Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
15100080
R; �`' ` ; r'; CITY OF CUPERTINO BUILDING PERMIT BUILDWG AAARESS' 10500 N DE ANZA BLVD CONTRACTOR: DEVCON PERMIT NO: 15100080 .,`y CONSTRUCTION INC OWNER'S Nt ME:i;MLSSIONMWEST PROPERTIES LP IV 690 GIBRALTAR DR DATE ISSUED: 11/04/2015 ;q i. 1 4 PHONE,40873$444 w MILPITAS, CA 95035 PHONE NO: (408)942-8200 IOW.YN;yER'S �•"a_•!`f:." '1 "LICENSED CONTRACTOR'S DECLARATION JOS DESCRIPTION: RESIDENTIAL COMMERCIAL r Licegse,C1 "... 11, f7 APPLE - T.I. TO RECONFIGUREIRELOCATE 3 (E) CHAMBERS' +,,j_;),i,-;'„Lie.'#!1' CONFERENCE ROOM & OFFICES & ADD 2 (N) CHAMBERS TO 4TH FLR Contractor t++!l ci % Dat IT •' �� ONLY (11,052 S.F.} I hereby affirm;that.I iui licensed under the provisions of Chapter 9 (commencing,with Section 7000) of Division 3 of the Business & Professions Code and that. 11 1censeas to full force and effect. I hereby affirms under penalty of perjury one of the fallowing, two declarations: I have and will maintain a certificate of consent to self -insure for Worker's ,1;1,,.},.11, ., - Compensation, provided foF by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: 584500 1as erf rmance of.the fvork fariWfiich this permit is issued. have:agdkwi,�l Compensation Insuranee, for by maintainWorker s as provided Section 3700 of the abor Code;!for the performance of the work for which this permit is issued.r i + -' i • 3 1'' APN Number: 31622017.00 Occupancy Type: [CANT CERTIFICATION I certify that Ihave read this`application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.,I agree'Eo comply with all city and county ordinances and state latus relating to building construction, •and hereby authorize representatives of this city to enter WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon the above;mentioned property for inspection purposes. (We) agree to save ISO DAYM LED INSPECTION. indemnify and keep hamiless the City of Cupertino against liabilities, judgments, costs, and expenses�� V ich may acerue' against said City in consequence of the granting of'this permit.' Additionally, •the applicant understands and will comply Date: with alLnon-poinf�source regulations per the Cupertino Municipal Code, Section RE -ROOFS: Signature date All roofs shall be spected prior to any roofing material being installed. If a roof is i , _ _ installed without first obtaining an inspection, I agree to remove all new materials for inspection. ER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm, thatI am exempt from the Contractor's License Law for one of the following two reasons: r! , ; I i ; ; 1, as owner ofdhc'prgperty;,oi'my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A” OR BETTER will dp the.wo'rk,'and'Ihe structure isnot intended or offered for sale (Sec -7044, i 'j 1,1 , � Io - , r ,, - , , ,' ,,v Business& Professions GoM I W,' ` ' t' 'J '' 1, as1 owner of tlie.progerty„3111 exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE ,4 oonstrflct the project g6c,7044;` Business & Professions Code), I have read the hazardous materials requirements under Chapter 6.95 of the I;.' : ! [ hereby penaity of one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will affirm•under perjury declarations: 'sl'; '"', maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the ,,3',;1 ? ,- j! Health & Safety Code, Section 25532(a) should I store or handle hazardous 1 have andiwill maintairi a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation;:ak.p ovided for by. Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Managemeut District 1 performance ofthe'wF :. -0r, _� ich- is'permit is issued. ` ' ' ' will maintain compliance with the Cupertino Municipal Code, Chapter 9,12 and '' 1 have and will'mats�tain �orkei•�s Compensation Insurance, as provided for by iiI the Health & Safe Code, Sectio 05, 25533, and 25534. Safety .� Seetion�37pq of the I;labor,Code,j for the performance of the work for which this ' Owner Date: t,; ; •w- , , • permit is tgsti d&-•'li'IyE'i;'1, ; li r it _ . or an agent: 1 certify that in tfle performance of the work for which this permit is issued, I shall not employ any,persdnin any maturer so as to become subject to the Worker's CompensalG+on laws f Califoiniii If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY I becvme'subject to,the Worl,6's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of d '' -" 119. 1, ` 6 forthwith' comply,wrth such provisions or this permit shall be deemed revoked. work's for which this permit is issued Sec. 3097, Civ C. P ( ) r "• ` Lender's Name II!!' 1: {tIA,1 7 APPLICANT CERTIFICATION Lender's Address I certify that.l ave:feais'application and state that the above information is correct, I: ee:to comply with all city and county ordinances and state laws relating to building ''cons tructi6n; 'r lid hereby authorize representatives ofthis city to enter upon the a6oYe men'tlgned property for inspection purposes. (We) agree to save indemnifyand keeplharniless: thZ City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, and'expepses -vymq i may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of.this pe`nnit. AddiiibnAy, the applicant understands and will comply withl][hoj=point.s'oufrce regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. II Date CITY OF CUPERTINO BUILDING PERMIT BUMDINGADDRESS: CONTRACTOR: PERMIT NO* 151.00080 10500 N DE ANZA BLVD CUPERTINO CA 95014 (316 22 017) OWNER'S NAME: MISSION WEST PROPERTIES IV DATE ISSUED: 11104/2015 OWNER'S PHONE: 408-7384444 PHONE NO: 408-964-5678 CONTRACTOR'SLICENSED BUILDING PERMIT INFO: License Class Lic. # Zoa loeb Contractor Date .�� ,, _BLDG _ELECT _ ]PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing MICH RESIDENTIAL COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in fall force and effect, JOB DESCRIPTION: APPLE - T.I. TO RECONFIGURE/RE'LOCATE 3 (E) I hereby affirm under penalty of perjury one of the following two declarations: CHAMBERS, CONFERENCE ROOM & OFFICES & ADD 2 (N) 1. 1 have and will maintain a certificate of consent to self-insure for Worker's CHAM13ERS TO 4TH FLA ONLY (11,052 S.F.) Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. DEFERRED SUBMITTAL #1: CIVIL SITE IMPROVEMENT I have and will maintain Worker's Compensation Insurance, as provided for PLANS; CHAMBER PLANS AND FOURTH FLOOR ANALYSIS FOR by Section 3700 of the Labor Code, for the performance of the work for which INSTALLATION. ISSUED 11-1245. this permit is issued. APPLICANT CERTIFICATION REVISION #1 - HVAC UPGRADES AND FIRE SMOKE DAMPERS certify that I have read this application and state that the above (FSD'S)- Issued 1/26/16 information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby TCO GOOD TILL 3/4/2016 authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep Sq. Ft Floor Area: Valuation: $84500.00 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 APN Number: Occupancy Type: comply with all non-point source regulations per the Cupertino Municipal 316 22 017 Code, Section 9.I S. V2rv'1(o PERMIT EXPIRES IF WORK IS NOT STARTED Signature Date WITHIN 180 DAYS OF PERMIT ISSUANCE OR OWNER-BUILDER DECLARATION 1.80 DAYS FROM LAST CALLED INSPECTION. I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: Issued by 1. I, as owner of the property, or my employees with wages as their sole Date: compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) RE-ROOFS: 2, I, as owner of the property, am exclusively contracting with licensed All roofs shall be inspected prior to any roofing material being installed. If a roof is contractors to construct the project (Sce.7044, $usiuess & Professions Code). installed without first obtaining an inspection, I agree to remove all new materials for I hereby affirm under penalty of perjury one of the following three declarations: inspection, 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 Signature of Applicant: performance of the work for which this permit is issued. Date: z. 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER this permit is issued. s. 1 certify that in the performance of the work for which this permit is issued, I HAZAR60US MATERIALS DISCLOSURE shall not employ any person in any manner so as to become subject to the I have read the hazardous materials requirements under Chapter 6.95 of the Worker's Compensation laws of California. If, after making this certificate of California Health & Safety Code, Sections 25505, 25533, and 25534. I will exemption, I become suhjcet to the Worker's Compensation provisions of the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Labor Code, I must forthwith comply with such provisions or this permit shall Health & Safety Code, Section 25532(a) should I store or handle hazardous be deemed revoked. material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I APPLICANT CERTIFICATION will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I certify that I have read this application and state that the above Information is the Health & Safety Code, Sections 25505, 25533, and 25534. 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 Owner or authorized agent: to save indemnify and keep harmless the City of Cupertino against liabilities, date: `CJh judgments, costs, and expenses which may accrue against said City In COIYSTRUCTTON LENDING AGENCY consequence of the granting of this permit. Additionally, the applicant I hereby affirm that there is a construction lending agency for the performance understands and will comply with all non-point source regulations per the of work's for which this permit is Issued (Sec. 3097, Civ C.) Cupertino Municipal Code, Section 9.18. Lender's Name Lender's Address Signature Date ARCHITECT'S DECLARATION ME CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10500 N DE ANZA BLVD CONTRACTOR: DEVCON PERMIT NO: 15100080 CONSTRUCTION INC OWNER'S NAME:, MISSION WEST PROPERTIES LP 1V 690 GIBRALTAR DR DATE ISSUED: 11/042015 OWNER'S PHONE: 408738444 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION RESIDENTIAL COMMERCIAL JOB DESCRIPTION. ❑ APPLE - T.I. TO RECONFIGUREIRELOCATE 3,(E) License Class Lie: # cF C7 9 1 6,9 CHAMBERS, CONFERENCE ROOM & OFFICES & ADD 2 ' II )1 (1)CHAMBERS TO 4TH FIR ONLY (11,052 S.F.) Contractor eor Dat I hereby affirm that I am licensed under the provisions of Chapter 9 ]+ E]Zi D,SI7BM)(TAL,#1'.. C, SITEINI�RO.'- 1I+ENT '+ +"�'ul "" (commencing with Section 7000) of Division 3 of the Business & Professions ='`s PLANS; HAM$EI_,,1LANS�,bi FOURTH FLOOR, Cade and that my license is;in toll force and effect. ANALYSTZ ER j1�1STALATXOI�T7 ISSUED 1-12=T5. I hereby affirm under penalty of perjury one of the following two declarations: I have anddwill maintain a certificatc.of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $84500 performance of the work for which this permit is issued. ve and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Cade, for the performance of the work for which this APN Number: 31622017.00 Occupancy Type: permit is issued. - APPLICANT CERTIFICATION I certify that I have read this: application and state that the above information is PERMIT EXPIRES IF WORKIS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR 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 b J�T�t J%�j� Date: granting of this permit,. Additionally, the applicant understands and will comply y u with all nonn�so regulations per the Cupertino Municipal Code, Section Signature Date Z i5' 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 M 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 wore, and the structure is not intended or offered for sale (Sec.7044, Business & Piofessions Cade)' 1, as owner of ihc�pioperty, air exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the prcjeet,(See,1044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Cade, Sections 25505,255j3, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: I , ,' - Health & Safety Cade, Section 25532(a) should I stare or handle hazardous I 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 Ouality Management District I performance of the work for,which this permit is issued, will maintain compliance with the Cupertino Municipal Cade, Chapter 9.12 and I have and will maintain, Woiker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 5505, 25533, and 25534. Section 3700 of the Labor Code,'for the performance of the work for which this mer or authorized agent: Date: l permit is issued.", ', 1 certify that in the perform_ ance of the work for which this permit is issued, I shall,' not employ any person in any'manner so as to became subject to the Worker's Compensation'laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to thc,Workei's Compensation provisions of the Labor Cade, I must I 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 (See. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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'rrientoned property for inspection purposes. (We) agree to save indemnify!andtcep 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 -paint source regulations per the Cupertino Municipal Code, Section Licensed Professional i Signature ' '� ` i' Date CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinclacupertino.om 1 S' 1 000 910 ❑ NEW CONSTRUCTION ❑ ADDITION ® ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10500 DeAnz�aBlvd # APN316-22-017 r �r� OWNER NAME Apple Inc �t/t.vSS�ory w`S �" ♦_ Ip PHONE 408-738-4444 E-MAIL l•Pf �nro STREET ADDRESS 1 Infinite Loop (`�� CITY, STATE, ZIP Cupertino CA 95032 FAX CONTACT NAME Terry Fullerton PHONE 408-519-8383 E-MAIL tfullerton@devcon-const.com STREErADDRESS 690 Gibraltar Drive CITY, STATE, ZIP Milpitas, CA, 95035 -[FAX 408-946-5513 h,f 11 OWNER 11OWNFR-BUILDER 11 OWNER AGENT IPL CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCtIITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME DEVCON Construction LICENSENUMBER399163 LICENSE TYPE B BUS. LIC Ii COMPANY NAMEDEVCONConstruction E-MAIL tfullerton@devcon-const.com FAX408-946-7713 STREETADDRES5690 Gibraltar Drive CITY' STATE, ZIPMiI itas, CA, 95035 PHDNE408-519-8372 ARCFBTECTIENGINEERNAME Brent Downing LICENSE NUMBER C-32444 •JG BUS. LIC Ii COMPANY NAME DEVCON Construction E-MAIL bdownin devcon-const.com FAX 408-942-7713 STREET ADDRESS 690 Gibraltar Drive CITY, STATE,ZIPMi[pitas, CA, 95035 PHONE408-942-8200 DESCRIPTION OF WORK Modification to an existing space added walls and ceiling, minor demo, 3 added chamber 2 relocated chambers and associated Electrical, Mechanical. Chambers to deferred submittal. EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES B B 1-b 4 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA Office B 11,052 84,500.00 BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ATTACH VDWELLINGUNITS: ISASECONDUNIT ❑YES SECONDSTORY ❑YES BEING ADDED? ❑NO ADDITION? [No PRE.APPLICATION []YES IF YES, PROVIDE COPY OF 1S THE BLDG AN ❑YE TOT> V.4L�OItI: PLANNING APPL i1 ❑NO PLANNING APPROVAL LETTER EICHLER HOME? O ((�� [-�f L By my signature below, I certify to each of the following: 1 am the prnperty owner or authorize agent Ct roperty owner's be ]f. 1 have read this application and the information I have provided is correct. I have read the Description of Work an accurate. I agree to comply with all applicable local ordinances and state laws relating to buil ' onstruction. I authorize representatives of Cupertino o enter the above -identified property f r inspection purposes. 10/12/15 Signature of Applicant/Agent: date: SUPPLEMENTAL INFOAMA TION REQUIRED 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 C3 STANDARD ❑ PUBLIC WORKS: form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIREDEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑: ENVIRONMENTAL HEALTH. d1dgApp_2011.doc revised 06/21/11 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (40B) 777-3228 • FAX (408) 777-3333 • building0cugertino.org [:]NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI n REVISION/ DEFERRED ORIGINAL PERMIT it 15100080 PROJECT ADDRESS 10500 DeAnza Blvd APNY 316-22-017 OWNERNAME Apple Inc PHONE 408-738-4444 E-MAIL STREErADDRESS Z Infinite Loop CITY, sTATE.zIP Cupertino CA 95032 —7 FAX CONTACT NAME Terry Fullerton PHONE 408-519-8383 E-MAIL tfullerton@devcon-const.com STREET ADDRESS 690 Gibraltar Drive CITY, STATE, ZIP Milpitas, CA, 95035 FAX408-946-5513 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT I( CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LICENSE NUMBS 777;TEB BUS. LIC 0 DEVCON Construction 99163 COMPANY NAMEDEVCONConstruction E-MAIL tfullerton@devcon-const.com FA71408-946-7713 STREET""690Gibraltar Drive CITY, STATE' Z"'MiI itas, CA, 95035 PHONE408-519-8372 ARCHTIECT/ENGINEERNAME Brent Downing LICENSENUMBERC-32444 BUS. LIC 0 COMPANYNAME DEVCON Construction E-MAIL bdownin devcon-const.com 1AX 08-942-7713 STREET ADDRESS 690 Gibraltar Drive CITY, STATE, ZIP Milpitas, CA, 95035 PHONE408-942-8200 DESCRIPTION OF WORK INSTALLING (2) TWO NEW RF CHAMBERS ON THE 4TH FLOOR AND RELOCATING (3) EXISTING CHAMBERS. (1) FROM 2ND FLOOR & (2) ALREADY ON 4TH FLOOR. EXISTING USE PROPOSED USE CONSM TYPE # STORIES B B 1-b 4 USE TYPE OCC. SQ.Ff. VALUATION (S) EAG N� FLOOR DEMO AREA TNET AREA Office B 800 24,500.00 BATHROOM KITCHEN OTHER REMODELARF.A REMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKMORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: ISA SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? NO ADDITION? [:]NO 24e 500.00 PRE -APPLICATION ❑ YES I YES, PROVIDE COPY OF IS THE BLDG AN [] YES RECEIVED BY: TOTAL VALUATION: a� PLANNINGAPPL# ❑NO PLANNING APPROVAL LETTER EICHLERHOME? []NOCP By my signature below, l certify to each of the following: 1 am the property owner or authorized agent to act on the property owner's behalf. ] bdve read this application and the information I have provided is correct. I have read escription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatingnr ding construction. I a e represe ative of Cupertino to cater the above-identifie property for inspection purposes. Signature of Applicant(Agent: Date: 2 J/ SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for _ existing building(s). Demolition permit is required prior to issuance of building OVER-THE-COUNTER BUILDING PLAN REVIEW permit for new building. ❑ EXPRESS PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El 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 ❑ SANCIARY SEWER DI STRICT submittal of Building Permit application, • ❑ ENVIRONMENTAL HEALTH B1dgt4pp_2011.doc revised 06121111 CONSTRUCTION PERMIT APPLICA T ION Sr CONiIh)IUNI TY DEVELOPMENT DEPAR`I DENT - BUILDING DIVISION t� D300 TORRE AVENUE • CUPERTINO, CA 95014-3255 L�JL/LJ�ff) CUI?1=R'i1hla (408) 777-3228 • FAX (408) 777-3333 - buildino(a.cuoer<ino.org ❑ 1<T -W CONSTRUCTION ❑ ADDITION . ❑ ALTS 'Lk ON / TI z REVISION / DEFERRED OZIGI2,,1.4L PER1vTr R PRD>rCf EDDREASS `o OYMMNAI--�RQIL ING �+SS%1>)M 0-30,5[ ?30TH r l STAFF! ADDlt 55 la POOD INCITY, STATE, 2IP FAX L*4� cDNTACT NAVE PHONE %0,409.Lo 1e\X0'R Kk sTREz, AnnAEss CITY, STAT':L,.�z? Kk wP `tS 016 SAX " r:�51 ❑ ovrx R ❑ OR'IL`-R-Bi amL :A ❑ owNT.RACmIc r CO'T;;t/.CTDA ❑ CON7RACTORAGTT ❑ ARC= -CT EI ENG=- R ❑ D1_-LOPFK CITE nkhr CONIRACIORNAMS �2YNe ilCr-t StNU]J3ER3 I ICE S'R7 TS I BulLIC� C01ZANY NAaS W � F -M JL �7 tOY►' G� r15-"� . FAX Ll Q4L -7-7 STREETADD}LS5` O & _-i'-¢- CISY,SiAia,Zi ` `LyS C� QJV7S Psi01 r 4Gk'rta7� L `7 ARC11UTECT�QGDA-rR NA�✓E y U NSF rUNGER C , � '1 BUS. L]C 11 CO19ANY 1111E(� 7JeVCDn C�►s�WlJwi�l� �B+/L.TC�JL�. FAX "[��Z` t. i 4�.7��VD'h1 STF=A.DDRESS / COac) G-1 Lid LVA I C7Y,STAT'LZIPkA, r* b��� vrl `+��u '2-�2aa ASSCRSPTION OF WOR`K� �Vl •� \OAR =STING USE PROPOSED USE CONSIR TYPE 9 STORMS USE TYPE OCC. SQ.FT. VALUA'fIOh {i) E)a TG NnW FLOOR DEATO T OTAL AR7<A AREA AMA' - BATHROOM KrCH�_ OTTER i RMMODEL AREA FxMoAEL AREA �LIIIIODE.FREA I PORCHIJUA DECKAMA TOTALI)ECKIPORCHARZA G?RAGEA.R?A: DEIACY ❑ ATTACH 4I 9DAELLINGIJNZ'S: ISASFCOTDUNrr ©YES SECOND STORY EIY'S BEING ADDED? ANO ADDMON? E]NO PP.bi.PPLiCAIION ❑lc5 EF YES, PROVIDE COPY OF IS THE BLDG AN E] YES l Ili] --- .-. TOTAL Vp ATION' PI_kNN1NGAPPL9 ❑NO PLAh1.7WGAPPROVALL=R EICHLERHOME? ©NO _ By my signature belOw, I certiy to each of the fol Io�;*ig: I am the property owner or authori ed agent to act on the property owmer's behalf. I h e read this application and the information I have provided is corect. 1 have read the Description of Work and verity it is accurate. I agree to -comply with 41 applicable local ordinances and state lads relating to building construction, I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. 1 Signature of Applicant/A-gent: Date._ -Yr SU-PPLF,MEl\TAL 'FORt,2ATION REQU=D a -nncsi �a - ---- New SFD or Multifamily dwellings: Apply far dernolition permit for .r= LXO.-O'KR T1�C:OU'hTER�`" ' ;A tl '_ BifII.DI;M1GPL4?i.REC�iy� fw - existing building {s}. Demolition pennit is required prior to issuance of bm'']ding ' — ,� y - permit for new building. 5• _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure SS - - �. �R-� ��* raL.A'�'h PLIL P2EFMIi— form if uzy Hazardous Materials are being used as part of this project. - _ Copy of Planning Approval Letter or >`faetirg with Planning prior to � ., submittzl of Building Permit application. Y, '���.�Si•v'4 ��� �� ��`?=sRnrsfitc � 4TH' � � � ��,.,x z,- • .fin r � Bldg-Xpp_2011.doc revised 06!21/!1 CITY OF CUPERTINO lI FEE ESTIMATOR - BUILDING DIVISION im ADDRESS: 10500 DE ANZA BLVD DATE: 1011212015 REVIEWED BY: MELISSA PC FEE ID APN: 316 22 017 BPIF: *VALUATION: 1$84,500 ~PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building IBTIPLNCK PENTAMATION TPERMIT TYPE: 1 B TL WORK APPLE - T.I. TO RECONFIGURE/RELOCATE 3 E CHAMBERS CONFERENCE ROOM & OFFICES SCOPE & ADD 2 (N) CHAMBERS TO 4TH FLR ONLY (11,052 S.F.) OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA 01) PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) I -A,1-13 11,052 $4,143.12 IBTIPLNCK $10,466.53 IBTIINSP Elea Insp. Fee; $10,466.53 Supp1. Insp. Fee.e Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administratn,e Fee: Work Without Permit? © Yes (F) No $0.00 TOTALS: 11,052 1 $4,143.12 Travel Documentation fees: $10,466.53 .Strong Motion Fee: IBSEISMICO MECH, HOURLY Q Yes O No ? PLUMB, HOURLY 0 Yes .E) No ' ELEC, HOURLY Q Yes.. ,Q No ,llech. Plan Check Plumb. Plan Check Flee. Plarr 0111111"'. Alech. Permit Fee: Plumb. Permir Fee: rrrrit Fee: Qther htc Ir..lr�sy�. Other Plumb It Other Elea lrt p. ,llech. Insp, Fee: Plumb. Insp. Fee: Elea Insp. Fee; NOTE: This estimate does not includefees due to other Departments (Le. 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 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,143.12 Select a Misc Bldg/Structure or EIement of a Building Suppl. PC Fee: (j)Reg. ©OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $10,466.53 Supp1. Insp. Fee.e Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administratn,e Fee: Work Without Permit? © Yes (F) No $0.00 Advanced Planning dee: $0.00 Select a Non -Residential 0 Building or Structure (� Travel Documentation fees: .Strong Motion Fee: IBSEISMICO '$23.66 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $4.00, suBTOTALs;14,637.31 $0.00,: TOTAL FEE:- - $14,637.31 Revised: 10/01/2015 CITY OF CUPERTINO FEE ESTIMATOR -- BUILDING DIVISION 1AADDRESS: 10050 N WOLFE RD DATE: 01104/2016 REVIEWED Y. PAUL. -fec , Perm CC; APN: 316 22 017 SP#: 15100080 "VALUATION: $0 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration I Addition 1 Repair PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? ® Yes ONo PENTAMATION PERMIT TYPE: 1GEf�COt Al WORK Recision #1 - HVAC U rades and Fire Smoke Dam ers FSD's SCOPE 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 Dept for addn'l info. FEE ITEMS Fee Resolution 11-053 E : 7/1/132 FEE QTY/FEE -fec , Perm CC; f'{7HF1i), PC4P1'IFi I'L'L': �S:PC', �'PF7Tdit 'L'('. (�ai.a; ;1•I� �°;d. irrsr�. Ur`:�,.1'idald�; lrri�;. (, lihI •; ksf�:'�, fasp. f�-ir�'T�':.>C, t•r..,. isid%dl�, iYM.il, i'i�': �('�, d�!?.ir� �:'f'.I 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 Dept for addn'l info. FEE ITEMS Fee Resolution 11-053 E : 7/1/132 FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? (D Yes O No $0.00 2 hours Plan Check, Hourly $286.00 1STPLNCK Suppl, PC Fee: O Reg. 0 OT0.0 hrs $0.00 PMB Plan Check: $0.00 Permit Fee: Hourly Only? 0 Yes O No $0.00 Suppl. Insp. Fee @ Reg, Q OT 0,0 hrs $0,00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1 BCONSTAXC $0.00 �Id'2d7 8 I"c.''. O Work Without Permit? ® Yes O No $0,00 Advanced PIanning Fee: $0.00 0 hours Inspections $286.00 ,STINSP inspection, Hourly O � Strong Motion Tee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0,00 $572.00 TOTAL FEE; $572.00 Revised: 2 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION w:7 - ADDRESS: 10500 N De Anza Blvd DATE: 11112/2015 REVIEWED BY: Sean i:.fC.',�i. iii?rlT.'?!!'E.... APN:' BP#: "VALUATION: Iso *PERMIT:TYPE: '' Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE:? Commercial Building Suppl. PC Fee: (E) Reg. 0 OT PENTAMATION PERMIT TYPE: 1GEIVCOM WORK DEFERRED SUBMITTAL 41: CIVIL SITE IMPROVEMENT PLANS; CHAMBER PLANS AND SCOPE FOURTH FLOOR ANALYSIS FOR INSTALLATION. NOTE:' This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, sanitary Sewer District, School nictrirt_ atr_ 1r Tlavcn fnnc am hncod nn thn mvJimi»nry infnrmntinn nvnilnhln and nro nn/v nn nctimatn C.'nniacl tl1n. 1),-nt fnr addn'l info - FEE ITEMS (Fee Resolution 11-053 Eff. 711/13) !6 fec h. ?''6Cl?4!l'.i'ie.�'is i� QTY/FEE MISC ITEMS i:.fC.',�i. iii?rlT.'?!!'E.... Plur ib, Jllei di Fvu.." 1_`i{'.C.1'.'P'lifiii`dC: -!:hher kh?O't,':ilI9FJi i#,5 �. �): �18P' �1f2C`. l:I: jJ.Ll Suppl. PC Fee: (E) Reg. 0 OT 0.0 NOTE:' This estimate does not include fees due to other Departments (i. e. Planning, Public Works, Fire, sanitary Sewer District, School nictrirt_ atr_ 1r Tlavcn fnnc am hncod nn thn mvJimi»nry infnrmntinn nvnilnhln and nro nn/v nn nctimatn C.'nniacl tl1n. 1),-nt fnr addn'l info - FEE ITEMS (Fee Resolution 11-053 Eff. 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee:, ' $0.00 1 # $286.00 Deferred Submittal IDEFSUBM Suppl. PC Fee: (E) Reg. 0 OT 0.0 hrs $0.00 PME`Plan Check:' $0.00 Permit Fee: $0.00 Suppl. Insp. Fee: Reg. 0 OT 1 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (:OOnstruefibrf Tax: .r1ci1;r1ihis1rwi1e Fee:. Q Work Without Permit? 0 Yes (D No $0.00 Advanced Planning Fee: $0.00 Select.a Non -Residential Building or Structure 0 Travel DQ((Iwvnt€rtjon Fees: Strom Motion Fee: $0.00 Select an Administrative Item Bldg Stds Comfnission Fee: $0.00 .: E SJBTOTA,LS; $0.00 $286.00 `TOTAL'FEE: $286.00 Revised: 1010112015