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14010071
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10100 N TANTAU AVE CONTRACTOR:NOVO CONSTRUCTION PERMIT NO: 14010071 OWNER'S NAME: CUPERTINO GATEWAY PARTNERS LLC 1460 O'BRIEN DR DATE ISSUED:02/05/2014 OWNER'S PHONE: 6506901160 MENLO PARK,CA 94025 PHONE NO:(650)701-1500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ APPLE TENANT IMPROVEMENT TO VALIDATION LAB License Class_ Lic.# 1333B AND OFFICE 1400 AT TANTAU 7B(2870 SQ FT). Contractor K,�jV(;: C�'j f/U'�C'f 1 U w Date � J^�/ 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. Sq.Ft Floor Area: Valuation:$100000 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: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 to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF�.LRMIT 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 LLED 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 �I S_ granting of this permit. Additionally,the applicant understands and will comply ed by: - ate: 1 with all non-point soulee7egulaticgs per the Cupertino Municipal Code,Section ��// -7 M 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,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 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 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 1 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 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 2 5,,_2033 nd 25534. Section 3700 of the Labor Code,for theerformance of the work for which this p Owner or authorized agent: �X,- �- 7 Date: f 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,1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,1 must 1 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 1 have read this application and state that the above information is correct.1 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: 14010071 OWNER'S NAME: CUPERTINO GATEWAY PARTNERS LLC 1460 O'BRIEN DR DATE ISSUED:02/05/2014 OWNER'S PHONE: 6506901160 MENLO PARK,CA 94025 PHONE NO:(650)701-1500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL EJ COMMERCIAL E] APPLE TENANT IMPROVEMENT TO VALIDATION LAB License Class_ Lic.# 1333B AND OFFICE 1400 AT TANTAU 711(2870 SQ FT). Contractor AAAIL V_1 T4v f1d1r/ Date 1.'vZ REV# 1 -CHANGE(E)LAYOUT& U ATE ELECTRICAL 1 hereby affirm that I am licensed under the provisions of Chapter 9 & OCCUPANY-ISSUED 2/25/14 (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:$100000 q 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 APN Number:3161906 1.10100 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 to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF 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 DAYS F AS LED 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 Z- 2 V granting of this permit. Additionally,the applicant understands and will comply I ate: with all non-point source regul ions per the Cupertino Municipal Code,Sectio 9.18. � ,�..� 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. EJ 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 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). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will 1 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 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,Section 55 55 ,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: ' Date:�/ L-✓/ permit is issued. -T 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, 1 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 CONSTRUCTION PERMIT APPLICATION` COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 1� 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•building@cupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRE/D ORIGINAL PERMIT# PROJECT ADDRESS h 1 G ` y APN# �//_ I q O �!/ ,1/f # OWNER NAME 1 HONE `f/ l iE-MAIL. (/Wiv LUCLIL71kltG-A'tCGti 1V `�— v c till iLt h Jt7Z v(T! U.Ca STREET ADDRESS CITY,STATE,ZIP FAX CONTACT NAME PHONEE-MAIL t5 e-, o IE c Cc • (D?4• l 1 Fi Grr�s co,.. STREET ADDRESS CITY,STATE,ZIP 7FIX O o IL/3 c�C�v /�lnitp e09 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICE Nf�NU M;ER LICENSE TYPE BUS.LIC# r-JS- r� ' I COMPANY NAME E-MAIL FAX ��,� )I ! / 1 ► O t �=N tvaie=C@� -�r Ong � �,. I STREET ADDRE$4 CITY,STATE,ZIPt _ PHONE ML,W �`i C Z ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMP NY NAME EI-MAIL q FAX i}(1- iv L ti �(� YCCT/ �%IC4A 6,;fl `Iveyp •L STREET ADD SS CITY,STATE,ZIPPHONE L a uta✓-t i �" �;C �aI✓ �c r - I`I(, S tic .gY7.8 DESCRIPTION OF WORK rte d f Z T pC. EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES I-/4$ ptFF/G 1( I_Ad Off7GJr -1 USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA 7 A�a AREA AREA NET AREA (Cr cEree, L^ 672 BATHRO<OMC7 KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH []AT ACII M DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? []NO PRE-APPLICATION []YES 1F YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED B1 _ TOTAL VALUATION: PLANNING APPL H []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO x )00 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 to b g construction. u rite representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: /3 SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition pen-nit for © OVER THE-COUNTER G gviLDINGPLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. © EXPRESS n PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD ElPUBLIC WORtCs 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 11 MMOR El SANITARY SEWER DISTRICT submittal of Building Pen-nit application. © ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06/21/11 CONSTRUCTION PERMIT APPLICATION 01 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 '0 b CUPERTINO (408) 777-3228• FAX(408)777-3333•building(cDcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI REVISION DEFERRED ORIGINAL PERMIT# QQ PROJECT ADDRESS �� N#1) ALs� -3, r / l p L 4 O9 OA WNER E P O l�b 1 -MAIL STREET ADDRESS CITY, STATE,ZIP FAX CONTACT AM P O L STREET DRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER—BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT -7 CONTRA R NAME LICE'S NUMBER LICENSE TYPE BUS.LIC 4 �. r< COMP N �! E—MAIL ,� f 1i� FAX r �),e ��I ^G r ! ! M J J STrET6DDRES S (� CITY,STATE,ZIP r� / PHONE ilii % ARCHITECT/ENGINEER NAMELICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK R-"- ' / l Gx—j UCG l EXISTING USE PROPOSED USE CONSTK TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT []YES SECOND STORY El YES BEINGADDED? NO ADDITION? []NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES TOTAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO 'r ` By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the pr wner's behalf. I have read this application and the information I have provided is ect. ave read the Description of Work and verify it is . I agree to comply with all applicable local ordinances and state laws relating to g tructiocn. authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of ApplicantlAgent: �'/ Date: SUPPLEME LTIO UIRED � `� Q PLANCHECICTYP $C3IIINGSLiT?3 _ - -• New SFD or MultifalSily dwellings: Apply for demolition permit for FOYER THE C©urtTER BUILDING PLANREViER existing building(s). Demolition permit is required prior to issuance of building , . permit for new building. Exi•xEss LAMMING PY ANREViER s a` I _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure © sTAvD>tD { Pi7BLICWORKS form if any Hazardous Materials are being used as part of this project. itd r i k LIItC;E �� l�;oErc ( _Co of Planning Approval Letter or Meeting with Planning prior to _�� " ` �� PY g PP g g p © s DisT]ucr submittal of Building Permit application. !_n""' MMW BIdgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10100 N TANTAU AVE DATE: 01/13/2014 REVIEWED BY: COUNTER APN: BP#: 14010071 'VALUATION: 1$100,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 113 TI USE: PERMIT TYPE: WORK APPLE-TI VALIDATION LAB 1333B AND OFFICE 1400 AT TANTAU 7B 2,870 SQFT SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B (Tenant Improvements) II-B,III-B,IV,V-B 2,870 $2,294.56 IBTIPLNCK $2,459.58 IBTIINSP TOTALS: 2,870 $2,294.56 $2,459.58 MECH,HOURLY 0 Yes E) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes G No El -I- ET--[- El NOTE.This estimate does not include fees due to other Departments(i.e.Planning, Public Works,Fire,Sanitary Sewer District,School District,etc. . 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' 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,294.56 Select a Misc Bldg/Structure Suppl. PC Fee: E) Reg. C) OT 0,0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $2,459.58 Suppl. Insp. Fee-.0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes ) No $0.00 7 E) Advanced Planning Fee: $0.00 Select a Non-Residential Building or Structure _ A Strong Motion Fee: IBSEISMICO $21.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $4.001 1 SUBTOTALS: $4,779.14 $0.00 TOTAL FEE: 1 $4,779.14 Revised: 01/15/2014 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10100 tantau ave DATE: 02/25/2014 REVIEWED BY: melissa APN: 31619061.10100 BP#: 14010071 "VALUATION: Iso ;PE;RMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1GEIVC01 i WORK REV# 1 - CHANGE E LAYOUT & UPDATE ELECTRICAL& OCCUPANY - ISSUED 2/25/14 SCOPE NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School District,etc.). Thesefees are based on the preliminar information available and are only an estimate. Contact the De t or addh 7 info. FEE ITEMS (Fee Resolution 11-053 Eff 7'1-'13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 1 hours Plan Check,Hourly Suppl. PC Fee: ) Reg. 0 OT 0.0 1 hrs $0.00 $139.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT Rol hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? ® Yes No $0.00 E) Advanced Planning F`ee: $0.00 Select a Non-Residential Building or Structure 0 A Strom, Motion Fee: $0.00 Select an Administrative Item Bldg,Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $139.00 TOTAL FEE: 1 $139.00 Revised: 01115/2014