14090063CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 2 INFINITE LOOP FLR 4
CONTRACTOR: XL CONSTRUCTION PERMIT NO: 14090063
OWNER'S NAME: CUPERTINO GATEWAY PARTNERS
851 BUCKEYE CT DATE ISSUED: 09/1112014
OWNER'S PHONE: 4087833025
MILPITAS, CA 95035 PHONP NO: (408) 240-6000
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
IL2-FOURTH FLOOR (SOUTH): TENANT IMPROVEMENT
License Class_ Lic. # G L11 �s 0
TO
Contractory� n Date Al
!� iJYll�lyeor�
MAKE TWO OFFICES INTO ONE LARGE OFFICE (220 SQ
.
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
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
Sq. Ft Floor Area:
Valuation: $35000
performance of the work for which this permit is issued.
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: 31602106.FLR4
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. l agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT ISSUANCE ®R
to building construction, and hereby authorize representatives of this city to enter
upon the above m ntioned property for inspection purposes. (We) agree to save
180 DAYS FROM LAST' CALLED INSPECTION.
indemnify and ee harmless the City of Cupertino against liabilities, judgments,
costs, and exp nses which may accrue against said City inconsequence of the
granting of is pen it. Additio ally, the applicant understands and will comply
Issued by: Date:
with all non point urce regu ons per the Cupertino Municipal Code, Section
9.18.
RE -ROOFS:
Signature Date q [. [
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 1 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 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. 1 will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cuper ' 10 Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 255 2( 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 se a uipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Ba Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with he Cu ertino Mun ipal Code, Chapter 9.12 and
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
the Health & Safety Code, Se ions 2 505, 25533 nd 25534.
9 !�
Owner or authorized agent; Date:
permit is issued.
1 certify that in the performance of the work for which this permit is issued, 1 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, l
CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code, I must
l 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 1 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
I understand my pians 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 SCUP ERTINO
IFMN -1 FEE ESTIMATOR - BIFELDRNG DlVff MON
ImADDRESS:
2 Infinite Loop
DATE: 09111/2014
REVIEWED BY:
PC FEE ID
APN:
BP#:
"VALUATION: $35,000
%PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY
USE: Commercial Building
$3,146.00
PENTAMATION
PERMIT TYPE: 16 Ta
WORK
ILL -Fourth Floor (South): Tenant Improvement to make two offices into one large office 220 sq ft).
SCOPE
Suppl. Insp. Fee:(D Reg. COT Q,Q
OCCUPANCY TYPE:
TYPE OF
CONS TR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
I -All -B
220
$3,146.00
IBTIPLNCK
$882.00
IBTIINSP
IJLr hisp.
Suppl. Insp. Fee:(D Reg. COT Q,Q
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
L.'o�tclt'ftclir�,=r 1 cfr:
Aldiniflisf- rtNe Fee:
0
Work Without Permit? C Yes E) No
$0.00
Advanced Punning Fee:
$0.00
Select a Non -Residential
Building or Structure
d
7i���fl'o�l >)oct:carlk�alfrnrf ?�"�?es:
TOTALS:
220
$3,146.00
Select an Administrative Item
$882.00
$2.00
MECH, HOURLY 0 Yes E) No
P1..U1b)(B, HOURLY 0 Yes 0 No
ELEC, HOURLY 0 Yes (D No
Weclr, Pleen ;'Ite�Tt
i'lufnh. I''lein Che
t,le� . I'01, C ., .k
b/zCaJ. Pel i10 Foe:
plwn6 I'cY7slst Yet::
fc!dr Al"WIlif F"IC
Oiho 1lcc br. Ins, .Ll L__
Otl r Numb hnp
0,.her 1:Irt /ns,%'.
Iusp, hee:
flan!'. how. I'r".
IJLr hisp.
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 nreliminary information available and are only an estimate. Contact the Dent for addn't info.
FEE ITEMS (Fee Resolution II -053 UL'711/131
FEE
QTY/)FEE
]0 ISC ITEMS
Plan Check Fee:
$3,146.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: (D Reg. C OT
Q.p hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$882.00
Suppl. Insp. Fee:(D Reg. COT Q,Q
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
L.'o�tclt'ftclir�,=r 1 cfr:
Aldiniflisf- rtNe Fee:
0
Work Without Permit? C Yes E) No
$0.00
Advanced Punning Fee:
$0.00
Select a Non -Residential
Building or Structure
d
7i���fl'o�l >)oct:carlk�alfrnrf ?�"�?es:
Strong Motion Fee: IBSEISMICO
$9.80
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$2.00
SUBTOTAI<s:
$4,039.80
$0.00
TOTAL FEE:
$4,039.80
Revised: 08120/2014
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 a buildinclocupertino_org
CUPERTINO
❑ NEW CONSTRUCTION ❑ ADDITION
ALTERATION / TI
REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS APN # '2/� /, /
2 �n�.���e_ (do�o J (�
OWNER NAME Y�F�Z!%`�O TrGWAy `�qf�f PHONE G
�'
E-MAII,�
E-MAII 1
VC
STREET ADDRESS
CITY, STATE, ZIP
FAX
STREET ADDRESS
v�J\ �c C�
q CITY, STATE, ZIP
61 C Am
CONTACT NAME
PHONE /
E-MAII 1
STREET ADDRESS
v�J\ �c C�
q CITY, STATE, ZIP
61 C Am
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT
❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME r1
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
a cte
414$0
COMPANY NAME
E-MAIL
FAX
Cl0
Y 0 t S(VWn•
C3 IeA
STREET ADDRESS
`�Sl
CITY, STATE, ZIP
PHO
C 21-
vcke C
' a3 50 S
4m lD
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
C t VA25
COMPANY NAME 1
E-MAIL
a(60, i -S. Co
FAX
STREET ADDRESS
405 . S7, 5. , �a
CITY, STATE, ZIP
q'Gnt�eN\ C�AkOs
PHONE
N15) 9g-1515
DESCRIPTION OF WORK 11 `-�
'MoV. ar\ aL v�a�� (!Jw` 1 t al J\-. A 2 kcJO
F YI O Ce$ one.
X"eL.5 \C.r t! K
EXISTING USE
PROPOSED USE CONSTR.
TYPE
# STORIES
0%)
8l . rC_
1- A
�
USE
TYPE
OCC.
SQ.FT.
VALUATION($)
EXISTG
AREA 220
NEW FLOOR
AREA Q
DEMO
AREA Z�
TOTAL
NETAREA 22o
0
n
�- A
qj
l7
220
36t 000
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: U DETACH
[]ATTACH
# DWELLING UNITS:
IS A SECOND UNTr [:] YES
SECOND STORY OYES
BEING ADDED? []NO
ADDITION? ❑NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECE BY:
TOTAL VALUATION:
PLANNING APPL # ❑ NO PLANNIN PROVAL LETTER
EICHLER HOME? ❑ NO
A 3513 0 0
By my signature below, I certify t6each f 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 p vided is c ect. I have read the Description of Work and verify it is accurate.
I agree to comply with all applicable local
ordinances and state laws relat to bui ding cons tion. I a orize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: MI5 1 1`{
SUPPLEME Al, INFORMATIONIREQUIRED
PLAN CHECK TYPE
ROUTING SLIP
DTNG PLAN REVIEW
_ New SFD or Multifamily dwellings: Apply for demolition permit forOVER-THE-COUNTERBUII
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 wom
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
❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_201 1. doc revised 06/21/11
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: Z r -n F: 4: e, Loop
PERMIT # 1 lio 006 3
OWNER'S NAME: lWele,
PHONE # 1Y09) VY0 -4WO
GENERAL CONTRACTOR: L nSkrwl:o�
BUSINESS LICENSE# 'z18-36
ADDRESS: gsl v� e
CITY/ZIPCODE: KIF4,5 035'
*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 CITE OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature
Please check applicable subcontractors and complete the following information:
Date
d
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
co �41N v
Ccl -1
Excavation
Fencing
Flooring / Carpeting
Linoteum / Wood
Glass / Glazing
Heating
60 PA
2. 060o
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
D(T),
aLisl
Tile
mka of s 14
Owner / Contractor Signature Date