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15100245CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15100245 19369 STEVENS CREEK BLVD (316 20 112) COMCORE CONSTRUCTION INC BALDWIN PARK, CA 91706 OWNER'S NAME: MAIN STREET AGGREGATOR 'S PHONE: 916-503-1073 License Class B Lic. #966885 Contractor COMCORE CONSTRUCTION INC Date 10/31/2017 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. ^` 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. r 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 MunDoal Code, Section 9.18. Date 04/27/16 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). 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. 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. Signature Date40 /27/16 ISSUED: 04/27/2016 PHONE NO: (626) 480-8800 BUILDING PERMIT INFO: _ BLDG _ ELECT _PLUMB _ MECH _ RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: CHEF HUNG - STE 100 (SHOP 3 MAIN STREET) - T.I. TO BUILD OUT SHELL FOR (N) RESTAURANT (3,600 S.F.) Sq. Ft Floor Area: Valuation: $100000.00 APN Number: Occupancy Type: 316 20 112 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: SEAN HATCH 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 Applicant: Date: 04/27/16 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 Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 5, 2553 25534. Owner or authorized agent: Date: 04/27/16 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 ARC'HITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPLICATION 15oty COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 rCUPi_RT[h[O (408)777-3228 • FAX (408)777-3333 • building(�cupartino:ora 6 11,7W CONRTRTICTRIN AnT_)TTTnTJ MAT TFR ATTov i'rT . F-1 Tnnu-nnm IT ==,,nl;i, nDTr_n.TAT 'M=n%, Z PROTECT ADDRESS 1 l r� 6 1It 1 v�+� 5��r�►, t VI�V1D� APN ° d �® 20— OV,NERNAME� s - y �L'1 i PHONE t.If AIL STREET ADDRESS ` itL q CITY - T 2Tr A _ .\ I FAX - CONTACTNAV.E C+-tJZ%S'CNUA _PH ONE _ ATy /�� STREET ADDRESS ` 10 S'�c 6 / A,Y JZ0 CITY,Y, STATE, ZIP FAX ❑ O'm FR ❑. OWNER-BUIIDER ❑ Ou1-.RAGENT ❑ CONTRACTOR 0 CONTRACTOR AGENT A ARCHIrCT ❑ ENGINEER ❑ DEvELOPER ❑ TENAhT CONTRACTOR CTORNAME fA \ LICENSE I -----i- � I LICENSE TYPE BUS. LIC I 1 COI IPANYN.A2 6 _ E -h fell 3 FAX STREET ADDR SS �� f ]6`C/�- S �L-6J�L, CITY, STATE; ZIP, �?` GLJ� y ! I PIi0ltlii u�/ e�L�GIF� q/' ARCHITE .'GIN RNA.ME t LICENSE NTJMPER !s Q T aa" N BUS. LIC f � • a COMPANY' NAME P� Q X,r►E� E-MAIL FAX STREET P.DDRESS15Zo %WY-4(XIL0W, 5 CITY, STATE; ZIP 5AWA WA, CR�2761cot��-662-dS[v PHONE DESCRIPTION OF WORK PCuCZ Pr `Y,. N Uti - 5--t 2va vtrl.- ha L A o L i(Ck16J 15- V_ rr'eIy`Ty L)f 1 �nJ t R-oa M �_0*7 EXISTING USE PROPOSED USE - CONSTR 1 II�� e'y + 9 STORIES - USE I TYPE ( OCC. " - VA gerrp.��Wl ► ` SQ.FT. VALUATION (S) AREAEXIST�d� h AREA OOR DEMO TOTAL NEI' AREA it �c+7 ► C5' _.. Z j.:.�.. 3-D • V UID t V y v BATHROOM KITCHEN Oi'1-�R REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA - DECKAREA TOTAL DECK/PORCH AREA GARAGE AREA: LJDFTACH - []ATTACH I ( n D\;rELLINGUNTIS: IS A SECOND UNIT ❑ YES SECOND STORY []YES - - - - - - BEING ADDED?- ENO ADDrrION? E3NO PRE -APPLICATION YES IF YES, PRU M)E COPY OrI IS THE BLDG AN [] YES - ' I�TED �Y -� TOTAI, VALUATION: PLANNINGAPPLm nNO PLANhaGAPPROVALLETTER EICHL£RHONTE? !EJ No "�- mn - /{�gV By my signature below, I certify to each of' he foil owing: I am the properly owner or auihori ed agent to act on the property ovmer'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 bu"ding construction. I authorize representatives'of Cupertino to enter the above -identified property for inspection purposes. Si—anatureofApplicant/Aeent: Date: SUPPLEMENTAL INFORMATION REQUIRED F ❑ Nn of R THEC0TJ_N'� D�BuliDL�cP x v v New SFD or Multifamily d-wellings Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building _ — 1� PI s�I,L�GPVA�v REvsEw permit for new building- Ess071 _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 1 � nT�7al�c�olu�s — form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to L� MA70R SARiT7aRYSEGiBR�ISI RICT submittal of Building Permit application.- s - Bldgflpp_, 011.doc revised 06121/11 CITY OF CUPERTINO 1 ft -7 FEE ESTIMATOR - BUILDING DIVISION lalADDRESS: 19369 Stevens Crk Blvd Ste#100 DATE: 10/30/2015 REVIEWED BY: PAUL APN: 316 20 112 BP#: `VALUATION: Isi00,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building . USE: F'iumb. Pe rrzit Fee: PENTAMATION PERMIT TYPE: 1A TI WORK CHEF HUNG - STE 100 SHOP 3 MAIN STREET - T.I. TO BUILD OUT SHELL FOR N SCOPE RESTAURANT (3,600 S.F.) OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. A (Tenant Improvements) II-13,111-B,IV,V-B 3,600 $2,621.99IATIPLNCK $1,953.27 IATIINSP ' TOTALS: 3,600 I $2,621 99 $1 953.27 gia NOTE. HC3UIT Yews EIOTJ[Is MISC ITEMS Plan Check Fee: , 1lech 11lccra (,heck }'Iamb. Plan C'lieck 1 lec. Tierra Check affect¢. Permit Fee: F'iumb. Pe rrzit Fee: V(,a Permit Fee: Other. %ch. Insp. 0Iher^.I11vrrtb Insp, Other 1lec.-ins}a. _ cch. Insp. Fee: Mirmb. Imp, Fee: Elea Insp. Fee. - 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 bared on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution .11-053 E . 711I13,� FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,621.99 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,953.27 Suppl. Insp. Fee: Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: dMinistrwil,e Fee: 0 Work Without Permit? 0 Yes No $0.00 Advanced. Planning Fee: $0.00 Select a Non -Residential Building or Structure i Travel Documentation Fees: Strong Motion Fee: IBSEISMICO $28.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $4.00 Y >TBTQTA3- $4,607.261 $0.00 TOL $4,607,26 Revised: 10/01/2015 JOB ADDRESS: OWNER'S NAME: GENERAL CONTE 1 ° ' Building Department City Of Cupertino 10300 ToA venue CONTRACTOR / SUBCONTRACTOR LIST4 '`Cupertino; CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 *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 Date Please -check applicable subcontractors and complete the following information: I/ 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 ate