B-2016-1492 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1492
10100 N TANTAU AVE CUPERTINO,CA 95014-2540(316 19 062) NOVO
CONSTRUCTION INC
MENLO PARK,CA
94025
OWNER'S NAME: (PR CUPERTINO GATEWAY LLC) DATE ISSUED:11/17/2016
OWNER'S PHONE:408-783-4731 .
08-783 4731PHONE NO:(650)701 -1500
JTCFNSFD CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class GENERAL BUILDING CONTRACTOR Lic.#791022 X BLDG ELECT PLUMB
Contractor NOVO CONSTRUCTION INC Date 02/28/2017 — __
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:
FIRST FLOOR-T.I.-R&D LAB(3,396 S.F.);EXPAND ROOF SCREEN
I hereby affirm under penalty of perjury one of the following two declarations: FOR NEW MECH EQUIPMENT;INSTALL WATER TANK AT
1. I have and will maintain a certificate of consent to self-insure for Worker's EXTERIOR LOADING DOCK(APPLE),
Compensation,as provided for by Section 3700 of the Labor Code,for the TI PREP PERMIT 14B-2016-1273
.-performance of the work for which this permit is issued. ''
.,2.><---I have and will maintain Worker's Compensation Insurance,as provided for by
(es Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$2500000.00
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 APN Number: Occupancy Type:1
and state laws relating to building construction,and hereby authorize 31619 062 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 Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 11/17/2016 Issued by;Abby Ayende
Date: 11/17/2016
OWl1�ER-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) i
2. I,as owner of the property am exclusively contracting with licensed Signature of Applicant:
Y
contractors to construct the project(Sec.7044,Business&Professions Code). Date:11/17/2016 .
i
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. I have and will maintain a Certificate of Consent to self-insure for Worker's 1
Compensation,as provided for by Section 3700 of the Labor Code,for the 1
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
maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
permit is issued.
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,shouldI 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 bythe BayArea 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 Code,Sections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall '
be deemed revoked. ---or authorized agent: -
APPLICANT CERTIFICATION C Date:11/17/2016
I certify that I have read this applicationand 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 II
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 ARCHITECT'S DECLARATION
and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records.
Code,Section 9.18.
Licensed
Signature Date 11/17/2016 Professional
- CONSTRUCTION PERMIT APPLICATIONOlb- .,
—I.= )ifCla
}- COMMUNITY DEVELLOPM€NT DEPARTMENT'BUILDING DIVISION j11
4,4„..,,,,, 10300 TORRE AVENUE`CUPERTINO,CA 00014.3200
CUP RTINO (400)777-3228.MX(400)7774333 S buildinue,cupertino.orci
•.NEW CONSTRUCTION 0 ADDITION O AL'JT RATION/Ti U ._REVISION I[?EFERRED ORIOINAL PLRM1Ttt
PROJECT APDRISs 10100 N Tantau APN# i i of 046 I
OWNER NAME Cupertino(.gateway Partners LLC. 4+ +<1 PIIONS 408-783-4731 B=MAIL galien apple.corn
rte..
STRGET AAARGSc {/ }� CITY,STATE,Z`P !A. ri,jFAX
CONTACT NAME Laura Hennessee PHONE E-MAII.lauraQdavldwhitnoyarch.com
STREET ADDRESS 2185 The Aimeda,Suite 100 cry.STATE,ZIPSan Josey CA 95126 FAj
in OWNBR El OWNER•IUILOBII 0 OWNER AGENT l:::l CONTRACTOR 0 CONTRACTOR AGENT Oil ARCHITECT 0 ENOINIER I 0 OEVS1.OPFR 0 TENANT
CQN'RAC1 OR NAME Craig Shea LICENSE NUMBPR 791022 LICENSE TYPE B BUfi t IC S 20891
COMPANY NAME NOVO Construction - FATAL csheaanovoconstruction.com�_PA
I
STREET ADDRESS 1460 O'Brien Dr. CITY,STATE,ZIP Menlo Park,OA 94025 PII1NL'.650.38045.075
ARCIIi'I'RC'I/ONOINUERNAME Laura Hennessee LICRNSI<NIIMIPR BUS.LIC It
,
COMPANY NAME David Whitney Architects E°MAlI.• Iaura@davidwhltneyarch.com TAX
STREET ADDRESS 2185 The Alameda,Suite 100 CITY,STATE,ZIP San Jose,CA 95120 PHONE 408-627-9123
DESCRIPTION or WORK Tenant Improvement of existing lab space, Upgrade to rooftop mechanical,Interior plumbing and electrical,
I
I
minim USE PROPOSER USC CONS i'vi'll -STORIES I
V-B use TYPE OCC. SQ.FT VALUATION(5)
EXIS6'C+ ... NEW FLOOR -.-... DEMO TGTAL - - I
ARRA 3,396 SF AREA AREA NET AREA 0 V B 3,396 2,500,000
iD TIiROOM - -- KITCHEN - T]IP.R�e..,...,..._..,.._.:.o.._,_ i
REMODEL AREA RRMQDELAREA REMODEL ARM
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PORCIIAREA DECK ARRA fTALPECK/POR:N•IW' IARAQEAREA: DETACH
CI ATTACH I
11 DWELLING UNITS: ISA SECOND UNIT IN YRS SECOND STORY YRS -
BEING ADDED? ONG ADDITION? NO t
PRC•AI'PLICATION YES IF YEE.PROVIDE COPY Or IS TUE BLDG AN [L YES RECEI•E~.Y: 1TOTA 'LUA'lION:
PLANNING APPL 0 ONO PLANNING APPROVAL 12116R I;ICIII.ICIIOME1 ONO �J - - : soo,000
- —soil 1
By my signature below,I artily to each of the following: I stn the property owner or authorized agent to nut on the property owner's behalf. I have read this
application and the information I have provided is eorreet, I have read the Description of Work andverlt}"it is accurate. I agree to comply with all applicable local
ordinances and state laws('elating to'buildin construction I authorize representatives.of Cupertino to enter the above.identi'ted property for inspection purposes.
' 3
Signnun•eel'Aphlicanl/Agent: Date• fq /6 1
t
SUPPLEMENTAL INFORMATION It F,QUIRIQLJIRID PLAN CHECK TYPE i ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for p OVER-THE-COUNTER ' 34Bt1tt,6ING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. El EXPRESS Old PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure KS•rANDARD 17 PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project. _`��.,(
LARGE J FIRE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJORSANITARY SEWER DISTRICT
submittal of Building Permit application. •
❑ ENVIRONMENTAL HEALTH
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Bldgfippp2U 1/.dcsc revised 06/2111