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B-2016-2399 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-201672399 20863 STEVENS CREEK BLVD CUPERTINO,CA 95014(326 32 053) TCG BUILDERS INC MILPITAS,CA 95035 OWNER'S NAME: STEVENS CREEK OFFICE CENTERASSOCITATES DATE ISSUED;08/15/2016 OWNER'S PHONE:408-799-7346 PHONE NO:(408)321-6450 LICENSED ONT A TOR' DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#835597 X BLDG _ELECT _PLUMB Contractor TCG BUILDERS INC Date 04/30/2018 _MECH_RESIDENTIAL X COMMERCIAL 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. JOB DESCRIPTION: I hereby affirm under penalty of perjury one of the following two declarations: STE 300;T.I.(5,964 S.F.)APPLE 1. 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. Sq.Ft Floor Area: Valuation:$250000.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 326 32 053 A(Tenant improvements),B(Tenant Improvements) 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Muni 'pal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature � Date 08/15/2016 Issued by:Sean Hatch Date:08/15/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. I,as owner of the property,:or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec,7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:08/15/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will.maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3.. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Cade,Sections 25505,25533, ,d-2 534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized;agen,: r APPLICANT CERTIFICATION Date:08/15/2016 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S beused Code,Section 9,18. i understand my plans shall be used as public records. Licensed Signature Date 08/15/2016 Professional CONSTRUCTION PERMIT APPLICATION ,. . COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CU PERTINO (408)777-3228•FAX(408)777-3333-buiiding0cupertino.orr /l r 16 El NEW CONSTRUCTION 0 ADDITION l] ALTERATION I Ti 171 REVISION 1 DEFERRED ORIGINAL PERMIT 1# PROJECT ADDRESS 20863 Stevens Creek Blvd. oV ..,�.�,V .. APNS326-32^U53 OWNER NAME pp PHONE E-MA1L Apple Inc, -Anh Vu 408-799-7346 anh_vu@apple.com STREET ADDRESS 1 Infinite CITY,STATE,ZIP 7FAX [ ' 'te Loop Cupertino CONTACT NAME PHONE E-MAILjrussell@fca-arch.com Russell 415..931.8600 �russeAl@fca-arch.com STREET ADDRESS CITY,STATE,ZIP 1361 Bush Street San Francisca, CA 9409 FAX OWNER ❑ OWNER-BUILDER. ❑OWNHRAGENT - © CONTRACTOR C1CONTRACTOR AGENT IN ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑:TENANT CONTRACTOR NAME LICENSENUMBER LICENSE TYPE BUS.LIC# Tim Tempel B-835597B 27856 COMPANY NAME The Core Group E-MAILtimt@tcgbullders.com FAX408-321-6455 STREET ADDRESS.89O North McCarthy Blvd, Shite 10.0 CITY,-STATE,ZIPMilipltaS, CA 95035 PHONE. 08-321-6450 ARCI-IITECTMNGINEER NAME LICENSE NUMBER I 1 lJ/`1 :! J BUS.LI'C`i#' 1 V Chiu Lin Tse Chan C-012739 COMPANY NAMEFong and Chan Architects E-MAILjrussell@fca-arch.com FAx415-931-8601 STREET ADDRESS CITY,STATE,ZIP PHONE 1361 Bush Street San Francisco, CA 94109 415-931-8600 DESCRIPTION OF WORK _ Replace existing finishes throughout office, construct two small private offices,security vestibule,and server room closet. No Change of Use, No Site Changes EXISTING USE - PROPOSED USE - CONSTR.•TYPE #STORIES. Office Office VN USE TYPE OCC. SQ.FT. VALUATION{$) EXISTO �+ NEW FLOOR �+ DEMO /�A TOTAL �+ (� �] /�(1 1� AREA 5,9V4 AREA 5,9641 AREA 5,964 NET AREA 5,964 Office' V� B 519 $25Q,000 BATHROOM RHMODELAREA na REMODELAREA na RP.MODELAREA PORCHAREA DECKARIIA TOTALDECKIPORCHAREA GARAGHAREA: DHTACH na Ina na ATTACH :O DWELLING UNITS: 18 A SECOND UNIT ❑YES SECOND STORY OYES na BRINGADDrD? ONO ADDITION? - [ENO PRF-APPLICATION ❑YFiS ]PYES,PROVIDE COPY OF ISTITEBLDGAN ❑YES TOTALVALUATION: PLANNTNG.APPL# ONO PLANNING APPROVALLETTER DICHLERFIO\4L? NO - $250,000.01 _ .._.. 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 correct. I have readthe Description of Work and verify it is accurate. I agrce to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: _ Data 7/28/16 SUPPLENfE A -INFORMATIONREQUIRED - _New SFD or Mult' roily dwellings: Apply for demolition permit for � gYER Tyle!coIJIVTER � J3U7LDIN6 PLAh1REyIEw existing building(s). Demolition permit is required prior to issuance of building permit for new building. p ExPlti ss ❑ PLANNIIV PLA1S Ii1 vlE�v _Conimercia Bldgs: Provide a completed Hazardous Materials Disclosure C� STAI.DARD L7 rvBLtc�vgltics form if any I-Tazardous Materials are being used as part of this project. Q.LARGE' NiREDEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. MAJOR. ❑ 3ANITARYSEWER DISTRICT ...' ❑.-ENVlltON1YfEI1TAL13EALTIe Bldg4pp_201],doe revised 06/21111