Loading...
14110008I CITY OF CUPERTINO BUILDING PERMIT I 1 BUILDING ADDRESS: 10900 N TANTAU AVE I CONSTRUCTION NC CON I PERMIT NO: 14110008 I OWNER'S NAME: CUPERTINO TANTAU LLC 1 690 GIBRALTAR DR I DATE ISSUED: 1 1/03/2014 1 OWNER'S PHONE: 4083933929 ! MILPITAS, CA 95035 1 PHONE NO: (408)942 -8200 LICENSED CONTRACTOR'S DECLARATION License Class/_ �__ _ Lic. #i Contractor li2t/zenn_ Date I hereby affirm that I am licensed under the provisi s 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. 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. 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 comp with all non -point source reg_ulat per the Cupertino Municipal Code, Section 9.18. /! �-r / r Signature ❑ OWNER - BUILDER DECLARATION I hereby affirm that I 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 compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). I 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 of the 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 of the work for which this permit is issued. 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 become subject to the Worker's Compensation provisions of the Labor Code,1 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 a]1 non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL APPLE - T.I. 1ST FLR, INTERIOR BUILD OUT TO RECONFIGURE/RE -TOOL (E) SPACE (7,365 S.F.) Sq. Ft Floor Area: I Valuation: $1500000 APN Number: 31609029.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 D PERMIT ISSUANCE OR 180 D -T CALLED INSPECTION. 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 Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "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(x) 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 255533, and 25534. Owner or authorized agent: 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 Ad ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO BUILDING PERMIT I 1 BUILDING ADDRESS: 10900 N TANTAU AVE I CON TRUC70O D C CON I PERMIT NO: 141 10008 I OWNER'S NAME: CUPERTINO TANTAU LLC 1 690 GIBRALTAR DR J DATE ISSUED: 11/03/2014 1 OWNER'S PHONE: 4083933929 1 MILPITAS, CA 95035 1 PHONE NO: (408)942 -8200 1 LICENSED CONTRACTOR'S DECLARATION License Class CA C-IL Lie. # Contractor Pevc(, . S�-. Date 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. 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. 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 ofthe granting of this permit. Additionally, the applicant understands and will comply with all non -point source gulations pg upertino Municipal Code, Section 9.18. Signature Date r �/ ❑ OWNER - BUILDER DECLARATION I hereby affirm that I 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 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1 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. 1 certify that in the performance of the work for which this permit is issued, 1 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 1 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 JOB DESCRIPTION: RESIDENTIAL E'] COMMERCIAL E] APPLE - T.I. 1ST FLR, INTERIOR BUILD OUT TO RECONFIGURE /RE -TOOL (E) SPACE (7,365 S.F.) 1kEV # 1 - REMOVE DEF SUBMITTALS FOR; CHAMBER, RAIL & STORAGE RACK. MINOR RECONFIGURATION OF FLOOR PLAN - ISSUED 1/6/15 Sq. Ft Floor Area: I Valuation: $1500000 APN Number: 31609029.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS DE YERMIT ISSUANCE OR ;180 DAY CALLED INSP C ION. Date: 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 Appl Date: ALL ROOF COVERINGS TO BE CLASS "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 1 will maintain compliance with the Cu tino Municipal Code, Chapter 9.12 and the Health &Safety Code, 5ectio OS 34. � /�2 r,. Owner or authorized agent: 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 Address ARCHITECT'S DECLARATION 1 understand my plans shall be used as public records. Licensed I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10900 N TANTAU AVE OWNER'S NAME: CUPERTINO TANTAU LLC OWNER'S PHONE: 4083933929 A LICENSED CONTRACTOR'S DECLARATION DECLARATION License Class �� % Lic. # 31q -f ContractorVZM6YZ?l 644 OU VDate 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: 1 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. 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. 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. Additionally, the applicant understands and will comply with all non -poi urce regulations per the Cupertino Municipal Code, Section 9.18. Signature Date ❑ OWNER - BUILDER DECLARATION I hereby affirm that I 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 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 construct the project (Sec.7044, Business & Professions Code). I 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 of the 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 of the work for which this 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 become subject to the Worker's Compensation provisions of the Labor Code, 1 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. Date CONTRACTOR: DEVCON PERMIT NO: 14110008 CONSTRUCTION INC 690 GIBRALTAR DR DATE ISSUED: 11/03/2014 MILPITAS, CA 95035 PHONE NO: (408)942 -8200 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ DEFERRED #1 CEILING LIGHT GRID- ISSD OTC 3/30/2015 Sq. Ft Floor Area: I Valuation: $1500000 APN Number: 31609029.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 S F PERMIT ISSUANCE OR 180 DAYS AST CALLED INSPECTION. Issued by: Date: 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 Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "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 HeaIth & Safety Code, Section 25532(a) shouId 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, ns 25505, 25533, and 25534. Owner or authorized age n 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building cDcugertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ®, REVI ON / EFERRED ORIGINAL PERMIT 4 PROJECT ADDRESS Q /�� APN # OWNER NAME PHONE E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAM � />n,�G� PxoNE E-MAIL, Z //C/' d ����2 7/ STREET ADDRESS 6 q� /r 1A �, P7� CITY, STATE, ZIP / /b/ f � J / n p. , I+ !❑ FAX OWNER ❑ OWNER - BUILDER ❑ oA,2, RAGENT CONTRACTOR El CONTRACTOR AGENT ❑ ARCHITECT ENGLNTER ❑ DEVELOPER ❑ TE'AM CONTRACTORNAME 1 LICENSE 1!UMBER3 � J6 LICENSE TYPE BUS. LIC # COMPANY NAME E -MAIL �jl/��1 FAX STREET ADDRESS CITY, STATE, ZIP / , /j PHONEi A.`� �) L `7f/ // eJ 1 / ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK jar � � � 1 / v� /„ �, ` )_ P Yr � 7L) EXISTII4GUSE PROPOSED USE CONSTR TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR //�� DEMO TOTAL AREA AREA U AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REN40DEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK /PORCH AREA GARAGE AREA DETACH ❑ ATTACH D AMLLING UNn'S: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? []NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF 1S THE BLDG AN ❑ YES JLECEIVEDB :': - k e '' TOT L N: PLA.NNINGAPPL# ❑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 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 bpld N. constructi uthorize representatives of Cupertino to enter the above- identified prop rty for inspection purposes. S i gnature of Appl icant/Agent: Date. —7 SUPPLEMENTAL INFORMA ON ED RE UIR Q New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building 11" OVERtiffu TER a BUIID]�GPL4IaREVIElV� s� permit for new building -'rLnnrncrvAK�nEtl�Y Commercial BldaS: Provide a completed Hazardous Materials Disclosure C3 sraI.DARD x y' e;#- t�.,r17BLTC voRlcs h form if any Hazardous Materials are being used as part of this project. 4 ' 4 . Copy of Planning Approval Letter or Meeting with Planning prior to _ t4 },,SAI�IT-,SRY SE'1'ERDiSTRICT . s: submittal of Building Permit application. E ldgApp_2 011. doc revised 06/21/11 CONSTRUCTION PERMIT APPLICATION Is COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIO 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 CUPERTINO (408) 777 -3228 • FAX (408) 777 -3333 • building(d,)cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI DEFERRED ORIGINAL PERMIT # ! 4 11 000 0 PROJECT ADDRESS I V D APN # .3 1 b r (J OWNER NAME 1 1 G o � I PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP - / FAX CONTACT NAME -7 1 %avc �i�YC� ✓ZZ� PHONE ��(3- �1� - X21 E -MAIL �nG�z2 C�evcr�- ��,nSE STREET ADDRESS %% � �( l 6?6 1, )��dGa�Y �Y� CITY, STATE, ZIP (�V � AS I FAX El ❑ OWNER ❑ OWNER. BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME 1 LICENSE NUMBER LICENSE TYPE C4 C1G BUS. LIC # i I� f I C cv l?i COMPANY NAME C / ✓� E -MAIL He r Gy27 ` � C ` n� l G�1�1. FAX STREET ADDRESS `�� ( C� r.�,h,v ��� CITY, STATE, ZIP c �,s �-- PHONE Li ,� , c ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK M EXISTING USF PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA ( ; _ I -- 3 U5 BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: LJDETACH ❑ 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 ❑ TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO n 1 By my signature below, I certify to each of the following: I ain the property owner or authorized agent to act on the property owner's behalf ve read this application and the information 1 have provided is co ect. [ have read k+e Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build' n ction. 1 au ze representatives of Cupertino to enter the above- identif d property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INF75RMATION R UIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER- THE - COUNTER ❑ BUILDING PLAN REVIEW 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 ' ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 c C v►^ CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(ckupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ®'ALTERATION / TI �)i�o ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS �/�, G Cj ek w'�l�tti 7AIN Oq ,I OWNER NAME ''/ �e ~'V O a A nn f E -MAIL. STREET ADDRESS / CITY, STATE, ZIP /J' / FAX CONTACT NAM , PHONE E -MAIL ST 'T ADD ESS /' CITY, STATE, ZIP �J� FAX OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT L7 4RACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT ONTRACTOR NAME LICENSE NQMBER LICENSE TYPE BUS LIC # CO PA Y NAME E -MAIL / FAX STREET ADDRESS &' " CITY, STATE, ZIP r''I.. C PH NE 313 3 z �t -.- ARCHITECT /ENGINEER NAME LICENSE NUMBER y '0 ` A 1/i B US LIC # G 5 COMPANY NAME LPS E -MAIL - AXS I &b STREET ADDRESS CITY, STAT , ZIP PHONE DESCRIPTION OF WORK S� / e-7- i e-7- J EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH ARFA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA El 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 TOTAL VALUATION. PLANNING APPL d r-1 NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO Sy / `•�� O Ct (j By my signature below, I certify to each of the fol lowing: I am the property owner or authorized agent t ct e property owner's behalf. 1 have read this application and the information I have provided is corre the Description of Work and verify ccurate. I agree to comply with all applicable local ordinances and state Taws relating to bu nstr coon. I author' representatives of Cupertino to enter the above -ides ifi7drope rty for inspection purposes. �s Signature of Applicant /Agent: Date: 117 1 SUPPLEMENT FORM fIO EQUI ,D PLAN CHECK TYPE ROUTING SLIP ❑ OVER -THE- COUNTER El BUILDING PLAN REVIEW New SFD Or Multifamily dwellings: Apply fo demolt permit for existing building(s). Demolition permit is required prlo ance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if anv Hazardous Materials are being used as part of this project. 1:1 LARGE El FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to 1:1 MAJOR El SANITARY SEWER DISTRICT m submittal Of Bulldg Permit application. ❑ EN VIRONNIENI'AL HEALTH BIcIgA1)p2011.doc revised 06 121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION DDRESS: 10900 N TANTAU AVE DATE: 01/06/2015 REVIEWED BY: MELISSA MISC ITEMS PN: 316 09 029 BP #: 14110008 'VALUATION: $0 MIT TYPE: Building Permit Pr PLAN CHECK TYPE: Alteration /Addition /Repair PRIMARY Commercial Building USE: PENTAMATION PERMIT TYPE: A WORK REV # 1 -REMOVE DEF SUBNIITTALS FOR; CHANIBER, RAIL & STORAGE RACK. NIINOR SCOPE RECONFIGURATION OF FLOOR PLAN - ISSUED 1/6/15 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 preliminar information available and are only an estimate. Contact the De t or addn'l in o. FEE ITEMS (Fee Resolution 11 -053 E f 7/1 %lam FEE QTY /FEE MISC ITEMS Plan Check Fee: $0.00 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: $0.00 Suppl. Insp. Fee: E) Reg. Q OT 0.0 I hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 G Work Without Permit? © Yes (j) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure E) Strong Motion Fee: $0.00 1 # $859.00 Revisions IREVCOMTI Tenant Improvement Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $859.00 TOTAL FEE: $859.00 Revised: 10/01/2014 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION F ESS: 10900 N TANTAU AVE TYPE OF CONSTR. DATE: 11/03/2014 REVIEWED BY: MELISSA 316 09 029 BP #: BP FEE ID "VALUATION: $1,500,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: IBTIPGNCK PENTAMATION 1 B TI PERMIT TYPE: WORK APPLE - T. 1. 1ST FLR INTERIOR BUILD OUT TO RECONFIGURE /RE -TOOL (E) SPACE (7,365 S. F.) SCOPE PME Plan Check: OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II- B,III- B,IV,V -B 7,365 $2,561.88 IBTIPGNCK $5,595.90 IBTIINSP hrs $0.00 PME Plan Check: $0.00 Permit Fee: $5,595.90 Suppl. Insp. Fee:Q Reg. 0 OT Q,Q hrs $0.00 PME Unit Fee: TOTALS: 7,365 $2,561.88 $5,595.90 MECH, HOURLY 0 Yes G No PLUMB, HOURLY 0 Yes Q) No ELEC, HOURLY Q Yes Q No --t- __L= 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 nreliminary information available and are onlv an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Eff 7 %1!13) FEE QTY /FEE MISC ITEMS Plan Check Fee: $2,561.88 Select a Misc Bldg /Structure or Element of a Building Suppl. PC Fee: (j) Reg. © OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $5,595.90 Suppl. Insp. Fee:Q Reg. 0 OT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? ® Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential Building or Structure i Strong Motion Fee: IBSEISMICO $420.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $60.00 SUBTOTALS: $8,637.78 $0.00 TOTAL FEE: $8,637.78 Revised: 10/01/2014 CUPERTINO Building Department City Orcupertino 10300 Torre Avenu e Cupertino, CA 9:5014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 CONTRA(I'TOR / SUBCONTRACTOR LIST . . .... .... . . -- -30B DDI SS:10 9 .. 00 N - Tantau PERMITg14110008 OWNER'S NAME.Appla, Inc. H#40 . . . ............ ... .. .. . ...... .. . PONE 8-942-8200 GENERAL CONTRACTOR : Deacon Construction, Inc, BUSINESS Ll(..ENSE# Gibraltar 6n�ue7 .-.J-C1j'Y/ZJPC0f)E, Milpitas, C' A 95035 *Our ratinicipal code I-eqtlires all businesses working in the city to Itsve a (',i-t'y-" of Cupertino husjne'ss license.. NO BUILDING,' FINAL OR. FINAL, OCCUPANCY INSPECTION(S) W11,L BE SCHEDULED UN'FIL THE G ,E NFRAL CONTRA('71'011 AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I fill, not using any subcontractors: Signature Please cheek applicable vu beon tractors and COMplete the following information: ....... . ...... ----- - V U B C 0 V SUBCONTRACTOR BUSINESS NAME --C i-- - -- --- --- . . . . .... . .......... . . . t Cabinets a Ile Cabinets & Millwork M C Cement Finishing X rica X Etc t I Redwood Electric F, i j" Date BUSINESS LICENSE # Kxcavation Fenc.1lig X —X V1 C' Flooring Carpeting ............ . .... - . ...... . . . . . . ........ RE Cuddle . ........... . .... . .. -L�inoleum / Wood . . ..... Class / Glazing Heating ..... . .... . . . . . ............... . . . Landscaping . .......... . .... . ................ .... Lathing Masonry X . ........... . Painting/ Wallpaper C&O Painting Paving . . ......... Haslering . . . . . ................. . J X Plumbing United Mechanical . . . . .. Roo-fing ...... Septic'raiik X Sheet Metal United Mechanical X Sheet Rock Magnum Drywall Tile owner i 6-611tractor Signature Date-