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13120146
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10900 N TANTAU AVE CONTRACTOR:DEVCON PERMIT NO: 13120146 CONSTRUCTION INC OWNER'S NAME: CUPERTINO TANTAU LLC 690 GIBRALTAR DR DATE ISSUED: 12/181013 CONER',S PHONE: 4152297005 MILPITAS,CA 95035 PHONE NO:(408)942-8200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIALL] Cass Lic.# I APPLE-RELOCATE CHAMBER DOOR&DEMO 8 FOOT SECTION Contractor DateOF METAL STUD WALL 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 maintaui 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 whieh this permit is issued. Sq.Ft Floor Area: Valuation:$12000 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of Ate work for which this APN Number:31609024.00 Occupancy Type: pcnnit is issued. APPLICANT CERTIFICATION 1 certify[hat 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 18 SOF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspeedon purposes. (We)agree to save 180 DAYS ROM AST CALLED SP , TION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, / costs,and expenses which may accrue against said City in consequence of the �J granting of this permit. Additionally,the applicant understands and will comply Issued by: Da with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: 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 1 hereby affirm that[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 stricture is not intended or offered for sale(Sce.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 nnder Chapter 6.95 of the California Ilenith&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(x)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,m provided for by Section 3700 of the Labor Code,for the air contaminants as defined by t Bay Area Air Quality Management District I performance of the work for which this permit is issued, will maim in compliance with t e Cupertino Municipal Code,Chapter 9.I2 and have and will maintain Worker's Compensation Insurancc,as provided for by the Health&Safety Code,SCeti 2 50 , 533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this O ucr-Fq-tletEtorazc;ageht: rrr —� Date:' permit is issued, �� 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 CONST RU ION 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 far which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lendcr's Address I certify that I have read this application and state that the above information is correet.I agree to comply with all city and county ordinances and stale 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 regulalions per the Cupertino Municipal Code,Section Licensed Professional 9.19. Signature Dale CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION oI� 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building@cupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑D ALTERATION/TI ❑ REVISION I DEFERRED ORIGINAL PERMIT 9 PROJECT ADDRESS 10900 Tantau,Cupertino,CA 95014 APN I 31609029. 00 OWNERNAMECupertino Tantau LLC PHONE 415-229-7005 E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX 4 Embarcadero Ste 2500 San Francisco CA 95210 CONTACT NAME PHONE 408-942-8200 E-MAIL Sylvester Ramirez sramirez@devcon-const.com STREET ADDRESS CITY,STATE,ZIP FAX 690 Gibraltar Dr Milpitas CA �5 ❑OWNER 11OWNER-BUILDER 11 OWNER AGENT EX CONTRACTOR 11 CONTRACTOR AGENT 11ARCIm-ECT 11 ENGINEER 13 DEVELOPER N TENANT CONTRACTOR NAME Sylvester Ramirez LICENSE NUMBER 3-99163 LICENSE TYPE B BUS.LIC a 11068 COMPANY NAME Devcon Construction,Inc. E-MAIL sramirez@deveon-const.com FAX STREETADDREss 690 Gibraltar Dr. CITY,STATE,ZIP Milpitas, CA 95035 PHONE 408-942-8200 ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC# . Andrew Giba COMPANYNAME Devcon Construction E-MAIL agibagdevcon-const.com FAX STREET ADDRESS 690 Gibraltar Drive CITY,STATE,ZIP Milpitas CA 95035 PHONE408-942-8200 DESCRIPTION OF WORK Relocate chamber door& demo 8 foot section of metal stud wall EXISTING USE PROPOSED USE CONSTR.TYPE N STORIES Office/Labs Office/Labs IIB 2 USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL " 1 AREA 1 5 0 k AREA N/A AREA NET AREA IC/ BATHROOM KITCHEN OTHER REMODEL AREA RENIODELAREA N/A REMODELAREA POACH AREA I DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH N/A N/A N/A N/A ❑ATTACR #DWELLINGUNITS: 15ASECONDUNIT ❑YES SECONI)STORY OYES N/A BEING ADDED! ®NO ADDITION? ®NO :21 PRE-APPLICATION []YES IF YES,PROVIDE COPYOF ISTHEBLDG AN [3 YES RECEIVED s TOT.�yL}y.yA3 TILu3� PLANNINGAPPLN QNO PLANNING APPROVALLEITL•R EICHLERHOME? ®NO By my signature below,I certify to each of the followi : I aryl the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have royyided, co et. I have read the Description of Work and verify it is accurate. I agree to comply With all applicable local ordinances and state laws rclatins to bu ldhg c �tru tion. I authorize representatifC-upertino to enter the above-id tified Voperty for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL %IREID ' ROUTING SLIP New SFD or Multifamily dwelli gs: Apply for dempermit for ❑ OVER-THE.COUNTERa-E� IUILDINGPLANREVIEW existing building(s). Demolition permit is required prior to issuance of but ding permit for new building. ❑ EXPRESS 11 PLANNING PLAN REVIEW, _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE :DEPT _Copy of Planning Approval Letter or Mecting with Planning prior to El MADOR El SAN ITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL IIEALTH BldgApp_201 Ldoc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION �A ADDRESS: 10900 Tantau Ave DATE: 12/1812013 REVIEWED BY: Mendez APN: I IBP#: 1210FO/ ''VALUATION: 1$12,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1GENC0T; WORK apple- Relocate chamber.door&demo 8 foot section of metal stud wall SCOPE i R-feeh.flan Check Plumb.Plan Check Elec. Plan Check INfi>clr.Penuif Fee: Plumb.Permit Fee: F,lec,Permit Fee: Other Mech.Insp. Other Plumb Insp. Other Elec.Lrsp. Ll Mech.112sp.Fee: Plumb.I)tsp. Fee: Flee.Insp.Fee: NOTE:This estimate does not include fees due to other Departments(ie.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 for addn'1 info. FEE ITEMS (Fee Resolution 11-053 E . 7/1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? ©Yes (E) No $0.00 1 hours Plan Check,Hourly Suppl.PC Fee: 0 Reg. Q OT0,0 hrs. $0.00 $139.00 IsTPLNCK PME Plan Check: $0.00 Permit Fee: Hourly Only? ®Yes Q No $0.00 Suppl. Insp.Fee:Q Reg. Q OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tux., Adtninistralive Fee: Q Work Without Permit? O Yes ie) No $0.00 (F) Advanced Planning Fee: $0.00 Select a Non-Residential 0 Ti-avel Documentation Fees: Building or Structure Strone Motion Fee: IBSEISMICO $2.52 4.0 hrs Inspections Bldg Stds Commission Fee: 1BCBSC $1.00. $556.00 IsTINsP Inspection,Hourly SUBTOTALS: $3:52 $695.00 TOTAL FEE: $698.52 Revised: 10/01/2013