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12010096CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20740 STEVENS CREEK BLVD I CON TRUCTOION NC BUTLER I PERMIT NO: 12010096 OWNER'S NAME: BYER PROPERTIES LP 1204 FRANKLIN ST I DATE ISSUED: 02/17/2012 1 OWNER'S PHONE: 4156262937 1 REDWOOD CITY, CA 94063 1 PHONE NO: (650) 361-1270 ❑ LICENSED CONTRACTOR'S DECLARATION License Class_ Lic. # Contractor /fie Date I hereby affirm that 1 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. 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 of the granting of this ermit. Additionally, the applicant understands and will comply with all no int ource regulation 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 foroneof 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, 1 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 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. Signature Date BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH r RESIDENTIAL h� COMMERCIAL JOB DESCRIPTION: PARTY CITY -COMMERCIAL TENANT IMPROVEMENT (I8,000SF) NON -STRUCTURAL -INCLUDE MECHANICAL,ELECTRICAL & NO PLUMBING 4/3/12- DEFERRED #I- INSTALL 1004 L.F OF INTERIOR MERCHANDISE RACKS - ISSUED 4/18/12 Sq. Ft Floor Area: Valuation: $100000 APN Number: 35908020.20740 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: r1 Date: �� Vol 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(a) should 1 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 25505, 25533, and 25534. wner�Ar autho i d 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 Professiona CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20740 STEVENS CREEK BLVD CONTRACTOR: W.L. BUTLER PERMIT NO: 12010096 CONSTRUCTION, INC OWNER'S NAME: BYER PROPERTIES LP 204 FRANKLIN ST DATE ISSUED: 02/17/2012 OWNER'S PHONE: 4156262937 REDWOOD CITY, CA 94063 PHONE NO: (650) 361-1270 ❑ LICENSED CONTRACTOR'S DECLARATIONF- BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class � Lic. # 3S 533 F- F- f - MECH RESIDENTIAL COMMERCIAL Contractor U3 t_ BJTc-LV (Z 0 0 S -T V x-?- Date -2 / z 1 hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: PARTY CITY -COMMERCIAL TENANT IMPROVEMENT (commencing with Section 7000) of Division 3 of the Business & Professions (I8,000SF) NON -STRUCTURAL -INCLUDE Code and that my license is in full force and effect. MECHAN ICA L,ELECTRICA L & NO PLUMBING 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 Sq. Ft Floor Area: Valuation: $100000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 35908020.20740 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Issued Date: Signature �� Date 2/1? t r— ❑ OWNER -BUILDER DECLARATION RE -ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed. If a roof is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials for I, as owner of the property, or my employees with wages as their sole compensation, inspection. will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: Date: I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE Compensation, as provided for by Section 3700 of the Labor Code, for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance, as provided for by compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined b the Ba Area Air y y Quality Management District I will I certify that in the performance of the work for which this permit is issued, I shall maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Health & Safety Code, Sections 25505, 25533, and 25534. 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 Owneof _ r authoriz agent: forthwith comply with such provisions or this permit shall be deemed revoked. (^ Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of work's correct. I agree to comply with all city and county ordinances and state laws relating for which this permit is issued (Sec. 3097, Civ C.) to building construction, and hereby authorize representatives of this city to enter Lender's Name upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, Lender's Address costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply ARCHITECT'S DECLARATION with all non -point source regulations per the Cupertino Municipal Code, Section 9. l8. 1 understand my plans shall be used as public records. Signature Date Licensed Professional ���� CITY OF CUPERTINO IMI FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20740 Stevens Creek DATE: 04/03/2012 REVIEWED BY: Sean PC FEE ID APN: 359-08-020 BP#: "VALUATION: 1$63,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition /Repair PRIMARY Commercial Building USE: Other Elec. Insp. Li PENTAMATION 1 DS PERMIT TYPE: WORK Installation of 1004 L.F of interior merchandise racks for Party City. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID Deferred Submittal (Not R-3) II-B,111-B,IV,V-B 0 $0.00 Other Elec. Insp. Li $0.00 Plumb. Insp. Fee: Elec. Insp. Fee: PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee,9 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 0 $0.00 (sa" I ,' ,, �'' $0.00 ViECii HOURLY' 1 es' o t"Y,UIYiI,,%OI7IY „ 'Yes Flo , • El O[IRLY : {� 1'es {) No Mech. Pla,z Check FT Plumb. Plan Check Elec. Plan Check Mech. Permit Fee: Plumb. Permit Fee: —Ld Elec. Permit Fee: Other Mech. Insp. Other Plumb Imp.Li Other Elec. Insp. Li Mech. Insp. Fee: Plumb. Insp. Fee: Elec. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the areliminary information available and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E, ..' 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. © OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee,9 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: 0 Work Without Permit? © Yes Q No $0.00 Advanced Planning Fee: $0.00 10-4 l.f. $1,339 Storage Racks 1SRACKS58 Over 8' High 0 0 Travel Documentation Fees: Strong Motion Fee: 1BSEISMICO 0* Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC 0 $1)(,23 $1,339.001,; TOTAL: $1,355.23 Revised: 1/19/2012 CITY OF CUPERTINO FM -,7 FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 20740 stvns crk blvd DATE: 01/12/2012 REVIEWED BY: bobs. PC FEES APN: 3,5200,R0 BP#: M BP FEE ID "VALUATION: j$100,000 -PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: IMTIINSP hrs PENTAMATION 1M TI PERMIT TYPE: WORK t.i. comm office space non structural include KE, no Ps. SCOPE $0.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID M (Tenant Improvements) II-A,111-A,V-A 18,000 $4,787.90 IMTIPLNCK $10,208.30 IMTIINSP hrs $0.00 PME Plan Check: $0.00 Permit Fee: $10,208.30 SuppL Insp. Fee Q Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 TOTALS: 18,000$4,787.90 $0.00 $10,208.301 MECH, HOURLY (0 Yes (D No PLUMB, HOURLYQ Yes (F) No ELEC, HOURLY Q Yes Q No FT LJ LJ NOTE: This estimate does not inehide fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District; School District, etc.). These fees are based on the nrel}nsnary information available and are only an estimate. Contact the Dent for addh7 info. FEE ITEMS (Fee Resolution 11-053 L , 711/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,787,90 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: $10,208.30 SuppL Insp. Fee Q Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 E) Work Without Permit? Yes (F) No $0,00 Advanced PlannjU Fee: $0.00 Select a Non -Residential Building or Structure Q 0 Strong Motion Fee: 1BSEISMICO $21.00 Select an Administrative Item 1 Bldg Stds Commission Fee: 1BCBSC $4.001 SUBTOTALS: 15,021.20 $0.00 TOTAL FEE: 1 $15,021.20 Revised: 1/01/2012