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15060154CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD CONTRACTOR: DEVCON PERMIT NO: 15060154 CONSTRUCTION INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR 690 GIBRALTAR DR DATE ISSUED: 09/24/2015 OWNER'S PHONE: 4089743516 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ® COMMERCIAL License Class ? Lic. # REVISION #1- ADD SITE WORK (SIDEWALKS, LOADING DOCK & LANDSCAPING). ISSUED 11-3-15. Contractor Ae? Date I9 aim licensed under the provisions f C apter 9 I hereby affirm that (commencing with Section 7000) of Division 3 of the Busin s & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $8500000 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 APN Number: 31620109.19339 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITIIIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Issued by: Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: installed. If a roof is 9.18. Signature Date All roofs shall be inspected prior to any roofing material being w - installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this the Health & Safety Code, Section "53, and 25534. i Owner or authorized age _ Date: `r permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I I I hereby affirm that there is a construction lending agency for the performance of become subject to the Worker's Compensation provisions of the Labor Code, must work's for which this permit is issued (Sec. 3097, Civ C.) forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION NAM 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 GUPERTCt`l0, (408) 777-3228 • FAX (408) 777-3333 building(c-)cuDertino.orq ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI 5?(REVISION / DEFERRED ORIGINAL PERMIT ! SOG d t _S PROJECT ADDRESS/ �j�/ / APN -'3/v L .. x PHONE q �{ - OWNERNANM /! . / I 7 �� � E-MAIL STREET ADDRESS ,/jam CITY, STATE, ZIP I FAX �f7C 49 CONTACT NAME tfew- Lo.'t'�l PHONE I E-MAIL STREET ADDRESS CITY, STATE, ZIP P FAX OWNER 11 OVER.BUDAER ❑ OATIERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME 4R+�- ) �SSf LICENS R LICENSE TYPE BUS. LIC 9 COMPANYNAbf g /evc //i► *011 d J �� E-MAIL C f��VCOYr^ COI�S�•C FAX STREET ADDRESSCITY, r 1J STATE ZIP g" PHONE • 9d� t a�•.393 ARCHITFCT/ENGINEFR NAME LICENSE NUMBER ,y' BUS. LIC m e vrn 5'" COMPANY NAME E-MAIL Kc�row s d�.os . cor+n. FAX STREET ADDRESS CITY, STATE, ZIP frC � PHONE g � LA-- S:32r3 s ♦ 1. 1 DESCRIPTION OF WORK !ey � s 1'4 1AKGGet* I` Aev(S ` r%11er+'w AfE4-xi 5. 1 E)GSTING USE PROPOSED U CONSTR. TYPE 9 STORIES USE TYPE I C, SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA '- BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH [-]ATTACH I ,' DV'ELLDNGUI4rrs: IS A SECOND UNrr ❑ YES SECOND STORY ❑YES - - - BEING. ADDED? ElNO ADDITION? ❑NO _ PRE -APPLICATION ❑ 1'ES IF YES, PROVIDE COPY OF { IS THE BLDG AN ❑ YES TOTAL VALUATION: - PLANNDN'G APPL m [:]NO PLANNING APPROVAL LETTER I EICHLER HOME? ❑ NO sr _ By my signature below, I certify to each of the folIowina: I am the property o"'vner or authorized agent t on the ro er's behalf. I have Tea application and the information I have provid ave read the Description of Work and ven ccurate. I aereetocomply with alt applicable 1 ordinances and state laws relating to. construction. I a Drize representatives 'of Cupertino to enter the abovef-ide Tied operty for inspection purposes. ��/ SionatureofApplicantlAgent: _ Date: - UIRD SUPPLEMENTA TIO E Q I\Tew.SFD or Multi f Ne lings: Apply for demolition permit for _I]MR Taz<CoultrER fl BUuvincrL�rrli> vLY = existing building(s). Demolition permit is required prior to issuance ofbuilding a { permit for new building. EXPRESS - -� PLAh'IihGPLA REVIEVT�. Commercial Bldgs: Provide a completed Hazardous Materials Disclosur Pus1C RaRTCS _ form if any Hazardous Materials are being used as part of this project. 4 Copy of Planning Approval Letter or Meeting with Planning prior to os�R ID s�Iuc _ submittal of Building Permit application. Mo Bld.-App 2011. doe revised 06/21/11 CITY OF CUPERTINO rw--7M7 FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 19339 STEVENS CREEK BLVD sites?a. DATE: 10/05/2015 REVIEWED BY: MELISSA APN: 31620109.19339B P#: 1'5060154 *VALUATION: Iso PERMIT TYPE: Building Permit 0.0 PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: PME Plan Check: Civil / Religious activities in BQ zone? 0 Yes +1 No PENTAMATION 1 GENCOM PERMIT TYPE: i WORK REV # 1 - ADD SITE WORK SIDEWALKS LOADING DOCK & LANDSCAPING & INTERIOR SCOPE REVISIONS TO SOFFITS AND ELEVATIONS Plan (..heck 11irrnnb f11an (..heck Dec. Play Check A'feels. flertnit Fe'e: Odwr Aleck l;rst;�: IAfech. Insp. Fee: Plumb, Per•ntir.F'ee: 0rh, r.Phmib :Zr sja. I'iarmb. Insp, Fee: Zslec. per ri-fit Foe: 01.rev Eke. 1;z t?- Eiec. Insp. tree: NOTE: This estimate does not include fees due to other Departments (Le. Hanning, FuDuc WorKs, 'r ire, Junflury oewer "Catifu, -a..— thv nant far addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef. . 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes No $0.00 l_J hours Plan Check, Hourly $286.00 1STPLNCK Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONST.9XCF-] $0.00 z'1(h1?rt171'i`pwth'e F,ee. Work Without Permit? 0 Yes No Advanced Planning Fee: $0.00 $0.00 Select a Non -Residential Building or Structure , Travel IJoC>Lf1'i7C':'tt(,L iopi .I t'es: Strome Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBT(?TALS $0.00$286.00 TOTzSiL =$281 aVV loco. ., ....�. �., ... CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD CONTRACTOR: DEVCON PERMIT NO: 15060154 CONSTRUCTION INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR 690 GIBRALTAR DR DATE ISSUED: 09/24/2015 OWNER'S PHONE: 4089743516 MILPITAS, CA 95035 PHONE NO: (408)942-8200 0 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ MAIN STREET - APPLE (OFFICE 1) T.I. TO BUILD License Class � Lic. # Sqqi 6�3 OUT SHELL (4 FLOORS -125,581 S.F.) Contractor k4.1C Date I hereby affirm that I am licensed under the provisions of Cha ter 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: $8500000 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. APN Number: 31620109.19339 Occupancy Type: 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 DAYS OF PERMIT ISSUANCE 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 DAYS FROM LAST CALLED INSPECTION. 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, Issued by: �%l%Cs Date: �� ! costs, and expenses which may accrue against said City in consequence of the granting of this permit. ition , the applicant understands and will comply with all non -point sc re n er the Cupertino Municipal Code,,Sectio 9.18. RE -ROOFS: Signature Date 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. 0 OWNER -BUILDER DECLARATIONDate: Signature of Applicant: I hereby affirm that I am exempt from the Contractor's License Law for one of ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER the following two reasons: 1. 1, 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 HAZARDOUS MATERIALS DISCLOSURE 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. 1 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. 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 Additionally, should I use equipment re devices which emit hazardous air Compensation, as provided for b Section 3700 of the Labor Code, for the contaminants as defined by the Bay Area Air Quality Management District I will p P Y maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the performance of the work for which this permit is issued. Health & Safety Code, 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 e cut: jK permit is issued. Date' d /✓ 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 4s;TRUCTION 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 (See. 3097, Civ C.) must forthwith comply with such provisions or this permit shall bedeemedLender's Name revoked. ` Lender's Address APPLICANT CERTIFICATION I certify that I have readthis application and state that the above information is ARCHITECT'S DECLARATION correct. I agree tocomplywith 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 CONSTRUCTION PERMIT APPLICATION MEMEL COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO, (408) 777-3228• FAX (408) 777-3333 • buildliin�g(Wcupertino.orcl ❑ NEW CONSTRUCTION n AT)T)TTToN �-a T TP -P e •rTr)m / -rT I' 1 111TH A T B1dgpp_2011.doc revised 06/21/11 dM PROIECtADDRESS /q3.39 APN r —?-0 S J ( t� v`� t OWNERNAME PHONE�• E-MAIL SIV STREET ADDRESS '� CITY, STATE, Z I FAX I Tr1t"1• L LIDOrA CONTACT NAME 7 Avp E MAII �9d•�t � 9a' • STREET ADDRESS �®TATE, ZIP FAXCv s C�y7��. ❑ OWNER ❑ OWNER -BUILDER ❑ OV,WTERAGENI' 3C0 TIRACfOR ❑ CONIRACTORAGENT ❑ ARCHIMcT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT e CONTRACI'ORNAME L t �� LICENSE NUMBER -19q, &P � LICENSETYPE I BUS. LIC � COMPANY NAMEp-CVCOf+ �p•1iiACt�%ni EMAH{�tSS1 �C/leVCt-Cove:{ FAX STREET ADDRESS !- 4b % 4o V f I CITY, STATE, IP 3 PHONE '01-3 3-39dQ ARCHITECTIENGLN'EERNAM a LICENSENUMBER obss Iacvd c � sga S - I BUS. LIC .In � a. .iv�.ra COMPANY NAME S�ud�•`DS �� E-MAIL 0 FAX Yi � 5 . C STREET ADDRESS yds" 5 . 15 CITY, STATE, ZIP Sam ;^"sCc CA PHONE S5• 3a• 39 DESCRIPTION OF WORK �:�:�, ^gyp jv� � �•� S��l EXISTING USE - 'PROPOSED USE CONSTR. TYPE n STORIE - - Neo � ` erpRa: e— USE TYPE OCC. SQ.FT. VALUATIONS) EXISTG .DEMO TOTAL .. -. AREA,'! =FLOOR, AREA AREA �•_ 'EPAREA!s BATHROOM. KITCHEN. OTHER. REMODEL AREA. REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKRORCH AREA GARAGE AREA: DETACH ' ❑ATTACH n D1i tLLDAG UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? r1N0 PRE APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING ADPL f ❑ NO ' PLANNING APPROVAL LETTER /AT IS THE BLDG AN ., TOTAL VALiJATION: EICHLER HOi � � oU rl E 19 By my signature below, I certify to each of the following: I am the property owner or au th _ to act on the property -owner's behalf. I have read this application and the information I have provided is corse trl-hare the Descriptio ork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to mg co ction. I auth representatives of Cupertino to enter the above -id fled prop rty for inspection purposes. . — Signature of Applicant/Agent: Date: 4 SUPPLEMENTA=INFTIONI��UIRED New SFD or Multifamily ly for ' ' permit for o�R �Oil�xTER � �W =BiJIGDIL�GPL32EYIES4- existingbuilding(s). Demolition permit is required prior to issuance of building for building. permit new Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ME MINE _ Form if anHazardous Materials are being used as art of this project. Y g P P 1 I�Asz � ` 01 MEM ' 1 arm, _ Copy of Planning Approval Letter or Meeting with Planning prior to x. aisTiirc; submittal of Building. Permit application. s B1dgpp_2011.doc revised 06/21/11 dM -- CITY OF CUPERTINO 15 /' 0 FEE ESTIMATOR — RITIL DING DIVISION K� OCCUPANCY TYPE: 19339 VY_ SL DATE: 06/24/2015 REVIEWED BY: MELISSA JimADDRESS: APN: 316 20114 BP#: VALUATION: 1$8,500,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building 1BTIPLNCK PENTAMATIUN PERMIT TYPE: 1 B TI WORK MAIN STREET APPLE -(OFFICE 1 - T.I. TO BUILD OUT SHELL SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA 61). PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) 11-B,111-B,IV,V-B .126,581 $14,372.10 1BTIPLNCK $51,059.78 1BTIINSP $0.00 PME Plan Check: $0.00 Permit Fee: $51,059.78 Suppl. Insp. Fee -.0 Reg. 0 OT —0,01.hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 126,581 $14,372.10 Consiraction 1 ally: $51,059.78 ' H.HOURLY,, Yes ', its" PLUMBS HOURLY -Yes e : 1�Tsa , E�.EC,, HO LY O Y` s No tieclr. Pyran (heck Pht/1117. Plan C h eek Elea ion Check kchF Pepinil F" ?e: 111L"imb. pe:rrZJ% Fee: ���E'. L'. Pi.'-P'nfir T,ve: {)i?re:r �1e4 t. ;ns, ( dT` , Plumb lrupi Od,.er Elcc. lnsz. J40612. tias'/y. 1"ee: I'hinib, T isp. Fee: L ec. Imp. Yee: VA71 . TLae aefirranty dnnc nrnt irrnlvda role thio to nthor Donartmente /ip Planning. Public Works. Fire. Sanitary Sewer District, School f'nntnrt tho Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 L . 711113) FEE QTY/Ff MISC ITEMS Plan Check Fee: $14,372.10 Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $51,059.78 Suppl. Insp. Fee -.0 Reg. 0 OT —0,01.hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 i 7= Consiraction 1 ally: Administrative Fee: 0 G Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 i 1 r"A,el Do a ne mail -m i''s:'.es: Strong Motion Fee: IBsEIsMICo $2,380.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $340.00 SUBTU�AL 68,151.88 $0.00 = T(?fiIJ FEE _' $68,151.88 RCVIJGU. vv/v.+cv .v C� Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: yew• v . PERMIT # /50 G O /5 - OWNER'S NAME: L =nc . PHONE # 440 •3 83.3 91 4 GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: &C(D �1�r�(-�.,� �ri,�.` CITY/ZIPCODE: !95 -D35 -- *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date ate SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cat,i l LOA L44 Cement Finishing 'j ;sem �• (mow Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing ��}t.rs .l Li 0 IF' Heating l� L L.0 ttri n Insulation Landscaping V Lathing Masonry Painting / Wallpaper, Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock TileR itUi ate el CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19339 STEVENS CREEK BLVD CONTRACTOR: DEVCON PERMIT NO: 15060154 CONSTRUCTION INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR 690 GIBRALTAR DR DATE ISSUED: 09/24/2015 OWNER'S PHONE: 4089743516 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION .TOB DESCRIPTTON: RESIDENTIAL COMMERCIAL E] MAIN STREET - APPLE - (OFFICE 1) - T.T. TO BUILD icense Classg1�3 Lic, # OUT SHELL (4 FLOORS - 125,581 S.F.) "�ontractor ,De Vc6 h Date Ja— R '�ISIQN:- f3 WORK AT�SrW� QqAS '.•?EVISE-SJT I hereby affirm that I am licensed under the provisions o Cbapter 9 C N'PA QIt Rio `UILUIN__G`7 1S�SUED'12-2-15 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $8500000 Performance of the wort: 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 APN Number: 31620109.19339 Occupancy Type: permit is issued, APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITPIIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION, indemnify and keep harmless the City of Cupertino against liabilities, judgments, eosts, and expenses which may accrue against said City in consequence of the granting of this permit, Additionally, the applicant understands and will comply Issued by: Date: with all non -point source re ul ' s per the Cupertino Munieipal Code, Section 9.18. \ � %r RE -ROOFS: Signature Date 02 All roofs shall ba inspected prior to any roofing material being installed. If roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applieant: Date: 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sce.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed eontractors to HA7ARDOTIS MATERIALS DISCLOSURE construct the project (See.7044, Business & Professions Code). I have rend the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapicr 9.12 and the declarations: Health & Safety Code, Seetion 25532(x) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as dcGned by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2 5 - 2553 , . d 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1Owncr or authorized agent: Date: a 15 a I certify that in the performance of the work for which this permit is issued, I shali� not employ any person in any manner so as to become subject to the Worker's Compensation laws of California, If, after making this cenificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3497, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is coreet. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public rceords, granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9. l 8. Signature Date n CONSTRUCTION PERMIT APPL[CAT[ON COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTItsO (408—) 777-3228 • FAX (40B) 777-3333 • buildincl(cDcugertino.ora NFW(-r)NCTI2Ttti-Trim I I Ai)T)TTif1N I�TAT.TFRATTCITI/TT n- 7 RRVTgT(')NIT)F.F'T=RRFT)` nR`T(-,TNAALPP.iRMrra PROJECr ADDRESS 19 33 I ,5 AIN R ? 1 OWNER NAME PHONE E-MAIL 'qVIK 97q. 35 7Ic'� STREET ADDRESS 1 Thi' Lr�o CITY, STATE, rA FAX CONTACT NAME a E-MAIL , =A o-1 ��'a. _?qa. 1 fP65� STREETADDRESS CITY, STATE, ZIP FAX 6(eft")_ Cbh��• r d ❑ OWNER .❑ OWNER -BUILDER ❑ OWNERACZNT CONTRACTOR ❑CONTRACTORAGENT ❑ ARC3,11TECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT C011TRACI OANAMEft 12 J., L C SS\ LICENSE NUMBERS I LICENSE TYPE BUS, LIC R COMPAtSYNAME'D-evcor+ Co {�tN�� E-MAILiIr�Srrl � ll���t� �C�1�1� r FAJt STREETADDRESS[D70 i r &;Vt Crry,STATEN, , C4 q �3� P os�. 393 3qd � CFFQTEC�* EER`AM + LICENSEINMEER ^ I o� BUS. LICk 4 COMPANY NAME S�ud�ds L E-MAIL S FAX lire n e s . t^ S•TRIFZTADDRESS CITY TATE,ZTP �jLl PHO]CI �y a a' O AFSC1tiPT10N OF WORK ~ 1•\ Llr T. • b b,,,Z 6L EiOSTIIGUSE PROPOSFDUSE CONSTRTYPE STORIES Neo :tt; �,( USE TYPE OCC. SQ.F7, VALUATION (5) =GNEW FLOOR• DEMO TOTAL AREA l �� , g& AREA AREA NET AREA RI' 33ATHROOM KITCHEN. OTIMR. , REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECKAREA TOTAL DECK/PORCHAREA GARAGEAREA: LJDETACH ' ❑ Ai 1'ACki ;�DWELUNGVNTITS: ISASECONDUNrr DYES sECONDSTORY ❑YES HEINGADDED? NO ADDITION? ❑No PRE -APPLICATION OYES IF YES, PROVIDE COPY OF PLANM@ ONO- PLANNINGAPPROVALIN I5 THE BLDG TOTAL VALUATION: By my signature below, I certify to each of the following: I am the property oNA7cr or auth to act on the property owner's behalf: I have read this application and the information I have provided i corre the escriptiowtilVork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating touif ind o ctiom I author' representatives of Cupertino to enter the above-ide 'f:ed prop rty for inspection purposes. Signature of ApplicantlAgent: Date: 1 SUPPLEMENTAL WF TION UIREAs_ �saE �� .��OLaITi4G SLiPa? r sti r f New SFD or Multifamily velli ppfor permit for�otR�rc iJzrTET2� IiTI[ )rAG=PLA7REYIE�iL -existing building(s). Demolition permit is required prior to issuance of building permit for new building.®EXPI31 xi s5 r��© P34h]hIPLATTREVEFV� OEM _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure M:-'0- STANDA73T t P form if any Hazardous Materials are being used as part of this project i Ra�osT.rljrDEPT Copy Planning Approval. Letter Meeting with Planning to k _ of or prior x�M1'7Jt'r--': n yr �°`sv'IFiiRS'SE'�'ERSIISTFUCT, submittal of Building Permit application. BldgApp_2011.doc revised 06121111 'dM CONSTRUCT [ON PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVFNUF - CUPERTINO, CA 95014-3255 (408) 777-3228 ' FAX (408) 777-3333 - buildina{Dcunerlina.arg y�- CUPERTIHO Y ❑ NEW CONSTRUCTION ❑ ADDTrION . TERATION 117 RE SION FERRED ORIGINAL PERMIT MOiECf ADDRESS APN 4 r C ?c I �C • ORTIi ERNAI� //}� e �-� PHONE L �`E' 1 •�I'�� .37.]' '�"/f P! Ci STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME G PHONE ` E-MAIL I / P.SSI+z / STREET ADDRESS CITY, STATE, ZIP FAX I] OWNER 13 OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONT-RACTOR AGENT ❑ ARCH -CT ❑ R*NEER ❑ MENTLOPER 0 TPNANr CONTRACTORNAML LICENSE ER LICENSETYPE BUS, LIC P ot)? CW eq. (01.9AW NAT4E STREET ADDRESSG Gr�� CITY, STATE ZIP PHONE p AitCHTIECT/ENGINcER Nf� fE LICENSE I\yLrN BER BUS. LSC COMPANY NAME EMAIL FAX STREET ADDRESS CrrY, STATE, W PHONE DESCRIPTION OF waRlc 33 r 3� EXISTING USE PROPOSED USE CONSUL TYPE k STORIES USE TYPE OCC, SQ.FT. VALUATION {S) EXLSTG NEW 7-OOR nEA40 TOTAL AREA AREA AREA NET AREA •- BATHROOM KITCHEN OTHER PJEMODEL AREA F0,10DEL AREA REMODEL AREA PORCIIAREA DECKARI:A TOTAL DECKIPORCHAREA GARAGEAREA; DETACH ATTACH m DR'ELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY E]) -Es BEING ADDED? NO ADDITION? EIND PRE ;L -PLICATION [2YES IFYES. PROVIDE COPY OF PLANNINGAPPLE] NO PLAMM,GAPPROVALLEFFER 15 THE BLDG AN I] 1'E5 EICHLERHOME? NO �C 'B�•�' '" - -"-' TOTAL VALUATION: By my signature below, I certify to each of the following: I am the property o.Ngner 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-omply with all applicable local ordinances and state laws relating to b rue on. I authorize representatives -of Cupertino to enter the above -i nti ed property for inspection purposes. 5ignatureofApplicantlAgent: Date: SL'PPLEMI✓NTA N REQUIRED New SFD or Multifamily t%Iellings: Apply for demolition permit for aX& ER TH)rG0f-NTER r ` � f �g';-T yL'tG I ?NRBASEii' yay existing building{s). Demolition permit is required prior to issuance of building rLt permit for new building? EssMr e LJ_FLAh EiET7EW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. �r�DAxut64 Approval Letter to kRi. ? _ Copy of Planning or Meeting with Planning prior ClrinhA7oa� Fr sA�.rrY si�x�isrliIcr� " submittal of Building Permit application. 4 � �.,`�L--+te�`O.'.,h � • �...�-=:i � ���+.+.4'YII•O'hSE1�3'z�T.'`HlsailJ7Air.. Bldg,4pp_1011.docrevised 06/21/11 V1-- CONSTRUCTION PERMIT APPLICATION COMMiiUM TY DEVELCP10ENT DEPARTMENT - BUIR IMN * �j '10300 T ORRE AVENUE • CUPERTINO, CA °50'14-3255 7� ✓�1� GtJPER'i1IdO, (408) 777-3226 - FAX (4DB) 777-3333 buildino aQ unartino.ora ❑ 14,W CCNSTR13C710N ❑ ADDrrm , ❑ AL i �kTION 1-1 REV 310N / DEFS=-D o�IGIt.Ta.� PE�.��.Sr��ls5� PROirzr'T RESs /�-33 ' CCC w I 11'N���IC' �O ~/ f i / `�7 •35� Aim-u����o ��� ST Er-. P.DDRES CTiY, STATE, Zi? I FAX ��9�vi7 Al / /f9�NL b � f = GR ` I C01v7ACT h°AN.S � PHOhc r=•M.4ii. • Lt sr +n t • 3 3.3 Fa 9 ►^/ s a &SCE vc&a - coti cd S1" -Eat ADDRESS " CITY, SrAT=•,r3t/� � a FAX 90 5� r-7 ❑ CAN -.R R vx� aP.•3UII KK ❑ Ckq ACEvT 2 �// 10,11 1Ci0R ❑ C0}.Tit?CTOR!.GD,7 ❑ AaMMECT ❑ D4G-1 -F3t ❑ p ELDP ❑ TTAh7' CONTRA ORY LiLNc'5 �55,� 1vUlJ.$aR 3 L1C�SEi`Y7B I BUS.L]CF �n COI�hTvYNA}�i r-N.4iI PAX STP:t.ET ADDRE£S CTT Y, STA i r,ml ,ZI fro 5 PHONE_ AAC:r-M-ENGDdSHR?.fJJ= � Li=-S-NU>~S=R 3Us.LIC 11 @Viii �.�fs�w Cp1JPA1S 1 gArc ) pl / H•!dE?l FAX Rc� A 55 STDDP= �P,M. I CIiY, STxv P 3p 7�' A A5 Ca 1 DESCRIPTION OF WMa a /� ,5f11 c caro•L ESS P G t1SE PROPOSED LS CONSTR MS < STOR'S VSE TYPE OCC. SQ -FT. VALUATION(S) E)M70 NEW FLOOR. DEMO TOTAL A.? -EA A-REA f.% k --- A. 3zr ASLA •. BAT1-TWOM 01r=- ?I y ;?12MOD=L.4'k7-A M-3•40DELAREA RE1,iOD=LARZA PORCri hREA DECK AR A TOTALD=Ci 1PORCi hR A Gi.RAGE,'.iL`-A: DEZACH [] ATTACi RDk'T_LLF1.GtlATrS: ISASEC:OND711irI' ❑YEs SDCO^D STORY E]}=9 BEIG A]]DrD? ❑NO ADDMON? ENo PPE•ivPLSChTIODI ❑trS 1-r}rS,PROVIDECOPY O'r Pilti\'hTnC+.PPL: ❑NO PihhhTII�GtBirtOVhLL• -FL IS THEBLDCAN ❑]iSC;]. VCHLERHOME' []?JO TOTSL ATION: By my signature below, I certify to each of the following: I ant the property eater or authorized agent to act on the property ow;:er's behalf. I have rednthis applicaticn and the iruarmation-I-heve-provided•is tort, ect-I have read the IJescription of S§>orlc and veriy it is accurate�I aPree to comply `;,ith e2f'aopl ica6?e loc�1� ordinances and state lams relating to build! C aLt Dr3 representatives Df Cup:.rtino to enter the above -Y entiftj property for inspection purposes. _SimetureofADD] Icant/Aeent:-_ 5L-PPLETi NTAL NIFFO TI F • IRSor �� CITY OF CUPERTINO FEE ESTIMATOR -BUILDING DIVISION 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 based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee.Resolution 11-053 E . 7/1/13) ADDRESS: 19339 STEVENS CREEK BLVD DATE: 1010512015 REVIEWED BY: MELISSA kdci:h: l'c:rmit Fee: APN: - 31620109.19339 BP#: 15060154 "VALUATION: $0 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Addition/ Repair PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone?. 4 Yes � No PENTAMATION PERMIT TYPE: 1 GENCOM � WORK REV # 1 -ADD SITE WORK SIDEWALKS LOADING DOCK & LANDSCAPING )& INTERIOR SCOPE REVISIONS TO SOFFITS AND ELEVATIONS 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 based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee.Resolution 11-053 E . 7/1/13) 11e ch. Plan Check Plumb, Plan Check Efec. Plan Check kdci:h: l'c:rmit Fee: Plumb, Permit Fee: Ilec. Per writ Ft"e: Other Alech. Insp. Other Plumb Insp. Li Other hlec..lnsp. ET Alech. Inst). Fee: Plumb. Insp. Fee: Elea Insp. 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 based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee.Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? o Yes Q No $0.00 hours Plan Check, Hourly $286.00 ISTPLNCK Suppl. PC Fee: O Reg. o OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Feer $0.00 Suppl. Insp. Feer Reg. o OT 0,0 yhrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONST.4XC $0.00 Adrnairiistralive Fee: Q Work Without Permit? ® Yes (j) No $0.00 Advanced Plannin Fee: $0.00 Select a Non -Residential Building or Structure 0 4 TravelDocumeritationTet:r: Strong Motion Fee: $0.00 Select an Administrative Item BIdg Stds Commission Fee: $0.00 SUBTOTALS:. - $0.00 $286.00 TOTAL FIRE,:, $286.00 Revised: 07102/2015 MM -7 - CITY OF CUPERTINO P50601�j l, FEE ESTIMATOR - BUILDING DIVISION IJ ! `j" 19 ADDRESS: 19339 SL DATE: 06124/2015 REVIEWED BY: MELISSA PC FEE ID APN: 316 20 114 BP#: "VALUATION: 1$8,500,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building IBTIPLNCK PENTAMATION PERMIT TYPE: 1 B T! WORK MAIN STREET APPLE - OFFICE 1 - T.I. TO BUILD OUT SHELL SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA S.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) 1[-B,1[1-B,IV,V-B 126,581 01hel• Plumb Inep. Li IBTIPLNCK $51,059.78 WNW Glec•. Insp. Fee: PME Plan Check: $0.00 Permit Fee: $51,059.78 Suppl. Insp. Fee -.0 Reg. ® OTT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 126,581 1 $14,372.10 Co)nswuCtion Tax: $51,059.78 MEC.H, HOURLY Q Yes No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes (j) No :Lfech. Plan (Y.leck Phrrnb. Platr Chcek Flee. Plan Check Jtfech. Pc>rrrri±Tca2:. Plumb, Permit ree: r1ec..Perndi Fey: Otho hfceh. fnsft. 01hel• Plumb Inep. Li Other L'lee_ bup. Li Mech. Insp, lire: Pherrib. Insp. I ee: Glec•. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the preliminarp information available and are only an estimate. Contact the Dept for addn'f info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTYIFEE MISC ITEMS Plan Check Fee: $14,372.10 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (D Reg. ®OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $51,059.78 Suppl. Insp. Fee -.0 Reg. ® OTT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Co)nswuCtion Tax: ,ldmuustrahve Fee: Q G Work Without Permit? ® Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G a Travel Documentalion Fees: Strong Motion Fee: IBsEtsmico $2,380.00 Select an Administrative Item Bldgs Commission Fee: IBCBSC $340.00 SUBTOTALS: 68,151.85 $0.00 TOTAL FEE: Revised: 1305 2M� I September 23, 15 VIA EMAIL Ms. Tiffany Brown City of Cupertino Planning Department 10300 Torre Avenue Cupertino, CA 95014 RE: 19339 Stevens Creek Blvd, Cupertino TI Project, and Application No. 15060154 Dear Ms. Brown: We are writing this letter to request your approval to release the building permit for the above referenced application. We understand that we will be constructing the tenant improvements at our own risk until Sand Hill Properties and the City of Cupertino reach an agreement on the recordation of a covenant on title for the above referenced building, requiring a minimum of 1,460 gross square feet of retail space in the building when Apple is no longer a tenant in buildings 1 and 2 at the Main Street Cupertino Development We appreciate your support through this process and look forward to the City issuing the building permit for the above referenced application. Please do not hesitate to call or email us if you have any questions. Sincerely yours, Vanessa Chow Cc: Kristina Raspe — Apple Bernie Baker — Apple ]acki Horton —Apple Dana Pesce — Apple Matthew Currie - Apple Apple 1 Infinite Loop, NLS 301-3VG Cupertino, CA 95014 T 408 996-1010 F 408 996-0275 wwwapple.com