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12110023CITY OF CU PIE]L TINO B UIDLIMNG PERMIT IT BUILDING ADDRESS: 10020 N DE ANZA BLVD CONTRACTOR: METHOD PERMIT NO: 12110023 CONSTRUCTION OWNER'S NAME: WESTWOOD COMPANY-CUPERTINO LLC P.O.BOX 2702 DATE ISSUED: 01/02/2013 OWNER'S PHONE: 4089844800 GILROY, CA 95020 PHONE NO: (408)842-0054 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 0 COMMERCIALIJ 7 /l Z License Class__ Lic. # O OLD REPUBLIC C TIPl['1L]C' - S'Il']C' 101 - AN INTERIOR �� J ! �- �C IMPROVEMENT ON THE FIRST FLOOR CONSISTING OF Contractor Date MO DEMO I hereby affirm that I am licensed under the provisions of Chapter 9 OF THREE (3)IEXISTI[NO ROOMS AND CONSTRUCTION OF (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: $86000 performance of the work for which this permit is issued. I have and will maintain Worker.'s Compensation Insurance, as provided for by Section 3700 of the Labot-Code, for the performance of the work for which this APN Number: 31626094.10020 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read, this application and state that the above information is ]PERMIT EXPIRES ES IIIF WORK IS NOT STAIIB'I('IED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN ��® �� ®� PERMIT ISSUANCE ®� 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 )IDA FROM (LAST(' CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which. may accrue against ity in consequence of the / L/, granting of this.permit. Addition , the appl' anttan and and will comply Issued by: IDa - with all n int source regul on er t4 he v Al o Municipal Code, Section 9.18'' RE -ROOFS: Signature Date �� All roofs shall be inspected prior to any roofing material being installed. If roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection, 11 ❑ OWNER-BUILDE J1 dCLARATION Signature of Applicant: Date: I 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 II 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 Q ity Management District I AZ performance of the work for which this permit is issued. will maintain compliance with the Cupertino rcip Code, Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, S do s 25 , 255 and "5534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent Date: permit is. issued. - 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 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.soch 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 ARCH ITECT'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 COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - buildingCd-cuUertino.orq 42I\002-�5 ❑ NEW CONSTRUCTION ❑ ADDITION QALTERATION/Tl ❑ REV[SION/DEFERRED ORIG[NALPERMIT # [;O]ECTADDRESS 10020 N. DE ANZA BLVD. APN# (1l I,^�l',�'� 7 lJ THE WESTWOOD CO. OWNER NAME PHONE 408-984-4800 E-MAIL ANTHONY MORICI STREET ADDRESS 1855 PARK AVE. CITY, STATE, ZIP SAN JOSE, CA. 95126 FAX CONTACT NAME JEFF OPAROWSKI PHONE 408-496-0676 E-MAIL JOPAROWSKI @ARCTEC INC. COM STREET ADDRESS 99 ALMADEN BLVD., SUITE 840 CITY, STATE, ZIP SAN JOSE, CA 95113 FAX 408-496-1121 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ID ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME DAVID METHOD LICENSE NUMBER 857112 LICENSE TYPE B BUS. LIC # COMPANYNAME METHOD CONSTRUCTION E-MAIL METHODCONST@CS.COM FAX 408-848-0906 STREET ADDRESS CITY,STATE,ZIP GILROY, CA 95021 PHONE 408-842-0054 P.O. BOX 2702 ARCHITECTIENGINEER NAME JEFF OPAROWSKI, AIA LICENSENUMBER C-21289 BUS. LIC# COMPANY NAME ARC TEC INC. E-MAIL JOPAROWSKIOARCTECINC.COM FAX 408-496-1121 STREET ADDRESS 99 ALMADEN BLVD. CITY, STATE, ZIP SAN JOSE, CA 95113 PHONE 408-496-0676 DESCRIPTION OF WORK AN INTERIOR IMPROVEMENT ON THE FIRST FLOOR CONSISTING OF DEMOLITION OF 3 EXISITNG ROOMS AND CONSTRUCTION OF 7 NEW OFFICES / CONF. ROOMS/ STORAGE ROOMS EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES SE ONLY BUSINESS BUSINESS V -B TWO occ TYPE DESCRIPTIO SO Fr. VALUATION(SI EXISTG 12, 353 NEW FLOORDEMO 2 , 706 TOTAL 2,706 ''......... V •` [ f/ p8� Qr�� V) AREA AREA 12, 353 AREA NETAREA v BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH # DWELI,ING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑ YES BEINCADDP,D? ❑ NO ADDITION? ❑ NO PRE -APPLICATION ❑ YES D YES, PROVIDECOPY OF PLANNER'S NANIE: RECEIVED BY: TOTAL VALUATION: PLANNING APPI.# ❑ NO PLANNING APPROVAL. LE'ITr;R 1 "(3 �,.qq �•'� r� V v 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 I have provided is correct. I have read the Description of Work and verify it is accurate. [ agree to comply with all applicable local ordinances and state laws relating to b 'Iding onstru ion. I au orize representatives of Cupertino to enter the above -identified property for inspection purposes. Ab— Signature of Applicant/Agent: Date: SUPPLEMENTA RMA ON REQU[RED 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 b t Commercial ? yid d als Disclosure ❑ EXPRESS ❑ PLANNING PLAN REVIEW El STANDARD El PUBLICWORKS form if any Haz t 1Fe � se as p o p ect. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with lanning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 03116/11 ,n Trrn'%T ?TTrn ?-1Tr TTM1"TMrMTrFT?T OCCUPANCY TYPE: 111_ ll ll ll s11r if 1. U IF n MJ1 ILI N lky FEE ESTIMATOR — BUILDING DIWSION >F>LR AREA s.g. ADDRESS: 90020 N. De Anza Blvd. DATE: 99/05/2092 REYUEWED BY: RDW PC FEE IID APN: 1BP#: /a2 /10 -VALUATION; 1$86,000 *PERMIT TYPE: Building Permit PILAN CUIECK TYPE: Tenant Improvement PRIMARY Building LI PENTAMATUON 9 B T! USE:Commercial �, PERMIT TYPE: Plumb. hrsp. Fee: Elec. Insp. Fee: WORK An interior improvement on the first floor consistingof demo of 3 existingrooms and construction of 7 SCOPE new offices / conf. rooms and storage rooms 0 OCCUPANCY TYPE: TYPE . �CONSTR.R >F>LR AREA s.g. PC FEES PC FEE IID IBP (FEES IB? FEE IID B (Tenant Improvements) II-6,111-B,IV,V-B 2,706 $2,183.85 IBTIPLNCK $2,280.84 IBTIINSP Permit Fee: 1lech. lnsp. Fee: Plumb. hrsp. Fee: Elec. Insp. Fee: hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction .Tax: Administrative .Fee: Work Without Permit? Yes E) No $Q.00 TOTALS: 2,706 $2,183.85 Travel Doca.nncntutic�n Fees. $2,280.84 Strong Motion Fee: IBSEISMICO MECH, HOURLY 0 Yes O No PLUMB, HOURLY ® Yes (E) No ELEC, HOURLY 0 Yes (D No Nfecb. Plan Check PhiniL Plun Check Elec. Plan Check iLlech. Permit Fee: .. b. Permit Fee: h,lec•. Permit Pe C7ther ;llcch. Insp.ID Other Plumb Insp. C Other Elec. Insp. $0.00 Permit Fee: 1lech. lnsp. Fee: Plumb. hrsp. Fee: Elec. Insp. Fee: 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 oreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE )ITEMS (Fee Resolution 11-053 E : i/1/12) FEE QTY/FEE MffSC ffTlEMS Plan Check Fee: $2,183.85 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: E) Reg. Q OT 0,0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,280.84 Suppl. Insp. FeeQ Reg. Q OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction .Tax: Administrative .Fee: Work Without Permit? Yes E) No $Q.00 Advanced Planning Fee: $0.00 Select a Non -Residential G Building or Structure 0 4 Travel Doca.nncntutic�n Fees. Strong Motion Fee: IBSEISMICO $18.06 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $4,486.75 $0.00 TOTAL FEE: $4,486.75 Revised: 10/01/2012 BuiRding 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 002!� PERMIT # 12 ) 1 OU Z OWNER'S NAME: •'-& PHONE # kal 6-i¢Z--w5 GENERAL CONTRACTOR:Cr t q BUSINESS LICENSE it 2,6 7 ADDRESS:' PC. A Q 2702 5�Ll CITY/ZIPCODE: C4( -Q *Our municipal code requires all businesses working in the city to have a City of Cupertino (business license, NO BUILDING (FINAL OR (FINAL OCCU?ANCY INSP ECTIION(S) WILL BE SCHEDULED > NTEL TIME GENERAL CONTRAC70R AND ALL SUBCONTRACTORS HAVE OBTAINED A CITE' OF C>L P EIIBTIN D BUSINESS LICIENNE. I ani not using any subcontractors: Signature (Tease check applicable subcontractors and complete the following inkoirmation: Nj Date Owner / Contract® Signature (Date SUBCONTRACTOR BUSINESS NAME BUSINESS 1LIICENSE # Cabinets & Millwork d` e i 7-6t+7 j Cement Finishing Electrical A -L LCL`/? L 3 l Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing U477 V Heating Insulation Landscaping Lathing Masonry v1 Painting / WallpaperC i c-� �aVSrXi(C l-ZOA CIV(, Lt 71 Paving Plastering Plumbing Roofing .o Septic Tank Sheet Metal Sheet Rock C l �� L�cruS p�Q�-1G� 0.J 24 0 % Tile Owner / Contract® Signature (Date CUPERTINO PROJECT DATA o COMMERCIAL COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION 10300 TORRE AVENUE m CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 ^ building(ftupertino.ora PROJECT ADDRESS 10020 N. DE ANZA BLVD. APN# OWNERNAME THE WESTWOOD CO. PHONE 408-984-4800 E-MAIL RTRUEMPLER@SOBRATO.COM ANTHONY MORICI STREET ADDRESS 1855 PARK AVE CITY, STATE, ZIP SAN JOSE, CA 95126 FAX APPLICANT NAME ARC TEC INC. PHONE 408-496-0676 E-MAIL JOPAROWSKI@ARCTECINC.COM JEFF OPAROWSKI, AIA STREETADDRESS 99 ALMADEN BLVD. CITY, STATE, ZIP SAN JOSE, CA 95113 FAY 408-496-1121 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTORAGENT 10 ARCHrfECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT TENANT CONTACT NAME PHONE E-MAIL BUSINESS NAME FAX DESCRIPTION OF WORK AN INTERIOR IMPROVEMENT ON THE FIRST FLOOR CONSISTING OF DEMOLITION OF 3 EXISITNG ROOMS AND CONSTRUCTION OF 7 NEW OFFICES / CONF RMS./ STORAGE ROOMS EXISTING USE(S): BUSINESS PROPOSED USE(S): BUSINESS OCCUPANCY(S): OCCUPANT TYPE OF PARCEL B 66 V -B LOAD: CONSTRUCTION AREA: AREA OF 2, 706 S F FLOOR(S) HAZARDOUS Y REMODEL SPACE: OF REMODEL SPACE: MATERIALS? FIRE O N WUl Y N FLOOD YCCD) SIESMIC Y N SPRINKLERS: AREA: AREA: AREA: NUMBER OF CHILDREN <2 YRS OLD: LEARNING CENTERS AND 24 HOURS CARE? Y N NUMBER OF STUDENTS >= 2 YRS OLD UP TO 12T° GRADE: EDUCATIONAL OPERATIONS: NUMBER OF ADULT CLIENTS: Governing Codes: 2010 California Building Code (based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residential Code) 2010 California Plumbing Code (based on the 2009 Uniform Plumbing Code) 2010 California Mechanical Code (based on the 2009 Uniform Mechanical Code) 2010 California Electrical Code (based on the 2009 International Electrical Code) 2010 California Energy Code 2010 California Green Building Standards Code Cupertino Municipal Code ProjectData-Commercial doc revised 03/01111