B-2016-3319CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-3319
20230 STEVENS CREEK BLVD CUPERTINO, CA 95014-2210 (369 02 03 1) DPR CONSTRUCTION
1AGENERAL
REDWOOD CITY, CA
94063
OWNER'S NAME: TORRE AVENUE PROPERTIES
ISSUED: 12/22/2016
OWNER'S PHONE: 650-426-1100 1 1 PHONE NO: (650) 474-1450
LICENSED CONTRACTOR'S DECLARATION
License Class B Lic, #953742
Contractor DPR CONSTRUCTION A GENERAL PARTNERSHIP Date 10 /31/2018
1 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:
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: -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 ERTIFICATION
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 mentionedproperty 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.
BUILDING PERMIT INFO:
BLDG —ELECT —PLUMB
MECH RESIDENTIAL X COMMERCIAL
JOB DESCRIPTION:
LAB 230 & 231; T.I. - REMOVE ONE PARTITION; ADD 3 NEW
CEILING HEIGHT PARTITIONS; ADD 2 DOORS; RELOCATE OF
SUPPLY AND RETURN VENTS TO (E) HVAC SYSTEM - AMAZON
REV#1 LAB 230 & 231; T.I - RELOCATE (3) WALLS, HVAC, DUCTS,
ELECTRICAL; REPLACE CEILING -ISSUED 2/16/2017
- ADD 4 RECESSED LIGHTS - ISSUED 2/22/2017
Sq. Ft Floor Area: I Valuation: $150000.00
APN Number: Occupancy Type:
369 02 031 1 A (Tenant Improvements)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Date 2/22/2017 Issued by: AbbXAA ev nde
Date: 12/22/2016
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).
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.
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, atter 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.
11 APPLICANTCERTIFICATION
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 212212017
RF—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 ofApplieant:
Date: 2/22/2017
ALL ROOF COVERINGS TO BE CLASS "A"
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 Cuper ino,Municipal Code, Chapter 9.12 and
the Health & Safety Code,rSeections 25505, 25533, and 25534.
Owner or authorized agent: i z
Date: 2/2212017 .
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 D • . •ARATION
I understand my plans shall be used as public records.
Licensed
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
L�
CUPERTINO (401) 177-3228 - FAX (408) 777-3333 - buildingcupeno.opq
1 affi
1)�7_
F]NEW CONSTRUCTION n ADDITION RALTERATION /TI X REVISION /DEFERRED
ORIGINAL PERMIT #B-2 016-3319
PROJECTADDRESS 20230 Stevens Creek Blvd.
APN
OWNERNAME Amazon / Lab 126
PHONE (650) 426-1100
STREET ADDRESS 1100 Enterprise Way
CITY, STATE, ZIP Sunnyvale, CA 94089
1 FAX
CONTACT NAME Ian Cunningham
157-2600
1 EMAH lanC@DPR.com
STREETADDRESS 1510 S. Winchester Blvd.
CITY, STATE, ZIP San Jose, CA 95014
1 FAX
[I OWNER [I owNER_nuMDFR [I OWNERAGENT X CONTRACTOR El CONTRACTOR AGENT 11 ARCHITECT 11 ENGINEER 1:1 DEVELOPER ❑ TENANT
CONTRACTORNAME Ian Cunningham
LICENSE NUMBER 953749
LTCENSETYPE B
BUS. LIC #
COMPANY NAME, DPR Construction
E-A" IanCCa-)DPR.com
FAX
sTREETADDRE'8 1510 S. Winchester Blvd.
CITY, STATE, ZIP San Jose, CA 95014
PHONE
ARCHITECT/ENGINMERNAME Alan Johansen
LICENSE NUMBER C-9672
BUS. LIC
COMPANYNAMB4
Interior Architects
E-MAIL
M.Wei@interiorarchitects.COM
FAX
STREET ADDRE"'2775 Great America PKWY
CITY, STATE, ZIP Santa Clara, CA 95054
PHONE (415) 296-5320
DESCRIPTION OF WORK Addition of recessed lights in room-M13i
EXISTING USE
R 0
PROPOSED USE CONSTR.
TYPE
'TY E
# STORMS
USE
TYPE
OCC.
SQFT.
VALUATION
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
AREA
i% TA
NETAREA
KITCHEN
RFMODEL�AAREA 0 REMODELARFA 0
0
OTHER
T'
REMODELAREA
PORCH AREA
DECK AREA
TOTALDECKIPORCH AREA
GARAGE AREA: []DETACH
0 [] ATTACH
0
0
DWELLING UNITS:
IS A SECOND UNIT LJYES
BEI GADDED? KNO
I
SECOND STORY El� Yf �,S
ADDITION? KNO
PRE -APPLICATION YES IF YES, PROVIDE COPY OF
-
IS THE BLDG AN [] YES
BY
TOTAL VALUATION:
JNO PLANNING APPROVAL
PLANNINGAPPL# LETTER
MCMERHOME? D(NO
=:aUW4."_
$15,000
By my signature below, I certify to each of the following: I am the property owner or authorized agent tact on the property owner's behalf. I have read this
application and the information I ovided is correct. I h read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating o bui ing construction. I 4thorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Date:01/_-2-1 C 72
Signature of Applicant/Age.
SUPPLEMENTAL INFORMATION ED
PLAN CHECK TYPE
ROUTING SLIP
M OVER-THE-COUNTER
❑ BUILDING PLAN REVIEW
New SFD or multifamily dwellings: Apply for demolition permit for
ex_isting building(s). Demolition permit is required prior to issuance of building
permit for new building.
El EXPRESS
El PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
0 STANDARD'
n PUBLIC WORKS
form. if any Hazardous Materials are being used as part of this project.
El LARGE
0 MZE DEPT
—CO -0y of Planning Approval Letter or Meeting with Planning prior to
El MAJOR
EI SANITARY SFWFRJ)ISTRICT
submittal of Building Permit application.
ENVIRONMENTAL HEALTH
BIdgApp_2011.doc revised 06121111
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-3319
20230 STEVENS CREEK BLVD CUPERTINO, CA 95014-2210 (369 02 03 1)
DPR CONSTRUCTION
A GENERAL
PARTNERSHIP
REDWOOD CITY, CA
94063
OWNER'S NAME: TORRE AVENUE PROPERTIES
DATE ISSUED: 12/22/2016
OWNER'S PHONE: 650-426-1100
PHONE NO: (6$0) 474-1450
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class 5 Lic. #953749
Contractor DPR CONSTRUCTION A GENERAL PARTNERSHIP Date 10/31/2018
X BLDG —ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— MECl3 — RESIDENTIAL X COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
LAB 230 & 231; T.I. - REMOVE ONE PARTITION; ADD 3 NEW
I hereby affirm under penalty of perjury one of the following two declarations:
CEILING HEIGHT PARTITIONS; ADD 2 DOORS; RELOCATE OF
1. I have and will maintain a certificate of consent to self-insure for Worker's
SUPPLY AND RETURN VENTS TO .(E) HVAC SYSTEM - AMAZON
Compensation, as provided for by Section 3700 of the Labor Code, for the
REV#1 LAB 230 & 231 • T.I - RELOCATE (3) WALLS, HVAC, DUCTS,
performance of the work for which this permit is issued.
ELECTRICAL; REPLACE CEILING -ISSUED 2/16/2017
. 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: $150000.00
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:
and state laws relating to building construction, and hereby authorize
369 02 031
A (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.
Additionally, the applicant understands and will comply with all non-point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source regulations per the Cuperti unicipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECJION.
Signature CA r P--Date 2/16/2017
Issued by Abby A gnde
Date: 12/22/201616
RE-ROOFS:
OWNER-BUILDER DECLARATION
I hereby that I from the Contractor's License Law for the
affirm amxem�pt one of
following two reasons:
All roofs shall be inspected prior to any roofing materialbeing installed. If a roof is
t. 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: 2/16/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
t. 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.
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
shall not employ any person in any manner so as to become subject to the
material. Additionally, should I use equipment or devices which emit hazardous
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 Code Sections 25505,255?, a d 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
j�
`Owe
or authorized agent: / ,•
APPLICANT CERTIFICATION
Date: 2/16/2017
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
CON TRUCTION LENDING NCY,
I hereby affirm that there is a construction 1,ending agency for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is issued (Seq. 30197, 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 DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records..
Signature Date 2/16/2017
Licensed .
CONSTRUCTION PERMIT APPLICATION
0 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING REVISION
0300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building0cupertino.oEg
❑NEWCONSTR.ucnoN Q ADDITION i ! ALTRRATTO-9/TT W RT1VTCTnV/T1VPPRRm, nurr_rnrer n.D.,rrTu8+2�'i�`f+ 'IQ
PROIECTADDRBSS 20230 Stevens Creek Blvd.
APNA QZ
OWNER NAME Amazon / Lab 126
PHONE (650) 426+1100
EMAIL
1
STREETADDRBSS 1100 Enterprise Way
CITY, STATE, ZIP Sunnyvale, CA 94089
FAX
CONTACT NAME Ian Cunningham 9
PHONE(408)857-2600
E.MAII, tanC@DPR.com
STREET ADDRESS 1510 S. Winchester Blvd.
CITY, STATE, ZIP San Jose, CA 95014
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT yti CONTRACTOR ❑ CONfRACTORAGBNT ElARCHITECT fl ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME Ian Cunningham
LICENSEMMBBP 953749
LICENSE TYPE B
BUS. LIC#
COMPANYNAME DPR Construction
EMAIL IanC@DPR.Com
rA"
STREET ADDRESS 1510 S. WinchesterBlvd.
CITY, STATR,Z`P San Jose, CA 95014
PHONE
ARCHITECTIENGINEERNAMEAlan Johansen
LICENSENUMBER C+9672
G
BUS.LIC#
COMPANYNAME Interior Architects
E-MATL
m.Wel@Interiorarchitects.com
FAX
STREETADDRBss2775 Great America PKWY
CITY, STATE, ZIP Santa Clara, CA 95054
PEO1 E 415 296_5320
DESCRIPTION OF WORK
Removal of one ceiling. Revision to (1) hard lid ceiling
Patition alignment revisions. Wall detail change. HVAC/Elec. adjustments
BXISTING USE
PROPOSED USE CONSTR.
TYPE
fl;TORIES
I
USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTO
NEW FLOOR
DEMO
TOTAL
AREA
ARBA
AREA
NBTARBA
BATHROOM/� MCHEN
REMODEL AREA 0 REMODBLAREA
OTHER
REMODEL AREA
PORCHAREA
D=AREA
TOTALDECWORCHAREA
GARAGE AREA: DBTACH
0
A
I V
V
0
0 ❑ ATTACH
SDWEELLINGUNIT&
IS A SECOND UNIT YES
SECOND STORY []YES
BEINGADDED? �No
ADDITION? KNO
PRE-APPLICATIONYES IF YES, PROVIDE COPY OF
PLANNING APPL # �NO PLANNING APPROVAL. LETTER
LS THE BLDG AN 13 YES
EICHLER HOMF,? NO
11E B
TOTAL VALUATION:
JK
> .p150y000
By my signature below, I certify to each of the £ollowin : I am the property owner or authorized agent to act on the property owner's behalf, I have road this
application, and the information I have rovided is come I have read the Description of Work and verify it is accurate. I agree to comply wish all applicable local
ordinances and state laws relating o buiidin conte ct' I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: -Data: 02/13/17
SUPPLEMENTAL INFORMA, rI N LTiRLD
PLAN CHECK TYPE
ROUTING SLD?
❑ OVER- TIE -COUNTER
❑ BUH,DINGPLANREVIEW
_ New SFD or Multifamily dwellings: ?(C11 y for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
I] EXPRESS
❑- PLANNINGPLANREvREW
_ Commercial Bldgs: Provide a completed hazardous Materials Disclosure
11 STANDARD
ElPTJBLIC WORKS -
form if any Hazardous Materials -are being used as part of this project.
® LARGE
.❑ FIREDEPT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
❑ MAJOR
11 $ANTTARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doe revised 06121111
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
20230 STEVENS CREEK BLVD CUPERTINO, CA 95014-2210 (369 02 031)
CONTRACTOR: I PERMIT NO: B-2016-3319
DPR CONSTRUCTION
A GENERAL
REDWOOD CITY, CA
94063
OWNER'S NAME: TORRE AVENUE PROPERTIES I I DATE ISSUED: 12/22/2016 I
OWNER'S PHONE: 650-426-1100 I I PHONE NO: (650) 474-1450 I
License Class Ja Lie. #953749
Contractor DPR CONSTRUCTION A GENERAL PARTNERSHIP Date 10/31/2018
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.
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 regulationspr the Cup rtino Municipal Code, Section 9.18.
Signatur Date 12/22/2016
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)
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:
t. 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.
z. 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.
s. 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.
U
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.
Date 12/22/2016
BUILDING PERMIT INFO:
X BLDG —ELECT -PLUMB
MECH _ RESIDENTIAL X COMMERCIAL
JOB DESCRIPTION:
LAB 230 & 231; T.I. - REMOVE ONE PARTITION; ADD 3 NEW
CEILING HEIGHT PARTITIONS; ADD 2 DOORS; RELOCATE OF
SUPPLY AND RETURN VENTS TO (E) HVAC SYSTEM -AMAZON
Sq. Ft Floor Area: I Valuation: $150000.00
"N Number: Occupancy Type:
369 02 031
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abl2y Ayendg
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: I
Date: 12/22/2016
l
AT 7 DAAL' !�l1�7CD71V!`_C TA DTi rQ A CC It A If
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, with,
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, c o 25505 25533, and 25534.
.s
Owner or authorized agent: v^
Date: 12/22/2016
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
ARCBTI`ECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
CUP Ri IND (408) 777-3228 - FAX ((4108) 777-3333 - buildli—ng(o)cupertino.org
I ' NPW (YINSTRT MTTrINT 17
I A T.nrT rTn1,T I Z I A T TUo A TTnr i err I I t i—
PROJECT ADDRESS 20230 Stevens Creek Blvd.
APN# 02— MI
OWNER NAMEPHONE
Amazon / Lab 126
(650) 426-1100
E-MAIL
STREET ADDRESS
1100 Enterprise Way,
CITY, STATEZIP
Sunnyvale, CA 94089
FAX
CONTACT NAME Ian Cunningham
PHONE(408) 857-2600
E-MAIL lanC@DPR.com
STREET ADDRESS 1510 S. Winchester Blvd.
CITY, STATE, ZIP San Jose, CA 95014
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT It CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Ian Cunningham
LICENSE NUMBER 953749
7
LICENSE TYPE B
BUS.LIC#
COMPANY NAME
DPR Construction
E-MAIL
IanC@DPR.com
FAX
STREET ADDRESS 1510 S. Winchester Blvd.
CITYSTATE, Jose, CA 95014
PHONE
ARCA TECT/ENGINEERNAME Alan Johansen
LICENSE NUMBER C-9672
BUS. LIC#
COMPANY NAME
Interior Architects
E-MAIL
m.wei@interiorarchitects.com
FAX
STREETADDREss2775 Great America.PKWY
CITY, STATE, ZIP Santa Clara, CA 95054
PHONE
415 296-5320
DESCRIPTION OF WORK Removal of one partition. Addition of 3 new ceiCing height partitions. Adding two doors
Relocation of supply and return vents to existing HVAC system. LcAp X: 1Q 4
EXISTING USE
PROPOSED USE CONSTR.
TYPE
# STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
REMODEL AREA O
KITCHENOTHER
REMODEL AREA O
REMODEL AREA
PORCH AREA
REA
DECK AREA
TOTAL DECK AREA
GARAGE AREA: DETACH
_
0
0
0
0 ❑ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑YES
BEING ADDED? KNO
ADDITION? O(NO
fe❑
PRE -APPLICATION YES IF YES, PROVIDE COPY OF
IS THE BLDG AN YES
RE y; -
TOTAL VALUATION:
PLANNING APPL # NO PLANNING APPROVAL LETTER
EICHLER HOME? )(NO
-
$mt%�
$150,000
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on thte property owner's behalf. I have read this
,application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to b i ding construction. authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: �/ �1
SUPPLEMENTAL INFORMATION REQ IRED
PLAN CHECKTYPE
ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for
❑ OVER-THE-COUNTER
BUILDING PLAN REVIEW 1�>to,-A
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS -
❑ PLANNING"PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ sTANDARD
❑l rewopmssy
form if any Hazardous Materials are being used as part of this project.
11 LARGE
PPur'B
I FII2E DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to
❑ mum
❑ SANITARYSEwER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06121111