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15060177-DCITE' OF CUP ERTINO BUILDING PERMIT BUILDING ADDRESS: 10594 S DE ANZA BLVD CONTRACTOR: BEVILACQUA & SONS PERMIT NO: 15060177 OWNER'S NAME: BYER PROPERTIES LP 451 VICTORY AVE STE 5 DATE ISSUED: 09/1512015 OWNER'S PHONE: 4085091575 S SAN FRANCISCO, CA 94080 PHONE NO: (650) 616 -9900 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL LEAPSTART - T.I. OCCUPANCY CHANGE TO BUILD OUT License Cass Lic. #� VACANT BUILDING (2556 S.F.) INCLUDING 2 ADA S� RESTROOMS Contractor Date I hereby affirm that I am Lensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions REV# 2 - BUSINESS ADDRESS CHANGES; MINOR CHANGES TO THE Code and that my license is in full force and effect. MENS AND WOMENS RESTROOMS; REVISE PLAN TO SHOW LOCATION OF (E) ELECTRICAL MAIN TO MATCH SITE CONDITION — ISSUED 1 hereby affirm under penalty of perjury one of the following two declarations: 12/11/2015 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 Sq. Ft Floor Area: Valuation: $10000 ,performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 36938037.10594 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that I have read this application and state that the above information is RMIT EXPIRES IF WORK IS NOT STARTED correct. 1 agree to comply with all city and county ordinances and state laws relating WITHIN ISD DAYS OF PERMIT ISSUANCE OR building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ISM jLAST CA LED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, ZOM costs, and expenses which may accrue amst said City in consequence of the Issued by: Date: Q� granting of this permit. Add' ovally, e applicant understands and will comply with all non -poi eg anion er the Cupertino Municipal Code, Section RE- ROOFS: 9.18. Signature Date All roofs shall be inspected prior to any rooting material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. _ ❑ OWNER - BUILDER DECLARATION Signature of Applicant: Date: H hereby affirm that 1 am exempt from the Contractor's License Law for one of 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, 1 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 1 performance of the work for which this permit is issued. will maintain compliance with the Cu rti Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sect' 05 33, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public 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 �r� CNTY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS:jmlQrS DE ANZA BLVD I CONTRACTOR: BEVILACQUA & SONS PERMIT NO: 15060177 OWNER'S NAME: SI 24 LLC OWNER'S PHONE: 4085091575 ❑ ]LICENSED CONTRACTOR'S DECLARATION License Class Lic. # �7 'iZ Contractor 3 iQ t;�l Date L% 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 perf ance of the work for which this permit is issued. 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 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 hamiless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit A itionally, the applicant understands and will comply with all non -point ice r I s per upertino Municipal Code ,;e/cfion 9.18. Signature Date t/O!r ❑ OWNER - BUILDER DECLARA'T'ION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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) 2. 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). T 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. 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. 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, 1 become subject to the Worker's Compensation provisions of the Labor Code, l 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 451 VICTORY AVE STE 5 I DATE ISSUED: 09/15/2015 S SAN FRANCISCO, CA 94080 PHONE NO: (650) 616 -9900 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ LEAPSTART - T.I. OCCUPANCY CHANGE TO BUILD OUT VACANT BUILDING (2556 S.F.) INCLUDING 2 ADA RESTROOMS REV # I - MINOR ELECTRICAL CHANGES AND CONFIRM OCCUPANCY FROM E TO B PER CODE ERRATA FOR 2013 CBC. Sq. Ft Floor Area: I Valuation: $10000 APN Number: 36938037.10600 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued byi /k / 147ei12 Date: le RE- ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, l agree to remove all new materials for inspection. Signature of Applicant: 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 1 store or handle hazardous material. Additionally, should l use equipment or devices which emit hazardous air contaminants as defy ed by the Bay Area Air Quality Management District I will maintain complianc ith the Cu ertino Municipal Code, Chapter 9.12 and the Health & Safe* C , Sectior�505, 25533, and 25534. OH6Ler r S��t: Date: CONSTRUCTION LENDING AGENCY 1 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 1 understand my plans shall be used as public records. Licensed Professi ��f CITY OF CUP EllBTINO BUILDING PERMIT BUILDING ADDRESS 0 S DE ANZA BLVD CONTRACTOR: BEVILACQUA & SONS � PERMIT NO: 15060177 I OWNER'S NAME: SI 24 LLC 1 451 VICTORY AVE STE 5 1 (DATE ISSUED: 09/15/2015 1 I OWNER'S (PHONE: 4085091575 11 S SAN FRANCISCO, CA 94080 1 PHONE NO: (650) 616 -9900 1 fLICENSED CONTRACTOR'S DECLARATION License Class Lic. # 7 3 ;L O( 7 t Contractor 51CN3 4 t6� Date 911 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. 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. 1 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. 1 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. d4itionally, the applicant understands and will comply with all non -point so r la pe�Cupertino Municipal Code, Se ti n 9.18. Signature r ' i Date S 1 SI ❑ 06VNER- BUILDER DECLARA'T'ION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). T hereby affirm under penalty of perjury one of the following three declarations: 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 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. 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 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. 1 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 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ LEAPSTART - T.I OCCUPANCY CHANGE TO BUILD OUT VACANT BUILDING (2556 S.F.) INCLUDING 2 ADA RESTROOMS Sq. Ft Floor Area: I Valuation: $10000 APN Number: 36938037.10600 u Occupancy Type: PERMIT MIT IEXPIR ES IF WORK IS NOT STARTED E>(D WITHIN N 1801CDAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. issued by: Q Date: � , 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: 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 ode, Sections 25505, 25533, and 25534. Owr r to ' agent 4 is �� �► Date: v I S 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 Professional Via.,.. C�MpCL°3'1701�JOO COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE o CUPERTINO, CA 95014 -3255 (408) 777 -3228 ^ FAX (408) 777 -3333 ^ building a wertino.org ❑ NEW CONSTRUCTJPN ❑ ADDITION ® ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS - 00 S UT DE ANZA BLVD, CUPERTINO, CA 95014 APN # �/ /A � 8 r ,� OWNERNAME:BYER PROPERTI S PHONE:(408) 509 -1575 E -MAIL: coacchhbbycrr@ @aol.com STREET ADDRESS: 66 POTRERO AVENUE CITY, STATE, ZIP :SAN FRANCISCO, CA 94103 FAX: (415) 626 -2767 CONTACT NAME: CARTER LEUNG PHONE: (510) 841 -3555 E-MAIL:car(erl@kda-berkeley.com STREET ADDRESS: 1810 SIXTH STREET CITY, STATE, ZIP: BERKELEY, CA 94710 FAX: (510) 841 -1225 11 OWNER ❑ OWNER - BUILDER 11 OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT Mt[ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME TBD LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTIENGINEER NAME :CHARLES KAHN LICENSE NUMBER 4CO16027 BUS. LIC # COMPANY NAME: KAHN DESIGN ASSOCIATES E -MAIL :charlesk@kda- berkeley.com FAX :FAX (510) 841 -1225 STREET ADDRESS : 1810 SIXTH STREET CITY, STATE, ZIP: BERKELEY, CA 94710 PHONE: (510) 841 -3555 DESCRIPTION OF WORK: THIS PROJECT CONSISTS OF AN INTERIOR IMPROVEMENT FOR A TENANT EXISTING SPACE. "T THE SCOPE OF WORK INCLUDES THREE CLASSROOMS, TWO A.D.A. BATHROOMS, LUNCH AREA, NEW NON -LOAD HEARING INTERIOR WALL, FLOOR FINISHES, NEW CEILING, AND AN OFFICE SPACE EXISTING USE: VACANT PROPOSED USE: CONSTR. TYPE: #STORIES : 1 TUTORING CENTER v -B USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL U7� AREA: 2,556 SF AREA: p AREA : 0 NET AREA : 2,556 SF o BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREAS DETACH '.. ❑ ATTACH ''........ 4 DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ONO ADDITION? ONO ''....... PREAPPLICATION 0 YES IF YES, PROVIDE COPY OF PLANNING APPL # NO PLANNING APPROVAL LETTER IS THE BLDG AN 0 YES f EICHLER HOME? NO RE IVE`D BY, O r TOTAL VALUAT[OIa T�-_- By my signature below, I certify to each th of lowing: 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 prove a rect. 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 buil truction. I authorize representatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent: Id Date: © a Z2�kn SUPPLEMENTAL INFORUATION REQUIRED PLAN CHECK TYPE 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 ANDARD ❑ 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 ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BidgApp_2011.doc revised 06121111 � O� cr" Tr'Tr',V R11TT !r''Tr TT1DTU T1D r'TrRTlr11 ��jUp/ 7��+�+�+ r7�+T��..uuu emu• v..v�uTluuT��Tu��u7iv�rTT� �7 Tr �T : < NOTE: This estimate does not include fees due to other (Departments (i e, Planning, Public Works, Fire, Sanitary Sewer (District, School (District, etc). These fees are based on the nreliminary information available and are only an estimate- Contact the (Dent for addn'1 info. FEE ET EMS (Fee Resolution 11 -053 f f 7/1/13) FEE QTY/FEE ADDRESS; Off- n DE ANZA BLVD DATE: 06/2612015 REVIEWED BAY: Paul Select a Misc Bldg/Structure or Element of a Building A?N: '369 38 037 BlP #: *VALUATION: 1$16,600 *IPEEIBIJ�IIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement �II�I�A>I�Y Commercial Building USE: $2,292.41 IP1ENTA1b�ilATIION 1B TI PERMIT TYPE: a WORK - T.I. Occu anc chap a to build out vacant buildin 2556 S.f. includin 2 ADA SCOPE PLEAPSTART restrooms PME Permit Fee: OCCUPANCY TYPE: TYPE OF CONSTR. F]LR AREA s.ff. PC FEES PC FEE ID BP FEES BP FEE RD B (Tenant Improvements) II- B,IIl- B,IV,V -B 2,556 $2,320.06 IBTIPLNCK Select a Non- Residential 0 Building or Structure d $2,292.41 1BTIINSP Strom Motion .Fee: IBSEISMICO $2.80 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC SUI)$TOTA]LS: $4,616.27 $0.00 TO7E'A� IEEE: 1 $4,616.27 TOTALS: 2,556 $2,320.06 $2,292.41 1aCEff, HOURLY 0 Yes (9 No PLUMB, HOURLY Yes (E) No IEILE+ C, HO><J]I.81LY Yes ' (D No Much. Plarr Check Licch. Perna! f-ce: Other ilkch. lisp. ,lrk':C11. lisp. 1'ee: Plumb. Plan (heck Placmh. Perrin Fee: Other• Plumb ]nsp C Phaub. hrsp, Fee: Elea .Plan Check ❑ Re.c. Permit Fee: Other Elec. Insp. a Occ. lisp. 1'ee: NOTE: This estimate does not include fees due to other (Departments (i e, Planning, Public Works, Fire, Sanitary Sewer (District, School (District, etc). These fees are based on the nreliminary information available and are only an estimate- Contact the (Dent for addn'1 info. FEE ET EMS (Fee Resolution 11 -053 f f 7/1/13) FEE QTY/FEE ME[SC ITEMS Plan Check Fee: $2,320.06 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (2) Reg. C) OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,292.41 Suppl. Insp. Fee C) Reg. C OT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: C :administrative Fee: 0 Work Without Permit? Yes (a No $0.00 Advanced Plannin Fee: $0.00 Select a Non- Residential 0 Building or Structure d Travel I�UCtltrleYtl "CXIi('1Y1 Fees': Strom Motion .Fee: IBSEISMICO $2.80 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC SUI)$TOTA]LS: $4,616.27 $0.00 TO7E'A� IEEE: 1 $4,616.27 Revised: 05/07/2015 cCET Y OF cCUPERTINO lne447 EIE IES'ETMATOR — BUILDING DI`TISION OCCUPANCY TYPE: ADDRESS: FLR AREA s.f. DATE: 06/26/2015 REVIEWED BY: Paul BP FEES APN: 369 38 037 0P #: II- B,111- B,IV,V -B *VALUATION: 1$10,000 xPERth[IT TYPE: Building Permit IETIPLNCK PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: $0.00 PENTAMATION 1 E TI PERMIT TYPE: WORK LEAPSTART - T.I. Occupancy change to build out vacant building 2556 S.f. including 2 ADA SCOPE restrooms ®OT 0 0 hrs OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID E (Tenant Improvements) II- B,111- B,IV,V -B 2,556 $4,060.48 IETIPLNCK $4,120.10 1ETIINSP $0.00 Permit Fee: $4,120.10 Suppl. Insp. Fee:Q Reg. ®OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 2,556 $4,060.48 $4,120.10 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 Ef. 711113,) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,060.48 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (D Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $4,120.10 Suppl. Insp. Fee:Q Reg. ®OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: :9dtninistrative Fore: G Work Without Permit? Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure 0 0 J Travel Documentation Fees: Strong Motion Fee: IBSEISMICO $2.80 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $8,184.38 $0.00 TOTAL FEE: $8,184,38 Revised: 05/07/2015 RMWM'� ' / cCRTY OIF �CIUP EIEBTINO l tliiq FEE IES'II'MATOR — BUI LDRN G MVISION NOTE: This estimate does trot include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminar information available and are on! an estimate. Contact the De t or addn'l in o. FEE ITEMS (Fee Resolution 11 -053 Eff. 711113) FEE QTY/FEET MISC ITEMS Plan Check Fee: hourly Only? 0 Yes E) No $0.00 hours Plan Check, Hourly Suppl. PC Fee: (Z) Reg. OT 570 hrs $0.00 $286.00 iSTPLNCx PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.0 Reg. OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC — $0.00 0 Work Without Pen-nit? Yes (E) No $0.00 G Advanced Planning Fee: $0.00 Select a Non- Residential Q . rx el Building or Structure L Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE: F $286.00 Revised: 07/02/2015 AIDIDRESS• 0 S DE AilIZA BLVD DATE: 09/25/2095 REVIEWED BY: NIELISSA APN: 36938037 600 BP #: 15060177 *VALIDATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: Civil / Religious activities in BQ zone? 0 Yes 0 No PENTAMATION 1 GENCOIVI PERMIT TYPE: WORK REV # 1 — NIIIVOR ELECTRICAL CHANGES AND CONFIRM OCCUPANCY FROM E TO B PER SCOFF, PREVIOUS CODE ERRATA FOR 2013 CODES NOTE: This estimate does trot include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminar information available and are on! an estimate. Contact the De t or addn'l in o. FEE ITEMS (Fee Resolution 11 -053 Eff. 711113) FEE QTY/FEET MISC ITEMS Plan Check Fee: hourly Only? 0 Yes E) No $0.00 hours Plan Check, Hourly Suppl. PC Fee: (Z) Reg. OT 570 hrs $0.00 $286.00 iSTPLNCx PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.0 Reg. OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC — $0.00 0 Work Without Pen-nit? Yes (E) No $0.00 G Advanced Planning Fee: $0.00 Select a Non- Residential Q . rx el Building or Structure L Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE: F $286.00 Revised: 07/02/2015 IT rl'1('; :. jler l7 z Fe c: 0"".1 v, Puna lr,s,), der lr«: f'/l:rr.•; ~,. 7,,.'p, vee ?5.ac. NOTE: This estimate does trot include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminar information available and are on! an estimate. Contact the De t or addn'l in o. FEE ITEMS (Fee Resolution 11 -053 Eff. 711113) FEE QTY/FEET MISC ITEMS Plan Check Fee: hourly Only? 0 Yes E) No $0.00 hours Plan Check, Hourly Suppl. PC Fee: (Z) Reg. OT 570 hrs $0.00 $286.00 iSTPLNCx PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.0 Reg. OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC — $0.00 0 Work Without Pen-nit? Yes (E) No $0.00 G Advanced Planning Fee: $0.00 Select a Non- Residential Q . rx el Building or Structure L Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $286.00 TOTAL FEE: F $286.00 Revised: 07/02/2015 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DPASION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 wo (408) 777228 o FAX (408) 777 -3333 m bullding(tcloartino -ern 6. ❑ NEW toAlb°i' ucnoN ❑ ADDium ❑ ALTERATION / TI ® REVISION / DFYMMED ORIGINAL PERMIT g 15060177 0014 mo–ftftr-m GiiO�.Lg AIIIIS�CS DEAW A BLVD. QMM94NO,CA CLy`M NAMUYER PROPFRTM FHON&(408) 509 -1576 &mAu,:kmclough@byer.com S 11,EEi AD5)RMS : 68 POTTtKKO AVENUE CITY, STA•f$ ZIP :SAN PRANCISCO, CA 94100 FAX: (415) 626.1767 CON TI ACT NAid 8: CARTEn L RUMO PHONE: (510) 841 -9555 P.MAIL caRed�lcda bedceley.ema ST ADDV —M :1890 SIX*W 39A69i'r' CITY, STATE, TIP : BERKELEY, CA 94710 FAX : (510) a41.1225 mt7m ❑ ow a- autLaFa1 ® owmAmw ❑ comm=R ❑ comvAC70RAonNT 19 ARCHIl= ❑ ENQINEIIR ❑ DEVELOPER ❑ MANT C01MAC'ts(21NAME PAULBAVRACQUA LICENSENUMER 36575 lICOTETYPE BUS. LIC0 COw�'ANYNA rm EAVRACQUA &SONS E-MAIL FAX ,S` M AEl3REB 451 Vl(7MRy A VH FM 5 OTY, STATE, ZIP 9 SAN FRANQSCO, CA 94080 PHONE 650.616 -9900 AackrITELTIMS a nor NAME QXLARLES rUH34 LICENSE NUMBIDt 000I6M7 Bus. UC 0 C2ANY NAME: KAHN DF.SM ASSOtSAM B-MA1L .dbadeA@kd9 -bak ft Sam FAX :FAX (510) 841.1225 8'aU23r ADDREW : 1810 SIXTH STREW CITY, STATG ZIP: •BERKELEY, CA 94710 PHONE: (510) 841 -1555 F aSMIPTION of WO:1IC : r"+ry mcm lXiA47= amma 1;3 6 m amosma =D Lam oCVI=w ON coven aHSET 0000 WED 0 CHANGE III OCCUPANCY 1RO11 GROCP -a' TO GROUP -131. 011dgMG =: VACAW PROPOSM USE: C014M TYPE: 0 STORM: I rMRM CVf a2 V-D USE TYPE ocr_ SQ.Fr. VALUATION (� r-901'a NM[9.001 DI60 TOTAL AURA; US3 S,: ARIA. 0 ARIA: 0 MM ARIA: 2,556 SF ZATP4 C" SITC mLV OTHM IkE^?4DZL A= RMMEL ARHA RMODEL AREA FC:= [91HA DM= AREA TOTAL DMUPORCH AREA GAIIAOE AREA DETACH I ATTACH tri 1 t IgiO [tSd fi 8 rS A SWOND UNIT t3YES 8F.COND STORY YES BMGADDEDY [] RO ADDMONr []NO FF,AFMCAr,0W ❑Y$4 W YES, PROWDBOO?VOY ISTHEILDCAN ❑ FL '100 APPL9 ONTO PLANNWG APPROVAL L TTEa FJCALLRHOMEY By my Signature below, l ar6fy to each of the fol owing; I am the property owner or authorized to owner's behalf. I have read this cppR and the information I have provided i rrect I have read the Description of Work and v rt is accurate. I agree to comply with all applicable local erEnncw and store laws relating to building cc ion. I authorize representatiees ofCupotino to enter the abovewi tified rty for inspection purposes. Sigkn= or Appliccant/Agent• Date: Z SUPPLEMENTAL IN AT N REQUIRED PtANCRE� TYPE ROUtING sL� ❑ DUUMING PLAN REVIEW _ New SFD or Multif imily dtwellit Apply f demolition permit for ® o�.r.�co� e:Xisting building(s). Demolition permit is required rior to issuance of building pmm*t for new building. ❑ GXPRBSB ❑ PLANNWG PLAN REVr9W _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ srAmm" ❑ PUBLIC weeks f6sm if any Hazardous (Materials are being used as part of this project. ❑ LARGB ❑ FM DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ aaAroe ❑ &1NITAItY SBWBS DtSTBYCP submittal of Building Permit application ❑ ENV@OM MNTAL NHALTS B1dgApp 201 Ldor revised 0621/11 CUF'Lk116'�U COMMUNITY DEVELOPMENT DEPARTMENT ^ BUIL t 10300 TORRE AVENUE o CUPERTINO, CA 95014 -325 (408) 777 -3228 o FAX (408) 777 -3333 o buildin @.cupertino.org F-1 NEW CONSTRUCTION ❑ ADDITION n ALTERATION / TI ® REVISION / DEFERRED ORIGINAL PERMIT # 15060177 PROJECT ADDRESS 00 0 1H DE ANZA BLVD, CUPERTINO, CA 95014 APN - -013 3 or voc Z OWNER NAME:BYER PROPERTIES PHONE:(408) 509 -1575 E -MAIL: kmcl0ugh @byer.com STREET ADDRESS: 66 POTRERO AVENUE CITY, STATE, ZIP :SAN FRANCISCO, CA 94103 FAX: (415) 626 -2767 CONTACT NAME: CARTER LEUNG PHONE: (510) 841 -3555 E-MAIL:carterl@kda-berkeley.com STREET ADDRESS : 1810 SIXTH STREET CITY, STATE, ZIP: BERKELEY, CA 94710 FAX: (510) 841 -1225 ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT KY ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME PAUL BAVILACQUA LICENSE NUMBER 36575 LICENSE TYPE BUS. LIC # COMPANYNAME BAVILACQUA & SONS E -MAIL FAX STREET ADDRESS 451 VICTORY AVE STE 5 CITY, STATE, ZIP S SAN FRANCISCO, CA 94080 PHONE 650- 616 -9900 ARCHITECT /ENGINEER NAME :CHARLES KA14N LICENSE NUMBER 9CO16027 BUS. LIC # COMPANY NAME: KAHN DESIGN ASSOCIATES E-MAIL :chariesk@kda-bcrkeley.com FAX :FAX (510) 841 -1225 STREET ADDRESS : 1810 SIXTH STREET CITY, STATE, ZIP : BERKELEY, CA 94710 PHONE: (510) 841 -3555 DESCRIPTION OF WORK: 1. BUSINESS ADDRESS'CHANGES FROM 10600 TO 10594 PER INSPECTOR'S NOTICE, SEE SHEET G000. 2. MENS AND WOMENS RESTROOMS LAYOUT CHANGES (MIR.RORED), NO CHANGE IN INTERIOR DIMENSIONS FOR ACCESSIBILITY COMPLIANCE, SEE SHEET A100. 3. EXISTING ELECTRICAL PANEL TO REMAIN IN SAME LOCATION, SEE SHEET E -2. EXISTING USE: VACANT PROPOSED USE: CONSTR. TYPE: # STORIES: 1 TUTORING CENTER v -B USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA: 2,556 SF AREA: 0 AREA: 0 NET AREA: 2,556 SF BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DEC"ORCH AREA GARAGE AREA: DETACH []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? ❑NO PRF-APPLICATION []YES IE YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED B TOTAL VALUATION: PLANNING APPL # C] NO PLANNING APPROVAL LETTER EICHLER HOME? [] NO t By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the pr rty owner's behalf. I have read this application and the information I have provided is co ct. 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 cons tr . I authorize representatives of Cupertino to enter the above -ide ified operty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFOPVTIO REQUIRED t1�1 /pply PLAN CHECK TYPE ROUTING SLIP ❑ OVER -TH &COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: for molition permit for existing building(s). Demolition permit is required pri 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 ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doc revised 06/21/11 ,r'Tfr1PR7 ?TlP tr TrT1MTGi1TDrTr rR\TA'A . _ 7�7� �+�'r 7�\L -ff 11 1L \LIVryryll` X1.77 ku� 11TT77�M111\1 7}11 X�111 V \UV 77�� �T ,5 FETE 1L1y MATO1N — IB U�L�1Ll NG IDEWS ID QTY /IEEE AIDID]RESS;,1V e Anna Blvd )[DATE: 11/20/2015 REVIEWED BY: Phuong l:;iru;..F'it?n C'iteE;; El APN: 36938037.10600 ]Bp #: *VALUATION: $0 *PE1RMRT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair ?RI MARY USE Commercial Building Civil/ Religious activities in BQ zone? 0 Yes E) No PENTAMATION PER MIT TYPE: 1GENCOM WORD REV# 2 - BUSINESS ADDRESS CHANGES; MINOR CHANGES TO THE MENS AND WOMENS SCOPE RESTROOMS; REVISE PLAN TO SHOW LOCATION OF (E) ELECTRICAL MAIN TO MATCH SITE ES $0.00 Suppl. Insp. Fee:Q Reg. Q OT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 q Construction Tax: IBCOAr. a $0.00 r diriviVrofiw, Fee: Whn n. Work Without Permit? C) Yes (D No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure d Ei "C.db'2i .�)(lt'U7lIt'S7tLit,'t7Yd'P�,S; Strong; Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: . $0.00 $286.00 T ® $286.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the areliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ffT EMS (Fee Resolution 11-053 Fff. 7/1113) FEE QTY /IEEE 1 / ch. 1' 1trn C =lea lc ("he l:;iru;..F'it?n C'iteE;; El Fill- P'. rmd 1"'etr.- 1'11 nr' ). I'c 1 aiii i` ec I: 1PE:, I'E'l �Ylit d 1" E ': olke1' .1' %a i'! ?. 1;! "w. E I i i&r ] hiwU l7 nvU bl'7"' M'S }J. $0.00 I'1nwb. bnnso. F«': Diet /nsp. Fce NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the areliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ffT EMS (Fee Resolution 11-053 Fff. 7/1113) FEE QTY /IEEE MRSC 1<'1('lEMS Plan Check Fee: Hourly Only? C) Yes (D No $0.00 2 hours Plan Check, Hourly $286.00 ISTPLNCK Suppl. PC Fee: a Reg. (0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCOAr. a $0.00 r diriviVrofiw, Fee: Work Without Permit? C) Yes (D No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure d Ei "C.db'2i .�)(lt'U7lIt'S7tLit,'t7Yd'P�,S; Strong; Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: . $0.00 $286.00 T ® $286.00 Revised: 10/01/2015 Building Department City Of Cupertino 10300 Torre Avenue II Cupertino, CA 95014 -3255 Telephone: 408- 777 -3228 C U F F RT 0 N® Fax: 408- 777 -3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: iOS4 ,S DE ANZA BLVD. PERMIT # 15060177 OWNER'S NAME: BYER PROPERTIES, LLC. PHONE # 650-616-4900 GENERAL CONTRACTOR:BEVILACQUA & SONS, INC BUSINESS LICENSE # 732067-B ADDRESS: 451 VICTORY AVE. S•5 CITY /ZIPCODE: S. SAN FRANCISCO *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECI'ION(S) WILL BE SCHEDULED UNTIL TIME 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: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical GENERAL LIGHTING SERVICES, INC. 22559 Excavation Fencing Flooring / Caipeting INTERIOR DESIGN SERVICES 36780 Linolemn / Wood Glass / Glazing INTERIOR GLASS 27762 Heating CITY MECHANCIAL 36779 Insulation RUANE 36763 Landscaping Lathing Masonry Painting / Wallpaper PYRAMID PAINTING 25999 Paving 36763 Plastering RUANE Plumbing SD PLUMBING 36764 Roofing Septic Tank Sheet Metal Sheet Rock RUANE 36763 Tile RODRIGUES TILE COMPANY 36778 Paul Bevilacqua Owner / Contractor Signature 1 -11 -2016 Date C0.DIt ERT�NO Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 Fax: 408 - 777 -3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: f og4 DE ANZA BLVD. PERMIT # 15060177 OWNER'S NAME: BYER PROPERTIES, LLC. PHONE # 650-616 -4900 GENERAL CONTRACTOR:BEVILACQUA & SONS, INC BUSINESS LICENSE # 732067-B ADDRESS: 451 VICTORY AVE. S-5 crrY /zipcoDE: S. SAN FRANCISCO 'Our municipal code requires akk businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL, THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTI.NO BUSINESS LICENSE. II am not using any subcontractors: Signature ]Please check applicable subcontractors and complete the following information: Date V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical GENERAL LIGHTING SERVICES, INC. 22559 Excavation Fencing Flooring / Carpeting INTERIOR DESIGN SERVICES 36780 Linoleum / Wood Glass / Glazing INTERIOR GLASS 27762 Heating CITY MECHANCIAL 36779 Insulation RUANE 36763 Landscaping Lathing Masonry Painting / Wallpaper PYRAMID PAINTING 25999 Paving r Plastering RUANE / -k. (-k— �Ll6_A 36763 Plumbing SD PLUMBING 36764 Roofing Septic Tank Sheet Metal Sheet Rock RUANE 36763 Tile RODRIGUES TILE COMPANY 36778 Paul Bevilacqua / Owner / Contractor Signature 1 -11 -2016 Date