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14040130CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10725 N DE ANZA BLVD CONTRACTOR: DEVCON PERMIT NO: 14040130 CONSTRUCTION INC OWNER'S NAME: 10725 DE ANZA LLC 690 GIBRALTAR DR DATE ISSUED: 04/22/2014 OWNER'S PHONE: 4089742757 MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] APPLE T.I. - INTERIOR UPGRADES FOR 1ST, 2ND & 3RD License Class11q LLiic.1# FLR RESTROOMS. ADD SECURITY DOORS IST FLR AND - In !^nIn fn l.U�� C,dV'�I 0VI Contractor V WY I Date DIMISING WALL ON 2ND FLR 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: $700000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32610065.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR 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 ed by: Date: granting of this permit. Additionally, the applicant understands and will comply with all non -p pint sourc regulations pe e Cup ino Municipal Code, Sect' 9.18. �} RE -ROOFS: Signatu Date04' !moi All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, l agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I 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) I, 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. I 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 I 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 I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 5�7) 25533,V 2 531. 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 the Health & Safety Code,Mfiol Date: L- Z a4 Owner or authorized ag _ 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, l 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10725 N DE ANZA BLVD CONTRACTOR: DEVCON PERMIT NO: 14040130 CONSTRUCTION INC OWNER'S NAME: 10725 DE ANZA LLC 690 GIBRALTAR DR DATE ISSUED: 04/22/2014 OWNER'S PHONE: 4089742757 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL License Classes APPLE T.I. - INTERIOR UPGRADES FOR 1ST, 2ND & 3RD Lic. 4 FLR RESTROOMS. ADD SECURITY DOORS 1ST FLR AND Contractor��� J' v� lV`Date ��/ -14- � - I hereby affirm that I am licensed under the provisions of Chapter 9 DIMISING WALL ON 2ND FLR (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. REVISION #1 REVISE WALL AT OFFICE SPACE (159); FRAME DOOR AT OFFICE (107) AND MONITORING LABS 224-228- ISSD OTC 8/28/2014 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. Sq. Ft Floor Area: Valuation: $700000 have and will maintain Worker's Compensation. Insurance, as provided for by ction 3700 of the Labor Code, for the. performance of the work for which this APN Number: 32610065.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree tocomply with all city and county ordinances and state laws relating PERMIT EXPIRES IF WORK IS NOT STARTED to building construction, and hereby authorize representatives of this city to enter WITHIN 180 DAYS OF PERMIT ISSUANCE OR 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 _ 180 DAYFAST CALLED 06RECTION. ) which may accrue against said City in consequence of the 4L/ granting of this permit. Additionally, th pplicant understands and will comply Issued by: Date: with all non -point sour regulations pe t e up rtino Municipal Code, Section 9.18. +� p Signature Date !/U 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. ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, 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 I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will declarations: maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the I have and will maintain a Certificate of Consent to self -insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quali Management District I will maintain compliance with the Cupert' o Mutticip 1 C d , Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, for by the Health & Safety Code, ecti ns 2 0 5 3, an t2 4 as provided Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized age Date: 14 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 such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address 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, ARCHITECT'S DECLARATION 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 I CITY OF CUPERTINO BUILDING PERMIT I j BUILDING ADDRESS: 10725 N DE ANZA BLVD I CON TRACT ON INC CON I PERMIT NO: 14040130 OWNER'S NAME: 10725 DE ANZA LLC 690 GIBRALTAR DR DATE ISSUED: 04/22/2014 OWNER'S PHONE: 4089742757 MILPITAS, CA 95035 PHONE NO: (408)942 -8200 j� LICENSED CONTRACTOR'S DECLARATION License Class Lie.# 1191105 Contractor Roeorj Date t vii 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 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. 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 r the Cupertino Municipal Code, Section 9.18. Signature Date Z S ❑ OWNtR- 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 (S4c.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, 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 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 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 9.18. Signature Date JOB DESCRIPTION: RESIDENTIAL F] COMMERCIAL ❑ APPLE T.I. - INTERIOR UPGRADES FOR 1ST, 2ND & 3RD FLR RESTROOMS. ADD SECURITY DOORS 1ST FLR AND (N) DIMISING WALL ON 2ND FLR REV #2 - Minor revisions to sidewalk Sq. Ft Floor Area: I Valuation: $700000 APN Number: 32610065.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 W 0( RO rrM LAST CALLED INSP CTIOIssued by: U� Date: Vq1M 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.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 M icipal Code, Chapter 9.12 and the Health & Safety Code, Sec ' n 505, 25 3 2s� Owner or authorized agen Date/ 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed i CITY OF CUPERTINO BUILDING PERMIT 1 1 BUILDING ADDRESS: 10725 N DE ANZA BLVD CONTRACTOR: DEVCON PERMIT NO: 14040130 I CONSTRUCTION INC OWNER'S NAME: 10725 DE ANZA LLC 690 GIBRALTAR DR DATE ISSUED: 04/22/2014 t OWNER'S PHONE: 4089742757 MILPITAS, CA 95035 PHONE NO: (408)942 -8200 I ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: ❑ RESIDENTIAL COMMERCIAL ❑ '72e'e`' APPLE T.I. - INTERIOR UPGRADES FOR 1ST, 2ND & 3RD License Class -' Lic. # 3 FLR RESTROOMS. ADD SECURITY DOORS 1ST FLR AND -k� �`�' {f�tf1 � (N)DIMISING WALL ON 2ND FLR Contractor l� Date ..,���,� 1 hereby affirm that I'am licensed under the provisions of Chapter 9 DEFERRED #2• ACCESSIBLE PATH OF TRAVEL FROM 3 h i i B i & P (commencing with Secton 7000) of Division 3 of the Business Professions PUBLIC WAY; INSTALL (3) LIGHTED BOLLARDS - ISSUED { Code and that my liceinse is in full force and effect. } 7/14/15 ° i I hereby affirm under penalty of perjury one of the following two declarations: j 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: $700000 erformance of the work for which this permit is issued. I I have and will maintain Worker's Compensation Insurance, as provided for by j Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 32610065.00 Occupancy Type: { permit is issued. 1 APPLICANT CERTIFICATION j 1 certify that I 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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter t 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 granting of this permit. Additionally, the applicant understands and will comply Issued by: 7�i4 N sg�L.� -/ Date: `% d with all non -point so94e regulations per the Cupertino Municipal Code, Section RE- ROOFS: 9.18. �I 11T Signature DateI 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) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE j construct the project Sec.7044, Business & Professions Code). p J ( ) I have read the hazardous materials requirements under Chapter 6.95 of the 1J California Health & Safety Code, Sections 25505, 25533, and 25534. I will ? 1 hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the I 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 I use equipment or devices which emit hazardous I 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 I I performance of the work for which this permit is issued. will maintain compliance with the Cuper no Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the of the work for which this the Health & Safety Code, Sections 2552553 },arrd'25534. / `y 1 performance may_ ., , Owner or authorized agent: r ' `4e Date: � . permit is issued. j 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, 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.) j i Lender's Name + APPLICANT CERTIFICATION Lender's Address I 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 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. i 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. I a Signature Date 1 I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10725 N DE ANZA BLVD CON CONTRACTOR: ON D C CON PERMIT NO: 14040130 OWNER'S NAME: 10725 DE ANZA LLC 1 690 GIBRALTAR DR I DATE ISSUED: 04/22/2014 1 OWNER'S PHONE: 4089742757 1 MILPITAS, CA 95035 1 PHONE NO: (408)942 -8200 1 ❑ LICENSED CONTRACTOR'S DECLARATION License Class_ V, Lic. # (0 "J �•� Contractor D,� ©0-o -4 4 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. 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. 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. 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 oft granting of this permit. Additionally, the applicant understands and will with all non -point source regulations per the Cupertino Municipal Code, Se 9.18. n l 1 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL APPLE T.I. - INTERIOR UPGRADES FOR 1ST, 2ND & 3RD FLR RESTROOMS. ADD SECURITY DOORS 1ST FLR AND (N) DIMISING WALL ON 2ND FLR DEF # I - DOCUMENT (E) CONDITION IN 3 (E) BREAKROOMS (SINKS & WATER STATIONS) ARE ADA ACCESSIBLE - ISSUED 5/6/14 Sq. Ft Floor Area: I Valuation: $700000 APN Number: 32610065.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 _DAYS FRS INSPECTION. Date: !� RE- ROOFS: Signatur Date 5 D T 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 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: 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. 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. 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; 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 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 Signature of Appl 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, 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, %SecC'ov2550, 25533, d 2 " !!77 V5 Owner or authorized agent ate 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 1 understand my plans shall be used as public records. Licensed CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10725 N DE ANZA BLVD DATE: 04/22/2014 REVIEWED BY: MELISSA PC FEES APN: 32610 065 BP#: , "VALUATION: 1$700,000 B (Tenant Improvements) YPERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building 1BTIPLNCK PENTAMATION PERMIT TYPE: 1BTIIA WORK APPLE T.I. -INTERIOR UPGRADES FOR 1ST 2ND & 3RD FLR RESTROOMS. ADD SECURITY SCOPE DOORS 1ST FLR AND (N) DIMISING WALL ON 2ND FLR OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,111-B,IV,V-B 1,600 $2,112.04 1BTIPLNCK $1,445.97 IBTIINSP Fr,'r'. It7J-F.t. t' ec— PME Plan Check: $0.00 Permit Fee: $1,445.97 Suppl. Insp. Fee -.(F) Reg. Q OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 1,600 $2,112.04 $1,445.97 MECH, HOURLY 0 Yes '• No PLUMB, HOURLY 0 Yes 0 ,No ELEC, HOURLY Q Yes - Q No. MISC ITEMS h! w;h, p o" i Fm-M CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10725 de anza DATE: 08/28/2014 REVIEWED BY: MENDEZ APN: BP #: "VALUATION: Iso 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: Select a Misc Bldg /Structure or Element of a Building PENTAMATION PERMIT TYPE: WORK REVISION #'I REVISE WALL AT OFFICE SPACE (159); FRAME DOOR AT OFFICE 107 AND SCOPE MONITORING LABS 224 -228- ISSD OTC 8/28/2014 ivviC: T his estimate aoes not incivae fees aue to other Departments i.e. manning, Yumic works, Tire, sanitary sewer District, scnooi District, etc). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 E . 7;'1!13) FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg /Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OTJ 0.0 Fhrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:O Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes No $0.00 Advanced Planning) fee: $0.00 Select a Non- Residential Building or Structure 0 0 Strong Motion Fee: $0.00 1 # $859.00 Revisions IREVCOMTt Tenant Improvement Bldg, Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $859.00 TOTAL FEE: $859.00 Revised: 08120/2014 Fm-7: CITY OF CUPERTINO VAia 0 FEE ESTIMATOR - BUILDING DIVISION th,-f,. i NOTE: This estimate does not include fees due to other Departments (i.e. Planning. Public Works. Fire. Sanitary Sewer District. School nictrirt_ otc )- Thoco foes are haled nn the nreliminary information available and are anly an estimate_ Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution I1 -053 Ejf 7/1/13) ADDRESS: 10725 N. De Anza Blvd DATE: 07/29/2015 REVIEWED BY: PAUL Plan Check Fee: Hourly Only? Q Yes Q No APN: 32610 065 BP #: 'VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY !Commercial Building USE: PME Plan Check: PENTAMATION 1GENCOM PERMIT TYPE: WORK REV #2 - Minor revisions to sidewalk SCOPE Suppl. Insp. Fee.S Reg. Q OT th,-f,. i NOTE: This estimate does not include fees due to other Departments (i.e. Planning. Public Works. Fire. Sanitary Sewer District. School nictrirt_ otc )- Thoco foes are haled nn the nreliminary information available and are anly an estimate_ Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution I1 -053 Ejf 7/1/13) FEE QTY /FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes Q No $0.00 1 hours Plan Check, Hourly . STPrNCx Suppl. PC Fee: Reg. OTT-0 . . PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.S Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Q Building or Structure (� i Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $143.00 TOTAL., FEE :` $143.00 Revised: 07/02/2015 CITY OF CUPERTINO FM -7, FEE ESTIMATOR — BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Hire, Sanitary Fewer U'strtct, School Metrirt am) Thoco foot aro hacod nn tho nroliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) ADDRESS: 10725 N DE ANZA BLVD DATE: 05/06/2014 REVIEWED BY: MELISSA 141-1:(1. permit r �r: APN: 32610 065 BP#: 14040130 'VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY USE: Commercial Building Nzmib. ?1) p,, I'l-e: PENTAMATION PERMIT TYPE: 1GENC0 i WORK DEF # 1 - DOCUMENT E CONDITION IN 3 E BREAKROOMS SINKS & WATER STATIONS ARE SCOPE I ADA ACCESSIBLE - ISSUED 5/6/14 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Hire, Sanitary Fewer U'strtct, School Metrirt am) Thoco foot aro hacod nn tho nroliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) A., ,:,:. ; r,,, t:: z:r rt,,,,;n. ?'rcrrt Elec. Plan Check 141-1:(1. permit r �r: T"r:,,,b. Permit -a•cr: (.0"ec Perini[ 011ie; ;'.IE'Ci`(. i?:�°ir>. 01heP t�himb lris .EI Other 1:1<'c. b7sp. &%e..ch- /t75U. / P:c°: Nzmib. ?1) p,, I'l-e: Elec. hiss. NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Hire, Sanitary Fewer U'strtct, School Metrirt am) Thoco foot aro hacod nn tho nroliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 I I # $2 .00 Deferred Submittal IDEFSUBM Suppl. PC Fee: Q Reg. 0 OT0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 1 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ;:'nrisr?'tic'=ir,fr ; err: :'ECJhilfUf:l'll(ii`c? f"r'i:: 0 G Work Without Permit? 0 Yes c• No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 �Fci:.c,f /Jt>1:Y:7118fT7rCFil(1j'7 /`CtG'J`: Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: 1 $0.00 $278.00 ;. TOTAL FEE: $ .00 Reviser.04/01 /2014 M FM-7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 10725 N DE ANZA BLVD DATE: 07/02/2015 REVIEWED BY: SEAN MISC ITEMS APN: BP #: C) *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: 0.0 PENTAMATION 1GENCOM PERMIT TYPE: WORK DEFERRED #2: ACCESSIBLE PATH OF TRAVEL FROM PUBLIC WAY. SCOPE !VU%E: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, rare, sanitary sewer District, school Dictrirt etc). Thow fees are based an the nreliminary information availahle and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11 -053 Ej' 7%1/13,) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? ® Yes Q No $0.00 1 hours Plan Check, Hourly $143.00 ISTPLNCK Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes Q No $0.00 Suppl. Insp. Fee:Q Reg. ®OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 E) Work Without Permit? © Yes E) No $0.00 Advanced Planning I'm $0.00 2 hours Inspections $286.00 ISTINSP Inspection, Hourly ©� :�+ Strong; Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $429.00 TOTAL FEE: $429.00 Revised: 07/01/2015