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15060032-F BUILDING ADDRESS: 10057 SAICH WAY CONTRACTOR:SILICON X PERMIT NO: 15060032 CONSTRUCTION INC OWNER'S NAME: DIANA TAYLOR TRUSTEE 2051 JUNCTION AVE DATE ISSUED:07/27/2015 OWNER'S PHONE: 4084530477 SAN JOSE,CA 95131 PHONE NO:(408)418-0099 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL p g SAIL H[STATION-CODER SCHOOL,-1BUILD OUT SHELL License Class_2 Lic.4 FOR ��,r_��t L'cgr XPi "? ( � 16 OCCUPANCYOCCUPANCY(9SS S.F.) Contractor I hereby affirm that R 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: 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. Sq.Ft Floor Area: Valuation:$65000 ave 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:32632041.10057 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 WITHIN ��®�PERMIT�� ®� to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save a'0 E][SSP T'O indemnify and keep harmless the City of Cupertino against liabilities,judgments, P costs,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: IDate: with all non-point source r gulations per the Cupertino Municipal Code,Section 9.18. 2-2.1 ROOFS: Signature Date All roofs shall be inspected prior to anyny roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. 13OWNE - IJILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 sale(Sec.7044, Business&Professions Code) 1,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 the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agent: Date: 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 Worker's Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCT 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.3097,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 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 i CONN RUCTlON PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE o CUPERTINO, CA 95014-3255 (408)777-3228 o FAX(408) 777-3333^building0cupertino.org / .5—o 6 o ❑NEW CONSTRUCTION ❑ ADDITION ® ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT 4 PROIECT ADDRESS 10057 Saich Way 77APN# 326-32-04 1. t U U� OWNERNAME Saich Way Station LLC PHONE (408)453-4700 E-MAIL larry@borelli.com STREETADDREss 2051 Junction Ave., Suite 100 CITY, STATE,zIP San Jose, CA 95131 FAX (408)453-5636 CONTACT NAME Robert Bearden PHONE(925)678.2033 E-MAIL bob@fcgainc.com STREET ADDRESS 301 Hartz Ave., Suite 213 CITY,STATE, zip Danville, CA 94526 FAx (925)820-5858 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT IXI ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME Tony Gonzalez LICENSE NUMBER 983292 LICENSE TYPE B BUS.LIC# COMPANY NAME SiliconX Construction E-MAIL tony@siliconxconstruction.com FAX (408)453-5636 STREET ADDRESS 2051 Junction Ave., Suite 100 CITY,STATE,ZIP San Jose,CA 95131 PHONE (408)418-0099 ARCHITECT/ENGINEERNAME Cedric Craig LICENSENUMBER C-15490 BUS.LIC# COMPANYNAME FCGA architecture E-MAIL ric@fcgainc.com FAx (925)820-5858 STREETADDRESS 301 Hartz Ave., Suite 213 CITY,STATE,z1P Danville, CA 94526 PHONE (925)820-7585 DESCRIPTION OF WORK Landlord/owner improvements to existing vacant tenant space in new building: demising wall, interior partitions with gypsum board finish, no paint, restroom, HVAC system, suspended acoustic panel ceiling with lighting, subpanel and electrical outlets. EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES Mercant;le Business` V-B 1 USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA 988 AREA 0 AREA 0 NET AREA 988 Business" V-B �Xing 988 $65,000 BATHROOM KITCHEN OTHER `Business-After July 1,2015 in accordance with CBC Section REMODEL AREA REMODELAREA REMODEL AREA 304.1;July 1,2015 Supplement PORCH AREA DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: Ll DETACH ❑ATTACH #DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY [I YES BEING ADDED? NO ADDITION? E]NO PRE-APPLICATION ®YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES BY: TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER ROME? []NO $65,000 By my signature below,I certify to each of the following: I am the property owner or authorize t to act perty,owner's behalt_ 'T?MVe read this application and the information I have provi ed is correct. I ha read the Description of Work and ve s accurate. I agree to comply with all applicable local ordinances and state laws relating to it tr ction. epresentatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: 06.01.2015 SUPPL ENTAL INFORMATION QUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-ice-COUNTER ❑l BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ., _ ;0 PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑,9TAN'DARD 'I T PtBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑, LARGE _ ❑' FIRE DEPT. „ 11 MAJOR IT SANITARY SEW � _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ER ENVIRONMENTAL HEALTH:: BldgApp_201 1.doc revised 06/21/11 A CITY OF CUPEIiBTINO FEE IEMMATOR-BUILDING DIVISION q:� j DIDTBESS: 10057 SAOCE�!fll�,Y TRATE: 06104/2015 REVIEWED 13Y: MELISSA N: 32632041.10057 BP#: 5�J c 'VALUATION: 1$65,000 *PERMT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PI8It0i[AII�Y PENTAMA71ON USE. Commercial Building PERMIT TYPE: 1 B T, WORK SAICH STATION -CODER SCHOOL -BUILD OUT SHELL FOR B OCCUPANCY 988 S.F. SCOPE OCCUPANCY TYPE: TYPE OF F]LIt AREA PC FEES PC]FEE IID BP FEES BP FEE IID CONSTR. s.f. B (Tenant Improvements) II-B,III-BjV,V-B 988 $2,133.82 IBTIPLNCK $1,066.52 IBTIINSP TOTALS: 988 $2,133.82 $1,066.52 I�YIi EcCH,DOURLY Yes (j) No PLUMB,HOURLY () Yes 0 No ELEC,HOURLY Q Yes (E)No lfech. Plan Check Plumb. Plan Check 1-7ec.Plan Check ah�ch.Permil Fee: Plumb. Permit Fee: Islec.Permit Fee.- Other ee:Other A1cch. lnrp. Orher•Plumb Insp. C Other k7ec. I lech. huN,Fee.' Plumb. hisp.Fee: Elec.Ins"). Fee: NOTE:This estimate does not includeJees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). TheseLees are based on the prelimina information available and are onLy an estimate- Contact the De t or addn 7 info. Y EE ITEMS(Fee Resolution 11-053 Eff.' 7/1;13) FEE QTY/FEE MISC I'T'EMS Plan Check Fee: $2,133.82 Select a Misc Bldg/Structure Suppl.PC Fee: E) Reg. 0 OT0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $1,066.52 Suppl. Insp.Feer Reg. ® OT p p hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consfruction Tax: F Aclininisfrative Fee: 0 Work Without Permit? 0 Yes E) No $0.00 Advanced Plannine Fee: $0.00 Select a Non-Residential 7ruvnl Doclunenladiun Fees: Building or Structure 0 i Strom:Motion Fee: IBSEISMICO $18.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $3.00 SUB'T'OTALS: $3,221.54 $0.00 TOTAL FEE: $3,221.54 Revised: 05/07/2015