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02080141=ile Edit Actions Details Links Favorites Help Permit Number 02080141 Status x C - Closed Master Number 504000 IEI Project 327 IQI Apply Date 08/26/2002 Permit Issue Date 08/26/2002 Certificate Issued. 1 - Private Certificate Type Certificate Number Address % I 19750 STEVENS CREEK BLVD City/State/Zip CUPERTINO IQI Notes 0 APN 36906008.00 IQI Unit M Operator conniew Operator conniew I Owner Name xl EVERSHINE VI, L.P. Operator Use Default Address Home -19750 STEVENS CR BLV Permit " Property Zoning Applicant Contractor' Defined Fields Permit Details Permit Type' COMML-NEW IQI DO NOT USE Usage Class x ST V N N IQI STORES V N N Applied Value x 850000 SQUARE FT. 10000 Calculated Value 504000 IEI US C-404 Type 327 IQI NEW: STORE/RESTRAUNT/TAVERN Permit Form " AUTOPERM - PERMIT Ownership 1 - Private Project Size 'ermit issued 08j26j2002 anter the purpose or any special conditions for this permit City/State/Zip CUPERTINO Purpose/Special Conditions REVISED STRUCTURAL {ORIGINAL #02050193} FILMED 5!20111 0K CA 95014 14% Back I[0Add Default T Imo. Contractors ,t-{. Fees Plan Reviews Ir p Inspections Ic s Print Permit I(a;;Adjustments li Holds Ir::_] Copy Permit Close Permit r- tl.; Overrides Supplemental Fields Notes I0il Attachments O C C U E t¢. Z 2 O Z y C X O a W U. u [—,O < N W ¢C X � u m-� F_Z> F 2 a3° CITY OF CUPERTINO CONTRACTOR INFORMAT BUILDING DIVISION PFRMI . BUILDING ADDRESS: PERMIT NO. 19620 STEVENS CR BLV PACIFIC GENERAL CONSTRUCTION 02080141 WNff9I NE VI, L. P. 38350 FREMONT BLVD APPLICATION %5266 J2 0 0 2 PHONE: (510)713-9343 SANITARY NO. CONTROL NO. ARCH ITECT(ENGINEER: I BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION Job Description I hereby affirm that I am licensed under provisions of Chapter 9 (commencing REVISED STRUCTURAL with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect' (ORIGINAL #02050193) License Class Lic. k Date Contractor PLMB FEES PD ON PERMIT 02070149 -IN HOUSE ARCHITECT'S DECLARATION I understand my plans shall be used as public records Licensed Professional OWNER -BUILDER DECLARATION , I hereby affirm that I am exempt from the Contractor's License Law for the following reason. (Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure -• - • ------ --- - - - - - -- - - - - •- ••-••-•- -- •^- •-•-- •-•• •• •---•• ••--•-•-•-....... prior to its issuance, also requires the.applicant for such permit to file asigned statement ,- F1 e ', ��i, �, ( q''p,,,i =„ 'X ;l ;'r�i' i . 'Sq -17t IFry . O10.�� Ik at`ti i•t „ $ 8 5 O O U'®lU atlon that`he is Iicenied,puistlafit tb'die provisions of the Contractor's License Law (Chapter 9 (commencing with Section, 700 ).of Division 3 the Business and Professions Code) of or thal'he'is exempt therefromand the basis for the alleged eiremption.'Any violation .: ,� ,ui 3 , - of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty 1 of.not more than, five hundred dollars ($500). 3 6 9 8,9N N@m� Occupancy Type ❑ I, as owner of the property, or my employees with wages as their sole compensation, - - 101 -- - FOUNDATIjuired Inspections will 'do'the work, and the structure' is not -intended -or offered for'sale '(Sec:'7044;' Businessand Professions Code: The Contractor's License Law does not apply to an owner of property Who builds or improves thereon, and who does such work himself 102 - PIERS or through his own employees. provided that such improvements not intended or _are �offei�ed for 'sale. [f,'fiewever; the building or improvement is sold within one year�of ` — . � •,,,;; , : , .- - completion, the owner -builder will have the burden of proving that he did not build or 10 4 improve for purpose of sale.). — REBAR �•4,.as;owner of the property, am exclusively contracting with licensed contractors to 5 construct the project (Sec. 7044, Business and Professions Code:) The Contractor's 106 — SEWER & WATER -- License Law does not apply to an o ownerproperty' wh(buiice&PCp __and who.contracts.for.such..projects _with.a..contradors).licensed _ __..__. 2-02 -� _ _...PLUMB-ING-•------ - - -- ---• --- ---- -- -- -- �UNDE�RF�LOOR rr.suc suant.to.the, Contractor's ec. this reason ❑lam pt 203 - UNDERFLOOR".MECHANIICAL Owner ... •' Date..', . .. 2 04 - UNDERFLOOR FRAME WORKER'S COMPENSATION DECLARATION _ 205 — UNDERFLOOR INSULATION I hereby affirm under penalty -of perjury,one, of the following declarations: - 301 — ROUGH PLUMBING ❑ 1 have and will'maintain'a Certificate of Consent to self -insure for Worker's 302 — TUB & OR SHOWER ,Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 303 - ROUGH MECHANICAL ❑ 1 have' maintain Workers Compensation Insurance, by Section 304 - ROUGH ELECTRICAL and will as required 3700 of'the Labor Code, for the performance of the work for-which'ihis permit is 305 — FRAME issued. M Workers Com ensation Insurance carrier and�Pohc number are: - .. _. ..,3.06..: -" HOLDOWN.S.. .. . .... ............_..._ ... ,.... .. �......, t. Catri • er ',�. S, ' Policy No.. - - ' CERTIFICATION: OF EXEMPTION FROM. WORKERS;' '�.. .. .r t� ,,..., L ,,,, ', 3 O 7 • %— f I NS'ULAT•I ON! I I " " , _,. ._....„ ., [NSURA•NCE" t , -, ., -,,., ,�• -:--S�HE'ETROCK-._......._..__. _ _......__.----_ ._.- --...... _......... . _. _............ . �'t"•'i' This section'needCOMPENSATION net be completed if me permit is for (' p p r one hundred dollars 3 0 9 "• - EXTERIOR LATH ($ 100) or less.) ' - :. ... ..; .,..�... :.... ., __..... -...._ .. .. -- R . R.. LATH . ..., ...., .._.n the er .. ' � y fomtance of the work for which this permit is issued, l Icertif that i p not employ any manner 311 • I' - SCRATCH COAT -,•-' " - ' ` ' shall any person in so as to become.suhject to the Workers' Compensation Laws of California. D ate"' .... Applicant 1 501 _ ROOF NAIL _ ......... .._...... — F I NAL ELE CTR I CAL ' ENERGY „NOTICE TO APPLICANT: If, after making this CertBicate of Exemption, yon should ' become subject to the Worker's Com' 7 pensatton previsions of the C.abor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 502 - F I NAL PLUMBING ENERGY n CONSTRUCTION LENDING AGENCY - 503 — F I NAL MECHANICAL ENERGY:' ' I hereby affirm that theie is a construction lending ageney for the performance 504 - t - F I NAL BUILDING ENERGY of the work for which this permit is issued (Sec. 3091. Civ. C.) --Lender's .adress' 505 = FINAL ELECTRICAL '. 506 GAS TEST •, I certify that I have read this application and'state that the above information is 'correct. d agree to,comply with all city and county,.ordinances and state laws relating •this 5 - I NAL PLUMBING to building construction: and hereby authorize represematives of city to enter upon the 5 8 — I NAL I CAL above-mentioned property for inspection purposes.• (Wei agree to Save, indemnify an&keep harmless'.ttie City of Cupertino against 50 - I NAL liabilities, judgments, costs and expenses which may in any way accrue against said City in consequence of the granting of,thfs permit.., 51 0 — F wxl�t, 'APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT SOURCE REGULATIONS. ^c'-, ISSlled Date , Signatureof Applicant/Contractor '.. . Date' Re -r0 s02 - OOF PLYWOOD NAIL HAZA MA .tERIALS DISCLOSURE �� RO BATTENS Will theta hcam oADOUS t fumre{bMi mg occupent'store or handle hazardous material. ,.. T eOf #*_ _ _ - ".. ---_ ... -• _ • --.' -, , - „ . as defined b .the pan' o Municipal Code, Chapter 9.12, and the Health and Safety m.. — R ' F, . - I N-,P.ROGRE S S ' ' 25532(a)? 3 Code, Seciionr_55 2O ' . c c `'❑ Yes _ •❑ All roofs -shall be, inspected prior.to,.any,.roofing..material"b.ein i g. nstalled Will the applicangor future building occupant use equipment or devices which If a roof is installed'without first obtaining an inspection,''I'agree' to -remove emit hazardous air contaminants as defined by the Bay Area Air Quality Management District?. , .. , ' . - .. all materials for inspection-.._ Applicant. understands and will comply with ElYes-, _,. .. �,.,❑No.. ..__ . _.. . ... . ..- .' all non -point . -- .- . ..., ... %._. source regulations , . y ,,., , _. ' (have read the'hazardous materials requirements under Chapter 6.95 of the Califomia'Health & Safety Code, Sections 25505, 25533 and 25534. 1'understand that -t t e'bm dmgdoes not currently have a tenant; that It ismy resporisibiliiy ronotify the � occupant of the requirements which must be m&'prior to issuance of a Certificate of - Occupancy. .. .. .. Si nature of Applicant Date All roof coverings to be Class "B",or better,' Uwneror, authorized agent Date _ _.......... OFFICE- . CITY OF CUPERTINO C?rY OF CUPERTINO PERMIT APPLICATION FORM � APN # ®O Fee Description Date: Z(o b �. BAPPLOTHER Building Address: Jq 5-® 1�5L-b- BCONSTAX Own.er'sQv4,5 14C ��! BUILDING Phone #: ®� �--- q / Contract o : BCONSTAXBQ License .1 � BUILDING Contact: Hotel and Motel Phone #: S/ 7J 713 - 473 y3 Applicant/Contractor: Constax — Resi/Mobile Fax #: BELEC1000 ,'BuilAg g Pe it Info: Bldg Elect Plumb Mech BELEC1001 Job De ption: si ential: Commercial: ftulsq>d�lr BELEC200 Sq.Ft. Floor Area: ELECTRICAL $/Sq.Ft.: Valuation: Occupancy Grout Energy Architect/Engineer: Type of Construction: ®r Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax — Resi/Mobile BUILDING BELEC1000 Elec 600V <= 1000A ELECTRICAL BELEC1001 Elec 600V > 1000A ELECTRICAL BELEC200 Elec Svcs 600V <= 200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BMITIGATR Res. Housing Mit Fee BUILDING BMNEWMULTI New Multi -Family Res MECHANICAL BNEWMULTI New Multi -family Res ' ELECTRICAL BNUCOMME New Comm Electric ELECTRICAL BNUCOIVD,4M New Comm Mechanical MECHANICAL BNUCOMMP New Comm Plumb PLUMBING zoo A)6,.) i�,� 4" q-4 A