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14040005 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10100 N TANTAU AVE CONTRACTOR:NOVO CONSTRUCTION PERMIT NO: 14040005 OWNER'S NAME: CUPERTINO GATEWAY PARTNERS LLC 1460 O'BRIEN DR DATE ISSUED:04/01/2014 OWNER'S PHONE: 4084062093 MENLO PARK,CA 94025 PHONE NO:(650)701-1500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ _ ADDITION OF MECHANICAL& ELECTRICAL IN(E)LAB License Class_ _ Lic.tl �d a� SPACE Contractor Nom �,DULTbV� Date_�g ?b� 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: 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. Sq.Ft Floor Area: Valuation:$50000 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 APN Number:31619061.10100 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 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 DAYS OF PERMIT ISSUANCE OR to building constriction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM L S LIED 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 Date: with all non-point source regulat s per the Cupertino Municipal Code,Section 9.18, 1� RE-ROOFS: Signature Date / 7 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. ❑ OWNER-BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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(x)should 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 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 25505,25533,a 25534. Section 3700 of the Labor Code,for the performance of the work for which this )� q permit is issued. Owner or authorized agent: Date: / 1 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 shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 1 certify that I have read this application and state that the above information is correct.1 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, ARCHITECT'S DECLARATION 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 _ ao CONSTRUCTION PERMIT APPLICATION �O ELI] COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION�O 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333- building Cokuperting.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION r ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS /010,0 APN# / ^ r O O WNER NAN PHONE. E-MAIL v 1'iJ aS .ZO TL- TT STREET ADDRESS CITY,STATE,ZIP FAX S50 5�' Sri.ZW S CONTACT NAME PHON E-MAIL 5 G CnAlick - STREET ADDRESS r CITY,STATE,ZIP FAX J 5 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT XARCHITEcT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER 7 q to ZZ LICENSETYPE BUS,LIC#z3 COMPANY NAME E-M`AIL / FAX STREET ADDRESS CITY,STATE,Z PHONE 1 O`8r_,fJ Ca40- /W.a ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# S TIL COMPANY NAME E-MAIL FAX Wig L STREET ADDRESS CITY,STATE,ZIP P ONE Z i S 5(oa &5r - 70/0 DESCRIPTION OF WORK A& 1 A .� O� Of It A ; O� �e- EXISTING USE PROPOSED USE CONSTR.TYPE I #STORIES L AFs, L �r A USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO V TOTAL •I••• AREA AREA AREA NET AREA Q `500 Fl BATHROOM KITCHEN OTHER CJ / (I REMODEL AREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑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 AL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? []NO 50 By my signature below,I certify to each of the following: I am the propertyner or au orized agent to act ont e 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 building construct, n. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Dater/y SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for (�OVER THE-COUNTER l BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building 7 / permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW __Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ElSTANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE tqFIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to 11 MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1.doc revised 06/21/11 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: la00 r PERMIT# OWNER'S NAME: �[e PHONE# O$• Y 0-6 — ZO .3 GENERAL CONTRACTOR: Nb\/p T4BUSINES§ LICENSE# 7q I Da a ADDRESS: l ' e CITY/ZIPCODE: &AApyO.:�5 *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 Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE# Cabinets & Millwork Cement Finishing Electrical Z[ Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass /Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10100 N TANTAU AVE DATE: 04/01/2014 REVIEWED BY: MELISSA APN: 316 19 061 BP#: �� 'VALUATION: 1$50,000 °PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION FURN/AC USE: PERMIT TYPE: WORK ADDITION OF MECHANICAL & ELECTRICAL IN E LAB SPACE SCOPE Mech.Plan Check 0.0 hrs $0.007;r / Mech.Permit Fee: IMPERMIT Other Mech. Insp. 0.0 hrs $47.00 of,';vr Phamb 7nefl_ Lil Oihe�l ['11-i iLj I J� ;.1 /, (I I I, 11, NOTE. This estimate does not include fees due to other Departments(i.e. Planning,Public Works, Fire,Sanitary Sewer District,School District,etc.). Thesefees are based on the prelimin information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS (lee Resolution 11-053 E f' 711%13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1 # Mechanical Suppl. PC Fee: Reg. OT T0,0Thrs $0.00 $139.00 IMCRAA VAV Boxes PME Plan Check: $0.00 Permit Fee: Hourly Only? C)Yes Q No $0.00 Suppl. Insp. Fee-.0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $47.00 f.fmmwrlli?ion Administrative Fee: (ADMIN $44.00 Work Without Permit? Yes (F) No $0.00 G Advanced Plannin2Fee: $0.00 0 hours Inspections G Travel Documentation Fee: ITRA VDOC $47.00 $417.00 ISTINSPInspection,Hourly 0 Strong Motion Fee: IBSEISMICO $10.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS: $150.50 $556.00 TOTAL FEE: $706.50 Revised: 01/15/2014 HAZARDOUS MATERIALS CHECKLIST COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228•FAX(408)777-3333• buildingC@cupertino.org PURPOSE To minimize possible delays that would result for the Fire Department plan review, please complete the following checklist to determine if an additional level of Hazardous Materials plan review will be required. MARK `YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING? PLEASE MARK YOUR ANSWER WITH AN `X' IN THE YES OR NO BOX ON THE SIDE YES NO BELOW. 1. Use, dispensing, mixing or storage of flammable or combustible liquids or gases, hazardous materials, etc. X 2. Battery back-up rooms or racks. X 3. Propane tanks. X 4. Gasoline stations with underground tanks. X 5. Installation or replacement above ground or underground storage of liquid petroleum products, liquefied petroleum gases, compressed natural gas, explosives or other X regulated hazardous materials. 6. Gas rooms for dentist, doctors or veterinarians. X 7. Generators with back-up diesel or other fuels. X 8. Large refrigeration systems. X 9. Fuel cell systems. X 10. Commercial pool systems. X 11. Chemical Storage areas. X 12. Flammable liquid storage. X 13. Compressed Gases. X 14. Dry cleaners. X 15. Print Shops. X 16. Auto Repair and Auto Body Shops. X 17. Research and Development. X For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa Clara County Fire Department, at(408) 378-4010. HasMaI 2011.doc revised 03/07/11 CUPERTINO PURPOSE HAZARDOUS MATERIALS CHECKLIST COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(@cupertino.org To minimize possible delays that would result for the Fire Department plan review, please complete the following checklist to determine if an additional level of Hazardous Materials plan review will be required. MARK `YES' IF THE PROPOSED SCOPE OF WORK INCLUDE ANY OF THE FOLLOWING? PLEASE MARK YOUR ANSWER WITH AN `X' IN THE YES OR NO BOX ON THE SIDE BELOW. YES NO 1. Use, dispensing, mixing or storage of flammable or combustible liquids or gases, hazardous materials, etc. 2. Battery back-up rooms or racks. 3. Propane tanks. 4. Gasoline stations with underground tanks. 5. Installation or replacement above ground or unde ,gra; nd a of liquid petroleum products, liquefied petroleum gases, compre,§se to 4as, explosives or other regulated hazardous materials. y., 6. Gas rooms for dentist, doctors or)a . ti 7. Generators with back-up diesel o fuels. 8. Large refrigeration systems. 9. Fuel cell systems. 10. Commercial pool systems. 11. Chemical Storage areas. 12. Flammable liquid storage. 13. Compressed Gases. 14. Dry cleaners. 15. Print Shops. 16. Auto Repair and Auto Body Shops. 17. Research and Development. For any additional information regarding this checklist, please contact Hazardous Materials Specialist, Santa Clara County Fire Department, at (408) 378-4010. HasMat 2011.doc revised 03/07/11 Kcco engineered systems 1133 Aladdin Avenue San Leandro, CA 94577 Tel: (510) 346-4300 Fax: (510) 347-1331 Contractors Lic#120696 TEST AND BALANCE ANALYSIS REPORT Job Na e: Apple SEG Phase III - Open Lab 10100 N. Tantau Cupertino, CA ACCO Job #: 620021 Contractor: Novo Construction Company, Inc. Engineer: acco engineered systems ITOq oozy FILE `1-- t �-C13 G AIR DISTRIBUTION SYSTEM HAS BEEN COMPLETELY BALANCED AS PER REQUIREMENTS OF SPECIFICATIONS AND RESULTS OF TESTS HEREIN LISTED. Date: April 22, 2014 Technician: Andy Bruns Approved By: Amber Ryman ACCOengineered systems Air Balance Symbols Urivi Lubec Feet Her Minute FPM Feet Per Minute Ak Free Area Factors CSD Ceiling Supply Diffuser CSG Ceiling Supply Grille CRR Ceiling Return Register EAG Exhaust Air Grille SWG Sidewall Grille EAG Exhaust Air Grille LT Light Troffer LSD Linear Slot Diffuser VAV Variable Air Volume Box AHU-1 Air Handling Unit #1 EF -1 Exhaust Fan #1 SF -1 Supply Fan #1 T -stat Thermostat D.A. Direct Acting R.A. Reverse Acting DDC Direct Digital Control N. 1. Not Installed N/L Not Listed N/A Not Accessable DNA Data Not Available FLA Full Load AMPS V Volts A Amperage PH Phase HP Horsepower BHP Brake Horsepower RPM Revolutions Per Minute SP Static Pressure TSP Total Static Pressure TES Total External Static Pressure VP Velocity Pressure OSA Outside Air RA Return Air MAT Mixed Air Temperature EAT Entering Air Temperature LAT Leaving Air Temperature AT Differential Temperature AP Differential Pressure W.C. Inches of Water Column engineered systems 1133 Aladdin Avenue San Leandro, CA 94577-4311 (510) 346-4300 • (510) 347-1331 • License # 120696 AIR OUTLET TEST REPORT DATE: 04/22/14 PAGE: 1 PROJECT Apple SEG Phase III - Open Lab SYSTEM NO. House Air TEST APPARATUS Flow Hood AREA SERVED 1310 Open Lab OUTLET MANUFACTURER DNA SUDENTIFSIER M OTYPELE ICM FINAL N0. SIZE gLOW COOL N) OOLLIMINAM N COOL MIN VAV 4-12 1 CD 2416 1330 - 935 120 2 CD 2416 1330 - 920 115 3 CD 2416 1330 - 946 128 4 CD 2416 1330 - 965 143 Total - - - - 5320 550 0 0 3766 506 REMARKS: VAV is 100% open. Changed the design setpoint on VAV 1-11 to try and increase flow at VAV 4-12. This did not assit in providing greater airflow. BALANCE TECH: Andy Bruns "! engineered systems 1133 Aladdin Avenue San Leandro, CA 94577-4311 (510) 346-4300 • (510) 347-1331 • License # 120696 AIR OUTLET TEST REPORT DATE: 04/22/14 PAGE: 2 PROJECT Apple SEG Phase III - Open Lab SYSTEM No. Return AHU-1 TEST APPARATUS Flow Hood AREA SERVED Lab 1310 OUTLET MANUFACTURER DNA SUB -SYSTEM OUTLETDESIGN �=Ak] (CFM) PRELIMINARY FINAL IDENTIFIER NO. TYPE I SIZE EXHAUST EXHAUST EXHAUST Return AH/1 1 CD 2416 1290 630 2 CD 2416 1290 855 3 CD 2412 1500 125 4 CD 2412 1500 1300 5 CD 2412 1500 1291 Total - - - - 7080 0 4201 g - i Rr-r"HKRMO: megisters 4 & o serve Moving cools. Kestrlcted airtlow on registers 1, 2 & 3 in order to get design CFM at the Moving Cools. Registers 1 & 2 were nto closed further due to noise level. Register # 3 was closed completely. BALANCE TECH: Andy Bruns engineered systems 1133 Aladdin Avenue San Leandro, CA 94577-4311 (510) 346-4300 • (510) 347-1331 • License # 120696 AIR OUTLET TEST REPORT DATE: 04/22/14 PAGE: 3 PROJECT Apple SEG Phase III - Open Lab SYSTEM NO. House Air TEST APPARATUS Flow Hood AREA SERVED Lab 133 OUTLET MANUFACTURER DNA SUB -SYSTEM OUTLET DESIGN (CFM) PRELIMINARY FINAL IDENTIFIER N0. TYPE SIZE Ak COOL MIN COOL MIN COOL MIN Vav Lab 133 1 CD 2416 350 - 379 150 2 CD 2416 275 - 281 116 3 CD 2416 275 - 255 132 4 CD 2416 275 - 265 116 5 CD 2414 275 - 285 130 6 CD 2414 275 - 295 107 Total - - - - 1725 690 0 0 1760 751 REMARKS: BALANCE TECH: Andy Bruns