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13030141I CITY OF CUPERTINO BUILDING PERMIT I I BUILDING ADDRESS: 10101 N WOLFE RD I CONTRACTOR: TECHCON I PERMIT NO: 13030141 1 OWNER'S NAME: SEARS ROEBUCK AND CO 116200 VINEYARD BLVD STE 100 1 DATE ISSUED: 04/29/2013 1 OWNER'S PHONE: 8472867538 1 MORGAN HILL, CA 95037 1 PHONE NO: (408)778-1350 ❑ ��L((ICENSED CONTRACTOR'S DECLARATION License Class /TR G �7 Lic. Contractor coot" 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 of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify. that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additio the applicant understands and will comply with all non -point source re0ationsher the Cupertino Municipal Code, Section 9.18. JOB DESCRIPTION: RESIDENTIAL u COMMERCIAL RELOCATE EXTERIOR SLIDING DOORS AT KIDS LOBBY TO THE INTERIOR AT CAFE & REPLACE SLIDING DOORS WITH NEW STOREFRONT SYSTEM. Sq. Ft Floor Area: � Valuation: $20000 APN Number: 31620080.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WIT AYS OF PERMIT ISSUANCE OR 180 DA OM LAST CALLED INSPECTION. Issued by: IDate: -_�&//3 RE -ROOFS: Signature ``'e'— 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 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) I, 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 l have read this application and state that the above information is correct. l 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. Date Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 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 Q will maintain compliance with the Cupertino cipal Code, Chapter 9.12 and the Health & Safety Code, Sections 2550 553Y, and 25534. Owner or authorized agent: 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. Licensed Professional CONSTRUCTION PERMIT APPLICATION ®� 91 COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 / 1_0 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 e building cDcupertino.org � ❑ NEW CONSTRUCTION ❑ ADDITION 4 ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT 9 PROJECT ADDRESS D APP # 3 j 6- 0 g0 OWNERNAMEK" L PH�Z Pp�E /53A91 Oo klgrto a. STREETADDRFSS333-PP691-y k-9 Y, STATE,ZIP�� '� 6"/21 1 FAX CONTACT NAM= OW dAVtOe- QW� PHONE �I a Q d� WM104*91VAC-d"5eW (c�% STREETADDRFSS/ "�A gr) �S���}� Y S E, ZIP S� C� FAX El OWNER 11OWNER-B/UI LDFFR'❑ OWNERAGENT ❑ CONTRACTOR CONTRACTOR AGENT ❑ ARCHnECT ❑ ENGINEER ❑ DEVELOPER PfTENANr CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARC ECT/ENGINEERNAME�� pp - 0,T - - LICENSE BER/�1 A�v � � �j BUS. LIC# COMP NY AME E-MAIL A s FAX STREET A DRESSV— og itgkz I �� CITY, STATE, ZIP � � Fwmi-sllg , DESCRIPTION OF WORK S /NfAWA At A -0D A5?744ro-ZF f4-1P1A14!5 PSS e-r/1VA/4c sw/" EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES �j -Z�' 3, %j /Loi 7 N� i4f4, IC �J USE TYPE OCC. SQ.FT. VALUATION ($) AREA #nl/vr�a/v' NEW AREAO TOTAL TAREAJ - 1,00 a BATHROOM REMODEL AREA I KITCHEN RI]NODEL AREA / OTHER REMODEL AREA PORCH A DECK A TOTALDECK/PORCHAREA GARAGEARFA: DETACH —` ❑ ATTACH # OWE ING ITS: ISA SECOND UNIT ❑ YES SECOND STORY ❑ YES BEINGADDED? 9110 ADDITION? 9ko PRE-APPLICATIO []YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES T AL VALUATION: PL INNING APPL # []NO PLANNING APPROVAL LETTER EICHLER HOME? �0 2-0 1 ovv, flys By my signature below, I certify to each of the following: I am the property owner or authorized agent to act otie perty 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 o build' lg{ construction. I uthonze reprye�entatives of Cupertino o enter the abov -identified property for inspection purposes. �� inid7��' Signature ofApplicandAgenC �/1M� r'" Date: SUPPLEMENTAL INFORMATION REQUI PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER 4 r� 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 WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGEFIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 &0*1 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10101 N WOLFE RD DATE: 03/22/2013 REVIEWED BY: MELISSA APN: 316 20 080 BP#: �D� ® 'VALUATION: 1$20,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1ATI USE: PERMIT TYPE: WORK T. I. TO REMOVE EXTERIOR EXIT DOORS & RELOCATE BETWEEN CAFE & LOBBY AREA. ALL SCOPE EGRESS REQUIREMENTS & PATH OF TRAVEL OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID A (Tenant Improvements) II-8,111-B,IV,V-B 420 $2,267.00 IATIPLNCK $551.00 ]ATIINSP Elec Insp. Fee: PME Plan Check: $0.00 Permit Fee: $551.00 Suppl. Insp. Fee -.0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 420 $2,267.00 Construction 1 ax. $551.00 MECH, HOURLY Yes 0 No PLUMB, HOURLY 0 Yes (!) No ELEC, HOURLY 0 Yes Q No Xlec:lt: Ilion Check Phunh, Plan Check F_lec:..Plan Check kfech. PerwitFee: Plumb. Permit Fire: Elec•, Permir Fee: Other dfech. Insp. (/her Plumb Insp.L1 I Other Elec. Insp. Ll Me& Insp. Fee: PJrnnb. Lisp. Flee: Elec Insp. Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc ). These fees are hated on the nreliminary information availahle and are only an estimate. Contact the Dent for addn7 into. TEE ITEMS (Fee Resolution 11-053 Eff 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,267.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $551.00 Suppl. Insp. Fee -.0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction 1 ax. Administrative .Fee: 0 E) Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or: Structure 0 0 Travel Documentation Fees: Strong_ Motion Fee: IBSEISMICO $4.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $2,823.20 $0.00 TOTAL FEE: 1 $2,823.20 Revised: 01101/2013 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10101 N WOLFE RD CONTRACTOR:TECHCON PERMIT NO: 13030141 OWNER'S NAME: SEARS ROEBUCK AND CO 16200 VINEYARD BLVD STE 100 DATE ISSUED:04/29/2013 OWNER'S PHONE: 8472867538 MORGAN HILL,CA 95037 PHONE NO:(408)778-1350 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL D COMMERCIAL License Class AII�,,,�c�7 Lic.# 7 Z T� TO RELOCATE EXTERIOR SLIDING DOORS AT IUDs LOBBY Contractor /e-4 C.Dou Date 'z Z®<•3 THE INTERIOR AT CAFE& REPLACE SLIDING DOORS I hereby affirm that I am licensed under the provisions of Chapter 9 WITH (commencing with Section 7000)of Division 3 of the Business&Professions NEW STOREFRONT SYSTEM. Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$20000 1 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 APN Number:31620080.00 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 WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WIT AYS 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 Igo DA OM LAST CALLED INSPECTIION. 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. Additio the applicant understands and will comply Issued by: Date: with all non-point source r ations er the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature ` 't�'� 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 hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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 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(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 theCupertino 'cipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 2550 533,a nd 25534. Section 3700 of the Labor Code,for the performance of the work for which this �,��`I—ZAI permit is issued. Owner or authorized agent: Date: 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 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE^CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333 bullding(cDcupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS n APN#116-" - 090 '6 r n� - 0 90 OWNERNAME/Til wV/ l L,^/-// �^a q j�-�f PH IDO" -S q d V V ,� R �17!/V N t7 V"I��I'" y '/S 37&19JL .3M4 STREET ADDRESS 333 P0 /A 14 P-11" Y,STJ� ATE,ZIP 6#121 FAX CONTACT NAME ES d G a"1 PHONE ®I a py E 104tvAc-el"5,cab P047 STREET ADDRESS/ mQApp Y S A E,ZIP P�^ FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE JARC 'CT/ENGINEERNAME�� LICENSE BER/A/, el Dv s- BUS.LIC# COMP NY AME E-MAIL t� FAX s STREET DRE � � CITY,STATE,ZIP DESCRIPTION OFNWORK e " - 77AAl 4f __ y4wokmnev WAlliM At J"44C,0�� Lqr AIPIA16 PIVXS _allfIA14 swNI;- . EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) AARREAG61l �7 �FLOOR t REE TOTAL !/t5 Z-4, 0®0 BATHROOM KITCHEN /.// OTHER REMODEL AREA IREMODEL AREA REMODEL AREA PORCH A DECK EA TOTALDECK/POORCHAREA GARAGE AREA: DETACH []ATTACH #DWE RJG rrs: ISA SECOND UNrr ❑YES SECOND STORY ❑YES BEINGADDED7 V0 ADDITION? *0 PRE-APPLICATIO ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES T AL VALUATION: PLANNING APPL# ❑ ; NO PLANNING APPROVAL LETTER EICHLER HOME? 0 OVV flys �/CJ By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on a 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 reIa[ingo build''pi'construction. I uthorize repre enta[ives of Cupertino o enter[he abov -identified property for inspection purposes. /Irvv.- r�r�n16- Signature of Applicant/Agv Date: SUPPLEMENTAL INFORMATION REQUIV5 PLANCHECKTYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER BUILDING PLAN REVIEW 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 P,STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARCEFIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10101 N WOLFE RD DATE: 03/22/2013 REVIEWED BY: MELISSA APN: 316 20 080 BP#: �D�® -VALUATION: 1$20,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1A TI USE: PERMIT TYPE: WORK T. I. TO REMOVE EXTERIOR EXIT DOORS & RELOCATE BETWEEN CAFE & LOBBY AREA. ALL SCOPE EGRESS REQUIREMENTS & PATH OF TRAVEL OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.L A(Tenant Improvements) II-B,111-B,IV,V-B 420 $2,267.00 IATIPLNCK $551.00 ]ATUNSP TOTALS: 420 $2,267.00 $551.00 MECH,HOURLY ! Yes E No PLUMB,HOURLY ® Yes No ELEC,HOURLY Q Yes Q No �fecar:Plan Check Phorrb, Plan Check Elec.Plan Check tLfech. Permit Fee: Plumb.Permit Fee: Elec.Permit Fee: Other rlfech.Insp. Other Plumb Insp. L1 01her Elec.Insp. El I ,Lech.Insp.Fee: 111tnrth. hrsp. Fee: Elec.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,eta). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,267.00 Select a Misc Bldg/Structure Suppl.PC Fee: E) Reg. 0 OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $551.00 Suppl. Insp.Feee. Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction I ax. Administrative.Fee: Work Without Permit? ! Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential Q Travel Documentation Fees: Building or:Structure Stronjz Motion Fee: IBSEISMICO $4.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: 1 $2,823.201 $0.001 TOTAL FEE: 1 $2,823.20 Revised: 01101/2013