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B-2016-1934CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1934 10088 N WOLFE RD STE 130 CUPERTINO, CA 95014 (316 20 108) MAVIN BUILDERS INC TORRANCE, CA 90505 OWNER'S NAME: CUPERTINO PROPERTY DEVEL I LLC DATE ISSUED: 01/05/2017 OWNER'S PHONE: 408-343-1088 I I PHONE NO: (310) 422-5651 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class ]a Lic. #1011125 Contractor MAVIN BUILDERS INC Date 92/28/2018 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: 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. 4-- 2. 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 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. BLDG, —ELECT _ PLUMB MECH _ RESIDENTIAL X COMMERCIAL JOB DESCRIPTION: SUITE 130 - T.I. FOR (I) A-2 OCCUPANCY (6,886 S.F.) - STEINS BEER GARDEN Sq. Ft Floor Area: I Valuation: $800000.00 APN Number: Occupancy Type: 316 20108 - I A (Tenant Improvements) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Date 01/05/2017 1Issued by: Kim Dunbar I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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) 2. I, 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. 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. 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. a. 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 01/05/2017 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: 01/05/2017 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, Sections5, 25533 and 25534. Owner or authoriz=tam�� Date: 01/05/2017 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 Professional a CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT * BUILDING DIVfSION 10300 TORRE AVENUE * OUPERTINO, CA 95014-3255 CUPERTINO (406) 777-3228 - FAX (408) 777-3333 - btiildin-Q@qupert1no.grg zo NEW C-014S17RUCTION 11 ADDITION X—ALTERATION nT1 MVISION / DnFrtRRED ORIGINAL Pppmy-r m AIN 4 S I Co 24 - D$11 ftl J> 0516 OMPRNAMECAWRONNO Pjp,� V M 0 STREL'T iWORMS G1 T�ZIP ttrrz 0 0 T 'F�' Few 4 40b 4- Jopi 54 JIT 1W Offik A*F-VeN No IdAFIL F&T21(lAAANT C CAIV.STATE, ?JP tAX 0CEtVNr R (3.0WRIMAGENT 000NTAACM 0CPhMACTQsAaaKr 0 Agostrrwr Otiwow= 0 Im-yawma CONT' ICTOR NAME .,m LWINSP KrCR 112LIC-1114SETYPH Bus_ LIC 4 CMIPANY 'r *, 0 MaVl PAX n, i 'ki CI PHONE NAME LiCENSE HINDER BUS L[C 9 COMPANY NAME D-SCV46me STUP10 &MAIL STRUITTADDRM 2.2.Z,, CI PH ST001 11,11"a4is-1-u-009 'so �Ai 114�fOlop. VNA-N-f imp lVrOWI C-FArk PIZ A W tW "STA10"I AWD 1�ft OWN, A101WAON Of Mt2-%A?4iwC-0 i6y-rCjzIcF- J.Mp USE Typli oce, SQSTI VALUATION 0) EYtISIG q&Q�Doas. NEWFLOOK Dmio I TOTAL -A fjf$&�Aii!A Lam r Fro 0- 1 F%-(AV%n FAAjL A"4 110)99(p BATHROOM AMMODMAUMM 41MODULAREA N/A - qnfell:s. 12NIOPMAIMA 91A TF%WQjj ARP ECKAREA T(iFfALi ARRAFUAWZ-i�rA .010 A t p [I UNFIM WASWONDUNtT 01A BEINGADDITI tinDrrfiBAi PREWPLICATION vis TFmvRcAqRroP.y5r PLAWINGAPPL9 1911LE111,80AN 13 EC in LY Cl U12T b C) I = tha-propeny omworauthorized agent to rict oFtlie property ov.-Act's behair. I two read this application and the intbrMatioll I have p'tied' 50W00t, I haw read the Dasorlption of -Work and verify it is smumm I agna to comply widi all applicable taco] ordinances and state laws rotftiingl 1U, tfuoiion I aullimim representatives ofCuparlino to onto tht abcm-Wonfilled propony for itupoodan purposes. SignaturcofAppIloont/Agel Date: SUPFJJM--EN'l RMA` ION RrQUTREL) NeWSK) Or IVIUltiflunily dwellhigs-. Apply rordentolition parnift lot ixIgtlng building(s). Demolition parmit is roqulmd prior to issuance ol'building Permit rear now building.E3 omm )C Commercial Bldgs; Proville a comploted Hazardous Mater-fals Disclo8uro 11 STANDARD TOrIll if filly HAZIIMOUS MAtOrifilS arc bOiAg H$Cd d$ Pfltj Of INS p1`Oj40t, LARGE .X.Copy of Planning Approval Letter car Meeting with Planning prior -to 0 submittal of Building Permit upplication. W1151L " FfI(Mov$1.4 "V"VfV wo.d, Vleigipp_.�011id(wrevise(i66l2lllI 11A-Zo1ro-041 AvjV ASA- 90 OWS AQ -5 AWIV No.(,