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15120076CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10201 TORRE AVE I GENERAL NTRACTOR: DP CONSTRUCTION, A I PERMIT NO: 15120076 I OWNER'S NAME: I & G DIRECT REAL ESTATE 21 LP 1 1450 VETERANS BLVD I DATE ISSUED: 12/08/2015 1 OWNER'S PHONE: 2066607603 I x LICENSED CONTRACTOR'S DECLARATION License Class P Lic. # q�`I Contractor 61A§ XGi-IOO 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 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 permit is issued. APPLICANT CERTIFICATION I certify that 1 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 pfw` Date �2 5 ❑ OWNER - BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, 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 (See.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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. 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, 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, 1 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. 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 REDWOOD CITY, CA 94063 J PHONE NO: (650)474 -1450 JOB DESCRIPTION: RESIDENTIAL EJ COMMERCIAL AMAZON - 2ND & 3RD FLRS - RELOCATE & UPGRADE 18 OUTLET /RECEPTICLES IN (E) CONFERENCE ROOMS Sq. Ft Floor Area: I Valuation: $15000 APN Number: 36941005.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FR034JAST_-jLASLED INSPECTION. 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 Appl Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER FIAZARDOUS 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.I2 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 25505, 25533, and 25534. Owner or authorized agent: °✓l Date: g 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 Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building a)cupertino.org B1dgApp_2011.doc revised 06121111 ❑ NEW CONSTRUCTION ❑ ADDITION JZ(ALTFRATION/TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS APN # / / — r0 r r OWNER NAME HONE E -MAIL st►.l,u r- at,14412, e7, c00 STREET ADDRESS E, ZIP FAX CONTACT NAME �VA� PHONES f _ ` E-MAIL Nvz / STREET ADDRESS (` C 14 CITY, STATE',, ZIP 5-44 1 �V 7fC l I J 129 FAX- ❑ OWNER ❑ OWNER-BUILDER 0 OWNERAGENT V21 CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME 5Afa h LICENSE NUMBER6rC 3,,-, lJ LICENSE TYPE BUS. LIC # COMPANY NAME E -MAIL a FAX STREET ADDRESS t5l, WL 1t/ CITY, STATE,ZIP5�� CA- 6 �G(r�P l . PHONE/' () ARCHITECT/ENGINEERNAME " vei LICENSE NUMBER Sv02Z� BUS. LICC # COMPANY NAME EL toR !UtEFuy-P( C- E -MAIL nAbD ?; �`CD��Q �Z,pI FAX STREET ADDRESS �3 t p 5456-1f 1 � JJ- CITY, STATE, ZIP5Q ✓f , L� PHONE iefkf86— DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR -T DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT [] YES SECOND STORY OYES BEING ADDED? I—il%NO ADDITION? )2NO PRE - APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN RECEIG ED '.' TOTAL VALUATION: PLANNINGAPPL# ONO PLANNING APPROVAL LETTER EICHLER HOME? O �', �'° a ov By my signature below, I certify to each of the following; I am the property owner or author ope wner's behalf. I have read this 7andverify application and the information I have provided is correct. I have read the Description of Work i cc c to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cuper above- identified property-tor inspection purposes. Signature of Applicant/Agent: Date: 5 SUPPLEMENTAL INFORMATIO UIRED Q PLANeCHECK�TYPF,i ROUTII\GStiIP R THE COUYTER ❑ BULL ➢IVG PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building g permit for new building. P g -'EXPRESS', ❑PLAN'VLVG PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ V STA➢ARD ❑ uBLlevloRtcs` � form if any Hazardous Materials are being used as part of this project. X ❑LARGE ak ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to .. ,,; r ❑ ?MAloi submittal of Building Permit application. r ❑ snvITARsEw�Ex DISTRICT-- 1 `ENVIRONMENTAt :HEALTH B1dgApp_2011.doc revised 06121111 CITY OF CUPERTINO - 74 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10201 TORRE AVE DATE: 1210812015 REVIEWED BY: MELISSA APN: 369 41 005 BP #: Plan Check Fee: }VALUATION: $15,000 *PERMIT TYPE: Building Permit 18 # $48.00 PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY USE: Commercial Building 0.0 T Civil / Religious activities in BQ zone? 0 Yes Q No PENTAMATION PERMIT TYPE: 1 CEAP1 WORK AMAZON - 2114D & 3RD FLRS - RELOCATE & UPGRADE O u SCOPE Permit Fee: $0.00 fe;::'r. 11 :'h :rk r,, = =: N1, Elec. Plan Check 10.0 1 hrs $0.00 d .. .. . . .. . . . . ... Elec. Permit Fee: IEPERMIT �. �'c ;'i,rrfri� .i� -�.,.� Other Elec. Insp. 0.0 hrs $48.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). I hese fees are based on the prelimmarV information available and are only an estimate. Contact the Dept for addn'l into. FEE ITEMS (Fee Resolution 11 -053 Eff.' 7/1/13 FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 18 # $48.00 Electrical 1BREMRECEP Recep /Switch /Outlets Suppl. PC Fee: 0 Reg. 0 OT 0.0 T 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: $48.00 Construction Tax: IBCONSTAXC $0.00 Administrative Fee: IADMIN $45.00 Work Without Permit? Yes (D No $0.00 Advanced Plannin g Fee: $0.00 Select a Non- Residential Building or Structure 0 Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICO $4.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTIOTALS TA$48.00 r.f $194.20$146.20 Revised: 10/01/2015 11 n. E Pw h6v H L I L z z i u L -2 Z EEL 0 M H F-H z w 1E 9L 9 2 UN— A Sv 0 sw !p. W 0 (c M. �n -,'Fh PHU- R x d - Z PIP,, gi g.. S 9 6 2— f �J All ic" Q N g Q m z i 1 gq y 2 _ as H u A ON -W �u 2'. T' ILE 81 0, F M ! J 2 dW, 31 OY 8 8 8 Z W vo,omindno 3M3AV 3U801 t0904 830VHDdn AV SH001:1 GUC I aNZ VNundVNNV COPS NOZVWV 1�3HSdRAOD IVOIAL0313 n. E Pw h6v H L I L z z i u L -2 Z EEL 0 M H F-H z w 1E 9L 9 2 UN— A Sv 0 sw !p. W 0 (c M. �n -,'Fh PHU- R x d - Z PIP,, gi g.. S 9 6 2— f �J All ic" Q N g Q m z i 1 gq y 2 _ as H u A ON -W �u 2'. T' ILE 81 0, F M ! 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