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12070176CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10165 N DE ANZA BLVD CONTRACTOR: CAREFREE TOLAND PERMIT NO: 12070176 POOLS INC OWNER'S NAME: INFINITE LOOP HOTEL LLC 1181 QUARRY LN STE 200 DATE ISSUED: 10/0211012 OWNER'S PHONE: 4086892971 PLEASANTON, CA 94566 PHONE NO: (925)462-1441 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 0 COMMERCIALE] License Class G 57 Lic. 4 334/?.fY A LOFT HOTEL - COMMERCIAL SWIMMING POOL ,," l0--2 /2 % CONSTRUCTION (6I2 SQIaT) ContractorL/�"&f>ae6 S Date 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: 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 Sq. Ft Floor Area: Valuation: $66549 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: 32634057.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that 1 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 WITIIIN 1801AYS OF PERMIT ISSUANCE ®]E8 to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the — / Issued by: ��x /y s71 Date: ��! 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. !�' `� Z RE -ROOFS: Signature Date 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: 1 hereby affirm that I 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 4.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous 1 have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should 1 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 II performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 1 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 thisa. Owner or authorized agent: Date./�/ permit is issued.' 1 certify that in the performance of the work for which this permit is issued, l 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 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 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 a SWIMMING POOL I SPA PERMIT APPLICATION ' Q COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 S P CUPERTINO (408) 777-3228 - FAX (408) 777-3333 - building ciicupertino.org PROJECT ADDRESS ®� - b� APN p ' 5, b 3 4- 05 OWNERNAME PHONE E-MAIL 45AA5ldi r^fro. 4b% -&Sq -:.4_44 rs10 ��a.�st6c�srl •ma 5- 3;s1 STREET ADDRESS 2 0 � C&515 CITY, cru 0(CA-II ~ On PA?{ CONTACT NAMEpPHONE A` ll�Jo E-MAIL �Gll�i4i SSB 531 �• G� • iC STREET ADDRESS 457 W CITY, STATE, ZIP . ccrn¢as '95r la FAX I11®•_7_a ,9_0(1&® ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER 13 DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC q COMPANY NAMEII °CA� - —� 'C�O GIL E-MAIL • Co V -'-FAX It"A I4 QC CriB F Tt>�c� ®C 9l -(4 STREET ADDRESS UAL ou�e!� ieotr-- 4-2.0& CITY, STATE, ZIP PLVAC 1vra,3 Cry Y 5-4,0 PHONE lout Firs ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC 4 COMPANY NAME- E-MAI,Lp ..,, --/I FAX STREET ADDRESS Iv �rrc�� >� CITY, STATE, ZIP � r fWnW_0 c� ��a�d PHONE �l$-��u-9®17® DESCRIPTION OF WORK 11 - (fVXAG"1_Cr,&L 6A A%W F.► coG�1S77xueA a USE OF ❑ SFDor Duplex ❑ Multi -Family TYPE MATERIAL TYPE (CODE) AREA (SQ. FF.) VALUATION ($) STRUCTURE: -f Commercial POOL POOUSPA MATERIAL TYPE CODES: SPA V - VINYL -LINED DEMO F - FIBERGLASS G - GUNITE RECEIVED BY. ,; °" ° °- � - - � �- _ TOTAL VALUATION: P - PREFABRICATED By my signature below, 1 certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information 1 have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ntatives of Cupertino to enter the above-identi6 d property for inspection purposes. ordinances and state laws relatinggn��_ Signature of Applicant/Agent: Date: 6 SUPPLEMENTAL INFORMATION IWQUIRED OFFICE USE ONLY PLAN CIIECiCTYPE - ROUTING SLIP ° -- L7 autLDavGDEPT _ Commercial or Multi -Family Buildings with Public Swimming Pools: Department of Environmental Health approval required.oyExTxe-coutvTgR F PRESS - .PLANNING.DEPT STANDARD © WORKS ORKS DEPT 0• LARGE> `ENVIRONMENTAL HEALTH .Q MAJOR - El SAMTARYSEWERDISTRICT SwimPoolApp_2011.doc revised 03/16/11 e' lTr I'%I 4-1TM A" IT TTM" Wh �T.rt. 1 ( /11! 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 vreliminary information available and are only an estimate. Contact the Dept for addn'l info. EEE ITEMS (Fee Resolution 11-053 E . 711/11) SIJ " in Vv - ]F]E]E ]ES'TMA TOR - BUff LMNG �DffVffSffON �f`� FEE I'ininh,. t':r,n : ;r�.r;, ADDRESS: 10165 N De Anza Blvd DATE: 07/23/2012 REVIEWED BY: suew Plan Check Fee: APN:. BP#: 12070176 Owrh tn,t' *VALUATION: 1$66,549 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building $0.00 PME Plan Check: PENTAMATION CBS USE: PERMIT TYPE: a WORK 17M4 0,0 SCOPE $0.00 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 vreliminary information available and are only an estimate. Contact the Dept for addn'l info. EEE ITEMS (Fee Resolution 11-053 E . 711/11) ',1,•t'!. Nl z,: (i,�'-k I'ininh,. t':r,n : ;r�.r;, 'I, Plan Check Fee: LjOhcr• Owrh tn,t' !h,., 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 vreliminary information available and are only an estimate. Contact the Dept for addn'l info. EEE ITEMS (Fee Resolution 11-053 E . 711/11) )FEE QTY/FEE MISC RT EMS Plan Check Fee: $0.00 612 s.f. $1,864.00 Swimming Pool IPOOGCOM Commercial Pool Suppl. PC Fee:) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 G Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure O d 1.'.11`C' l,;)C7NYINiNufrOrl i'c'r; �: Strong Motion Fee: IBSEISMICO $13.98 Select an Administrative Item 131h, Stds Commission Fee: IBCBSC $3.00 SUBTOTALS: $16.98 $1,864.00 TOTAL FEE: $1,880.98 Revised: 07/01/2012 CUPER TI]NO BuiRdnng Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: �'O�(9 ,��- ���� Hyl PERMIT # /ble�Atq 74 OWNER'S NAME:) PHONE # �g ::� - IV6 ,,9 e / / GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: A�= ,o CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City off Cupertino business llicense. NO BUILDING FINAL OR FINAL, OCCUPANCY INS? ECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUIPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature PRease check applicable subcontractors and eomptete the Tollowing information: v✓ Date Owner / Contractor Signature Date 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 October 17, 2012 Sean Hatch City of Cupertino Building Department 10300 Torre Ave Cupertino, CA 95014 Re: Swimming Pool, BD#120700176 Aloft Cupertino, 10165 N. De Anza Blvd. Dear Sean, MGCha lc&➢ Engonaa ss The swimming pool for Aloft hotel is a separate permit item. The following sheets are used for reference as part of the pool package: P0.1, P2.1 and P4.1. These sheets dated 12/09/11 are permitted for construction under BD#11070140. Our office reviewed the pool submittal and marked it as reviewed on October 15, 2012. Sincerely, TEP Engineering Tim Souza, P.E., C.E.P.E j L 880 Second Street o Santa Rosa, CA 95404-4610 < 707-538-0400 0 707-538-0406 fax October 16, 2012 Sean Hatch City of Cupertino Building Department 10300 Torre Ave Cupertino, CA 95014 RE: Swimming Pool, BD #12070176 Aloft Cupertino, 10165 N. De Anza Blvd. Dear Sean: The swimming pool for Aloft hotel is a separate permit item. The following sheets are used for reference as part of the pool package: A2.11, A3.62, and A3.64. These sheets dated 7/10/12 are permitted for construction under BD #11070140. Our office reviewed the pool submittal and marked it as reviewed on October 15, 2012. Please contact our office if you have any further questions. Robert . Sa vageau, AIA Principal, Architects :�Cr ltr Y. SAU"I Gc?U, ALA KUNCI , h,-\LIMPNIA 941:31 415.341.91 rG 41.,.041.'.'039 FAX WWV—RSAKI LANDSCAPE ARCHITECTURE PLANNING October 19, 2012 Sean Hatch City of Cupertino Building Department 10300 Torre Ave. Cupertino, CA 95014 RE: Swimming Pool Permit Set — BD #12070176 Aloft Hotel 10165 N De Anza Blvd. Cupertino Hi Sean 151 N. Noriin Street Sonora, CA 95370 209.532.2856 office 209.532.9510 fax vrww.knoxla.corr We understand that the permit for the swimming pool has been submitted as a separate permit than the building permit. The swimming pool permit documents, prepared by the pool contractor, references specific KLA sheets. Sheets L1.1, L2.4, L5.1 dated 10-27-11 (from when the hotel was a Hyatt Place) are included in the pool contractors submittal set for permit. KLA reviewed the submittal and accept our sheets being provided within the swimming pool permit set. Please let me know if you have any questions or need any additional information. Tom Holloway, ASLA Principal KLA, Inc. CLA #3589 Page 1