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14030166 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10411 BUBB RD CONTRACTOR:SC BUILDERS INC PERXIIT NO: 14030166 OWNER'S NAME: M WEST PROPCO Il LLC 910 THOMPSON PL DATE ISSUED:03/27/2014 OWNER'S PHONE: 4084503854 SUNNYVALE,CA 94085 PHONE NO:(408)328-0688 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL APPLE-T.1 PREP 20,330 SQ FT-(DEMOLITION TO License Class Lic.# '1 lD"l 1C1 1p EXTERIOR OF BUILDING IS NOT PART OF THIS SCOPE OF Contractor x J IT--r-NC, Date WORK) 1 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. 1 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$45000 l 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:35720010.10411 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.1 agree to comply with all city and county ordinances and state laws relating WITHIN 1 0 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 DAY M LAST CALLED INSP TON. 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 Issued by: Dat with all non-point source regulatio r the Cupertino Municipal Code,Section 9.l 8. RE-ROOFS: Signaturen 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 1 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. 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 I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505, , d 25534. Section 3700 of the Labor Code,for the performance of the work for which this ?SK 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,[ 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. Date CONSTRUCTION PERMIT APPLICATION U COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION b` L9 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 n3 (408)777-3228• FAX(408) 777-3333• buildingpcupertino.org 1� CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 7APN k 1c U�11 — 3S ��PL� OWNER NAME PHONE E-MAIL M u cs L 0 L L-C 3F)5 STREET ADDRESS CITY, STAT IP FAX CONTACT NAME PHONE E-MAIL fSS�LA 1J '7 >QSo r1 � � S c�lis��rt�C rtWc'��s+ rC, co r� STREET ADDRESS CITY,STATE, ZIP FAX 3 3S l O c.�r '_T(2 psi c��2 CA clSaSL) ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX C,6vftD�� Sc-r3vrL.7eQSirJC..t,� STREET ADDRESS CITY,STATE,ZIP PHONE C1 �oil�or�Sc�� LraC� 5�� qo� b��a ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# �L It=c�O CqAQ,CIq � l S�iF�S COMPANY NAME E-MAIL FAX l7qnQLIfl� S�Vi�ro$.Corl STREET ADDRESS CITY,STATE,ZIP S�'� r e.n�L I S(.o PHONE _ )-)R, r,2J 15T(I Ct 1 3J d DESCRIPTION OF WORK 0E ELSI 10CI �WTc6ZI�oz l loyll �v 2w EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA I J'2 5c) BATHROOM KITCHEN OTHER J REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJDETACH ❑ATTACH #DWELLING UMTS. 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 RE IV BY- TOTAL VALUATION PLANNING APPL k ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the followin the property owner Or authorizgnag4t to act on the property owner's behalf. I have read this application and the information I have provided is c c hav ead the Description of Work a erify it is accurate. I agree to comply with all applicable local ordinances and state laws relating it g o truct n. author' e representatives of Cupertin to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: MAQcda SUPPLEMENTAL INF A '21, QUIRED PLA NCHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for VER-THE-COUNTER LD GPLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑"kq,REss ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ' ❑ PIJBLICWORKS form if any Hazardous Materials are being used as part ofthis project. ❑ LARGE FIRE DEPT " Copy of Planning Approval Letter or Meeting with Planning prior to ❑. El ` 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: 10411 Bubb Rd DATE: 04/01/2014 REVIEWED BY: Mendez APN: _T-BP#: *VALUATION: 1$45,000 TYPE: Building Permit —T—PLAN CHECK TYPE: Tenant improvement PRIMARY Commercial Building PENTAMATION 1TIPREP USE: PERMIT TYPE: woRK Apple, T.1 PREP ALL INTERIOR WORK ONLY 20,330 SQ FT 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 prelimina information available and are only an estimate. Contact the Dept/or addif I info. FEE ITEMS (Fee Resolution 11-053 E 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Tenant Improvement Prep Suppl. PC Fee: (j) Reg. () OT r 0.0 hrs $0.00 $405.00 ITIPREP PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:G Reg. 0 OT "00 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 r ern Work Without Permit? Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non-Residential G Building or Structure Strong Motion Fee: IBSEISMICO $9.45 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 1 SUBTOTALS: 1 $11.451 $405.00 TOTAL FEE: 1 $416.451 Revised: 01/15/2014 Building Department � City Of Cupertino V 10300 Torre Avenue Cupertino, CA 95014-3255 C O P E R'I'I N O Telephone: 408-777-3228 Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 10411 13v3,d 1204D PERMIT# 140,f0!C. OWNER'S NAME: Al VhS7 r' PRaPCO a/ tLC PHONE # 406'/3-?9-09&&- GENERAL 08/3•?9-D9&&- GENERAL CONTRACTOR: SC SUIcQr,QS £n/C • BUSINESS LICENSE# a40 ADDRESS:7/C7 CITY1ZIPCODE:St1NNYVA4-E® 94+085 *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 CupE/217nro ELEGTR!G 4- 69 ;Z- Excavation Fencing Flooring / Carpeting Linoleum/ Wood Glass / Glazing Heating u/E91T-AW A-GLI&0 '"ECAM W ID44 04000 Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering Plumbing 0417 /NEC[44A)jCM, A .�904 9 Roofing 106/00 TA/VUS C OR.P # 33 &07 Septic Tank Sheet Metal Sheet Rock Tile a Owner/Contractor Signature Date