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14010067
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10680 S DE ANZA BLVD CONTRACTOR:JBS HOMES INC PERMIT NO: 14010067 OWNER'S NAME: BYER PROPERTY 21831 ALCAZAR AVE DATE ISSUED:01/09/2014 OWNER'S PHONE: 4153212828 CUPERTINO,CA 95014 PHONE NO:(408)390-5577 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑ T.I.TO CREATE(N)OPTOMETRY OFFICE(1363 S.F.), License Class Aj,13,x_ Lie.# 9RD521' RECONFIGURE RECEPTION AREA,EXAM ROOMS& Contractor Date ! LAVATORIES,INCLUDING M.E.P.'S.ADD 2(N)SINKS I hereby affirm that 1 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. Sq.Ft Floor Area: Valuation:$65000 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:36937025.00 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 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 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 Iss Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date I y 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 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). 1 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 Cupertino Municipal Code,Chapter 9.I2 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 I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this 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 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 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 VJ� CONSTRUCTION PERMIT APPLICATION ELI] COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION t (� O 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 ` V CUPERTINO (408)777-3228 • FAX(408) 777-3333•buildingAcupertino.orcl ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 10680 SOUTH DE ANZA BLVD.STE C APN# 369-37-025 OWNERNAME DON TEPMAN(REP.OF BYER PROP.) PHONE 415.321.2828 E-MAIL STREET ADDRESS 1000 BRANNAN ST.SUITE 202 CITY, STATE,ZIP SAN FRANCISCO,CA 94103 FAX CONTACT NAME TIFFANY CHANG PHONE 408.865.0440 7 E-MAIL TWC@CUPERTINO-OPTOMETRY.COM STREET ADDRESS 10430 SOUTH DE ANZA BLVD.STE 100 CITY,STATE,zip CUPERTINO,CA 95014 FAx ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME BALDEV JANDU LICENSE NUMBER 980527 LICENSE TYPE A,B&C-29 BUS.LIC# COMPANY NAME. JBS CONSTRUCTION E-MAIL JANDU408@GMAIL.COM FAX STREET ADDRESS CITY,STATE,ZIP PHONE 408.390.5577 ARCHITECT/ENGINEER NAME FREDDY SEEN LICENSE NUMBER C-30739 BUS.LIC# COMPANY NAME E-MAIL FREDDYSEEN@YAHOO.COM FAX STREET ADDRESS 398 JACKSON STREET CITY,STATE,ZIP SAN JOSE,CA 95112 PHONE DESCRIPTION OF wORK T.I.FOR ANEW OPTOMETRY OFFICE IN AN(E)COMMERCIAL BUILDING. IMPROVEMENTS INCLUDE ANEW RECEPTION AN OPTICAL RETAIL AREA,1 OFFICE,2 EXAM ROOMS,STORAGE AREAS,AND ADA IMPROVEMENTS OF AN(E)RESTROOM. EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES OFFICE OPTOMETRY OFFICE VB 1 &2 USE TYPE OCC. SQ.FT. VALUATION($) EXISTGNEW FLOOR DEMO TOTAL AREA 1,363 SF AREA - NET AREA �j r�i'L T2 BATHROOM 7O SF KITCHEN OTHER o V REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECVJPORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? [:]NO PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES IEC I3 `.. - TOTAL❑ VALUATION: PLANNING APPL# NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO �)O V By my signature below,I certify to each of the following: I am the property owner o ac perry owner's behalf. 1 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 authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: ! Date: 0(09119 SUPPLEMENTAL INFORMA ON REQUIRED PLAN CRECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER El 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 ❑' STANDARD ❑ FVBLIC 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 ❑ SAMTARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doe revised 061'21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10680 S DE ANZA BLVD STE C DATE: 01/09/2014 REVIEWED BY: MELISSA APN: 369 37 025 BP#: y® "'VALUATION: $65,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1 B TI WORK T.I. TO CREATE N OPTOMETRY OFFICE RECONFIGURE RECEPTION AREA EXAM ROOMS & SCOPE LAVATORIES,INCLUDING M.E.P.'S OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B (Tenant Improvements) II-B,111-B,IV,V-B 1,363 $2,092.21 IBTIPLNCK $1,301.07 IBTIINSP TOTALS: 1,363 $2,092.21 $1,301.07 MECH,HOURLY Yes d No PLUMB,HOURLY Q YesQ No ELEC,HOURLY © Yes Q No 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 prelimina information available and are only an estimate. Contact the Dept-for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E f 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,092.21 Select a Misc Bldg/Structure Suppl. PC Fee: (•j Reg. OTT0.0 r hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $1,301.07 Suppl. Insp. Fee:Q Reg. Q OT T O.OT hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 4 Work Without Permit? Yes ID No $0.00 0 Advanced Plannin&Fee: $0.00 Select a Non-Residential 0 Building or Structure Stroni;Motion Fee: IBSEISMICO $13.65 Select an Administrative Item Bldp-Stds Commission Fee: IBCBSC $3.00 SUBTOTALS: $3,409.93 $0.001 TOTAL FEE: $3,409.93 Revised: 01/01/2014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RTI NO Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: V "9'0 S. A N2A C bt . PERMIT# OWNER'S NAME: tic PHONE# - - C �}� GENERAL CONTRACT BUSINESS LICENSE ADDRESS: 80 A CITY/ZIPCODE: CU =7Q ,,v _b/ *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: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C O P E RT I N O Fax: 408-777-3333 CONTRACTOR i SUBCONTRACTOR LIST JOB ADDRESS: 6 Qt!� PERMIT# OWNER'S NAME: (,�j'Z_ PHONE# GENERAL CONTRACTOR: J69 BUSINESS LICENSE# Z 3 O ADDRESS: 1431 LCA A/1- CVVe- CITY/ZIPCODE: *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 subcontractors14: Signature D to Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing ✓ Electrical Excavation Fencing Flooring/ Carpeting G f V - Linoleum/Wood Glass /Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering t ' Plumbing l/1� S - ( eSgj of ) tv . ZZ Fl Septic Tank _ S Sheet Metal I/• Sheet Rock Tile Owner l Contractor Signature Date May 9, 2014 Permit No. 14010067 Project No. 13.03 TO: City of Cupertino 10300 Torre Ave. Cupertino, CA 95014 RE: Cupertino Optometry Tenant Improvements 10680 S. De Anza Blvd. Ste. C Cupertino, CA 95014 Enclosed is the revised sheet responding the Building Inspection comment by Sean Hatch. All changes to the plans have been clouded and identified with delta #1 as Building Inspection Comments dated 5.9.14. BUILDING INSPECTION COMMENTS 1. Revise site plan to reflect existing site conditions and modify the accessible path of travel to terminate/originate from the existing accessible parking space only. Do not extend accessible path of travel to the public sidewalk (ROV/ . Response: The required accessible path of travel has been revised to comply with CBC 1 16- 206.2.1 exception #2. See revised sheet A0.1 I . I hope the statements above adequately respond to the Building Inspection comments. If you have any questions or require additional information, please do not hesitate to contact me. Sincerely, Fre y en Architect Email: freddyseen0yahoo.com Cell: (510) 798-9640