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13100048 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20916 HOMESTEAD RD STE C- CONTRACTOR:SMI CONSTRUCTION PERMIT NO:13100048 INC OWNER'S NAsY1E: OAKMONT INVESTMENT GROUP LLC 595 MONTAGUE AVE DATE ISSUED:02/18/2014 OWNER'S PHONE: 4088936989 SAN LEANDRO,CA 94577 PRONE NO:(510)351-3288 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL 1 J TENANT IMPROVEMENT#C(1200 SQ FT)BLUE AROMA lVicense ClassLic.9 r l i+ SPA. Contractor 94AT Date: 114 1 hereby affirm that lam licensed under the provisions of haptcr 9 (commencing with Scction 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: 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 Arca: Valuation:540000 I have and will maintain Worker's Compensation Insurance,as provided for by ection 3700 of the Labor Code,for the performance of the work for which this APN Number:32609052,C0 Occupancy Type: ermit is issued, APPLICANT CERTIFICATION I certify that l 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 A T CALLED INSPECTION. indemnify and keep harmless thtrtiity of Cupertino against liabilities,judgments, costs,and expenses which may gainst said City in consequence of the r1+ JV granting of this permit. A�di ovally, c applicant understands and will comply Issued by: Date: with nil non-point sourc r gu ' ns er the Cupertino Municipal Code,Section 9,18. .�/i f 0 RE-ROOFS: Si nature Date i 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. ❑ IvNER-BUILDER DECLARATION 1 hereby affirtulthat 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(Sce.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)shouill store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipmdt or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Hay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cup to 1 icipji0Codc,Cbapter9,I2 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25 533,an 25534.�r_ Section 3700 of the Labor Code,for the performance of the work for which this - Oivnc ti tt o�rLe ingen �. Dale: / permit is issued. I certify that in the performance of the work for which this permit is issued,l shall j not employ any person in any manner so as to bee0nle subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,I NSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a orsstmetion lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit ii issued(See.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address certify that I have read this application and state that the above information is correct,1 agree to comply ivith 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, ARCIIITECT'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 �O 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333•building(ftupertino.org l' 1 CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION V/ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS�/`b V APN 1! 3 �1 l /7 9 r 5- —2— OWNERNAME lk"Fp�/!t PHONE / E(M/AfLC/ r v .3-- STREET ADDRESS �. l] . /Q'�i (iL CITY, STATE,ZIP FAX CONTACT NAME (f yI P PHONE E-MAIL S; ake STREET ADDWS, CITY,STATE� cAi*+� FAX 7 ! �,(/ 13 OWNER ❑ OWNER-BUILDFR ❑ OWNERAGENT 11COMMACTOR ❑CONTRACTORAGENT 1:1 ARCHITECT' YJ E`1GINFER ❑ DEVELOPER ❑TENANi CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS,LIC 9 W. COMPANY NAME E-MAIL FAX �- STREET ADDRESS `1 CITY,STAT P � PHONE _pV IFID ARCHITECT'IENGINEERNAME LICENSE NUMBER BUS,LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK a�U rL,,to EXISTINGUSE R OSED USE CONSTRTYP 9STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL y� AREA /�o AREA I 1�` AREA NET AREA �,Q v�� Ill��O (tCU k BAT OoM KITCHEN OTHER Y G!! REMODELAREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL.DECKIPORCH AREA GARAGE AREA: D DETACH ❑ATTACH #DWELLINGUNITS: ISASECONDUNIT ❑YES SECOND STORY DYES BEING ADDED? NO ADDITION' DNO PRE-APPLICATION DYES IP YES,PROVIDE COPY OF IS THE BLDG AN ❑YES EIJ .,�.,iy' "-` TOTAL VALVAti"; PLANNTNGAPPL# ❑NO PLANNING APPROVAL LETTER EICHLERTIOAtE' ❑NoavJ_ By my signature below,I certify to each of the fol {ving: I am the property owner or auth Ized agent �c property owner's beh lf. I have read this application and the information[have provided' o!5;, have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to buildi L struI autho ze r entatives of Cupertino to enter the about-ident'Fed p perty for inspection purposes. Signature of Applicant/Agent: Date: J / SUPPLEMENTAL INFORMATION REQUIRED rsoo;7iivc - _New SFD or Multifamily dwellings: Apply for demolition permit for "r- 'O.;OvRR-THF-cbUNTER �.; �❑ BUILI]1NGPLANREV11:1V,• existing building(s). Demolition permit is required prior to issuance of building permit for new building. Ex�R�sst ❑ PLANNING PLANREVIEV • _Commercial Bldgs: Provide a completed Hazardous Materials Disolosure ❑_ Pu_BLiCWORKS form if any Hazardous Materials are being used as part of this project. � ' I❑:�zaRc"s• Fid DEPr_. _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. CD�Ivf1JOR :❑'SANITARY SEWER,DISTAICT' C7_EN WffkONhiEPiTAL IILAt TIt. B1dgApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 20916 HOMESTEAD RD#C DATE: 10107/2013 REVIEWED BY: MELISSA APN: 326 09 052.00 BP##: 13MO 'VALUATION: j$40,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 16 TI USE: PERMIT TYPE: WORK BLUE AROMA SPA-T.I. TO CREATE 7 N SERVICE ROOMS. UPDATE/UPGRADE E SCOPE RESTROOM FOR ACCESSIBILITY 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 1,200 $2,081.99 1BTIPLNCK $1,168.33 IBTIINSP TOTALS: 1 1,200 $2,081.99 $1,168.33 MECH,HOURLY Q'Yes O No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes Q No ,Meth. Man Check Plrrnrb. Plan('heck Elee. Plan Check FIV-111,Pc+rnth Fee: Plumb.Per•nri!Fee: Eley.Pennir Fee: Other Afech.Insp. Darr Plumh Insp. Other Elee.Insp. 1leelr. !nsp.Fee: P11110. h1sp. lee: Iilec.Insp. Foe: NOTE:77nis estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Server District,School District,etc.). These ees are based on the prelinaina information available and are only an estimate. Contact the Dept-for addn'l info, FEE ITEMS (Fee Resolution 11-053 Eft: 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,081.99 Select a Misc Bldg/Structure Suppl.PC Fee: (F) Reg. Q OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $1,168.33 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Coils/).11clion Tax ifdininistrative Feer: Q Work Without Permit? Q Yes (F) No $0.00 Advanced Plannin>;Fee: $0.00 Select a Non-Residential Trai,el DOC11Mel7latiOl7 Fees: Building or Structure Q i Strong Motion Fee: IBSEISMICO $8.40 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $2.00 SUBTOTALS: $3,260.72 $0.00 TOTAL FEE: 1 $3,260.72 Revised: 10/0112013 193 Ito 1 !A r Im �*CA ! # A YOTO to ezg deo ioiv s vo on nivae n s T :4svI3ossv V vo `ouj}a8dn3 `'J# `Ovom avaisawoH MOZ sods VWoxV HnzU W U j o w p 12 4 a AyH �o E s ro. vm.n.nhu��hrn U�$N".�m.nmrn wrr=k'����tr 5�.- € g fr g 8 a S s 8g aaa` s eesi �LL$LLa �ogA �� _.. = S = � �� ��E��� �� �� �� ��goaaoo as _aaaaaaaaaa�a o ro��� aa�roro«�&roro� E� .F t T r s x s g $ e #a x e s€ a€ z a€ s s& € S t a S ««oaaw a#<a�a«q««rod«roromaromrorororo aaoro�a�o= ooa000U rooa�000000,oag� „d�www.�wwwoww aW--a�aac _aaaas. ati �w ��q. a««aa«�««« ro©rorororomroao=rorororo _ooi��.,a��aa=���3 v000 .00aooaa$'�0000eoo w.ww y�a�wa�wwwroro w,.aa�. �. �. �.w�d�«.«tea J g M gHM w w 1 G oz 3 S .8 £ _ rs • - - � � oz ; {�0 W mie _ass€ G€ t In p i i< 3 3= W W� - 0 (9 1 -- 2 55 z «Hs aw =g x� Esq /ui � g o « « CE , n I i i I f ill I I �f I i f ,�I FSI Z _ z o63 iz o 4i W C J r V J¢ ZZ Z �C', r o o t E c�Y LL /Q�' ¢"✓ w a�co a�om'�n 4a ac�� ".in o oc�cz p 12 Ld LL- C € g fr g 8 a S s 8g aaa` s eesi �LL$LLa �ogA �� _.. = S = � �� ��E��� �� �� �� ��goaaoo as _aaaaaaaaaa�a o ro��� aa�roro«�&roro� E� .F t T r s x s g $ e #a x e s€ a€ z a€ s s& € S t a S ««oaaw a#<a�a«q««rod«roromaromrorororo aaoro�a�o= ooa000U rooa�000000,oag� „d�www.�wwwoww aW--a�aac _aaaas. ati �w ��q. a««aa«�««« ro©rorororomroao=rorororo _ooi��.,a��aa=���3 v000 .00aooaa$'�0000eoo w.ww y�a�wa�wwwroro w,.aa�. �. �. �.w�d�«.«tea J g M gHM w w 1 G oz 3 S .8 £ _ rs • - - � � oz ; {�0 W mie _ass€ G€ t In p i i< 3 3= W W� - 0 (9 1 -- 2 55 z «Hs aw =g x� Esq /ui � g o « « CE , n I i i I f ill I I �f I i f ,�I FSI Z _ z o63 iz o 4i W C J r V J¢ ZZ Z �C', r o o t E c�Y LL /Q�' ¢"✓ w a�co a�om'�n 4a ac�� ".in o oc�cz E ----- — ---- v i'."S; V"VN, FEg O-WIROVdSIWOVA LROR, TI+ A#1wHsnDod I o#iinoAddvH H#Qa &MI SMSA Vo 'ou!vadno'o#'avom OV31S3WOH 91,60Z P., 2tiLviaossv 79 S VdS VI ONV HfI'M LU A EH AvId E ----- — ---- v i'."S; V"VN, FEg O-WIROVdSIWOVA LROR, TI+ A#1wHsnDod I o#iinoAddvH H#Qa &MI SMSA 0 z LU P., Nl� 0 0 z LU s c szs-seg tQ1s7 6 ds o foM a� Nti> HZVI3t?ssv 79 9NIxa2tNI9u� Avx -- VO'ougjedno "J# `avow atl31S3WOH MOZ °' � P was vwowv arizg F a d z � � Q �Q y s � r Eq I s� _L` r �a3 NIwgZ 'w 6Z 'XMkK w t X # 0vi , 3N_J J18 01 X'M4 D g c6i'1n o L Nr -, s --- s 4 r`F�D� 9_ w. ! —_ - Fol Alull- C� U U - z w ¢ , cr —.--� 1 - lilw.5+ .; J �, ••^agar �'Vrt.9b� W a b=<1 Mp e g g® �o< '... xrMlxutav mrvnm ,as � - y 99 wnvalNlrv.cs J� �� � wnrviniri,ero � n� o N p0 to m umi ��� MFoi Z f(i 3 �o m zSa U��o a " _ ...g ws tw-� d'Qj OgV'-Zm1nQo JV �09>Q �N4�Oy UaO �~ W\ ¢N Nxm Zvm Z�OVO� b l;`. 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X C Z : g w @ K o a ' z 11 � dusk t o � w W g o\W G1 4 c 'S8 Y ffi g� v, E z d c� a,- Egg s S i i Y 'a 5. X N 9 , G ✓} �, Z 1 i C Z : g w @ K o a ' z 11 � dusk t o � w W g o\W G1 4 c 'S8 Y ffi g� v, E z d - z Egg s S i i Y 'a 5. X i I g w @ K o a ' z 11 � dusk t o 1 � g o\W G1 'S8 Y ffi g� v, E z d T c o o z Egg s S i i Y 'a 5. X N 9 , G ✓} �, Z wl} i 3 � 1 @ K o a ' z 11 � dusk t o 1 � M % s 1 � g o\W G1 w LLJ UNREASONABLE HARDSHIP EXEMPT-ION FORM GG�tG ` COMMUNITY DEVELOPMENT DEPARTMENT•BUILDIIAG DI ISIQN ALBERT SALVADOR, P.E., C.B.O., BUILDIN DV09 1 10300 TORRE AVENUE •CUPER71N0 C�9 0 4-3 � r LL REMAIN ONCUPERTINO. �` (408)777-3228 •FAX(408)7T • U -y- /� I � For Tenant Improvements where thea, -of,( cJN dcAULeTJ1W A H`NG SITE ADDRESS 20916 Homestead Road, Unit C CITY Cupertino ZIP Ca TOTAL CONSTRUCTION COST A $..55,000;00............ ................. DESCRIPTION OF WORK: Tenant Improvement on building 7 massage rooms, new partition wall, electrical outlets, upgrade existing T-bar ceiling, new counter, and upgrade restroom. The following is a list of costs to provide access features in order to comply 100%with the current State Title-24 Disable Access Standards.(AII costs to be documented by actual bids or other information accepted by the Bui ding Official. Accessible Features Complies with If not,list required upgrades in order for Cost to make feature current standards? features to fully comply? fully accessible? 1.Path of travel to accessible entrance. Adding Truncated Dome on path. $600.00 2.Cost of providing a primary entrance. (Including but ADA signage. not limited to,thresholds,landings,door hardware, $750.00 max.door pull,etc. 3.Cost of providing the primary path of travel to the Slope Level and Striping specific area of alteration,structural repair,or s2,500.00 addition. 4.Cost of providing accessible restroom facilities. Restroom fixtures, wall space, $11,500.00 r b-bar Doors 6.Cost of providing an accessible drinking fountain. (if NIA $ required or it a drinking fountain is provided.) �* 6.Cost of providing accessible public telephones(if NIA provided) $ 7,Cost of providing other accessible features,including Parking lot striping, Signage $3,800.00 but not limited to,parking,storage,alarms etc. TOTAL COST OF ACCESS FEATURES(B): $19,150.00 Has the same tenant performed work in the Calculate(B 1 A)x 100% 35 ° same tenants ace within the last three ears? NO �° Description of access features to be provided: -Upgrade Existing restroom to ADA complianed. -Entrance signage and hardware. TOTAL COST OF $12,250.00 ERCENTAGE (20%minimum 22 PROPOSED UPGRADE pe enditure is required ARCHITECT OR ENGINEER OF RECORD INFORMATION: I certify thatthe ote inf mation is true and correct. Name(print): Raymond Situ Signature: Date: 11/05113 Firm address: 319 Vicente Street Title: D sign Engineer Phone:510-688-6261 -----------—---------------------—------------------.--------------------- FOR DEPARTMENT USE ONLY -------------------------------------------------------------- ❑ The above named project has been denied an unreasonable hardship exemption under 2010 CBC Section 11348.2.1, s { ❑ The above named project has been granted an unreasonable hardship exemption from the requirements of the State of California CCR �L (Regulation for the Accommodation of the Disabled)pursuant to 2010 CBC Section I Q413.2.i. COMMENTS: REVIE Ep �� - RE viewe( 42 Building Official Designee(print): G Signature; Date: /O -49'`/3 HardshipExenrpfioi+Forin_2011.doc revised 10117/13