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B-2016-2939 (2)CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-2939 10001 N DE ANZA BLVD CUPERTINO, CA 95014-2263 (326 34 074) TCG BUILDERS INC MILPITAS, CA 95035 OWNER'S NAME: TAMBELLINI DEANZA PROPERTIES LLC (TAMBELLINI DEANZA PROPERTIES LLC) DATE ISSUED: 01/17/2017 OWNER'S PHONE: 408-974-5951 I I PHONE NO: (408) 321-6450 License Class 11 Lie. #835597 Contractor TCG BUILDERS INC Date 04/30/2018 I hereby affirm that I am licensed under the provisions of Chapter 9 (comme7ocing 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. �j 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 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. r EEE Signature' Date11. 7.17 OWNER -BUILDER DECLARATION 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 propert3; 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. 3. 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 1.17.17 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH _ RESIDENTIAL X COMMERCIAL JOB DESCRIPTION: SITE IMPROVEMENT UPGRADES INCLUDING NEW AND REPLACED FLAT -WORK, INSTALLATION OF LANDSCAPING, ACCESSIBILITY IMPROVEMENTS, INSTALLATION OF (4) ELECTRICAL VEHICLE CHARGING STATIONS. Sq. Ft Floor Area: Valuation: $75000.00 APN Number: Occupancy Type: 326 34 074 B (Tenant Improvements) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: SEAN HATCH Date: 01/17/2017 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) Date: 1.17.17 "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, Sections 25505,25533, an 5534. Owner or authorized agent.. Date: 1.17.17 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 A HIT T'S DECLARATTON I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228- FAX (408) 777-3333 - buildingacupertirlo.0m, CUPERTINO I ,yam 01(p r CV z ❑ NEW CONSTRUCTION ❑ ADDITION ,■ ALTERATION I TI ❑ REVISION,' DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10001 DeAnza Boulevard APN'32V-34-071 & 326-34-074 p. OWNER NAME Apple Inc. - Eileen MollylPFIONE40Q_974-5951 ��Cupertino, E•MAILemolloy@apple,com STREETADDRESS'1 Infinite Loop,r MS 18 -DDC C CITY, STATE, ZIP ti A/ 95014 FAX CONTACT NAME Bryan Carrera P"ONE408-6507"532 1 E.MAILbryan@a nterragroup.com STREET ADDRESS 1155 N FIRST ST. Suite #214 CITY, STATE, ZIP San Jose, .CA 95112 1 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR 11 CONTRACTORAGENT ❑ ARCHITECT M ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Daniel asuna TLICENSENUMBER �° j� �7�"! LICENSE .1 BUS, LIC N J 7 056 (j. J COMPANY NAME The Core Group E-MAIL danielo@tcgbuilders.com FAX STREETADDRESS890 N McCarthy Blvd., Suite 100 CITY,STATE,ZIPMilpitas, CA 95035 �jr} /+ PHONE408-321-6450 ARCHITECTIENGINEER NAME Dave Voorhies LICENSE NUMBER 26429 BUS. LIC N COMPANYNAMENterra Group E-MAILdvoorhies@nterragroup.com FAX STRE$TADDRESS 1'155 N First St. Suite #214 CITY, STATE, ZIP San Jose, CA 95112 v p n n a PHONE40S-610"995$ DESCRIPTION OF WORK Site improvement upgrades, including new and replaced flatwork; installation of landscaping, accessibility improvements, and installation of electrical vehicle charging stations. EXISTING USE PROPOSED USE CONS"IR. TYPE I STORIES Office No Change I 3& USE TYPE, OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODELARFA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECKIPORCH ARE R GARAGE AREA: DETACH I B ATTACH 0 DWELLING UNITS: ISASECONDUNIT []YES SECONDSTORY []YL•S BEINOADDrD? ©NO ADDITION? [:]NO " PRE -APPLICATION ® YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES ;12E - -_ TOTAL VALUATION: PLANNING ADPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? 0 NO By my signature below, I certify to each ofthe 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 ro ded i, clorrcct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rel t b ' ing c struction. I authorize representatives of Cupertino to enter the abov denti Ied property for inspection purposes. Signature of ApplieanUAgent: Date: SUPPLEMM-12,,VrINFORMATION REQUIRED ? C DECK rvri:- _,v< <.:"`; `-?; `'`: .iouriivcsiva'_:: :°'.=:'•:`:': AVER-THE-.Z•'OUN].'ER 'r:"—::"Y?.. - :BILI7.,13TNG'PiaAN REt'IEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building 4.. _:,...;,.-: -:;= permit for new building. �'xrsliEss '"t` 1: ': ' ' `:ivG'riaiv.' .... v jam.:..: •:. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure . .... L STANDARD .:".,' -- _ form if any Hazardous Materials are being used as part of this project. - -=---�-'• =•� ; °• °--_—�- ~, �- " - — 0 LARGE.. ` ` " `• ' - - "" "' " _ Copy of Planning Approval Letter or Meeting with Planning prior to D "nTnig_L_J::,SANITARY.`SETOi submittal of Building Permit application. ENV1RONMENTALHEALTH`:` BldgApp 2011. dor. revised 06121111