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B-2016-1737CITY OF CUPERTINO BIDING PERMIT BUILDING ADDRESS; CONTRACTOR: PERMIT NO: B-2016-1737 11 RESULT$ WAY CUPERTINO, CA 95014-5924 (357 20 041) BARRON BUILDERS INC MOUNTAIN VIEW, CA 94043 OWNER'S NAME: BVK PERIMETER SQUARE RETAIL LLC ET AL DATE ISSUED: 04/13/2016 OWNER'S PHONE- 408-996-1010 PHONE NO: (650) 9644493 LIC .b ED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic. #-56 Contractor BARRON BUILDERS INC Date 0713112017 X BLDG _ELECT _PLUMB MECH _ RESIDENTIAL X COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) ofDivision 3 of the Business & Professions Code and that my JOB DESCRIP'T'ION: license is in full force and effect. {"GROUND FLR, NORTH-EAST CORNER - T.I. TO CREATE 6 (N) I hereby affirm under penalty of perjury one of the following two declarations: OFFICES (APPLE) t. I have and will maintain a certificate of consent to self-insane for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Ck 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 Sq. Ft Floor Area: Valuation: $180000.00 permit is issued. APPI rCANT CER'T'IFICATION certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances 55720041 B (Tenautlmprovements) 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 PERMIT EXPIRES IF WORD IS NOT STARTED may accrue against said City In consequence of the granting of this permit. WITHIN 1$0 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST C INSPECTION. Signature 4,­;4 Date 04/93/2016 Issued by: ME Date: 0 1 2 1 OWNER IMDF'RDECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of ti:e Res All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: t. 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 inspection. compensation, will do the work, and the structure is not intended or offered for sale (See.7044, Business & Professions Code) 2, I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: the (Sec.7044, Business & Professions Code). Date: 04!13!2016 contractors to construct project I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BET'T'ER s, 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 HAZARDOUS MATERIALS DISCLOSI ISE performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Health & Safety Code, Sections 25505, 25533, and 25534. I will Section 3700 ofthe labor Code, for the performance of the work for which this California maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. health & Safety Code, Section 25532(a) should I store or handle hazardous s, I certify that in the performance of the work for which this permit is issued, I material, Additionally, should I use equipment or devises which emit hazardous shall net 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 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 exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be doomed revoked. owner or authorized agent: °"L— APPLICANT C ERTIFICATLON Date: 04/13/291 6 v!nwLTnGGr;TION 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 correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Civ C.) relating to building construction, and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes, (We) agree to save Indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands Ai•CE TFCTIS DFCLA pR UJI& and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 04/13/2096 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE ° CUPERTINO, CA 95014-3255' B. CUPERTIN® (408) 777-3228 s FAX (408) 777-3333 , bulldinaCa cupertino,orcl � � 0 ❑ I,tEw C0NsTRUCTI0i1 ❑ AD1)Molq, ❑ .kLTERA.TION i TI ❑ REvlsioN I DEFERRED ORIGII4AL PEi—NET n PRadECTADDREss �� �S�L�S w , a+A�'tz>�ll�� "�" O1AT3 NAME t;672 )Oe C® EGA -PHO, ,6 l016 E-MAIL STR FF r e nr cc n 1 + e , STAT , �^.� j � 1 FAS ew CONTACT NOME (PHOIQE � E h4AIL r ,64 TR TADDRESS Ve E -- k0'A 7f JTCITY, STAT N ►u } ,j � � FAX C-Lq r1--- it nnn.:Fv aRF>;T LJ r.nwTRA!"rOR ❑C0NTRACTORAGENT d ARCHITECT ENGINEER ® DEVELOPER TENANT CONTR ACTOR X.4ME EggeSM n p ,p /j o + t LICENSE WUi cB R LICEh 11 PE BUS, LIC' existing building s . Denlolirion permit is required prior to issuance of buildilTg:. COMPA Ah 1U a t `� x� VALUATION W GAF is�v 1 c/ U� 1 F—q DEMO TREE�{�'i uG le U f TOTAL NET cM®ST nt �&i'1 d Q � � F Copy of Plarming Approval Letter or Meeting with Planning prior to- ARCZ3ITEC'rlENGIA'EERN'EsaQi"r' t +�, k WRIk LICENISENUMBER BUS. LIC A1LEA ca� N h$E STREET ADDRESS �— i%'7 c&.S$1 �� AREA E•h3A CITY, -STATE, ZIP d41wis t rA ll.S rr ``�� � p � *� �y h� VII= ri , ` 6 "f4a'f— ,} PHONE IS.ESC-iUPT'IONOFWOW 000t"011'N Of PAW MOO owtws E5.35TII�G LtsE -� r.:::: z. `CHEC r1 PROPDSED USB i CONSTR. TYPE n STORIES - USE � TYPE � OCC. existing building s . Denlolirion permit is required prior to issuance of buildilTg:. SQ.FT. � VALUATION W EXISTG j N£tt� PE OOR DEMO TOTAL NET Copy of Plarming Approval Letter or Meeting with Planning prior to- .... r: AREA lk AREA A1LEA AREA BATHROOM WCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA ��----���, '''j�� •• PORCH AREA DECK AREA TOTAL D£C}:JPDP,CH.AREA GARAGE AREA: DETACH I pATTACH 1 J DWELLING UNITS: IS A SECON [?SIT' [] YES SECO':D STORY YES BELIGADDBD? 0 N ADDITION? LJwO rRE :APPLicArio*. p YEs IF YES, PROVIDE COPY OF APPROVAL LETTER IS THi: BLDGA \ ETCHLER HOME? r.-„r:>�.;:^.,.::x•_<"..:�:� �,`' _ _ - _, t-ss-•° TOTAL VALUATION: -�ywJ,��'/ PLANTIi+G APDL NO PLANNING By my signature below, I certify to each of the follo-wing; I ame �z�er thty (Y'wner ar ieTi2n agent t atah the pial application and the information I have provided is comet. I have read the Description of worl n erify it is Becural ordinances and state laws relating w building construction. I authorize representatii es o£ , e3i amigo Signature of ApplicanUAgent: C�--� Dale: .4 t SUPPLEMENTAL 4L I;1FORh4A7I0N RBQLTIAED -� r.:::: z. `CHEC r1 I\Tew SFTD or A4ultifamily dwellings: Apply for demolition permit forC1� ai=ER 40 CO' '! Rz existing building s . Denlolirion permit is required prior to issuance of buildilTg:. for .E'aR£s5 perrnitnewbuilding. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure _ forum if any Hazardous ltfaterials are being used as pari of this project.011 Copy of Plarming Approval Letter or Meeting with Planning prior to- .... r: _ subnait-tal of Building Permit application.-- ner arr. I nave reau uns to ly tvjtlr all applicable local property. zpection purposes. B1d&4pp_?011.doc revised 06121111 Test, Adjust & Balance Report PROJECT: Apple RW11 ADDRESS: 11 Results Way Cupertino, CA 95014 ARCHITECT: Not Listed ENGINEER: Silicon Valley Mechanical GENERAL CONTRACTOR: Barron Builders HVAC CONTRACTOR: Silicon Valley Mechanical LEAD BALANCE TECHNICIAN: Scott McClung DATE: 6/7/2016 SiliconValley S Mechanical 2115 Ringwood Ave. San Jose, CA 95131 AIR SYMBOL SHEET DATE: 6/7/2016 PROJECT: Apple RW11 PAGE: 1 SiliconValley S%ml Mechanical 2115 Ringwood Ave. San Jose, CA 95131 GENERAL NOTES DATE: 6/7/2016 PROJECT: Apple RW11 PAGE: Z SiliconValley s m,n Mechanical 2115 Ringwood Ave. San Jose, CA 95131 VAV DISTRIBUTION REPORT PROJECT: Apple RW11 DATE: 6/7/2016 SYSTEM: E Supply air PAGE: 3 .;....SAERRVEAEScS >::;,p11A •::•: FINAL =>: i ; : • ::•:...;.. .. , : :: . .:.--AX'CLGMAXXMTGYPE 169 1 CD 10 DNA DNA DNA DNA 240 240 215 185 81 69 130 115 255 220 170 2 CD 10 TOTAL 150 240 480 400 150 245 475 RHVAV 2-6 171 1 CD 10 DNA DNA 240 190 72 115 230 172 2 CD 10 DNA DNA 240 215 78 135 255 RHVAV 2-A TOTAL 150 240 480 405 150 250 485 173 1 1 CD 1 10 1 DNA DNA 230 200 68 115 225 174 2 CD 10 DNA DNA 230 150 74 125 245 RHVAV 2-B TOTAL 140 230 460 350 152 240 470 REMARKS: TESTING ENGINEERS, IN 2811 Teagarden St. 510-835-3142 a ®1 10-834-3777 fax San Leandro, CA 94577 800-660-3142 r, i PROJECT # 63088 PROJECT: 11 Results Way Cupertino, CA DATE HOURS Permit # B-2016-1737 4/21/16 8 shift INSPECTOR C. Mingoia San Leandro • San Jose - INSPECTION REPORRT Week Ending: 4/22/16 TYPE OF INSPECTIQ :_ Epoxied Anchors PLACE OF INSPECTION: Jobsite 4/22/16 Reported to Tim Scott of Barron Builders at the jobsite as requested. 4/21/16 Witnessed the drilling of holes of proper diameter and depth. Observed the cleaning of holes. No anchors installed this dated, no epoxy. The preceding work was, to the best of my knowledge, in compliance with approved job plans and specifications, including revisions by engineer, and Drawings S1, S2 and S3, Details 9 and 10, dated 4/4/16. 4/22/16 Inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and the injection of Hilti HY 200 epoxy (exp. 3/17). Witnessed the proper insertion of thirty-two (32) 5/8" diameter Allthread anchors, 6" in length, embedded 3?/2"at mil track;_ seyenteen (17) 5/s" diameter,-Allthread anchors, l8"_iwlength, embedded 4" atmil_track:and eig-ht.(8)_5/8"_ -- _ diameter Allthread anchors, 6" in length, embedded 3-1/2" for Simpson =0 at 5" slab. Verified nine (9) additional holes and all others cleaned and drilled on 4/27/16. The preceding work was, to the best of my knowledge, in compliance with approved job plans and specifications, including revisions by engineer, and Drawings S1, S2 and S3, Details 9 and 10, dated 4/4/16. APIMCEIVED ,JUN 16 2016 BY 7Ad- 1cc: Barron Builders/E. Barron City of Cupertino/Bldg. Inspection Dept. Reviewed by:j `bavid �iippero Special Inspection Division Manager The results presented in this report relate only to the item(s) tested/inspected and may be reproduced only in its entirety unless written pemussion from TO is obtained. Page 1 of 1