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15040013CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20605 LAZANEO DR CONTRACTOR: DEVCON PERMIT NO: 15040013 CONSTRUCTION INC OWNER'S NAME: BOYER FAMILY PRTNERSHIP I LP 690 GIBRALTAR DR DATE ISSUED: 04/02/2015 OWNER'S PHONE: 4087384444 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] APPLE- IST FLOOR COMM T.I MODIFY (E) SPACE M,E License Class Lic. # 37143 (165 SQ FT) Contractor lOc.vG� r� e_,-9/1 J, - Date 1 2- I hereby affirm that I am licensed under the provisions of Chapter 9 1 (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: $16500 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 APN Number: 32633096.00 Occupancy Type: 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 D 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 D ST 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: Date: with all non -point source regulations per the Cupertino Municipal Code, Section r ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is any 9.18. / Signature -7 Date � / Z installed without first obtaining an inspection, I 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) 1, 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 aCertificate 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 I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 505, 25533 nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner Date: permit is issued. or authorized agent: 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 shal I 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building cupertino.orq ❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION / TI ❑ REVISION /DEFERRED V\q � D ORIGINAL PERMIT # :J PROJECT ADDRESS 20605 Lazaneo Rd. I - APN# 326-33-096 OWNER NAME Apple Inc PHONE 408-738-4444 E-MAIL STREET ADDRESS IInfinite Loop CITY, STATE, ZIP Cupertino CA 95032 FAX CONTACT NAME Terry Fullerton PHONE 408-519-8383 E-MAIL tfullerton@devcon-const.com STREET ADDRESS 690 Gibraltar Drive CITY, STATE, ZIP Milpitas, CA, 95035 FAX408-946-5513 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT X CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME DEVCON Construction TICENSENUMBER399163 LICENSE TYPE B BUS. LIC # COMPANY NAME DEVCON Construction E-MAIL tfullerton@devcon-const.com FAX408-946-7713 STREETADDRESS690 Gibraltar Drive CITY, STATE, ZIP Milpitas, CA 95035 PHONE 408-519-8372 ARCHITECT/ENGrNEERNAME Brent Downing LICENSENUMBERC-32444 l' BUS .LTC 0 COMPANY NAME DEVCON Construction E-MAIL bdown in devcon-const. COM FAX 408-942-7713 STREET ADDRESS 690 Gibraltar Drive CITY, STATE, ZIP Milpitas, CA, 95035 PHONE 408-942-8200 DESCRIPTION OF WORK Modification to an existing space, added room, with Associated electrical and mechanical. EXISTING USE PROPOSED USE CONSTP- TYPE # STORIES B I B Vb 1 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA Office B 165 16,500.00 BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA ODETACH ❑ ATTACH # DWELLING UNITS* IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? ❑ NO ADDITION? ❑ NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECFJVEI) BY. .. TOTAL VALUATION: PLANNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to ro 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 Iocal ordinances and state laws relating to 7ding construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. 4/11/115 Signature of Applicant/Agent: Date: SUPPLEMENTA FORMATION REQUIRED PLAN CcTYP otltGS%>P ER Btltt i)I d PLAN $EVIEW- New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building , permit for new building. ©QP";' 0 PLANNING PLAN "VIE _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD Q P ' WORKS form if any Hazardous Materials are being used as part of this project. © LARGD+ P IMT _ Copy of Planning Approval Letter or Meeting with Planning prior to © aaaR CJ. SAN MW S> WER01STWIL submittal of Building Permit application. Q EI�iVIRt)1`tME1'ITTAL I3EnLTu' BldgApp 2011.doc revised 06/21,/11 CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 20605 lazaneo rd FLR AREA sJ. DATE: 04/01/2015 REVIEWED BY: mendez BP FEES APN: BP#: Zdo q10013 `VALUATION: 1$16,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial BuildingT USE: IBTII,VSP Permit Fee: PENTAMATION 1B TI PERMIT TYPE: WORK a le- 1st floor comm t.i modify e space m e SCOPE PME Unit Fee: OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA sJ. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 165 $2,097.00 IB77PLNCK $588.00 IBTII,VSP Permit Fee: $588.00 Suppl. Insp. Fee -0 Reg. Q OT F0701hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 G Work Without Permit? 0 Yes E) No $0.00 TOTALS: 165 1 $2,097.00 1 1 $588.00 Strong Motion Fee: IBSEISMICO NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District_ etc )_ These fees are haled on the nreliminary information availahle and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 a./7/1//13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,097.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $588.00 Suppl. Insp. Fee -0 Reg. Q OT F0701hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 G Work Without Permit? 0 Yes E) No $0.00 Advanced Plannin& Fee: $0.00 Select a Non -Residential Building or Structure A :.. Strong Motion Fee: IBSEISMICO $4.62 Select an Administrative Item 1 BIdP, Stds Commission Fee: IBCBSC $1.001 SUBTOTALS: $2,690.621 $0.00 TOTAL FEE: 1 $2,690.62 Revised: 02/14/2015 From D U :501o' Jk- 15-4*8 CUPERTINO 04/24/2015 15:27 0700 P.001/001 CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: oG PERMIT # 0 p OWNER'S NAME: PHONE # t GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: lgqo CITY/ZIPCODE: "Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date Owner / Contractor Signature D e SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting :GC"J�i Linoleum / Wood Glass / Glazing W c s �J a l E— k C, 11@"� �AvP,4� mol Insulation Landscaping Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature D e