'Erf�R�ONM a HE: TH
BldgApp_2011.doc revised 06121111
FIR,
SAN �TA C RA COUNTY u ��
C11�0 r Blvd..
ps ac , C . ----- ----
L ,_ ('08) 378-111342 - --- P-—1,AI--N—
UWZc��none)?^_!00 l zcnpC _ _ - t
PLAN CHI,ECK No.
PLAN REVIEW COMMENTS
S
li .lntla' sptiulerPelle alarm a�- $ shall � i0� r.
:4 ri �ac"j �tCnli� . ,iinecessary. ) -='-s Otdraw 11 �s, a
C�. Y1C�'d perT1r p�11C_i1Gn ° r�. 't0 -ha 32L,?Clara County
I`Ire D..y+t,Mr ap�;ro1 cl p'lOr�0 _It..,,;!
3/: .en, Ci C 1101,A
X11 pot ,ons of ule buil l'g shall bewithin/6 .tet of a t.Le ex ln'�uflshei h_•ving a rnInlil11in i eiir,g Oi?-
10-BC, Ci C 9001
_Cori., ,Cl�l iGOl:l l�20Lir,T,e�f�li21�D.�^G�1G 0 VY'n a Class !�poi A=ble Eye�� t om-guish L loccTGd �jiu!1`1
0 iaet of t11e equiprue,lt and In aie pa��l 02 c 1t .cr 1. C C 90A
i
I"•cr e doors shall be readily openabl'-from h e eSS Side F Ithout rectal knG�'ledge c f & sh ll
-- r _ Or lloi" %Jt
r gL1ie Ig1ltsr�sping, 11aP.ip rlChing o! LF'lsting of h ii'iistt0 operate. tieV Gper,at looking'
de'F10ES ai
y
o=-r„li�L'ed when rtad ily distinguis`iable as locked and sign,ed THIS DOOR TO R. i UNLOCICED
YV'r'>E'•\T BUILD-1 0 1S OCCUPIED, CBC 1008,1.8
Ttreans of egress shall be illuminated at all tm—ts with 90 minute back up \Mere 2 or more exiU are
required, C3C 1006,3
Exits shall be marked by illurn-Inated Exit signs, Sims shall be 'lllu nineLed atoll times and havz 90 `
m1r>u,,=s
oz er ,ergency backup power. CBC 1011
Contractor small?1 eld verify th int-egri y of E iStinI rated consullCtonlaSs,e-1ol,es and res Ore or rtPalr as
necessary, Pent ;;flons in rated wa-lis/ceilings shall_be protected by lis.ed fira rated assemblies (da, !pers,
doors, caulking, fire Stopping, etc,) CFC 103
Tenant shall Provide a labeled ema:rQency acC'esS kcV Gi pl'acement In the bitlldlnv rn=_ganCV acess
7 e
b�;.. CFC 506 key
C> .
This 171:1 Check dGas not permit the fuse, storage or d! erisi g of hazardous mater ials,o =_rations or i