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12080013CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10100 N TANTAU AVE CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 12080013 OWNER'S NAME: ROCKTINO FEE LLC 1460 O'BRIEN DR DATE ISSUED: 11/09/2012 OWNER'S PHONE: 4159994505 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL License Class �6P Lic. 2 `r� APPLE BLDG-TA07B HYPERNOVA LAB-COMM.T.I 35,679 Iii 1# Contractor O'J CQ + �j Tr�TlYaie �i ?j FT I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions REVISION #3- REMOVAL OF SCOPE OF WORK RELATED Code and that my license is in full force and effect. TO LAB 1163 - ISSUED 11/13/13 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 Sq. Ft Floor Area: Valuation: $8000000 performance of the work for which this permit is issued. 1 have and will maintain Worker's Compensation Insurance, as provided for by ection 3700 of the Labor Code, for the performance of the work for which this APN Number: 31619061.10100 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 WORK IS NOT STARTED correct. I agree tocomply with all city and county ordinances and state laws relating WITHIN 180 D IT 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 DA OM L�ALLED 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 granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulatio er the Cupertino Municipal Code, Section s� 9.18. — % T RE -ROOFS: Signature Date 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. ❑ 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 I, 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, 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: Health & Safety Code, Section 25532(x) should I store 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 Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 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, the Health & Safety Code, Sections 25505, 3, and 25534. Owner or authorized agent: Date: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, 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 (Sec. 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 mentioned property for inspection purposes. (We) agree to save indemnify and keep 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 -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10100 N TANTAU AVE CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 12080013 OWNER'S NAME: ROCKTINO FEE LLC 1460 O'BRIEN DR DATE ISSUED: 11/09/2012 OWNER'S PHONE: 4159994505 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIALE] LICENSED CONTRACTOR'S DECLARATION License Class_ Lie. # -71 y ZZ APPLE BLDG-TA07B HYPERNOVA LAB-COMM.T.I 35,679 Contractor h/�j�() UIQ d r&LYI�J Date /is SQ FT I hereby affirm that I am licensed under the provisions of 9 (commencing with Section 7000) of Division 3 of the Business & Professions 7/1/20 REV #2 -REDESIGN LAB FOR NEW EQUIPMENT & Code and that my license is in full force and effect. D ST MECH, ELECT,PLUMB- ISSD 10/4/2013 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 Sq. Ft Floor Area: Valuation: $8000000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided f Section 3700 of the Labor Code, for the performance of the work for wh' s APN Number: 3161906] .10100 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED 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 WITHIN 1 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS/RM 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 4,9CA granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. ,J RE -ROOFS: 6 ? Signature Date 7 All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all 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, wil I 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, 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: Health & Safety Code, Section 25532(a) should I store 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 Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 5 53 , and 25534. Section 3700 of the Labor Code, for the performance of the work for which this(� Owner or authorized agent: Date: 186 7 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, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, 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 (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 1 understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10100 N TANTAU AVE CON'I'RACFOR: NOVO CONSTRUCTfON PERMITNO: 12080013 OWNER'S NAME: ROCKTINO FEE LLC 1460 O'BRIENDR DATE ISSUED: 11/09/2012 OW 'ER'S PI [ONE: 4159994505 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 LICENSED CONTRACTOR'S DI?CLARATION f �J License Class if Lic. N 9 0 Z— Z BUILDING PERMIT INTO: BLDG ELECT PLUMB MECH RESIDENTIAL COMMERCIAL Contractor_NCjQ Ci9f1S ��1iJYl Date 3 1� 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: APPLE BLDG-TA0713 HYPERNOVA LAB-COMM.I.I (commencing with Section 7000) of Division 3 of the Business & Professions 35,679 SQ F-1 Code and that my license is in full force and effect. 1 1/37/12-REVill - REVISIT OFFICE SPACE TO RID LABS, NEW ROOFTOP PLA I FORM ROOF SCRHN, MECH UNITS, EXISTING LABS -ISSUED 3/28/13 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 Sq. Fl Moor Arca: Valuation: $8000000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 3161906 1. 10 100 Occupancy Type: APPLICANTCF,RTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City ol'Cupertino against liabilities, judgmcnts, 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 T CALLED INSPECTION. with all non -point source regulations per the Cupertino Municipal Code, Section 9.18 7 _.µ..__.. Issued bbv: Date: Signature Datev� ❑ OMINER-BUILDER DECLARATION RE -ROOFS: 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed Il a rool is the following two reasons: installed without first obtaining an inspection, I agree to remove all new materials or 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 ol'Applicanl: Datc: I, as owner of the property, am exclusively contracting with licensed contractors to ......... construct the project (Sec.7044, Business & Professions Code), ALL ROOF COVE121NGS TO BI? CLASS "A" OR BL:'F1'F.R 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 Rx Workers HAZARDOUS MA Il;12LU,S DISCLOSURE Compensation, as provided for by Section 3700 of the Labor Code, for the 1 have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Ilealth & 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 licalth & Section 3700 of the Labor Code, for the performance of the work for which this Safety Code, Section 2S532(a) should 1 store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air- irpermit permitis issued. contaminants as defined by the Bay Arca Air 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 iNlunicipal Code, Chapter 9.12 and lire 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, 1 must Ow or ut rizcd agent. Date: 3 13 forthwith comply with such provisions or this permit shall be deemed revoked.-°�•�} _. CONSTRUCTION LENDING AGENCY APPLICANT CER"TIFICATION 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 ARCIITTF,CT'S DECLAWkTION with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. 1 understand m_y plans shall be used as public records Signature Date Licensed Prol'cssional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10100 N TANTAU AVE I CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 12080013 OWNER'S NAME: ROCKTINO FEE LLC OWN'ER'S PHONE: 4159994505 ❑ LICENSED CONTRACTOR'S DECLARATION License Class, Lic. k -79 �0 ZZ Contractor Ilip> jo CALhh Date 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 orthe 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 permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. q Signature 4Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, 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, 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. Signatu Date 4025 BOHANNON DR I DATE ISSUED: 11/09/2012 MENLO PARK, CA 94025 1 PHONE NO: (650)701-1500 BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH RESIDENTIAL r, COMMERCIAL JOB DESCRIPTION: APPLE BLDO-TA07B HYPERNOVA LAB-COMM.T.1 35,679 SQ FT Sq. Ft Floor Area: I Valuation: $8000000 APN Number: 31619061.10100 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS 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, 1 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. 1 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. Ownehorized en�� 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. CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO. CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(Qcupertinoj.- ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION/DEFERRED I a5Zc'13 ORIGINAL PERMIT # PROJECT ADDRESS APN M ` C) U/ I OWNER NAM!F + -.. N D °a�.> inRcPL�T�GS PHONE y15-�T- y5o E-MAIL �aI>;rAe_U9a�ra tw STREET ADDRESS �t�}QJ�q/J K4&_) .0 STN CCTV cTTATP 71P FAX CONTACT NAME P PHON���E-MAIL STREET ADDRESSCITY, STATE,��ZIP� FAX lq620 O ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT XCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE LIC N 15BUS. z s COMPANY NAME E-MAIL FAX A6"CA0A1sT9it�- min STREET ADDRESS CITY, STATE, ZIP PHON $: 1 /Yl 10.45 (�& (0,70 ARCHITECT/ENGINEER NAM LICENSE NUMBER BUS. LIC H I_b 41 1511y COMPANY NAME E-MAIL FAX QIP STREET ADDRESSCITY, 21 5 1 He- STATE, ZIP CA '75lzG PHONE iIZ3 DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE R STORIES �� 4Z v I VI -3 USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA ft NEW FLOOR DEMO AREA AREA TOTAL y NET ARF^ BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREATOTAL DECKIPORCH AREA GARAGE AREA: DETACH ATTACH NDWELLING UNITS: Cy IS A SECOND UNIT E] YES BEING ADDED? YffNO SECONDSTORY ❑YES ADDITION? RNO PR YES IF YES, PROVIDE COPY OF IS THE BLDG AN YES C]E-APPLICP,TION RECEIVED Y; TOTAL VALUATION. PLANNING APPL H �NO PLANNING APPROVAL LETTER EICHLER HOME? )VO „ .... ,., QOO 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 tobuilding qpffstru on.Il1 authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicandAgent: (ol-- Date: 3 1Z SUPPLEMENTAL INFORMATION REQUIRED PLAN CRECK TYPE ROUTING $1 ,11? ❑ pVER-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 WOR" _ 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 ❑ SANITARY DISTRACT submittal of Building Permit application. MAJOR SEWER ❑ ENVIRONMENTAL HEALTH BidgApp_201 1. doc revised 06/21/11 Ti CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building cu ertino.or ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/T1 REVLSIO EFERRED ORIGINAL PERMIT # IltA's MiM PROJECT ADDRESS APN # , a OWNER NAME PHO' 572 y5 E-MAIL -Lp STREET ADDRESS 72 FAX CITY,, STATE, ZIP�%�y y CONTACT NAME PHONE E-MAIL STREETADDRESSj CITY, STATE, ZIP yr FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME A14TWAI h,,; -CV LICENSE NUMBER 7`1102-2 LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX r" � �T�l M>411' �� "3-=ildV°'L STREET ADDRESS .. W CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC 4 COMPANY NAME E-MAIL FAX STREET ADDRESSCIT`!, V2t 36 STATE, ZIP PHONE ��� �6' DESCRIPTION OF WORK �= t %Lr t a Lab 14213 EXISTING,IJSE SE PROPOSED USE C ONS TR TYPE STORIES LJ L6 ,_— r{ V (✓TOTAL USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR DEMO AREA AREA NET AREA / �✓ C BATHROOM KIT HEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJDETACH ❑ ATTACH K DWELLING UNITS: IS A SECOND UNIT E] YES SECOND STORY []YES BEING ADDED? ❑NO ADDrrION? ❑No PRE -APPLICATION ❑ 1'PS IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES CEIVED >< TAL VALUATION: r a ✓ r PLANNING APPL k M No PLANNING APPROVAL LETTER EICHLER HOME? NO I ✓ 9� i _ �`�r`j By my signature below, I certify to each of the following: I am the property owner or authorized agent to ac 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 building construction. I th representatives of Cupertino to enter the above-ide tified property for inspection purposes. Signature of Applicant/ Agent: Date: SUPPLEMENTAL INFOR-MiATION RE UIRED Q r��, r., % " x 1„✓� �'” ' r 7 `�✓`� r �i,�,�'1..A�'r-13ECK�3'T'kA�r�.✓t�`ff�✓�,�✓i,,�,1t�u,�,L%�yRQU�'rNG'ST`>IP✓��,`U✓ �'`� '�'1 ✓t ;1+���i �'��y�h� � �'� , �� ❑' OVER JHE-COLIr�ER ✓ lr ' 1 d"� �� �� its � fi������ � �` "✓'�'q ""x' � � `e � ❑ BT�TLDIING YLAIr REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building ;; r�� ka✓�;✓� ,��f�� ✓;� ��;u� %r,`, fr�,f✓ ��N>�� �� rg ;�; >'f�+�k"�y,'"r�°T'4r�✓"� per -mit for new building. pe ✓f �� �08"" r �t �1����fi �,4n�����,G rr ✓cri C3' r.ss ✓ , �� rr ° ,1`,rre ; ✓�( ��1 �,�" a'r, ��9 LA rnzNGpz A rt> w �,' �� ���✓ s��, ✓a „' ��✓i✓� �{Y�oJ La,h prYr l�/i„r��'������ ��ati'������%F 4��� , 41, �',� '��! � elf rf9��9� ly lei ���i�l�✓/�;�,+��5 ���;aK7f �y I,Sriy _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure LU�"srLrDARn��1 �y �r a✓ �a,tr, t�1�PUBLI �yoRT r ✓ r✓y✓ ' �'�� form if any Hazardous Materials are being used as part of this project. �n , G�, ,;� ,p El]A(/f {l( 1 G'6 /Rf✓ifF e✓t✓ry,��F ,�' is �� �« �r 1 A p lA ff l LF EIDE K X",D §;�/ J'r�, r�/✓ ry � ✓��, X Copy of Plannin Approval Letter or Meeting with Planning pyior to F r ,� � 1 F ,�„ � � f ,1��t� rF /rah 9 �x�� �,�� �r7 _ submittal of Building Permit application. ✓Y✓ t Eh; AIAJ , ri ' , "�' ' `� is ;��, ✓L7y1sAt TTnRx s rt RDzsTIUC� r, l'i` aa ' �,r �7A�a /lr„T�m na %��iJ yir✓���° i u� ✓� / .? „i✓, (, /, ,.;.r;,.. �;:EA\rTI�01�MEAT,�Lti]iF,ALTH,,,'�"✓°✓X=- Bld,aApp_2011.doc revised 06/21/11 kti CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a1cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ® REVISION /DEFERRED ORIGINAL PERMIT # 1 2 G ASCO 13 PROJECT00ADDRESS "! APN it J 1 b l L O { 1 Tr V e i 10(j( 0 1 OWNER NAME -^'v\e\ PGV-I A- V PHONE �G%'S(77-q4s� ^VQ E3 1274 -'ITroU( cC� els W 11 VFAX STREET ADDRESS -J 2,0 G k%Q qt k.J CITY, STATE. ZIP S o5�`z C S (Z� CONT A4 NAME li-T �1�1 Liz PHONE o - 10 - NO E-MAIL 'c� �b�10 6095T¢pCt STREET ADDRESS LA 6 6 O Giz 6 L N il ek V I i CIT!�Y STATE, ZIP fJ t� }� r 4 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E -MAI L FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME— LICENSE NUMBER Q� BUS. LIC # COMPANY AME Wh;�4\�C�G��� �,, E-MAIL \�&\): @wk a com FAX STREET ADDRESS � " 00S 100 CITY, STATZIPE, � S i Z6 PHO; j 7 f7 ^ 123 1�\a.+�t�a. e ZCA-, 1 DESC e N G� � \ RK o� Scc� � Gt A e�Q -�o cl b 1 63. 2 e rtov a -I o L cL 6 EXISTING USE L_ N Q PROPOSED USE CUR. t `0 w,) � TYPE _ (Z !..,TOTAL N STORIES l USE TYPE OCC, SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ODETACH []ATTACH # DWELLING UNITS: ISASECOND UNIT E] YES SECONDSTORY []YES BEING ADDED? ❑ NO ADDITION? ❑ NO PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THEBLDG AN ❑YES RECO $ I�" ALL)FFi%1'ION: PLANNING ADPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO/� J By my signature below, I certify to each of the following: I am the property owner or authorized a en 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 Vfify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER THE -COUNTER ®UILDING 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. ❑ LrXPRE*; ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure mANDARD ❑I PUBLIC wOORKS form if any Hazardous Materials are being used as part of this project. LARGE ❑ FIRE DEFT` Copy of Planning Approval Letter or Meeting with Planning prior to 11 ❑ SANITARY SI �VERDISTRIOT submittal of Building Permit application. hLAJOR ❑ EN%'IRONNIENTAL HEALTH BldgApp_2011.doe revised 06/21/11 et�r�S.�Y Q - Cr- bA4 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildino c-ftupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI 0�" EVISION / DEFERRED ORIGINAL PERMIT #fZ PROJECT ADDRESS/0/00 APN # O\VNERNAME EMAIL P.✓ r A' STREET ADDRESS 30v50 -J 114 k r -*J 1 5 CITY, STATE, ZIP FAX -5/2 a CONTACT NAME (e PHON E-MAIL - lr 5� f`1 /CA1p�� STREET ADDRESS CITY, STATE, ZIP FAX (I�� 0 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT fes-" CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHnECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER `' iozz LICENSE TYP BUS. LIC R z3 COMPANY NAME E-MAIL FAX STREET ADDRESS l yCoO fJ� CITY, STATE, ZIP 9`�OZg PRONE CGSo G90 •ICS ARCHITECT/ENGrNEER NAME LICENSE NUMBER BUS. LIC p 1 l� irAi COMPANY NAME E-NIML FAX STREET ADDRESS Z Z CITY, STATE, ZIP PH NE '112- f I27- t2DESCR]PTION DESCRIPTIONOF WORK T �Q- I d IS LADS J T k LUJIM.1'1401L VI��o1� To -n0j EXISTING USE PROPOSED USE CONSTR. TYPE R STORIES oFf'-IGiZ I b V V p i USE TYPE OCC. SQ.FT. VALUATION (5) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA cb (/ e BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH 9DWELLINGUNITS: IS A SECOND UNIT ❑YES S£CONDSTORY DYES BEING ADDED? jrNO ADDITION? ��o PRE-APPL TION ❑ YES IF YES, PROVIDE COPY OF PLANNIIJG P.PPLO PLANNING APPROVAL LE"T"TER IS THE BLDG AN ❑ YES EICHLER HOATE? r1�1V0 RECEIVED $Y' r u >i'. r a r TONAL VALUATION: /,�f D 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 tobuildingconstr 'on. uthorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: //� Date:/JTZ SUPPLEMENTAL INFORMATION REQUIRED New SFD or Multifamily dwellings: Apply for demolition permit for r C.) r. Ati" rl rf 4 r _ existing building(s). Demolition permit is required priorto issuance of building OVER THIrCOUnTER � IiiIILJ)IvCi PLAN REVIFR r r permit for new building. >x> ss �'T AT NI1rGI'L4N�w Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANpARD r uBLI�� oRh _ form if any Hazardous Materials are being used as part of this project. S Copy of Planning Approval Letter or Meeting with Planning prior to LARGES _ submittal of Building Permit application. lYfAJOR S4NITARYSEREY2DISIRICT ❑; EN'�'IitON>`�NTP:L;H£;ALTH . B1dgApp_201 ].doe revised 06/21/11 CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School %)1Qlrirl_ P//'_ ) _ ThPQP fPPQ on, hnQPd an lhP nroliminnry infnrma/inn availahlP and arP nnty an owimalP_ Contort lhP I)Pnl for addn'l inia_ FEE ITEMS (Fee Resolution 11-053 a. 7/1/12) ADDRESS: 10100 n. tantau DATE: REVIEWED BY: bobs. APN: BP#: *VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration i Addition I Repair PRIMARY Commercial Building USE: •. Re OT Suppl. PC Fee: Q g. Q PENTAMATION PERMIT TYPE: WORK revise offices ace to RID labs new rooftop latform roof screen mech units existing labs. SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School %)1Qlrirl_ P//'_ ) _ ThPQP fPPQ on, hnQPd an lhP nroliminnry infnrma/inn availahlP and arP nnty an owimalP_ Contort lhP I)Pnl for addn'l inia_ FEE ITEMS (Fee Resolution 11-053 a. 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building •. Re OT Suppl. PC Fee: Q g. Q 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ElfB.'i C/ ffr' CLoJ k2 r7x1 ��lr'PkhJKvClCJl�'i P ,"`�:a'.' Work Without Permit? Yes (F) No $0.00 Advanced Plannin& Fee: $0.00 Select a Non -Residential Building or Structure A Strong Motion Fee: $0.00 F1 # $799.00 Revisions IREVCOMTI Tenant Improvement Bldg Stds Commission Fee: $0.00 ` I,TBTO W :° $0.00 $799.00 T4T:AL�TIEE: ' $799.00 Revised: 10/01/2012 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Mctriet otr ) Thoco fooc nro hacod nn !ho nroiiminary infnr»malinn 7vai1ah/o and nro n"Iv nn oclimalo_ Cnnlacl lho nonl lnr addn'I inin_ FEE ITEMS (Fee Resolution 11-053 Eff 7/1/12) ADDRESS: 10100 N TANTAU AVE DATE: 07/01/2013 REVIEWED BY: MELISSA MISC ITEMS APN: 316 19 061 BP#: *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building 0,07 PENTAMATION PERMIT TYPE: 1GENC0 ; WORK REV # 2 - REDESIGN LAB FOR N EQUIPMENT AND ADJUST MECH ELECT PLUMB SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Mctriet otr ) Thoco fooc nro hacod nn !ho nroiiminary infnr»malinn 7vai1ah/o and nro n"Iv nn oclimalo_ Cnnlacl lho nonl lnr addn'I inin_ FEE ITEMS (Fee Resolution 11-053 Eff 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (D No $0.00 2 hours Plan Check, Hourly $266.00 ISTPLNCK Suppl. PC Fee: Q Reg. Q OTJ 0,07 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 �rif�2lttP�Pf"Cd',"'ISL.' � ai'f'' Work Without Permit? 0 Yes (D No $0.00 Advanced Planning .Fee: $0.00 Select a Non -Residential Building or Structure Q i Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SL1)TITALSc $0.00 $266.00 TCI ALE`E $266.00 Z�gowRev ised : 04/29/2013 CITY OF CUPERTINO FE M71 FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 10100 N. Tantau Ave DATE: 08/03/2012 REVIEWED BY: Sean PC FEE ID APN: BP#: *VALUATION: 1$8,000,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: IBTIPLNCK PENTAMATION 18 TI PERMIT TYPE: WORK Tenant Improvement 35679 sq ft R and D Bldg TA07b - H pernova Lab. SCOPE 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 35,679 $3,770.92 IBTIPLNCK $13,391.07 IBTIINSP $0.00 PME Plan Check: $0.00 Permit Fee: $13,391.07 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 35,679 $3,770.92 1 $13,391,07 IYIEC)1I� H0 1R Y Q Yep o% TaL 11IB HHCJRLY Q Yes Qo ELEC H©LTRLY Q`Yes +lo , _L ),n -r �Jr rl. /rt•�� Olhce .uirl, fo,"" ET -t_ i%ir`vr lar'r boy, NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School nietrirt_ otr_ ) Thaw foes aro hated an the nreliminary information availahle and are oniv an Pvtimatn_ Contact the Dent far addn'l info. FEE ITEMS (Fee Resolution II -053 E . 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,770.92 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F)Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $13,391.07 Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 I�},lYil rh1;1.X1'I4(! i'f.'. G Work Without Permit? Q Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure Q Q '17mv(' Om oMI(11710NI ON Strong Motion Fee: IBSEISM1Co $1,680.00 Select an Administrative Item Bldg. Stds Commission Fee: IBCBSC $320.00 1 AUT ; 19,161.99 T0T 'L FE � , $19,161.99 Revised: 07/01/2012 :'0000e L21VI CONTRACTOR / SUBCONTRACTOR LIST ,Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOBADDRESS: -��V 11 ,, ,, IV'. Z�WZM 11111?pi� PERMIT # OWNER'S NAME. 4 e_9 PHONE # GENERAL CONTRACTOR: BUSINESS LICENSE # ADDRESS: 111 r"", Z:) CITYIIZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business license, NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Owner / Contractor Signature Z. 'bate SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical T Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating > L: A Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sbeet,Rock Tile Owner / Contractor Signature Z. 'bate