14110054CITY OF CUP ERTINO BUILDING PERMIT
BUILDING ADDRESS: 20111 STEVENS CREEK BLVD CONTRACTOR: DOUBLE ED PERMIT NO: 14110054
CONSTRUCTION fNC
OWNER'S NAME: TRANS - CONTINENTAL REAL ESTATE INVS
189 BELEVUE AVE
DATE ISSUED: 12/19/2014
OWNER'S PHONE: 4087300808
PARTY CITY, CA 94014
PHONE NO: (415) 420 -8145
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
TENANT IMPROVEMENT FOR PRESCHOOL (1360 SQ FT).
f �
License Class Lic. # f
�., /
Contractor
/
1 hereby affirm that I am licensed wider the provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business & Professim+s
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
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: $80000
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: 31623026.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
rtify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTLED
correct. 1 agree to comply with all city and county ordinances and state laws relating
�)(T)(�)� 180 )I�A�S ®� IPIEISI�I[1<T )(SSIJAI�I�IE ®�
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
issued by: It/ j Date:
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.
% J %
Z �`
RE- ROOFS:
Signature Date ` Y
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
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).
1 have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 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 I store or handle hazardous
1 have and will maintain a Certificate 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 25505, 25533, nd 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: 171( Date: 2
�}
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, 1 must
1 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. 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
yll do5�
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE a CUPERTINO, CA 95014 -3255
c
(408) 777 -3228 ^ FAX (408) 777 -3333 a building (a)cugertino.org
Ct:UPERTINO I
S
❑ NEW CONSTRUCTION ❑ ADDITION 'p
PROJECT ADDRESS ZoI 1
OWNERNAME 'rya
STREET ADDRESS pr -y�7} 1� k4 y p l y
ALTERATION /, TI LJ REVISION i DEFERRED "� ORIGINAL PERMIT #
V APN 9 -3 1 6 ! (i3 . � 0 7-.�
PHONE _"] L� E -MAIL
1 CITY, STATE, ZIP,/ (AnMVV/A �(�' l4 FAX
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CONTACT NAME :5 1 / n ^
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PHONE O_ / �'y
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EMAIL 'n�'� '�a �I_
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STREET ADDRESS �(�
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CITY, STATE, ZIP ^ (��W/
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FAX
❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAMF �}j,,,n 1Q/ e� p� 'LICE NSE NUMBER 'S(`�'/�f'7 LICENSE TYPE
CJ �J �J
BUS. LIC9
COMPANYNAME j JJ E -MAIL
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FAX
STREET ADDRESS J�`'
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CITY, STATE, ZIP // 'jy
PHONE
ARCHITECT /ENGINEER NAME �^�'e
LICENSE NUMBER _T
BUS. LTC Hy
COMPANY NAME 1t
E -MAIL ���' ` ! ��p/� 1 I�
(IL (IIG'0, CCV1lr`r
FAX
STREET ADDRESS �� 0O �5 �r "� �®
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CITY, STATE, ZIP
PHONE/a -rU_ I �J
`p ( tl
DESCRIPTION OF WORK
EXISTING USE
PROPOSED USE CONSTR
TYPE
Al STORIES
.�
USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTG I
AREA 1 ��U
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA
/I
\//F
(�'
I -3 0011
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECKlPORCH AREA
GARAGE AREA: DETACH
❑ ATTACH
#DWELLINGUNITS:
ISA SECONDUNIT
YES
SECONDSTORY YES
[]YES
BEING
G ADDED?
P
CF
ADDITION? NO
PRE - APPLICATION YES IF YES, PROVIDE COPY 0111111FFFFFFF"''''
IS THE BLDG AN ❑ YES
RFCEIV BY `'
- TOTAI, VALUATION:
PLANNING APPL N NO PLANNING APPROVAL LETTER
EICHLER HOME? -drtT O
By my signature below, I certify to each of the 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 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 bui ing construction. 1 a vmoolrlze presentatives of Cupertino to enter the above-identified pro for inspection purposes.
Signature of Applicant/Agent: Date: CAL
SUPPLEMENTAL INFORMATION REQUIRED Q
PLAN CHECK TYPE �
ROUTING SLIP «,
❑: OVER-THE-COUNTER
BuILnHVC PLAN REVEw
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.
EXPRESS
,PLANNINGPLANREVIEW '
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑" STANDARD
0 PUBLIC'WORK$
form if any Hazardous Materials are being used as part of this project.
LA RCE
FIxE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to
❑ - t,
,..
submittal of Building Permit application.
MAJOR
SANITARY SEWER DISTRICT,",'.,!,
❑- ENVIRONMENTAL HEALTH -
2011.doc revised 06/11/11
1-4 2
MY OF CUP Ellg']C NO
FEE ]ESTIMATOR - BUI LMNG DIVIRON
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLIT AREA
s.f.
PC FEES
!
BP FEES
ADDRESS: 20911 Stevens Creek Blvd ]DATE: 11/10/2014
REVIEWED BY: Sean
II- B,III- B,IV,V -B
APN:
BP #:
'VALUATION: 1$80,000
*PERIi1[ITTYPE: Building Permit
PLAN IIEC TYPE: Tenant Improvement LIL/
]PRIMARY Commercial Building
$2,580.48
PENTAMATION 1E TI
USE;
PERMIT TYPE: a
WORD
Tenant Improvement for preschool 1360 sq ft).
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLIT AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
E (Tenant Improvements)
II- B,III- B,IV,V -B
1,360
$3,805.20
IETIPLNCK
$2,580.48
IETIINSP
/,.'loc. Lzsp. Pee:
$2,580.48
Suppl. Insp. Fee:E) Reg. C) OT Fo ,0 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
G
Work Without Permit? 0 Yes (D No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential
Building or Structure
TOTALS:
1,360
$3,805.20
Select an Administrative Item
$2,580.48
$4.00
MECH, HOURLY 0 Yes E) No
[PLUMB, HOURLY 0 Yes Q No
lE1LEC, HOURLY Q Yes Q No
MISC ITEMS
ilhu,';,. Pion ( 1pt
Elee, Phan chec /(
rrit ", ce
l 1poli I erovi I et:
l iec Perwir Fee,
hrs
0:her Plu,nh Insf,
Olhvr hhx. Ins").
Lj
'h fi";; h:r
1117oah. lisp. Vcc
/,.'loc. Lzsp. Pee:
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 Dent for addn'l info.
FEE ITEMS (Fee Resolution 11 -053 Eff 711113)
FEE
QTY /FEE
MISC ITEMS
Plan Check Fee:
$3,805.20
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,580.48
Suppl. Insp. Fee:E) Reg. C) OT Fo ,0 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
G
Work Without Permit? 0 Yes (D No
$0.00
Advanced Planning Fee:
$0.00
Select a Non - Residential
Building or Structure
Strong Motion Fee: IBSEISMICO
$22.40
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$4.00
SUBTOTALS:
$6,412.081
$0.00 TOTAL ]FEE:
1 $6,412.08
Revised: 10/01/2014
C
CUWERT 110 OO
I (11 I` l In ( (1> \ I P� I� ( I (1> I I I I
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014 -3255
Telephone: 408 - 777 -3228
Fax: 408-777-3333
JOB ADDRESS: 1011 S� ` ,
ERMIT e J�
O WIVER' S NAME �SC'�y� �� /f�lt1,
PHONE # ��D �e
GENERAL CONTRACTOR C,7-1
USINESS LICENSE #
ADDRESS: ellff— ,�Z —Q
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 UN'T'IL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPIERT1fNO
BUSINESS LICENSE.
11 am not using any subcontractors:
Signature Date
?Dense check applicable subcontractors and complete the following information:
V
SUBCONTRACTOR
BUSINESS NAPVlIIE
BUSINESS LICENSE #
Cement Finishing
s _ —
Electrical
oaten;
�y ,
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
0-A j V
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner / Contractor Signature
Date
*1
A1157
s L d Adaptive Architecture
20111 Stevens Creek Blvd, Suite 270
Cupertino, CA 95014
MEMORANDUM
Double Ed Construction
Attn: Tenny Leopold
189 Belevue Ave
Daly City, CA 94014
April 29, 2015
RE: Clarification - Permit #14110054
20111 Stevens Creek Blvd., Suite 130, Cupertino, CA 95014
Dear Mr. Leopold:
I am issuing this letter to clarify a few items on the plans:
Tel: (408) 865 -1089
Email: info @adaptivearch.us
1. Sheet E3.0, Sheet Note #10 indicates electrical outlets to be 42" o.c. It should be
clarified to indicate "the bottom of the electrical outlets to be 42" A.F.F. Min." This is to i
accommodate the height of the shelving that will be located against the classroom
walls.
2. Sheet 2.1, detail 3 Enlarged Restroom Plan does not indicate any toilet seat cover
dispenser, therefore the seat cover dispensers are not required in the children's
restrooms.
3. Toilet fixtures and accessories shall be mounted per dimensions shown on detail 3/A7.3,
Kindergarten (K) dimensions.
Please let me know if you have any additional questions or comments.
Sincerely,
A-�,
Janice Yeh, AIA
Principal Architect
(408) 865 -1089
ianiceC@adaptivearch.us
CAPEX ENGINEERING INC.
P.O BOX 14198, FREMONT, CA 94539
Tel: (510) 668 -1815 Fax: (510) 490 -8690
Building Department Project No. 9803
City of Cupertino January 19, 2015
10300 Torre Avenue
Cupertino, CA 95014 -3232
Sub eet: Little "Tree Montessori New Cupertino Campus at
20111 Stevens Creek Blvd.
Cupertino, CA
(Permit N _
SPECIAL INSPECTION ECTION SIElI VICIES REPORT FINAL AF1FI®AVRT FOR
C.M.0 WALL TRASH ENCLOSURE
Dear Sir:
CAPEN ENGINEERING INC., has provided testing and special inspection services at the
subject
site in accordance with section 1701 of the California Building Code (2013 Edition) as
listed below:
As masonry construction begin;
(X)
Proportions of site — prepared Mortar
I-
(X)
Location of reinforcement, connectors, prestressing tendons, and anchorages
During
Construction;
(X)
Specified size, grade, and type of reinforcement, anchor bolts, prestressing tendons and
anchorages.
Prior to
grouting in the C.M.0 wall:
(X)
Placement of reinforcement and connectors and prestressing tendons and anchoraghes.
(X)
Proportions of site - prepared grout and prestressing grout for bonded tendons.
Grout placement:
(X)
Grout placement has been verified ensure compliance
Inspection of welding_
(X)
Complete and partial joint penetration groove welds
(X)
Plug and slut welds
(X)
Single -pass fillet welds <--5/16"
(X)
Floor and roof deck welds
Personnel under the general supervision of a registered Civil Engineer performed these
inspections. Based on the inspections performed and upon our substantiate reports that the
inspected work was performed, to the best of our knowledge, in conformance with the approved
plans and specifications and the applicable workmanship provisions of thq °California Building
Code.
Sincerely, V?,OF ESSIO
CPEX E NI — EERING INC., ��® �b S'
Gary I u, P.T
Im
Principal cc n Dot
i � Q
OF M. 1
ALTERNATE MATERIALS AND METHODS / MODIFICATION FORM
COMMUNITY DEVELOPMENT DEPARTMENT e BUILDING DIVISION
Man
10300 TORRE AVENUE - CUPERTINO, CA 95014 -3255
(408) 777 -3228 - FAX (408) 777 -3333 ^ buildip cu.ettin, 7 .
cCUPERTINO
® REQUEST FOR MODIFICATION OF CODE (CBC 104.10)
® REQUEST FOR ALTERNATE MATERIAL, DESIGN OR METHOD OF CONSTRUCTION (CBC 104.11, CFC 1.11.2.4)
To annly for this recuest. complete sections 1. 2. & 3 (ink or tvoe)
SITE 20111 Stevens Creek Blvd., Suite 150
APN 316 -23 -026
DATE
09/22/2014
ADDRESS
The plumbing fixtures in question are for children's use and are in excess of the required number of
plumbing fixtures required by 2013 CPC. The 2013 CBC does not show mounting heights for-various
Trans.
. . Contin . . . . en en . tal . .REIC
Owner. r .............................................................................. ...............................
PC 4: ...... ....3 ..........................
Type: ....... .�t.'.�..................
500 S. Murphy Ave, Sunnyvale, CA 94086
Address. ............................................................................................. ...............................
Permit #:......
Stories:.................
...................... Phone.......... ...............................
M1 Email. jkwo. k @transconre com 408- 730 -0808
........
' 0
PLN #.................... 1.
Dept./Div . ...............................
.................
f?%
Occupancy:.. 13/
Floor Area :.............................
Janice Yeh Architect
Applicant.......... ............................... ................ ..........Title ........,... ................I..............
20100 Stevens Creek Blvd., Suite 190
Address............................................................................................... ...............................
lanice@adaptivearch.us 408- 865 -1089
Job Status: .......................
Occ. Load :.............................
/
Use of Bldg: .�I...I^ ..............
Email . ............................... Phone................ ...............................
Receipt No.: ..............................
Processed b - :......................—
i
REQUEST: For code modifications, please state the applicable code requirement and the extent of relief desired. For alternate requests, state the type of system
proposed and design methods. Submit plans if necessary to illustrate request. Additional sheets or data may be attached.
Building Official:.. ... L��........... i %n .............................
2013 CBC 11 B -604.9 shows suggested fixture mounting heights by children's age
3 -4, 5 -8, and 9-12).
However in the preschool facility the children's age ranges from 2 to 6 years old encompassing more
than one category of mounting heights. Table 11 -604.9 also does not show mounting eig is or
sinks, and urinals. Therefore we would like to use dimensions from previous 20 10
CBC, specifically
the, kin dei gartei i dime, isio, is, as shown un detail .
I ....... ........... .......................... Date: ...................................
3
JUSTIFICATIONIFINDINGS OF EQUIVALENCY: For code modifications, applicant shall demonstrate that
special, individual reasons exist that make compliance with the strict letter of the ordinance impractical and that
equivalency is provided. For alternate requests, applicant shall demonstrate suitability, strength, effectiveness, fire
resistance, durability, safety and sanitation that is equivalent to the code for a similar use.
Code Section(s):
Table 11 B -604.9 (2013 CBC)
Table 11158 -1 (2010 CBC)
Attach additional sheets if necessary.
The plumbing fixtures in question are for children's use and are in excess of the required number of
plumbing fixtures required by 2013 CPC. The 2013 CBC does not show mounting heights for-various
children's Ix ures, such as sin height an unna eig ere ore we would I e o use a mounting
heights per 2010 CBC table _ kinderg4ll .
Petitioner's q
Signature: Position:. �.!.:.` '�!....... Date:.(./ ......... /..j.
Reviewed
By: ................................. ... Date :...........................
1--10 .44FI� .
The Request is: GRANTED ❑ DENIED
I Dept. Comments:
CONDITIONS OF APPROVAL: MS
5T
t
2 FV�2
t t�l
t.lJtP�l =,
.............................
ok.
Due: $ .. ...............................
Dgtj P' i® ..........................
Cj
Receipt No.: ..............................
Processed b - :......................—
i
� `......
Building Official:.. ... L��........... i %n .............................
Print:
.... ......... .............................. Date: ....
...
FireMarshal: .................... ...................................................................
Print: .............................
I ....... ........... .......................... Date: ...................................
DEPARTMENT ACTION: After determination, copies to: 1) applicant, 2) permit file
Altfornt_2014.doc revised 01115119