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15120063CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120063 10275 S DE ANZA BLVD (359 17 00 1) YOUR WAY CONSTRUCTION CENTER BURLINGAME, CA 94010 OWNER'S NAME: (ALLARIO ROBERT L TRUSTEE) DATE ISSUED: 04/15/2016 OWNER'S PHONE: (408) 867-3060 PHONE NO: (650) 208-5990 LICENSED CONTRACTOR'S DECLARATION License Class GENERAL BUILDING CONTRACTOR Lic. #985209 Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2017 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: t. 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 1 v 4,,., 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 j 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 er the Cupertino Municipal Code, Section 9.18. ,//��1� 'Signature � Date OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: r. 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 (See.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). I I hereby affirm under penalty of perjury one of the following three declarations: 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. z. 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 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. Date BUILDING PERMIT INFO: —BLDG —ELECT —PLUMB _ MECH _ RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: T.I. "CRAB LOVER" RESTAURANT (2854 S.F.) DEF#I - TRASH ENCLOSURE ***BIN A-7.5*** REV #4 - FEEDER TAP AT ROOM; REVISE ELECT PANEL LAYOUT - ISSUED 11/14/2016 REV #3 - REMOVE ALL REVISED DUCT WORK FROM SCOPE - ISSUED 10/7/2016 REV#1 - SWITCH RESTROOM LOCATION AND WALK IN COOLER - ISSUED 7/11/2016 REV#2 - STRUCTURAL SUPPORT FOR ROOF BEAM AT WALK IN FREEZER PER REQUEST OF BOB S. - ISSUED 9/2/2016 Sq. Ft Floor Area: Valuation: $70000.00 APN Number: Occupancy Type: 359 17 001 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Ayende Date: 04/15/2016 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. Signature of Date: ALL ROOF COVERINGS TO 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 Cu ertino Municipal Code, Chapter 9.12 and the Health & Safety Code, ectio/Ins 25505, 25533, and 25534. �\ Owner or authorized agent: Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance FLF,F1 CUPERTINO nI, wrrn,:r �TIr CONSTRUCTION PERM APPLICATION COMiMUNITY DEVELOPMiENT DEPARTMENT • BUILDING DIVISION 10300 I ORRE AVENUE • CUPERTINO, CA 55014-3255 (408) 777-3228 - FAY (408) 777-3333 - buildina(E�cuoeriino.org TTn'.r n A T)TYTTTr)M 1-7 d T TLJ A T1(1TT ; T ILIVV111= I(/ - -� PROIECTADDRESS p -PN. fi I O\J"'KMXA.JEs II �/J PHONM /_ 1L_IL % E_ c -.> VU�I ST]R ET ADDRESS CITY, STATE, Zip FAY CONT -5 � �`� LG"l- l/ PyO��j� �I &,\L=�L� �077 �'�617'p STRz;TADDRESS CITY, STATE, ZIP RAJ: l❑ OV,Tr-3t ❑ 0\+^. -3L Dcn ❑ 0\1'.�.'�t.gGETT ❑ CONTRACTOR ❑ C0N7XSCTORAGEI.'r ❑ A-RCHITECT ❑ E.:�GII.'E'R ❑ DEVELOPER ❑ TEIIANIT C01TTR4CTOR NAh E LICE?\SE?1LT!3ERC,J f 7 J LICENSEETYPE BUS. LIC 4 COhJA Y NAJME E -h A.IL FAQ o— �1J �� STREET ADDRESS � `� � �r L c 7/ CITY, STATE, Z:P ltV l[,q Q `/¢ �%�� PriO i /jf�'!/ ..R.CnrTECTrNGiNEER NAI,fE LI CEN SE'\Il?,!B--R BLS. LIC -' CCW, NY NA,a E-hiq L FAX - ---------- STREET ADDRESS I CITY, STATE, M?--- ----- PHO'\ I DESCPPTIONT OF WORK _TAP (Z— EXISTING USE PROPOSED USE CONSTR. TYPE - STORIES i vSE TYPE OCC. SQ.FT. I VAL:(AMN -S) EXISTO N'EW FLOOR DEI, 10 TOTAL AREA ARJEA. I A.RE4 N'ET AREA I BAT'rROOM I:ITCr.Eh OTHER R.T40DEL AREA REMODEL AJRZA REF40DEL AREA PORCH '= A DECK AREA TOTAL DECKPORCH AJRak GA.RgGE ASa4.: DETACH '-- ❑ ATTACH D\i LUd0 UNITS: IS A SECOND LNIT ❑ YES SECOND STORY ❑YES — BEI G ADDED? ❑ NO ADDITION? []NO I PRF•=3PLiC.g71CN 17 5-_S rScS;FRCVDECOPY OF 15THE BLDG.? [3 YES RECEITEDBI 10I"T��,TION: °PL= �]NO R'_�' N' O.'PPROVALLETTER PLAN 1G4 N I EICHLERHOME? No � 3 ] = 1 By my signature below, I ce;ti',v to etch ofthe following: 1 Fin the property mwner or authorized went to ac, on thelproperty owner's behalf. I have rend h^p- application and the info vhation I h e provided is correct. 1 have read the Descl' tion of'W'orl: andd veriiv it is accurate. ag ee tacoimply with all applicable local j ordinances and state Iz\\ s re1a: ne 1-g cons +' authorize represent Lives of Cupeaino to enter the above -1 ' ntiaed .Op snection puiposes. Siznature of Applicant%Agent: Date: SLTPPLE.MENT A L INFOR-MATI ON REQUIRED I r PLAN CFiECF� T 'PE, .k; : ROUTING cI.IP: r� \e -,v SFD cr h!ultifainily dwellings: Apply for de n]olition permit for c• c �c c m n=-7 req - Dr10r t0 :SSL Ce 0: bLlldl. g iii:_ biZG'ing(_). De_..olliion perinit IS _C. -wired i 05 R TfE OL''TEF: E C � F b LiLDI�CPL4T\PEl2ER .. p errn;t for nvm building. ❑ il'PF2EcS >.. ... ❑ PLAN\L�GPL �'\R£\`Ii\\ CO::]mhe;Cial Bldgs: Pr0\'?de a Coih:pi.eted I-i2Zardous'\7_ter:zl5 D.- _C`SL'*e ❑ cT '\•DD r PL�L,C\j'ORi.S - n: e b e c c n-•- � j;:S ern' or;l;i _I cazzr�o__ rc..,,als ar r__ ed 2_ rte, i. �.�je=t. ❑ r ❑ Copy of Piam]ing Approval Lever or Meeting ,vith Planning prior to 4RGE 3 fl �igJOR e FIF£ DEPT < ❑ 54\ITaR1 submittal of Building Permit application. SE�iERDI�TRICT s x ice. ENVIROMNIE 4L) E.4LTF3iK Bldg <vp_201 Ldoc revised 05/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120063 10275 S DE ANZA BLVD (359 17 001) YOUR WAY CONSTRUCTION CENTER BURLINGAME, CA 94010 OWNER'S NAME: (ALLARIO ROBERT L TRUSTEE) I I DATE ISSUED: 04/15/2016 1 OWNER'S PHONE: (408) 867-3060 1 I PHONE NO: (650) 208-5990 License Class GENERAL BUILDING CONTRACTOR Lic. #985209 Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2017 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. 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 accrueagai st said City in consequence of the granting of this permit. Additionally, the pplicant understands and will comply with all non -point source regulatio s er the Cupertino MunicippI Code, Section 9.18. Signature Date I hereby affirm that I am exempt from the Contractor's License Law for one of the 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 sale (Sec.7044, Business & Professions Code) 2. 1, 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 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. 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 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB _ MECH _ RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: T.I. "CRAB LOVER" RESTAURANT (2854 S.F.) REV # 3 (9/14/16) - REMOVE ALL REVISED DUCT WORK FROM SCOPE - ISSUED 10/7/2016 DEF#1 - TRASH ENCLOSURE REV#1 - SWITCH RESTROOM LOCATION AND WALK IN COOLER - ISSUED 7/11/2016 REV#2 - STRUCTURAL SUPPORT FOR ROOF BEAM AT WALK IN FREEZER PER REQUEST OF BOB S. - ISSUED 9/2/2016 Sq. Ft Floor Area. I Valuation: $70000.00 "N Number: Occupancy Type: 359 17 001 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: KIM DUNBAR r Date;.^ (U ! • 11. 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. Signature of Date: ALL ROOF "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 upertino Municipal Code, Chapter 9.12 and the Health & Safety Code Sections 25505, 25533, and 25534. L�'A/er uthorized agent: - Date: CONSTRATON LENDING AGENCY I 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.) Lender's Name Lender's Address CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISI 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildino(dcupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # 1512 006 PROJECT ADDRESS A.PN OWNER NAME PHONE E- 2 S TREET ADDRESS CITY, STATE, W FAX CONTACT NAME PHONE E-^tiAIL q Ci STREET ADDRESS CITY, STATE, ZIP ] FAX S (Ya4.1-Q � ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR. AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSENUMBER LICENSE TYPE BUS. LIC Y COMPANY NAME E-MAIL F.AX STREET ADDRESS CITY, STATE, ZIP PHONE .ARCHITECT,'ENGINEER NAME L: N ER BLS. LIC COMPANY NAME E-NiP.l AX P Me STREET ADDRESS' CITY, STATE, ZIP PHONE DESCRIPTION OF WORK of Lr"> L p u(,T , (Iry a _ _ iii WrnAtj EXISTING USE PROPOSED USE CONS TR. T1TF. = STORIES LJSF. TYPE OCC. SQ.FT. VALUATION (S) — EXISTG NEW FLOOR DEMO - TOTAL. AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REN40DEL AREA REMODEL AREA REMODEL AREA P 0 R C F .AREA DECK AREA TOTAL DECKPORCH AREA GARAGE AREA: DETACH ❑ ATTACH DWELLLNG UNITS: ISA SECOND UNIT ❑YES SECOND STORY [I YES BEINGADDED? NO ADDITION? []NO PRE-4PPLICATiON ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ Y CE ' .� TOTAL. I/ALUATION: PLANVMA—PPL-- ❑NO PLANNING APPROVAL LETTER I EIC14LER HOME? By my signature below, I certify to each of the following: I am the property owner or authcrized 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 buildingjonstruction. I authorize representatives of Cupertino to enter the above -identified proper for inspection purposes. Date: Signature of Applicant/Agent: SUPPLEMENTAL LNTFORMA ON IPED PLANCHECKTYPE ROUFISGSLIP ❑ ODER-THE-COUNTER ❑ BUILDING PLAN REl1ER New SFD or Multifamily &vellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD' ❑ PUBLIC WORKS _ form if any Hazardous Materials are being used as part of this project. ❑ ❑` LARGE FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior t0 ❑ 1•L4JOR ❑' SANITARY SERER DISTRICT submittal of Building Permit application. ❑ EN!'IRONn1ENTAL HEALTH BIcII;App_1011.doc revised 06121 11 pr4 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120063 10275 S DE ANZA BLVD (359 17 00 1) YOUR WAY CONSTRUCTION CENTER BURLINGAME, CA 94010 OWNER'S NAME: (ALLARIO ROBERT L TRUSTEE) DATE ISSUED: 04/15/2016 OWNER'S PHONE: 408-316-8851 PHONE NO: (650) 208-5990 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Ja Lic. #985209 Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2017 —BLDG —ELECT —PLUMB MECH RESEDENTLAL COMMERCLAL 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: T.I. "CRAB LOVER" RESTAURANT (2854 S.F.) 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 REV#1 - SWITCH RESTROOM LOCATION AND WALK IN COOLER - Compensation, as provided for by Section 3700 of the Labor Code, for the ISSUED 7/11/2016 1,,. performance of the work for which this permit is issued. REV#2 - STRUCTURAL SUPPORT FOR ROOF BEAM AT WALK IN 2- I have and will maintain Worker's Compensation Insurance, as provided for by FREEZER PER REQUEST OF BOB S. - ISSUED 9/2/2016 Section 3700 of the Labor Code, for the performance of the work for which this DEF#1 - TRASH ENCLOSURE permit is issued. APPLICANT CERTIFICATION BIN B-7.5 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: $70000.00 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 City of Cupertino against liabilities, judgments, costs, and expenses which APN Number: Occupancy Type: may accrue against said City in consequence of the granting of this permit. 359 17 001 Additionally, the applicant understands and will comply with all non -point source regulatiogls per the Cupertino Municipal Code, Section 9.18. PERMIT EXPIRES IF WORK IS NOT STARTED Signature i ! - -:'� - Date 9/2/2016 —�1 WITHIN 180 DAYS OF PERMIT ISSUANCE OR ONV,NF,R-RXJTT,DF,RDECLARATION 180 DAYS FROM LAST CALLED INSPECTION. I hereby affirm that I am exempt from the Contractor's License Law for one of the Issued by: Abby Ayende following two reasons: Date: 04/15/2016 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 sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed RE -ROOFS: roofs shall inspected prior to any o material being installed. If a roof is contractors to construct the project (Sec.7044, Business & Professions Code). stalled withoutt fust obtaining an inspection, I agree to remove all new materials for installed inspection. I hereby affirm under penalty of perjury one of the following three declarations: t. I have and will maintain a Certificate of Consent to self -insure for Worker's Signature of Applicant: Compensation, as provided for by Section 3700 of the Labor Code, for the Date: 9/2/2016 performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 of the shall not employ any person in any manner so as to become subject to the California Health &Safety Code, Sections 25533, and 34. I will Worker's Compensation laws of California. If, after making this certificate of Municipal ter 9.1 maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the exemption, I become subject to the Worker's Compensation provisions of the Health & Safety Code, Section 25532(a) should I store or handle hazardous Labor Code, I must forthwith comply with such provisions or this permit shall material. Additionally, should I use equipment or devices which emit hazardous be deemed revoked. 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 APPLICANT CERTIFICATION the Health &Safety Code, Sections 25505, 25533, and 25534. 1 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 Owner or authorized agent: to enter upon the above mentioned property for inspection purposes. (We) agree Date: 9/2/2016 to save indemnify and keep harmless the City of Cupertino against liabilities, CONSTRUCTION LENDING AGENCY judgments, costs, and expenses which may accrue against said City in I hereby affirm that there is a construction lending agency for the performance consequence of the granting of this permit. Additionally, the applicant understands of work's for which this permit is issued (Sec. 3097, Civ C.) and will comply with all non -point source regulations per the Cupertino Municipal Lender's Name Code, Section 9.18. Lender's Address Signature Date 9/2/2016 ARC'HITECT'S DECLARATION t t->aoc" � CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 1— ' I (408) 777-3228 + FAX (408) 777-3333 • building(c cupertino.org CUPERTINC3 ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI �RF.VTSION / I�RFFRRFFI RTr,TNar PFRTvTIT If PROJECT ADDRESS � 0 0 �+' � APN # OWNER NAME �A A I , 2 7 PHOY'l —'/l IL L_U 9-7 � ^ -, / (�� K STREET ADDRESS / CITY, STATE, ZIP -7 F r n L CONTACT NAME PHONE MAIL 1 �v STREET ADDRESS o n CITY, STATE ZIP ^ , ❑ OWNER ❑ OWNER-BUILDER11 OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANI CONTRACTOR NAME . LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA 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 ❑ YES REC V ED BY: TOTAL VAL�jJ�iTION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? E] NO / By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on tie 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 buildin2tonstructiOn. I authorize representatives of Cupertino to enter the above -identified Pied pro rty for inspection purposes. Signature of Applicant/Agent: Date: Z 71 SUPPLEMENT -AL INFORM ON RED PLAN CHECKTYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD El PUBLIC "OAKS To—run if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 6 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120063 10275 S DE ANZA BLVD (359 17 001) YOUR WAY CONSTRUCTION CENTER BURLINGAME, CA 94010 OWNER'S NAME: (ALLARIO ROBERT L TRUSTEE) DATE ISSUED: 04/1512016 OWNER'S PHONE: 408-316-8851 PHONE NO: (650) 208-5990 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #M Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2017 — 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: T.I. "CRAB LOVER" RESTAURANT (2854 S.F.) 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 REV#1 - SWITCH RESTROOM LOCATION AND W kLK IN COOLER - ompensafion, as provided for by Section 3700 of the Labor Code, for the ISSUED 7/11/2016 performance of the work for which this permit is issued. z!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 Sq. Ft Floor Area: Valuation: $70000.00 permit is issued. APPLICANT CiRTIFICAIJON I certify that I 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 ordinances 359 17 001 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue agai t said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the " pplicant understands and will comply with all non -point source ns p the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED SPECTION. /regulati f Signature ' Date 7111/2016 Issued by: AbbyAyende Date: 04/15/2016 ATION OWNER -BULL DER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RF. -ROOFS: All roofs shall be inspected prior to any roofing material be g installed. If a roof is following two reasons: 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: 7/11/2016 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 HAZARDOUS MATE IAL DISCL E performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under California Health & Safety Code, Sections 25505, 255 Chapter 6.95 of the 3, and 25534. I will Section 3700 of the Labor Code, for the performance of the work for which this maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. Health & Safety Code, Section 25532(a) should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued, I material. Additionally, should I use equipment or device which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the upertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Co e, ti ns 25505, 255 3, 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: 7/11/2Q 1 � CONSTRUCTION DING A I certify that I have read this application and state that the above information isI e hereby affirm that there is a construction lending age cy forthe 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, C.) relating to building construction, and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands ARCHITECTIS and will comply with all non -point source regulations per the Cupertino Municipal I understand my plans shall be used as public records Code, Section 9.18. Licensed Signature Date 7111/2QI CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION � 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255' S �y �y��-B (408) 777-3228 • FAX (408) 777-3333 • building(c-cuOertino.ora CUPERTINO ❑ N,�-.« CONSTRucuoN ' ❑ ADDITIOINT ❑ LTERATION / TI ❑ REVISION / DEFERRED ORIGNNAT. PPRUT PRO -ECT ADDRESS APN I II E-1,1AIL q OWrNTERN.SI✓E s?zLf a `PHONE y�� a �I oaf) STREET ADDRES� py� I CITY, STATE; ZIP I FAX CONTAC A isI P�1 �PJ 1"A.' l I E-1 SIL STREET. DRESS CITY, STAiE, IP E FAX ep El OV ? ER ❑ 01WER-BUILDER OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTORAGENT nRCHITECT ❑ EINGWEER ❑ E�-LOPER ❑ TENANT CONTRALTO N. LICE, E NUTTER I LICENSE TN E I BUS. LI n ( C0A1PAh1 E-MAIL A FAX .T -,IE I STREET. $1,72V� C STATE: ZIP PH01 ogrL ARCHITECT,ENGII EERNA,4E LICENSEWU?JEER BUS. LI C01,0ANY NAME E-IcLkIL FAX STREET ADDRESS I CITY, STATE, ZIP PHONE DESCRIPTION OF WORK L6 �._ , EXISTING USE PROPOSED USE CONSTR. TYPE = STORIES USE TYPE I OCC. SQ.FT, I VATU ATIONTT (S) FUSTG NEW FLOOR DFMO TOTAL AREA AREA fihF 4 I NET AREA BAT??ROOh4 KITC)iEN1 OTHER - REMODELAREA RE1.90DELAREA I REAIODELAREA PORCH AREA DECK F3,EA TOTA? DECKTORCH AREA Gr'.P AGE AREA:U DETACH ❑ATTACH -D\a%cLLiNGt?�ITSt IS .4 SECOND DXIT ❑YES SECOND STORY ❑YES EELNGADDED? El No ADDITION^ [:]I,•O ;IF :=..P?LC��70N ❑YES '.F7�S,PROV?DE COPY OF IS THE BLDG A\ ❑� .:3cCF�: DB} ,� - - TOTA1-VAL ATION: PLAT�TIh.i.APPL' C1N0 7'tAl\'1�]TGAP?RO\.e.LLEiiEP, EtCHLERHOA4E? ❑?.O WN RO Ey my signai'se below, I certify to each of the following: I am the prope- t' owner or authorized a2-nt to act on L e property owner's behalf. L have read this application and the infomiation I have provided is correct. I have read the Description of )ATork and verify it is accurate. I agree to comply N i`, all applicable local ordlIlal2e:S and -state laws :ei2ilrig t0 blllldL]-' OIlSi1 ct on. tbo* e rep. Selitzti�'es of Capel no to enter the aboi=e-ide *t'=led pre erty, for inspection purposes. Signature of ,Applicant%:4=ent: Date: 11 STJPPLE\lEi,TT, L INTORMATIOl\ RE T PD R1111112 PL4 t CIiECIp T1 PE ,, .... ,..fix OtiTI}G.�LTP; N -c -,v SFD or ?V nitifa oily dwellings: Apply for demolition peri -nit for EIk Ol ER TSE COII\TFR * F I] BLZLDI GPI �\ RE\ IE1 existing building(s). DeI?lolliton pe, �t Is required prior :o Issuance ol'b 111 -dingy u S r permit for re«wbuilding. REss LJ pT �\ GPT REiiEi� .r Co-a?�ercial BidQs: Provide a col^pleted Tazzrdeus_fzterizls Disc1_osure !� sT �RD J PLBLIC i(R _ fon_I if any Hazardous l-\!ateriais are be.Lnj 'sed Z= D"cI l GT_ his D--OJect, — r 1. I aRGE r x . ❑ PIPED PT z Copy of Planning .Approval Letter of Meeting \-c:_h Planning prior to z.: _ SLbIl7iiial of Euildi^Q PEii217t application. SA\IT 1 �EtiERDIsTRICT -,-, ❑ E\5780 r }i-,NRLrIEj LTH Bldg. pp_?017.a'oc revised 06121111 I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120063 10275 S DE ANZA BLVD (359 17 00 1) YOUR WAY CONSTRUCTION CENTER BURLINGAME, CA 94010 OWNER'S NAME: (ALLARIO ROBERT L TRUSTEE) I I DATE ISSUED: 04/15/2016 I OWNER'S PHONE; 408-316-8851 1 I PHONE NO: (650) 208-5990 I LICENSED CONTRACTOR'S DECLARATION License Class B Lic. #985209 Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2017 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. �X2 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. Date 4/15/2016 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the 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 sale (Sec.7044, Business & Professions Code), 2. 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 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. 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 4/15/2016 BUILDING PERMIT INFO: —BLDG _ ELECT —PLUMB _ MECH _ RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: T.I. "CRAB LOVER" RESTAURANT (2854 S.F.) Sq. Ft Floor Area: I Valuation: $70000.00 APN Number: Occupancy Type: 359 17 001 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Ayende Date: 04/15/2016 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. Signature ofApl Date: 4/15/2016 ALL ROOF COVERINGS TO 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 Fuse 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 Co e, Sections 255550-5,225533, and 25534. O mer or authorized agent: Date: 4/15/2016 CONSTRUCTION LENDING AGENCY I 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.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CONSTRUCTION PERMITAPPLICATION COM10UNI IY DEVELOPhliENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 buildino5ouDertino.ora CUPERTINO, IAM [I NT -W CONSTRUCTION u ADDITION . ❑ ALTERATION / TI 7 REVISION / DEFERRED ORIGTI\TAT. PFR I TT PROIrCf A.DDRZSSu APN OtiNER NAIL PHON*A E- ✓SAIL - _ STREETADDRESS / CIi1, STATE,I/�� F PHONE A STREir AD R SS® 4 l 7 CITY, STA' Z5P i 1 FAX 1 3 OLVNgR 11 CA; hNER-BU?IAER ❑ OV,INFR AICEN-r ❑Y/C'OI.-ML0.CTOR ❑ CON°IR.ACTOR AGENTI-a h=-itCT ❑ ...I.I K ❑ DEVELOPER ❑ T=NAh� CONTRACTOR NAM I LICn'NSEWMI3ER I LICENSE TYPE I BUS.LIC R COl✓3ANYNAb I E -NAIL I FAX STREET ADDRESS CITY, STA -1r., ZIP I PHOht ARC:*'1TEC-1rr-vGI11EERNAME I LICENSEDU11MER 3L`S.LICR COMPANYXAT.4E � E-MAIL FAX STREET ADDRESS I CITY, STATE, ZIP � PHOI DESCR�TION OF V✓O K i IZ EXISTING USE PROPo5tD USE - CONS- STORT�'S ' 1 V i USE I TYPS I OCC. ( SQ.FT. I i VALUATIONI(S) AltEA AREA I AREA LOOR/, AREA ' DEA:O _ I AREA N�l;I'AREA ME57 A I e. ,n - VJIt3 AR � - BATIMOON! I:IiCI-iEN OTEMR REMODELAREA RE ODELAREA REMODEL.I EA PORCHAREA DECKAREA TOTALDECIUPORC3AAEA GA.RAGEA-REA: DETACH . ❑ATIAGI-I DlI'ELLINGUNtIS: ISASECONDUNI'r ❑.YES SECOND STORY [YS BEING ADDED? ❑NO ADDITION? E] NO PP.:-AIMICATION ❑YrS IF YFS, PROVIDE COPY OF IS THE BLDG AN ❑ YES TOT.kL VALUATION: PLANNINGAPPLR ❑NO PL/T'N—GAPPRDVAI-L==R I EICHLERHONIE? El NO 0 v v v By my signature below, I certify to each of the following: I am the property o-wmer or aut] iorizt,agent to act on the property of tier's behalf. I have read this application and the information I have provided is con ect. I have read the Description of Rork and verify it is accurate. I ee to comply -with all applicable local ordinances and state 1-aws relating to building cons Ion. I authorize e - entztiyes -of Cupertino to enter the above -Tae i led p opery for 'inspection purposes. Sismature of Applicant/Agent: Date: SLIPPLEI`fi--PNTAL lit OR2,2ATION 1ZF TIRr — I O�TRSCOII�TEY2 -:27,; BIIILDLNGPL3NRa� - NTew SED or Multifamily dwellings: Apply for demolition ptninit forRED . existingbuilding(s). Demolition permit is required prier to issuance of bolding - permit for new building.L� _ Commercial Bldgs: Provide a completed Hazardous l"faterials Discl-esureZia1'D ERsss L1GFLah RE4ZEF� — PUSLTeoRxs form if any Hazardous Materials are being used as part of this project. Copy of Plali i iQ Approval Le<ier or Meeting with Planning prior to � Ys �RVTsr'RrcT �— 5Z_ A submittal of Building Permit application. y- �...._ Blde-App__;011.doc revised 06/21/11 CUPERTINO C] lata CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 T ORRE AVENUE - CUPERTINO, CA 95014.3255 (408) 777-3228 • FAX=7-3333 + buildingQcuoertino.org � �� El ADDITION ION / TI REVISION / DDFERRED ORIEL' -AL, PER= PROJECT ADDRESS m2XJ /1)2v-, O'WWERN.4iJE att j Ulo I PHONE ,(ot-0 G I E-bL4IL �I'(. l �/ VL L STREET ADD?.ESS/j,(� CIT Y, STATE; ZIP % r�, • �v V11 r) CI I r. ( V� I v f 1a CONTACT NA?JE PHONE I E-h24IL STREETADDRESS CITY, STATE, ZIP I FAX ❑ ORNER ❑ 0vNER-3=- ER I] OWNERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGLNEER ❑ DEVELOPER ❑ T--\L1-XT CONTRACTORNA4mE L LICENSE NUMB ER % LICENSE TYPE fur CU%�r� 0 BUS. LIC n COMP? hl' NA2,1E/,;� M (/ OP2,F� F d /c}�C� STREETADDR'r.SS� n, /j/ �i%iL iY CITY, STATE, ZIPPHONV£�//�.-/�i`�>1j0� ARCHITECTENGLnEER NA /1E LICENSE MUMMER BINS. LI(C�'.^' COI riP 2 Y NAh!£ E-2,64IL I FAX STREET ADDRESS I CITY, STATE, ZIP I PHONE DESCRIPTION OF YWOP C L 0`1� v % f 7l/vv L, �'!%�1 �� ' /1C/✓� , rl Q/ V / G le� E\ISTING USE PROPOSED USE CONSTR. TYPE --.STORIES USE TYPE I OCC. I SQ.i-T. VALUATION (S) ENaSTG NER FLOOR DEh,O TOTAL J A2EA AREA I AREA NET AP—T:4 ) B.4774ROOhd ISCHEN OTHER REh40DELAREA ( REMODEL, AREA REMODELAREA PORCH AREA DECK AREA TOT A T DECKTORCH ARE:4 G.0 AGUE AREA: LJDETACH ❑.ATTACH DWELLTNG UOTS: ISA SECONDIT O\DTORY [-]YES CS� I BELDED° NO []S F'r.E-AP Lift T70V ❑ 1`ES r 1 E5: PROVIDE COPY OF IS TY.E BLDG .4\ ❑ YES RECT=I1 I D BY ` TOTAL V A LU.ATION: PLANNT\G APPL 4 ❑ NO PLA?` -N -NO APPROVAL LETTER EICHLER HO!, -TE? ❑'O�-� � ` � kr '� ,� By my Signa ire bolo«'; I certify to each of the follo-wing: I am the proper' owner or authorized agent to act on the property owner's behalf. I have read this application and th., infomlation I have ovided is correct. I have read the Description of \ao_l. and ve.IfV it is accurate. I ageeto comply with all applicable local ordinances and sate 12tt s relZting to bu lding constivctioa autho_: e rep.esentatives of Cupei Ino to enter the a(bo�ve-? e+tiie poaer*y. for inspection purposes. IJate: dJJI ~ r Signature of Applicant%Agent: % SLTPPLEMEN. ,TAL _ TFOR 4ATIG ,� REQUIRED ROUI'I�G�LIP J,;:;PL4't,CHECIs,TY'PE ., ❑3 rLILDI\G I TeYs� SFD or -Multi nail y dN-,7ellinrcs: A l y for demos tion emit for 5 pp E7.i5t:1r1Q bL11d1nQ(S)mo1itl0_1 pelit is required p110r to lsSul ance Of bLildilla Oi ERT E COLITFR F - - pennitfel nese bulleinQ. E�CPRE U pr 41\L\G Pra. REYIEi CO Tn1EIc1aI Bldgs: Provide 3 CO1T!plcied I cZaTCOLS f2tE1121S Disclosure:STS\�4RD PLELICYYORI� HazardousT / %� �,'1a 1'C • ^C T1^•.11_J "1 oiect. ror__n 1f any V iate1-'a_s are bei__ __ea a_ - Y � �� ZfiRGE s i— D FINE EPT � Copy of Plaiva ng Approval Letter o1 -MI-eeting w ith Planning prior to tL4lOR ]�i— S \IT RISEYYERDI�IRICT _ Pemiit 11. na submit-La.1 of Bolding appliCat10 •� �E\F'IRO`C14E'`T.4LT�E.4LTH. Bldo pp_?011.doc revised 06121111 CITY OF CUPERTINO 15 1 - FEE ESTIMATOR — BUILDING DIVISION ADDRESS: 10275 S De Anza Blvd FEE DATE: 12/07/2015 REVIEWED BY: PAUL ` APN: 359 17 001 BP#: *VALUATION: 1$70,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building Suppl. PC Fee: Reg. C OT F6.0 PENTAMATION PERMIT TYPE: 1A TI WORK T.I. "CRAB LOVER" RESTAURANT 2854 S.F. SCOPE $0.00 TYPE OF FLR AREA OCCUPANCY TYPE: CONSTR. (s.f.) PC FEES P FEE ID BP FEES BP FEE ID A (Tenant Improvements) 11-13,111-B,IV,V-B 2,854 $2,551.36 ATIPLNCK $1,613.28 IATIINSP TOTALS: 2,854 $2,551.36 $1,613.28 {, I;eck 1� �ZSf?, El ."fv, a. -YS,3_ NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District etc These ees are based on the reliminar information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E f. 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,551.36 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Reg. C OT F6.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,613.28 Suppl. Insp. Feer Reg. 0 OT 0 Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? Yes (E) No $0.00 Advanced Plamnn Fee: $0.00 Select a Non -Residential Building or Structure 0 0 71,(i el D cumeraxion Fees,- Strong Motion Fee: 1BSEISMICo $19.60 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $3.00 S BI YACs: $4,187.24 $0.00 TOTAL FEE; ; $4,187.24 Revised: 10101/2-015 J08 C NkF PLAN S/-/4 opy JOS UNREASONABLE HARDSHIP EXE" CL RE COMMUNITY DEVELOPMENT DEPARTMENTN r16 ON IFeive t)L/R//VG ALBERT SALVADOR, PE., 0.8.0., BUILDING OFFICIAL 7'Ruc�,/o CUPERTI 0 10300 TORRE AVENUE -CUPERTINO, CA96014-3255 /V (408) 777-3228 - FAX (408) 777-3333 - lbuilldlnqg�cuyertino.orci (FnrTpn:int lmnrnvPmt�nt,, whi--rt-thc- Cn4 nfCnnr.;tnun4inn does not awcaad ^x139.934.11111 SITE ADDRESS 10276 S. Do Anza Blvd t 1A"`35q 11- 00( -5 I'P*J!5)2,C6&- CITY Cupertino zip I TOTAL CONSTRUCTION COST (A) DESCRIPTION OF WORK: Now Restaurant (Tenant Improvement) features to MIN corriofV7 The following s a list of costs to provide access features in order to comply 100%, with the current State Titte-24 Disable Access Standards.( ll _".M, — t.1 -i h1l th. a, lihli nffili.1 I Accessible Features Complies with if not, list required upgrades in order for Cost to make feature curient standards? features to MIN corriofV7 fuliv accessible? 1, Path of travel to accessible entrance. yes $ 2, Cost ofloravidings primaryentrance. (Inctudingbut now main entry doors with accessibility 3,000.00 not limited to, thresholds, landings, doorhardware, No compliant door hardwares. $ max, door pull, etc.) 3. Cost of providing the primary path of travel to the accessible path between kitchen & storage specific area of alteration, structural repair, or No is not provided. 9" attached tatter of addition. axpl[ai;-tation of hardship. 4 Cost ofpmviding accessible restroom facilities. Na New accessible restrooms provided with $ 14,000.00 accessible plumbing lbdures and accessories 5, Cost ofproviding an accessible drinking fountain. (if require or I a drinking fountain is provided') notrequired 6 Cost of providing accessible public telephones (if $ provided) not required 7 Cost of providing other accessible features, including No re -stripe Handicap stall loading and $ 2,000.00 but not limited to. parking, storage. alarms etc unloading area, Install new tactitesigns. TOTAL COST OF ACCESS FEATURES (8): $ 19,000.00 Has the same,teriant performed work in the No CadcuWta (B i A) X 27 % same tenant space within the last three 4ars? Description of access features to be provided: TOTAL COST OF S PERCENTAGE WA minimum % PROPOSED UPGRADE expenditure Is required) ARCHITECT ORENr-4NEEROFRECORD INFORMATtON. Icertifythatthe abov oted informatton is true and correct, Name (print). Sy Chang Tsai Signature.Dote, Firm address- RCU SA Corporation Title: Ar et Phone. (408) 321-088 . FOR DEPARTMENT USE ONLY' 11 The above named project has been denied an unreasonable hardship exemption undi 2010 CBC Section 1134B 2-1 [I The above named project has been granted an unreasonable hardship exemption from the requirements otthe State of California CCR -Title 24 (Regulation forthe Accommodation of the Disabled) pursuant to 2010 CBC Section 11348,21, SUBMITTAL CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building()cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI Q REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESSD ^)- APN # OWNER NAME t (�.�1 L o �l PHL4,6 (, E-MAIL STREET ADD 0 ��/ CITY, STATE, ZIP CJ CONTACT NAME } ll� PHONE ^ MAIL STREET SI SS CITY, S�TE, ZIP � FAX J i ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEr , C LICENSE NUMBER `6 W TYPE BUS. LIC # COMPANY NAME pLICENSE E-MAIL b F 61.V / STREET ADDRESS CITY, STATE, ZIP �, PHO ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS, LIC;; COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES I USE TYPE OCC. SQ.FT. VALUATION ($) 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 # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? ❑ NO PRE -APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN [I YES RECEIV BY: TOTAL VALUATION: PLANNING APPL # []NO PLANNINTG 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 oh the propVrty owner's behalf. I have read this application and the information I have provided is conect. 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 buildin vls>Iction. I a e representatives of Cupertino to enter the above -identified pro for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENT INFORMAT REQUIRLPIA\ CHECK Tl' E ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDI\G PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ ❑ LARGE FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ NIAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONAIE\TAI. HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15120063 10275 S DE ANZA BLVD (359 17 001) YOUR WAY CONSTRUCTION CENTER BURLINGAME, CA 94010 OWNER'S NAME: (ALLARIO ROBERT L TRUSTEE) DATE ISSUED: 04/15/2016 OWNER'S PHONE: (408) 867-3060 PHONE NO: (650) 208-5990 LICENSED ENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic. #985209 Contractor YOUR WAY CONSTRUCTION CENTER Date 07/31/2017 _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: T.I. "CRAB LOVER" RESTAURANT (2854 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: DEF#1 - TRASH ENCLOSURE - ISSUED 12/9/2016 r. I have and will maintain a certificate of consent to self-insure for Worker's REV #4 - FEEDER TAP AT ROOM; REVISE ELECT PANEL LAYOUT - Compensation, as provided for by Section 3700 of the Labor Code, for the f /10-11' performance of the work for which this permit is issued. ISSUED 11/14/2016 REV #3 - REMOVE ALL REVISED DUCT WORK FROM SCOPE - v 2. I have and will maintain Worker's Compensation Insurance, as provided for by ISSUED 10/7/2016 Section 3700 of the Labor Code, for the performance of the work for which this REV#1 - SWITCH RESTROOM LOCATION AND WALK IN COOLER - permit is issued. ISSUED 7/11/2016 APPLICANT CERTIFICATION REV#2 - STRUCTURAL SUPPORT FOR ROOF BEAM AT WALK IN I certify that I have read this application and state that the above FREEZER PER REQUEST OF BOB S. - ISSUED 9/2/2016 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 Sq. Ft Floor Area: Valuation: $70000.00 may accrueagains said City in consequence of the granting of this permit. Additionally, thea Iicant understands and will comply with all non-point source regulation per the Cupertino Municipal Code, Section 9.18. APN Number: Occupancy Type: I ` Signature �� Date 12/9/2016 359 17 001 OWNER-BUHMER DECLARATION PERMIT EXPIRES IF WORK IS NOT STARTED I hereby affirm that I am exempt from the Contractor's License Law for one of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR followingtwo reasons: 1.180 r. I, as owner of the property, or my employees with wages as their sole DAYS FROM LAST CALLED INSPECTION. compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Issued by: Abby Ayende 2. I, as owner of the property, am exclusively contracting with licensed Date: 04/15/2016 contractors to construct the project(Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: RE-ROOFS: r. 1 have and will maintain a Certificate of Consent to self-insure for Worker's All roofs shall be inspected prior to any roofing material being installed. If a roof is Compensation, as provided for by Section 3700 of the Labor Code, for the installed without first obtaining an inspection, I agree to remove all new materials for performance of the work for which this permit is issued. inspection. 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 Signature of Applicant: permit is issued. Date: I2/9/2016 3. 1 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 F ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE be deemed revoked. I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will APPLICANT CERTIFICATION maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the I certify that I have read this application and state that the above information is Health & Safety Code, Section 25532(a) should I store or handle hazardous correct. I agree to comply with all city and county ordinances and state laws material. Additionally, should I use equipment or devices which emit hazardous relating to building construction, and hereby authorize representatives of this city air contaminants as defined by the Bayea Air Quality Management District I to enter upon the above mentioned property for inspection purposes. (We) agree will maintain compliance with the Cup rtino Municipal Code, Chapter 9.12 and to save indemnify and keep harmless the City of Cupertino against liabilities, the Health & Safety Code, S ctior�,2 505, 25533, and 25534. judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands Owner or authorized agent: and will comply with all non-point source regulations per the Cupertino Municipal Date: 12/9/2016 Code, Section 9.18. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Signature Date 12MI2016 of work's for which this permit is issued (Sec. 3097, Civ C.) CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: D Z 7 PERMIT # I512. OWNER'S NAME: x1pi PHONE # 0 . — Z Z GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: CITY/ZIPCODE: Tti! *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL O CUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND AL SUBCONTRACTORS DAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. / I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date