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12080044CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20605 LAZANEO DR OWNER'S NAME: BOYER FAMILY PRTNERSHIP I LP OWNER'S PHONE: 4089961010 ❑ LICENSED CONTRACTOR'S DECLARATION License Classes y� Lic. p Contractor b6 O.AQ� Date vAt 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. 1 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. 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 CERTIFICATION I 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, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionalk, the applicant understands and will comply with all non- ' ulat' per the Cupertino Municipal Code, Section 9.18. rt Signatur Date 1 ❑ OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner of the property, or my employees with wages as their sole eompensation, wiii do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner ofthe property, am exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 ofthe 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 ofthe work for which this permit is issued. I certify that in the performance ofthe work for which this permit is issued, I shall not employ any person in any manner so as to become subjeel to the Worker's Compensation laws of Califomia. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions ofthe 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 whieh may accrue against said City in consequence of the granting of this permit. Additionally, the applieant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date. CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 12080044 INC 690 GIBRALTAR DR DATE ISSUED: 10/19/2012 MILPITAS, CA 95035 PHONE NO: (408)942-8200 BUILDING PERMIT INFO: BLDG F ELECT i PLUMB r MECN F RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: APPLE -COMMERCIAL TENANT IMPROVEMENT IN EXISTING OFFICE BUILDING (5590 SQFT) Sq. Ft Floor Area: I Valuation: $559000 APN Number: 32633096.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAY M LAST CALLED INSPECTION. Is5ue b : U Date: RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without fust obtaining an inspection, 1 agree to remove al] new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.I2 and the Health & Safety Code, Section 25532(x) should I store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the He" & Safety Code, Sections 25505, 25533, and 25534. O ner 'z a e Date: 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20605 LAZANEO DR CONTRACTOR: DEVCON PERMIT NO: 12080044 CONSTRUCTION INC OWNER'S NAME: BOYER FAMILY PRTNERSHIP I LP 690 GIBRALTAR DR DATE ISSUED: 10/19/2012 OWNER'S PHONE: 4089961010 MILPITAS, CA 95035 PHONE NO: (408)942-8200 C5 LICENSED CONTRACTOR'S DECLARATION JOB D CRI N: RESIDENTIAL COMMERCIAL II License Class Lic. ft ` 3 - COMMERCIAL TENANT IMPROVEMENT 1N Contractor [(1 Dale ISTING OFFICE BUILDING (5590 SQFT) 1 hereby affirm that I am licensed under the provision of Ch (commencing with Section 7000) of Division 3 of the Business essions REVISION 4l- REVISE RESTROOM SHOWERS, REMOVE AND Code and that my license is in full force and effect. ADD NEW E,M W/ MINOR STRUCTURAL-ISSD OTC 3/26/2013 1 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: $559000 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 DAYS 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 DAYS FROM LAST 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 no oint s rce regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signatur Date*416 All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. ❑. OWNER -BUILDER D CLARATION Signature of Applicant: Date: 1 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 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) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 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 wi the Cupertin Municipal Code, Chapter 9.12 and 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 the Health & Safety Code, aSon 255 5 533, and 25534. Owner or authorized agen Date: 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, 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 1 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20605 LAZANEO DR CONTRACTOR: DEVCON PERMIT NO: 12080044 CONSTRUCTION INC OWNER'S NAME: BOYER FAMILY PRTNERSHIP I LP 690 GIBRALTAR DR DATE ISSUED: 10/19/2012 OWNER'S PHONE: 4089961010 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ CONTRACTOR'S DECLARATION JOB DESCRIPTION- RESIDENTIAL COMMERCIALII �jLICENSED License Class A Lic. # 37 /6__1 APPLE - COMMERCIAL TENANT IMPROVEMENT IN EXISTING Contractor Date OFFICE BUILDING (5590 SQFT) 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions 5/14/2013 -REVISION # 2- REVISE 416 SQ FT TO WESTSIDE Code and that my license is in full force and effect. RESTROOM, REMOVE EXISTING HALLWAY IN BEADS 1 hereby affirm under penalty of perjury one of the following two declarations: BLASTSS OTC I have and will maintain a certificate of consent to self -insure for Worker's lr Compensation, as provided for by Section 3700 of the Labor Code, for the vow Floor Area: Valuation: $559000 performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided fo Section 3700 of the Labor Code, for the performance of the work for AP,""umber: 32633096.00 Occupancy Type: permit is issued. , +, APPLICANT CERTIFICATION >` 1 certify that 1 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 1$$ DAYS 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 DAY M LAST 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 a granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non -point source ulations per the Cupertino Municipal Code, Section 9.18. /-� RE -ROOFS: Signature Date %t/ �.J All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. ❑ OWNER -BUILDER DECLARATION Signature ofApplicant: Date: 1 hereby affirm that l am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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) 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 1 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 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 complianee 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 05, 25533, and 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, 1 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 I certify that 1 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 CITY OF CUPERTINO F -M-91 FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 20605 Lazaneo DATE: 05/14/2013 REVIEWED BY: Mendez A9r.°ch. P[:rinir Fee: APN: BP#: 12080044 *VALUATION: 1$85,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: 11!wrli''. 177Jp. l`e'e: PENTAMATION PERMIT TYPE: WORK Revise 416 sq ft to existing restroom remove existing hallway in beads blast room SCOPE NOTE: This estiurate does not include fees due to other Departnnents (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). Thesefees are based on the reliminary information available and are only an estimate. Contact the Dept ar addn'l in a. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/12) Liech. ps[irt (i;('C/' llbrnlb, 111Uit ( leck Elec, Phi?t A9r.°ch. P[:rinir Fee: 1'l•:n,b, 11t'I'mia F'ee L;cr. I'(rn,ii 1 t' (71iti r IIIc�i i!. Ir �h.ET_L_ Of!ier I'ironh 't,.rj�. ET Oah(r, F_ ec. Ingo. irLy. PC": 11!wrli''. 177Jp. l`e'e: hl.p. Fee: NOTE: This estiurate does not include fees due to other Departnnents (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). Thesefees are based on the reliminary information available and are only an estimate. Contact the Dept ar addn'l in a. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc B1daiStructure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0,0Firs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:O Reg. 0 OT O,Q Fhrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Corfs0-wt lion Tox: ,le1ndidsaratire Fee: 0 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 i 7f'a'dcl l)o�:raf�:c;:7rarie�ez Fees: Strong Motion Fee: IBSEISMICO $17.85 1 # $799.00 Revisions IREVCOMTI Tenant Improvement Bldg Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $21.85 $799.00 TOTAL FEE: 1 $820.85 Revised: 04/29/2013 CITY OF CUPERTINO FM7, FEE ESTIMATOR - BUILDING DIVISION 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 based on the Preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (lee Resolulion 11-053 Eff 711112) ADDRESS: 20605 Lazanso Dr DATE: 03126/2013 REVIEWED BY: Mendez Tech. Permit Fee: APN: BP#: 12080044 *VALUATION: Iso 7. PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building Plumb. In p. Fee: PENTAMATION PERMIT TYPE: 1 GENCO i WORK Revision #1- revise restroom showers remove and add new E M and minor structural SCOPE 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 based on the Preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (lee Resolulion 11-053 Eff 711112) Afech. Plan Check Plumb, Plan Check Glee. Plan Check Tech. Permit Fee: Pl+rmb. Permil Fee: F;lec. Permit Fee: Usher Afech. Insp. Other Plumb Insp. Odter Elee. Insp. E17L- lleclr. Imp. Fere: Plumb. In p. Fee: Clec. Insp. Fee: 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 based on the Preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (lee Resolulion 11-053 Eff 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? O Yes O No $0,00 2 hours Plan Check, Hourly $266.00 ISTPLNC% Suppl. PC Fee: (F) Reg. () OT 0,0 hrs $0.00 PME Plan Check: $0.00 Permit Feb: Hourly Only? ()Yes Q No $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Consti-t•rction Tnx•' Adin inietrali ve .Fee: O E) Work Without Permit? Yes No $0.00 Advanced Planning Fee:' $0.00 hours Inspections $266.00 ISTINSP Inspection, Hourly ©� Travel Doc;tuncntulion bees: Stron Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $532.00 TOTAL FEE: $532.00 Revised: 01/01/2013 CITY OF CUPERTINO Im-ft, FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20605 Lazaneo Dr FLR AREA s.f. DATE: 08/07/2012 REVIEWED BY: Sean MMN AN: Z�_ 3 () BP#: /_� *VALUATION: 1$559,000 PERMIT TYPE: Building Permit 1BTIPLNCK PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: Elec. Insp. Fee: PME Plan Check: PENTAMATION 1 B TI PERMIT TYPE: WORK Tenant Improvement in existing office building 5590 sq ft SCOPE Permit Fee: OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,111-B,IV,V-B 5,590 $2,298.36 1BTIPLNCK $4,411.98 IBTIINSP Elec. Insp. Fee: PME Plan Check: $0.00 Permit Fee: $4,411.98 Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 5,590 $2,298.36 Constracrion Tux: $4,411.98 MECH, HOURLY Q Yes G No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY Q Yes Q No Pec•h, Plon Check Pluruh. Plzen Check Elea_ Plan Check rttech. Penf;il F'oe' Plumh. Permit Fee. Floc. Perrnir Fee; OlI7L'1' Hoch. Insp• EL Other Plulnh Insp. Other FICC. Imp. Aicch. /lisp. Fee PhaO. lnsp. Fee; Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,298.36 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. O OT F0707 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $4,411.98 Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Constracrion Tux: Acfrninistr rive Fee: Q E) Work Without Permit? Q Yes No $0.00 Advanced Planning Fee: $0,00 Select a Non -Residential Building or Structure Q i Truvel Doctrrnentulion Fees: Strong Motion Fee: IBSEISMICO $117.39 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $23.00 SUBTOTALS: $6,850,73 $0.00 TOTAL FEE: 1 $6,850.73 Revised: 07/01/2012