B-2017-0534CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0534
10201 TORRE AVE CUPERTINO, CA 95014-2131 (369 41 005) DPR CONSTRUCTION
A GENERAL
PARTNERSHIP
REDWOOD CITY, CA
94063
OWNER'S NAME: I & G DIRECT REAL ESTATE 21 LP DATE ISSUED: 04/13/2017
I OWNER'S PHONE: 650-426-1100 . I I PHONE NO: (650) 474-1450 I
License Class Ja Lic. #953749
Contractor DPR CONSTRUCTION A GENERAL PARTNERSHIP Date 10/31/2018
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. I have and will maintain a certificate of consent to self -insure for Worker's
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH _ RESIDENTIAL X COMMERCIAL
JOB DESCRIPTION:
)N - 3 (1) EV CHARGING STATION (40 AMPS); (N) BRANCH
(225 AMP) - PARKING LOT
Compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
2. 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. Sq. Ft Floor Area: Valuation: $100000.00
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 ,L w• „� Date _41Z.
r ,
APN Number: Occupancy Type:
369 410 B (OFFICE)
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: SEAN HATCH
Date: 04/13/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. I, as owner of the property, or my employees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for inspection.
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant:.
contractors to construct the project (Sec.7044, Business & Professions Code). Date: 4_1
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF
1. 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.
2. 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.
3. 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, 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 4.1
"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 I
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
the Health & Safety Code, Sections 25505, 25533, and 25534.
Owner or authorized agent:?y�t�
Date: 4-13, b;� V
ON TR TION 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
CUPER'TINCJ (408) 777-3228 • FAX (408) 777-3333 • buildiinlng(a—cupertino.org
n MPW (VINRTRTI(-TTC)N n ATTTTITT()N n AT.TFRATTCIN / TT l 1 I RFVTCT0 N / T-)F.FF.RR F.D C)RTC?TNAT. PFRMTT #
PROJECT ADDRESS 10201 Torre Ave. Cupertino, CA 95014
APN#�
I'll Amazon / Lab 126
PHONE (650) 426-1100
E-MAIL
STREET ADDRESS 1100 Enterprise Way
CITY' STATE, ZIP Sunnyvale, CA 94089
FAX .
CONTACT NAME Henry Martinez
PHONE (415) 521-8418
E-MAIL henry@asquaredps.com
STREET ADDRESS 1100 Enterprise Way
CITY, STATE, ZIP Sunnyvale, CA 94089
FAX
❑ OWNER ❑ OWNER -BUILDER K OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Ian Cunningham
LICENSE NUMBER 953749
LICENSE TYPE B
BUS.LIC#
„J
cOMPANYNAME DPR Construction
E-MAIL ianc@DPR.com
FAX
STREET ADDRESS 1510 S. Winchester Blvd.
CITY, STATE, ZIP San Jose, CA 95128
PHONE
ARCHITECT/ENGINEER NAME
LICENSE NUMBER 500228
BUS. LIC #
COMPANY NAME Elcor Electric
E-MAIL
FAX FAX
STREET ADDRESS 3310 Bassett St.
CITY, STATE, ZIP Santa Clara, CA 95054
PHONE (408) 986-1320
DESCRIPTION OF WORK
INSTALLING NEW ELECTRIC VEHICLE CHARGING STATIONS IN EXISTING PARKING LOT
EXISTING USE
PROPOSED USE CONSTR
TYPE
#STORIES
"
1 N/A
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
.
BATHROOMKITCHEN
REMODEL AREA 0
REMODEL AREA 0
OTHER
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: U DETACH
0
0
0
0 ❑ ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? DONO
ADDTTION? D(NO
PRE -APPLICATION DYES IF YES, PROVIDE COPY OF
IS THE BLDG AN I -] YES-
RERIVED By:-
TOTAL VALUATION:
PLANNING APPL # NO PLANNING APPROVAL LETTER
EICHLER HOME? Rj NO
rrcc
-
0U,4
$100,000
By my signature below, I certify to each of the following: I am the property owner or authorized agent tt act on the property owner's behalf. I have read this
application and the information I ha, v rovided i rrct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relatin o bu Iding co s con. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agen Date: 04/04/2017
SUPPLEMENTAL INFORMATION REQUIRED
CHECK
PLAN TYPE
ROUTING SLIP
❑ OVER -TRE 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
❑ FLANNMGPLAN 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
_
submittal of Building Permit application.
❑ MAJOR
❑ SANITARY SEWERDISTRICT
- -
❑ ENVIRONMENTAL HEALTH
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