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15080214CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19800 VALLCO PKWY CONTRACTOR: ABM ELECTRICAL PERMIT NO: 15080214 SOLUTIONS OWNER'S NAME: CUPERTINO PROPERTY DEVELOP LLC 16940 KOLL CENTER PKWY STE 100 1 DATE ISSUED: 08/31/2015 OWNER'S PHONE: 4083431088 . ' I PLEASANTON, CA 94566 1 PHONE NO: (510) 932 -2275 1 ❑ LICENSED CONTRACTOR'S -DECLARATION License Class c- Lic. # q6 / 7 � 7 L Contractor A'Q M Date �I�I 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 erformance of the work for which this permit is issued. 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. 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 r ulations per the Cupertino Municipal Code, Section 9.18. Signature Date . �/. A ❑ OWNER- BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec. 7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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. I 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, 1 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 1 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 EJ COMMERCIAL E] INSTALLATION OF (2) L3 AND (1) L2 EV CHARGING STATIONS IN PARKING STRUCTURE AT MAIN STREET. Sq. Ft Floor Area: Valuation: $52000 APN Number: 31620108.19800 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: ZL/7` Date: e 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 Code, Sections 2550_) 25533, and 25534. Owner or authorized agent: r- Date: • %'f 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Profess CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19800 VALLCO PKWY CONTRACTOR: ABM ELECTRICAL PERMIT NO: 15080214 SOLUTIONS OWNER'S NAME: CUPERTINO PROPERTY DEVELOP LLC 16940 KOLL CENTER PKWY STE 100 1 DATE ISSUED: 08/31/2015 1 OWNER'S PHONE: 4083431088 1 PLEASANTON, CA 94566 1 PHONE NO: (5I0) 932 -2275 ❑ LICENSED CONTRACTOR'S DECLARATION License Class��) V Lic. # Contractor ) 1 E N Date [� 1<' 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 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. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authori c representatives of this city to enter upon the above mentioned property for in ction purposes. (We) agree to save indemnify and keep less tCiupertino against liabilities, judgments, costs, and expense ich maaid City in consequence of the granting ofth.i it. Ad tcant understands and will comply with all non -poin rce regul no Municipal Code Section 9.18, Signat Date to 2,10y ❑ OWNER - BUILDER DECLARATION 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). I 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. 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. a. 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 Califomia. 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 shal I 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.I8. Date JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALLATION OF (2) L3 & (1) L2 EV CHARGING STATIONS IN PARKING STRUCTURE AT ROSEBOWL(134.2 KW). Revision #1 - Add (N) charging station to van accessible parking spot - ISSUED 10/28/15 Sq. Ft Floor Area: Valuation: $52000 APN Number: 31620108.19800 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 D YS FjROMj��LAST CALLED INSP �CQT�O/jN. Issued by: e 1 ""�'��`�""^ Date: O 1013 (JN 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. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sectio 5532(a) should I store or handle hazardous material. Additionally, sho I use a uipment or devices which emit hazardous air contaminants as fined the Bay Area Air Quality Management District I will maintain com nee w' he Cupertino Municipal Code, Chapter 9.12 and the Health & S Cod ctions 25505, 25533, and 25534. Date: ze- / v 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 I understand my plans shall be used as public records. Licensed Professional CUPERT[ NO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • buildina(a.cuDertino.org J L S j 1 I PROJECT ADDRESS l p o o V A't r U 1�9 l. (� j UWNi:R NAI,QE _PT'ONG� � � E•1`4A1L l v _ � STREET ADDRESS Moo 0 oo W/ v p'tw I Crrryi fLA E ZIP v o FAX -- CONTACT N ?A4EA '' wjw1 CG o '�0 /�' 132 - 7774;- E�4A �•4S }hcr8 r (,-e O ®� STRE�T�D SS j'��1%/7�`1/��t1l�d�1 ppk CITY TA�e Zjp_ - /B ��7 �7 U� Y FAX ❑('CC0?.�jA/CTTOlR/AGEN'T ❑ ARCHTCT ❑ ENGINFFR ❑ DEV-- LOPE,R ❑ TENANT ❑ OuW=R ❑ ON WER- B(b'LTDEER ❑ 01A1N= RAGE)v'T CONTRACTOR CO,'TR4CTQRNA74E LICtBER� /G LICxe'SE]1�E ` BUS. LICR e1 COMPANY 'AME E- L . '1 ti1.�1 -�t�IC i o ► 66ie ®,�r�•�Ltt/'�If I FAX S �,� j(/ cIT]LTPT- IP �7 - -7 7'r `- te! TOD��s�/ ,/Db l N• 1 r -'�O g� L [ ARCHITECT1E •EE 0c„ LICENSE I.!AeER ..� ( BUS. LIC R COMPANY NAME � -e f�� s L E -M.AIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑SFD or Duplex ;2multi- Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: eCOmmercial URBAN INTERFACE AREA ❑ Yes NO FLOOD ZONE ❑ Yes 1"0 ❑ SOLAR PANELS � STATION ❑ SOLAR WATER I EATINTTG ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: �Z VO FJ DESCRIPTION OF WOR} A � S4 / / 1 r ! j ( An ` � A � /4 � Ct �s O .. • , .RECEIVED BY `� u�?2.2„- y; 6 k By my signature below, I 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 corect. I have read the Description ofWork and verity it is accurate. I agree to comply with all applicable local ordinances and state la \vs relating to building co authorize representatives of Cupertino to enter the above- idennt�ified property for inspection purposes. Signature of Applicznt/Azent: Date:? " SUPPLEI`6ENTAL INTFOR?`QATION REQUIRED 5` PI!4pp_2011.doe revised 03116111 Wo" CONSTRUCTION PERMIT APPLICATION IL �. COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 up CUPERTINO (408) 777 -3228 • FAX (408) 777 -3333 • buildina(a,cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI V REVISION / DEFERRED ORIGINAL PERMIT PROIcCf ADDR>� � t' W APN R pop. 3�3 �o�'� •' des'• alo.c� -ti STREET ADDR 1, C FAX Iw NB �"[u��� •• I.i�WJ Qr6rV °M'V STOEf •r r1b, 11 Cps x 7 1S�ghi�O�V `r� FAX 13 o\%gTR ❑. OWNER - BUILDER - ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ,ac=cT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT C0 ' ME L" %T%7/, %E / L1C S ;170 `'vE (,w040�, BUS. L1C 4 COMP �SLb 1V1 e e C FAX I TL.H1.'IP L �J�' /� /� A ` u; � / `_� qK 9 14—u* ARCHUECVENGIIV NEERNA.ME LICESENUMBER BUS.LICR COMPANY NA-Ma E -MAIL FAX STREET ADDRESS CITY, STATE; ZIP PHNE • +O_J DESCRIPTION OF WORK 1b V'w W {� II A cS S�V1b . Spot v EXISTING USE PROPOSED USE CONSTR TYPE 4 STORIES USE TYPE f I OCC. j I SQ.FT. VALUATION (S) FDaSTG NEW FLOOR DE1.4O TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK TORCII AREA GARAGE AREA: LJDETACH -- ❑ ATTACH n DWELLING UNITS: IS A SECOND UNrr ❑ YES SECOND STORY []YES BEING ADDED? NO ADDITION? NO PRE - .APPLICATION ❑ YES IF YES, PROVIDE COPY OF 15 THE BLDG AN YESiE TOTAL VAL ATION: PLANNTI.G.APPLR ❑NO PLANT'7I�GAPPROVAL LETTE. EICHLERHOME? ❑1.0 _ -' By my signature below, I certify to each of the fo ving: I am the prop owner or authorized agent to act on the propel owner's behalf. I hav read this application and the information I have provi correct, have re .e Description of Work and verify it is accurate. I agree to comply wr t all pplicable local laws bu ' ' 'of ordinances and state relating to constructi author representatives Cupertino to enter the a v -id t fi t p!e r inspection purposes, ��1 Signature of Applicant/Agent: Date: ` SUPPLEMS11TAL INTFORAZATION RE IRED � ; _ otizznc �Lle __= New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building �o EIZ ralicoti�rl lz T4IIII.DL'SGPLANREVIE�Y permit for new building. 4N1LnGpL4? 9 v Jz> �TEF 3 Commercial Bldgs: Provide a completed Hazardous Materials Disclosure l� T nDAxn ;0 pLEI C�oRrts Y _ form if any Hazardous Materials are being used as part of this project.; r�I4RG2 L7 FSREDEPT - _ Copy of Planning Approval Letter or Meeting with Planning prior to a submittal of Building Permit application,7oRz saa�T?�x� sEnERDlsrxicr f B1dg,4pp_2011.doc revised 06121111 FM_7 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION 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 onlv an estimate. Contact the Deat for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Lfl,' 7i1113� ADDRESS: 19800 VALLCO PARKWAY DATE: 08/31/2015 REVIEWED BY: SEAN [ttech. I'r�rrrri: f-,ee: APN: BP #:� *VALUATION: $52,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? 0 Yes (F) No PENTAMATION PERMIT TYPE: SOLAR-COMM WORK INSTALLATION OF 2 L3 AND 1 L2 EV CHARGING STATIONS. SCOPE Suppl. Insp. Fee:Q Reg. Q OT 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 onlv an estimate. Contact the Deat for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Lfl,' 7i1113� ie<llh. Flom Chick Plrrnrh. Plcrn Cher.A. Elec, Plan Check [ttech. I'r�rrrri: f-,ee: Plurnh. Permit Fcce,: Islee. Pere it Fee' Other n(e"Ir. 1rrvp Other Phonb Imp. Other El"­. hup. Lj )tech, Laso. Fee': I' %rear. h?.sv. Fees: 0e:c. l l o. ilc,: 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 onlv an estimate. Contact the Deat for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Lfl,' 7i1113� FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 0 # Alternative Energy System $327.00 ICHRGSTA EV Charging Station Suppl. PC Fee: 0 Reg. OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT kmo hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 Ae'.1ininistrwive Fee: 0 0 Work Without Permit? 0 Yes (j) No $0.00 Advanced Plannin Fee: $0.00 Select allon- Residential Building or Structure 0 1'ravel Doetanenlaiion Fees: Strong Motion Fee: 1BSEISMICO $14.56 Select an Administrative Item Bldy Stds Commission Fee: IBCBSC $3.00 SVBTQTALS: $17.56 $327.00 TOTAL FEE: $344.56 Revised: 07/02/2015 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION i9s, ADDRESS: 198000 Vallco Parkway DATE: 10/28/2015 REVIEWED BY: PAUL d/eclr. Permit Fee: APN: 316 20 108 BP#: "VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? Yes � No PENTAMATION 1GENCOM PERMIT TYPE: WORK Revision #1 - Add N charging station to van accessible parking sot SCOPE Suppl. Insp. Fee:(!) Reg. ® OT 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 onlv an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11 -053 Eff, 711113) aleclt. ,Pleat (.` /reek Numb, Nat? ( " /tec•k l? /ee,. Plan CFte<:k d/eclr. Permit Fee: Plumb. PerniirFee: Glee. Permit Fee: Olher,llec/c. 1ns'p. Other Plumh./usp. Other Elee. hap. Afech. /nyp7 /'c'e: I Plumb. insp. Fee: /aec. Insp. Vee: 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 onlv an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11 -053 Eff, 711113) FEE QTY /FEE MISC ITEMS Plan Check Fee: Hourly Only? () Yes (!) No $0.00 0 hours Plan Check, Hourly $143.00 1STPLNCK Suppl. PC Fee: (j) Reg. () OT 0,0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:(!) Reg. ® OT 0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCoNSTAXC $0.00 AdminisireVive F'ee: 0 G Work Without Permit? Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure � Travel Docutneriluliotr Fees: Strong Motion Fee: $0.00 Select an Administrative Item Blda Stds Commission Fee: $0.00 SUBTOTALS: 1 $0.001 $143.00 TOTAL FEE: $143.00 Revised: 10/0112015 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Tone Avenue Cupertino, CA 95014 -3255 Telephone: 408 - 777 -3228 Fax: 408- 777 -3333 JOB ADDRESS: PF800 V, Il ( 6 P,2KW . PERMIT # OWNER'S NAME: PHONE # '57e q -C Z ZZ -K- GENERAL CONTRACTOR: kg M BUSINESS LICENSE # ADDRESS: /6AV 0011(-M +Q/ oPOCL0 • STS /06 CITY /ZIPCODE: Pj eACAN1 ,r,,1 CA *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE 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: Owner / Contractor Signature 2- . 3/' /S-- 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 2- . 3/' /S-- Date