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B-2016-1645
J CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1645 10079 SAICH WAY CUPERTINO,CA 95014-2124(326 32 041) ZHONGRI LIU SUNNY-VALE,CA 94087 OWNER'S NAME; (SAICH WAY STATION LLC) DATE ISSUED:03/30/2016 OWNER'S PHONE:408-453-4700 PHONE NO:(408)966-3782 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#966503 Contractor ZHONGRI LIU Date 10/31/2017 X BLDG _ELECT —PLUMB _MECH_RESIDENTIAL 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: I hereby affirm under penalty of perjury one of the following two declarations: TENANT IMPROVEMENT(SITE FOR SORE EYES)-TO CREATEOFFICE,LENS CLEANING,AND EXAM ROOM(440 SQ FT). i. I have and will maintain a certificate of consent to self-insure for Worker's - - Compensation,as provided for by Section 3700 of the Labor Code,for the REVISION#1: REVISE MECHANICAL EQUIP TO REDUCE CFM;'" performance of the work for which this permit is issued. REVISE OCCUPANT LOAD TO MATCH CODE. ISSUED 8.17.16 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:$20000,00 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 ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 326 32 041 A(Tenant hnprovements),B(Tenant Improvements) 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 PERMITEXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature h =� – _; Date Issued by:SEAN HATCH Date:03/30/2016 OWNER-BUIL DER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date: 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 performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the s. 1 certify that in the performance of the work for which this permit is issued;I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.t agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(See.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 UPERTI' (408)777-3228•FAX(408)777-3333•b1ildinq(rclalsrtir�ta.Orcl ❑NEW CONSTRUCTION ❑ ADDITION X ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 10079 SAICH WAY, CUPERTION APN# 326-32-041 OWNER NAME MIKE KRONZER PH8-453-4700 EX 13- E MAII. _ mike@borelli.com STREET ADDRESSn051 JUNCTION AVE SUITE 10 CITY, STATE,zIP SAN JOSE, CA 95131 TAX CONTACT NAMEKENNYCHANG I PHONE 650-965-3937 E-MAIL STREET ADD CITY,STATE,ZIP FAX. db79 SAICH WAY CUPERTION, CA 95014 ❑OWNER ❑.OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER TENANT CONTRACTOR NAME � LICENSE TYPE BUS.LIC#. LICENSE NUMBER 111 COMPANY NAME r E-MAIL l[G( Cs�GIS'�f'iCC�Et�Ov1� �tj'�o�, AX STREET ADDRESS / / y^;�7/' CITY,STATE,:ZIP lose- tilt/ t 2 ZPHONE ARCHITECT/ENGINEER NAME LICENSE:NUMBER C26469 BUS.LIC# JEFFREY EATON l� CJ�-FtJ.7 COMPANY NAMEEATON HALL ARCHITECTURE E-MAIL FAX Jeffrey@ehastudio.com 408-265-6155 STREET ADDRESS 1501 THE ALAMEDA STE 105 CITY,STATE,ZIP SAN JOSE, CA 95126 PHONE 408-2.65-5255 DESCRIPTION OF WORK REVISION OF SHEET A0.3, OCCUPANCY LOAD CHANGE FORM' 15 TO 30. REVISION OF SHEET M0.1, CHANGE CFM FROM 2,400 CFM TO 2,000 CFM. EXISTING USE - PROPOSED USE CONSTR.TYPE -#STORIES NEW SHELL I I V_g 1 USE TYPE OCC, SQ.FT. VALUATION($l EXISTG NEW FLOOR DEMO TOTAL AREA 1,.554 1 AREA 1,554 AREA NET AREA BATHROOM - KITCHEN - .OTHER - -REMODEL AREA REMODELAREA REMODEL AREA PORCH AREA I DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑-YES BEING ADDED? [:]NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN E]YES TOTAL ON: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑.NO 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 Work and 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-ide ified pro erty for inspection purposes. Signature of Applicant/Agent: Date: d' ( 7/ �r� SUPPLEMENTAL INF(a NATION REQUIRED PLANCTiECKTV'1 E New SFD or Multifamily dwellings: Apply for demolition permit for � TIER?`HEi✓fJTIN'I'EIi. UILDINGELAt�TREVIEw existing building(s). Demolition permit is required prior to issuance of building k permit for new building. ss a ELNNtNrr E ArrxEvrw Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTAlvi> iD Evt?its _,, form if any Hazardous Materials are being used as part of this project. I-( >;I=ARGE � , �t FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior toPTO 0 DT, submittal of Building Permit application. Q SITE FOR SORE EYES BIdgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1645 10079 SAICH WAY CUPERTINO,CA 95014-2124(326 32 041) LIU'S CONSTRUCTION 1582 QUEBEC CT APT 2,SUNNYVALE,CA 94087 OWNER'S NAME: (SAICH WAY STATION LLC) DATE ISSUED 03/30/2016 OWNER'S PHONE:408-453-4700X13$ - PHONE NO:408-966-3782 LICENSED CONIRACTOR'S DECLARATION, BUILDING PERMIT INFO: License Class Lic.#966503 Contractor LID'S CONSTRUCTION Date 10/31117 , X BLDG _ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing. _MECH—RESIDENTIAL X COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: TENANT IMPROVEMENT(SITE FOR SORE EYES)-TO CREATE I hereby affirm under penalty of perjury one of the following two declarations: OFFICE,LENS CLEANING,AND EXAM ROOM(440 SQ FT). 1. I have and will maintain a certificate of consent to self.-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. a I have and will maintain Worker's Compensation Insurance,as provided for by 6/ 'Section 3700 of the Labor Code,for the performance of the work for which this " permit is issued. Sq.Ft Floor Area: Valuation:$20000.00 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 ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 326 32 041 A(Tenant hnprovements),B.(Tenant Improvements) 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands•and will comply with all non-point source regulations perheCuhertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 3/30/2016 Issued by:ABBY AYENDE LM N"LL Date:3/30/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofmg material being installed.If a roof is i. 1,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property;am exclusively contracting with licensed Signature,of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:,3/30/2016 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 performance ofthe work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 255.05,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. f Owner or authorized agent: � APPLICANT CERTIFICATION bate:3/30/2016 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature . Date 3/30/2016 professional CONSTRUCTION PERMIT OP .ICATIOI COMMUNITY DEVELOPMENT DEPARTMENT,BUILDING DIVISION 40300 TORRE AVENUE CUPERTINO,CA 95014-3255 CUPERTW (408)777-3228 FAX(498)777-3333.btfilding0cupertino.org tb- x 01(#o,4—l� t—IN1 y t EtSi' J CON-i UCTICIN 11 At�DMON 433 ALTERATioNIITI _E] REvisioNmi=FERIII�D'. f31liC'rINALPE lIT4 PROMCTrADDRESS 6€I7 SAICH WAY, CUPERTICN APTNtr 826-82-041 pE"BR hfAAtP> PFf E.`utAtt -.... l a 7l � w�1 - 711E mike@b.orelli.com b.orelli.com TR":F�I}�t7 .1 II T AVE IJI"C 1 od CITY,sTA"B zl` SAN JOSE, CIS 95131 CONTACT NAMB KENNY CHANE PI.....F 550-965-8987 HAIAT 'STREXTAD CITY;ZTA:TZ ZIP 6 SAICH WAY CUPERTION, CA 5t�fi I;l catm x` Q ow .sur:.Vf--- ©OVNEP AoEW CONMAcrat{ Cl CONTRACTOR A r 0 ARCHITECT Q ElIG-Num 11 t, w.0VFP TrwANT CO NTRACTTOR I&ME 71�►01 L LICRI'MNUMBER � COMPV �> IAC iYP£ R BUSAX3 9 3S.NYMANM I T t 2t,�Il> 1 I i FAX / i�tJ �qie f�rcr�� GE (C{�q�pa f7 STRELTASIDRPS$ ft } �C CI1Y,3T1TL, t7a✓ y1 P^ PFSt3al ARCFSCfiG"wxtI€'*lEER?+St4R4G I Ltt~T�SIR`tlhfllt~R Htli,iSC# - JEFFREY EATONC26i46 _z _(Ov'Pi"N:i ISA%u`E1AT'CgN HALL ARCHITECTURE tr!,LAIL J I effrey@ehastudio 11.com. FAx 408-265-6155 sTtaFPrAl�ntu"31501 TIME ALAMEI A TE '165 errv.sTA-`U'7-lP SAN JOSE,CA 95126 PkT{rr3l 408-265-5255 DESCRIPTION OF1CWORK TENANT IMPROVEMENT PROPOSED RETAIL.AREA, OFFICE AND EXAM ROOM, MECHANICAL, ELECTRICAL, PLUMBING. �- wast7 ousE PROPOSED USE COti3TIL.TIDE #i 51YlFrIa" _...- NE f SHELL WB ( USF TYPF OCC. SQ.]�T. v£u.UArltlrr(s) JAISTG NE V MOOR - I M40 TOTAL _ AR1,554 AFFA 1,554 ARFA NAPA A %XTIIRoom IS.tTCF(I'til - OTHF-It - - - - REMODFLAREA KHMODFA.AKFA MIODELARFA; a roactARFA DEO1:ATWA TCr'rALI3UMMORC.EI-AitFA GARAGE Af2EA•: DE iCI-i.. �IATCACII - xrl Elu r�errs: ISASECO`t'IStWIT ©YES stc NDSTORY p _ 13FINGADDEDT 0140 AnnrrlM OW PRE-APPLICATION BYES IFYESPROVIDECOPYOF LSTHEBLUGAN ©Y7iS ItLt:EtV - 3:';, .,. :_:" TOTAL VAFi�7AyTIOh;.. . PLA'NNIIv,GAPPLia I I`IO. FL.4NNINGAPPROVALLErt'ER EICHLERHOMEn H.NO + 20,000 By my signature below,I ccttilytg each ofthe following..i am the propertyowuer or authori °`agen to act o the pro owner's betray I have read this applic;aatiun and the information F "ve prqq ided' cnrreci It react the Description of Work and verily it is accurate.I agree to comply with all applicable local ordinances and slate laws relating tsuildt?i �`si�ttnctirx:. t aulhonw representatives of Cupertino to enter the above-ide ufied prop for iuspeetion purposes. Signaturc vfApplicarn/Agent: . .._ Dater SCtI PI.>l viBivT I INF �$ I +t REQUIRED r"N C CWTV-pr ROUTINGSLIP Ne�y SFD or Multifamily dwellings- Apply for demolition permit for O BUILDING I LAAT `r'€I W eXisting building(s). Demolition permit is required prior ice issuance of building permit for new building, 0 EXPRESS CI PLANWING PLAN AEVIM Commercial Bldgs. Provide a completed Hazardous Materials Disclosure 0 s'tA gUARD GI PuBLIewuw. f©rat 1fany Hazardous Matedals are being used as part of this project 0 LARGE C:opyofPlanningApprovalLetterorMeeting-with Planning;prior to 03Wota nITARYSEWER DISIRIET subrttittal of Building Permit application. 81dg,lpp 01 t'dbc revised 05121111 SITE FOR SERE EYES