12070083 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20620 HOMESTEAD RD CONTRACTOR:SOUTH BAY PERMIT NO: 12070083
CONSTRUCTION,INC
OWNER'S NAME: THE SOBRATO ORGANIZATION I TI 1 DELL AVE DATE ISSUED:03/06/2013
OWNER'S PHONE: 4084460700 CAMPBELL,CA 95008 PHONE NO:(408)379-5500
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
SAFEWAY-TENANT IMPROVEMENT 54,964 SQ FT FOR
License ClassLic.# 33(,� 1 `� RETAIL/MERCANTILE SPACE TO INCLUDE M,E,P'S
REVISION#2-ADD DOOR TO ENCLOSED EXISTING
Contractor� '. Date i (E)ROOM,REPLACE SHELEVING WITH NEW DOOR,SELF
I hereby affirm that 1 am licensed under the provisions of Chapter 9 CONTAINED,REFRIGERATED BORGEN,REVISE
(commencing with Section 7000)of Division 3 of the Business&Professions LIGHTING 6/19/14
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
Eveof the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1500000
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:32610060.20620 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 P 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 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
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
I RE-ROOFS:
Signature a Il 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
Signature of Applicant: Date:
1 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)
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
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 t Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,S dons 25505 5533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized age Dater
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,1 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 1 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 1 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
3 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•building cDcupertino.org
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ® REVISION/DEFERRED ORIGINAL PERMIT# 12070083
PRO.IECT ADDREss 20620 HOME STEAD ROAD APN"
OWNER NAME THE SOBRATO ORGANIZATION PHONE 408-446-070
0 E-MAIL
STREET ADDRESS 10600 N. DeAn z a Blvd. CITY, STATE,ZIP Cupertino, CA 950 14 FAX
CONTACT NAME Rich Truempler PHONE 408-446-0700 rtruempler@sobrato.com
STREET ADDRESS CITY,STATE,ZIP FAX
9 OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Larry Paterson LICENSE NUMBER LICENSE TYPE BUS.LIC#
COMPANYNAME South Bay Construction E-MAIL 1paterson@sbci .com FAX
STREET ADDRESS 1711 Dell Avenue CITY,STATE,ZIP
Campbell, CA 95008 PHONE 408-379-5500
ARCHITECT/ENGINEER NAME Robert Lyman ILICENSE NUMBER C 19 215 BUS.LIC#
COMPANY NAME Johnson Lyman Architects E-MAIL darcy@johnsonlyman.Com FAX
STREET ADDRESS 1375 Locust S t. CITY,STA ZI PION'
a�nut Creek, CA 94596 25-930-9690
DESCRIPTION OF WORK Add door to enclosed existing electrical room. Replace existing
shelving with new 5-door, self-contained, refrigerated Borgen case in Liquor
Dept . Revise adjacent lighting and island displays for new Borgen case.
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES
USE TYPE OCC. SQ.FT. VALUATION(S)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECKPORCH AREA GARAGE AREA: DETACH
ATTACH
#D ELLINGUNITS: ISA SECOND UNIT []YES SECONDSTORY I]YES
BEING ADDED". ❑NO ADDITION" ❑NO
PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: TO VALUATION;
PLANNING APPL# []NO PLANNING APPROVAL LETTER EICHLEB HOME" []NO
By my signature below,I certify to each of the following: 1 am the property owner or authorized agent to ac Ohe 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 a urate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I auth ize representatives of Cupertino to enter the above-identified rt for inspection purposes.
Signature ofApplicant/Agent: Sm AMOM4 Date: `•,0•/
SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP
_New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ 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 ❑ PUBLIC 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 ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doe revised 06/21/11
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino,CA 95014-3255
C O P E RT I N O Telephone: 408-777-3228
Fax: 408-777-3333
CONTRACTOR/SUBCONTRACTOR LIST
JOB ADDRESS:20620 Homestead Square PERMIT#12070082& 12070083
OWNER'S NAME:Sobrato Organization PHONE#
GENERAL CONTRACTOR:South Bay Construction BUSINESS LICENSE#5655
ADDRESS:1711 Dell Ave CITY/ZIPCODE:Campbell,CA 95008
'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 NA NA
Cement Finishing Noah Concrete Corporation 29578
Electrical Capital Valley Electric 34273
Excavation Blue Top Construction See receipt#1
Fencing Pacific Security Fencing See receipt#2
Flooring/Carpeting McGinness Flooring 34750
Linoleum/Wood McGinness Flooring 34750
Glass/Glazing USA All Glass See receipt #3
Heating The Trilio Company 29816
Insulation Central California Insulation 557
Landscaping Jim Roberts Company 28615
Lathing Ageless Plastering See Receipt#4
Masonry McCurley and Day See Receipt#5
Painting/Wallpaper NJ Kann Painting See Receipt#6
Paving Blue Top Construction See Receipt#7
Plastering Ageless Plastering See Receipt#8
Plumbing Master Craft Plumbing See Receipt#9
Roofing Statewide Roofing 23509
Septic Tank NA NA
Sheet Metal The Trillo Company 29816
Sheet Rock South Bay Interiors 25499
Tile Fischer Tile and Stone See Receipt#10
3/11/14
Owner/Contractor Signature Date
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20620 HOMESTEAD RD CONTRACTOR:SOUTH BAY PERMIT NO: 12070083
CONSTRUCTION,INC
OWNER'S NAME: THE SOBRATO ORGANIZATION 1711 DELL AVE DATE ISSUED:03/06/2013
OWNER'S PHONE: 4084460700 CAMPBELL,CA 95008 PHONE NO:(408)379-5500
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
SAFEWAY-TENANT IMPROVEMENT 54,964 SQ FT FOR
License Class____ Lic.# 6M1� RETAIL/MERCANTILE SPACE TO INCLUDE M,E,P'S
Contractor (b Date DEFERRED# 1 -DEF SUBMITTAL FOR
I hereby affirm that I am lic sed under the provisions of Chapter 9 COOLER/FREEZER- ISSUED 3/11/14
(commencing with Section 7000)of Division 3 of the Business&Professions REVISION# 1 - ENLARGE PHARMACY,OMIT ROLL UP
Code and that my license is in full force and effect.
GRILLES/ADD FOLDING DOORS& RELOCATE
I hereby affirm under penalty of perjury one of the following two declarations: SHELVING. MOVE ICE MAKER-ISSUED 3/11/14
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:51500000
1 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:32610060.20620 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
1 certify that 1 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 180 DAYS OF P T 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 STC ED 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 per it. Additionally,the applicant understands and will comply Issu Date:
with all no -poi s rce regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
r installed without first obtaining an inspection,I 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
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). I 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 9.12 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 wi h t upertino nicipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se 25505,2553 4,rq nd 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent: Date:
permit is issued.
1 certify that in the performance of the work for which ibis 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 CONSTR CTION 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. 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 l 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
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ra 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 \
CUPERTINO (408)777-3228•FAX(408)777-3333•building(a-)cupertino.org r�
❑NEW CONSTRUCTION [I ADDITION ❑ ALTERATION/TIREVISION DEFERRED ORIGINAL PERMIT# 083
PROJECT ADDRESS O AIN# O O
OWNER NAME PHO D$- p O O E-MAIL
STREET ADDRESS CITY, STATE,ZIP �O , FAX
D b0 LL Q V. ino
ACT NA�/ _ O/1 S Gy• PHONE �yy. ��� E-MAIL Jo/7
9�2jy AJ owl L 1,2n c
STREET DRESS v CITY,rST n,T Cteoti CA 14-5-WeFAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR w❑CONTRACTOR AGENT P�ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME LICENSE NUMBERLICENSE TYPE BUS.LIC#
In4
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
5AZ),l c
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES
USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOORDEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODELAREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: DETACH
[3 ATTACH
_J
#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 RE D VALUATION:
PLANNING ADPL# []NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO
By my signature below,I certify to each of the following: 1 am the property owner orj4wo nzed a o act on th rrty owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work a verify it is a te. I agree to comply with all applicable local
ordinances and state laws relating t ild' g struction. I thorize representatives of Cupertino to enter the abov -ident Ied property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFO ATION REQ IRED PLAN CHECK TYPE ROUTING SLIP
_New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER 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 PIQTANDARD ❑ PUBLIC 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 ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
ENVIRONMENTAL HEALTH
BldgApp_201 Ldoc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20620 HOMESTEAD RD DATE: 06/07/2013 REVIEWED BY: MELISSA
APN: 326 10 060 BP#: 12070083 *VALUATION: Iso
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair
PRIMARY Commercial Building PENTAMATION 1GENCOM
USE: PERMIT TYPE:
WORK DEFERRED# 1 FOR COOLERIFREEZER BOXES
SCOPE
LJp
NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,eta). These fees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info.
FEE ITEMS(l=ee Resolution 11-053 UL 7,/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? Yes Q No $0.00 2 hours Plan Check,Hourly
Suppl. PC Fee: (j) Reg. Q OT 0.0 1 hrs $0.00 $266.00 ISTPLNCK
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Feer Reg. Q OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
t. ,r, i•<;;rr;err ?u�.
Work Without Permit? Q Yes Q No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential1
7 Building or Structure
Strom Motion Fee: $0.00 Select an Administrative Item
Bldg Stds Commission Fee: $0.00
SUBTOTALS: $0.001 $266.001 TOTAL FEE:'1 $266.00
Revised: 04/29/2013
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20620 HOMESTEAD RD TDATE: 06/07/2013 REVIEWED BY: MELISSA
APN: 326 10 060 BP#: 12070083 *VALUATION: Iso
FPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARY Commercial Building PENTAMATION 1GENCOM
USE: PERMIT TYPE:
WORK REVISION # 1 TO ENLARGE PHAMACY OMIT ROLL UP GRILLES/ADD FOLDING DOOR. OMIT &
SCOPE RELOCATE SHELVING & NEW LOCATION FOR ICE MAKER
El El
E^
NOTE.This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). Theseees are based on the prelimina information available and are only an estimate. Contact the De t or addn7 info.
FEE ITEMS (Fee Resolution 11-053 Eff 711112,E FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? ®Yes Q No $0.00 4 hours Plan Check,Hourly
Suppl. PC Fee: Q Reg. O OT 0.0 hrs $0.00 $532.00 isTPLNcx
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp. Feer-) Reg. Q OTT0 0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Work Without Permit? ® Yes (F) No $0.00 E)
Advanced Planning Fee. $0.00 Select a Non-Residential Q
Building or Structure 0
Strong Motion Fee: $0.00 Select an Administrative Item
Bldg Stds Commission Fee: $0.00
SUBTOTALS: $0.00 1 $532.00 TOTAL FEE: 1 $532.00
Revised: 04/29/2013
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333•building0kupertino.org \�
CUPERTINO
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/Tl REVISION DEFERRED ORIGINAL PERMIT# 12070083
PROJECT ADDRESS 2 0 6 2 0 HOMESTEAD ROAD APN# i Q - o6 (0
OWNER NAME THE SOBRATO ORGANIZATION PHONE 4 08-446-0700 E-MAIL
STREET ADDRESS 10600 N. DeAnza Blvd. CITY, STATE,ZIP Cupertino, CA 9 5 014 FAX
CONTACT NAME Rich Truempler PHONE 408-446-0700 rtruem trueuler@sobrato.com .
STREET ADDRESS CITY,STATE,ZIP FAX
®OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Larry Paterson LICENSE NUMBER LICENSE TYPE BUS.LIC#
COMPANY NAME South Bay Construction E-MAIL 1paterson@sbci .com FAX
STREET ADDRESS 1711 Dell Avenue CITY,STATE,ZIP Campbell, CA 95008 PHONE 408-379-5500
ARCHITECT/ENGINEER NAME Robert Lyman LICENSE NUMBER CI-9215 BUS.LIC#
COMPANY NAME Johnson Lyman Architect E-MAIL darcy@johnsonlyman.com FAX
STREET ADDRESS 1375 Locust S t. #202 CITY,STA ZIR PHI
"925-930-9690
Creek, CA 94596 ' 925-930-9690
DESCRIPTION OFwORK Enlarge Pharmacy, omit roll-up grilles/add manual folding door,
Replace shelving w/ Rx shelving, omit mid aisle shelving near Produce,
New location for ice maker.
EXISTING USE PROPOSED USE CONSTR TYPE #STORIES
USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH ARE�ULIII, TOTAL DECK/PORCH AREA GARAGE AREA. DETACH
ATTACH
DWELLINA SECOND UNIT []YES SECOND STORY []YES
BEING ADDED? ❑NO ADDITION? []NO
PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES CEI TOTAL A U.�JON:
PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ /7
By my signature below,1 certify to each of the following: 1 am the prope o r or a Ize ent to t e property owner's behalf. I have read this
application and the information I have pro ided is correct. l have read escription of Work eri
vfy it is accurate. I agree to comply with all applicable local
ordinances and state laws rei b i ing uction. [authorize representatives of Cupertino to enter the Dov -ident led property for inspection purposes.
Signature ofApplicant/Age : Date: C/Q
SUPPLEMENTAL INFORMA ON REQUIRED PLAN CHECK TYPE ROUTING SLIP
_New SFD or Multifamily dwellings: Apply for demolition permit for ❑ ONE ❑ 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 ❑ PUBLIC 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 ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
B1dgApp 201 Ldoc revised 06/21/11
JOHNSON
LYMAN
ARCHITECTS,LLP
City of Cupertino June 4,2013
Community Development-Building Division
Arnold Hom
10300 Torre Avenue
Cupertino, CA 95014-3202
408.777.3235 408.777.3333 fax
PROJECT Safeway T.I. - Permit 412070083
20620 Homestead Road
Dear Arnold,
We have made some minor revisions to the Permit. Enclosed is the fee of$532, and five partial sets for
your review and comment. The revisions are clouded, labeled Delta 7, and are as follows:
Sheet A1.1, A5.1, A8.1, and F1.1:
A. Omitted gondolas in rows adjacent to Produce, and added end caps. Added 15' gift card
island, Larson 25240.
B. Wellness Pharmacy: Expanded Pharmacy into Sales Area. Omitted roll-up grilles. Added
millwork, and manual folding door furnished/installed by Safeway's vendor Uniweb. New
partitions for door pocket by G.C. Amended ceiling, lighting and supply/return diffusers.
Added five rows of 5' high Pharmacy shelving fixtures with built-in LED's. Refer to
Electrical Drawings.
C. Ice Machine: Relocated ice machine, floor sink, and partition closer to entry/exit 101
D. Starbucks Seating Area: Added railing, refer to detail A1.2-23.
Ddcor Revisions:
DLI -Updated flooring Entry, Bank, Produce and Pharmacy per plan changes
D2.1 -Updated finishes and decor per plan changes at Pharmacy and Entry
D2.2 -Updated Entry elevation per plan changes.
D3.1 -Updated finishes and decor per plan changes at Pharmacy and Entry
D4.1 -Updated finishes at Entry and Pharmacy per plan changes
Plumbing Revisions:
P2.1 Relocated Ice Maker and associated plumbing, and relocated Pharmacy sink.
P2.2 Same as above
P2.4 Revised ice maker floor sink dimension.
Electrical Revisions:
E0.3 Revised T24 calculation for removal of type Din Pharmacy and BI at ice machine.
Added lighting for Pharmacy work space
E2.1 Revised lighting in Pharmacy
1375 Locust Street., Suite 202, Walnut Creek, CA 94596 9 925.930.9690 9 fax 930.9039 9 www.johnsonLyman.com
City of Cupertino -Permit#12070083
Page 2
Revised and added power at Center of Store fixture layout.
Power pole removed from Pharmacy island counter, all power to be conduit under slab to nearest
wall.
Added power for coffee grinder.
Removed power for Pharmacy roll-up grille.
Added power for LED strip shelf lighting at Rx sales fixtures
Relocated power for drinking fountains, ice maker, and riding carts
Added quad receptacle at soup display
E3 AB Added circuit for exterior signage
E5.1 Updated panel schedules
E5.2 Updated panel schedules
E5.3 Updated panel schedules
This concludes responses to City Plan Check comments. Should further clarification be needed, please
email to darcyna,iohnsonlyman.com, or telephone at (925) 930-9690 x11.
Sincerely,
Darcy Meyer
Johnson Lyman Architects
Pk '
Enclos es, �
1375 Locust Street., Suite 202, Walnut Creek, CA 94596 • 925.930.9690 9 fax 930.9039 9 www.johnsonLyman.com
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20620 HOMESTEAD RD CONTRACTOR:SOUTH BAY PERMIT NO: 12070083
CONSTRUCTION,INC
OWNER'S NAME: THE SOBRATO ORGANIZATION 1711 DELL AVE DATE ISSUED:03/06/2013
OWNER'S PHONE: 4084460700 CAMPBELL,CA 95008 PHONE NO:(408)379-5500
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL Ll COMMERCIAL
License Class B Lie. SAFEWAY-TENANT IMPROVEMENT 54,964 SQ FT FOR
RETAIL/MERCANTILE SPACE TO INCLUDE M,E,P'S
Contractor Dat
I hereby affirm that I am licenseiDivision
er the provi ions of Chapter 9
(commencing with Section 7000) 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:$1500000
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:32610060.20620 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
1 certify that 1 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 mentionedproperty for inspection purposes. (We)agree to save 180 DAYS LAST CALLED 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 Issued by: Date:
with all non-point source re ions per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Data 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
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)
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
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,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 Cuperti unicipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety%de,Sections 2 33,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which thispermit is issued. Owner or authorized Dat
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,1 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[ending 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 g3
ILE]
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CP
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•building(aDcupertino.org �a
❑NEW CONSTRUCTION ❑ ADDITION ® ALTERATION/Tl ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS 20620 HOMESTEAD ROAD 7APN# 326-10-0-5�"OT3"'
OWNER NAME THE SOBRATO ORGANIZATION PHONE408-446-0700 E-MAIL RTRUEMPLER@SOBRATO.COM
RICH TRUEMPLER
STREET ADDRESS 10600 N. DE ANZA BLVD. CITY, STATE,ZIP CUPERTINO, CA. 95014 FAX 408-866-6638
CONTACTNAME JEFF OPAROWSKI PHONE 408-496-0676 E-MAILJOPAROWSKI@ARCTECINC.COM
STREET ADDRESS 99 ALMADEN BLVD. , SUITE 840 CITY,STATE, ZIP SAN JOSE, CA 95113 FAX 408-496-1121
❑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
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCHITECT/ENGINEERNAME JEFF OPAROWSKI, AIA LICENSENUMBER C-21289 X BUS.LIC#
COMPANYNAME ARC TEC INC. E-MAIL JOPAROWSKI@ARCTECINC.COM FAX 408-496-1121
STREET ADDRESS 99 ALMADEN BLVD. CITY,STATE,ZIP SAN JOSE, CA 95113 PHONE 408-496-0676
DESCRIPTION OF WORK
CONSTRUCTION OF A NEW 54,964 SF RETAIL TENANT IMPROVEMENT FOR SAFEWAY
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES OFFICE E NLY
NONE RETAIL III-B ONE
VALUATION
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA 54,964 AREA NET AREA 54,964 / /C
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA:❑ DETACH
❑ ATTACH
n DWELLING UNITS. IS A SECOND L2nT ❑YF.S SECOND STORY ❑YES
BEING ADDED? ❑NO ADDITION? ❑NO
PRF.-APPLICATIONS
IF YES,PROVIDE COPY OF PLANNER'S NAME RECEIVED BY: TOT1, 500, 000
IAL VALUATION:
PLANNING APPLn ❑NO PLANNING APPROVAL LETTER 1 I 5 Q O r Q O Q
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. 1 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 c ltn. I thorize pr en tives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/AgenCm"FZ Date: I- VC-('h
SUPPLEMENTAL INFO ION RE UIRED PLAN CHECK TYPE ROUTING SLIP
_New SFD or Multifamily dwellings: Apply for demolition permit for ❑ ,�_
OVER-THE-COUNTER l� BUILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building /�
permit for new building. E❑, ExP SS 2_PLrNNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure s? TANDARD .�Ppu�]C WORKS
form if any Hazardous Materials are being used as part of this project. ❑ LARGE EPT
Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application. ❑ MAJOR SANITARY SEWER DISTRICT
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 03/16111
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20620 homestead rd. DATE: 07/11/2012 REVIEWED BY: bobs.
APN. BP#: J `0-7M 8'3 "VALUATION: $1,500,000
°PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building PENTAMATION 1 M TI
USE: PERMIT TYPE:
WORK T.I. comm. retail/mercantile space includes M E Ps
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
M (Tenant Improvements) II-B,111-B,IV,V-B 54,964 $7,976.00 1MTIPLNCK $20,156.50 1MTIINSP
TOTALS: 54,964 $7,976.00 $20,156.50
MECH,HOURLY 0 Yes (F) No PLUMB,HOURLY 0 Yes E) No ELEC,HOURLY 0 Yes Q No
F-1 -7-- I_
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 prelinddna information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS YI'ee,Resolution 1l-( 3 C " %,'1,'1l j FEE QTY/FEE MISC ITEMS
Plan Check Fee: $7,976.00 Select a Misc Bldg/Structure
• Re OT 0.0 hrs or Element of a Building
Suppl. PC Fee: 0 g. 0 $0.00
PME Plan Check: $0.00
Permit Fee: $20,156.50
Suppl. Insp.Fee-.(F) Reg. 0 OT ro,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
77
0
Work Without Permit? 0 Yes r'• No $0.00 G
Advanced Planning $0.00 Select a Non-Residential 0
Building or Structure 0
A
Strong Motion Fee: IBSEISMICO $315.00 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $60.00
SUBTOTALS: $28,507.50 $0.00 TOTAL FEE: $28,507.50
Revised: 07/01/2012