B-2017-1431 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1431
10335 N TANTAU AVE CUPERTINO,CA 95014(316 06 064) S C BUILDERS INC
SUNNYVALE,CA
94085
OWNER'S NAME: CAMPUS HOLDINGS INC DATE ISSUED:09/08/2017
OWNER'S PHONE:650-324-5316 • PRONE NO:(408)328-0688
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#767196
Contractor S C BUILDERS INC Date 08/31/2019 2i BLDG _ELECT _PLUMB
MECH RESIDENTIAL X COMMERCIAL
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. JOB DESCRIPTION:
APPLE TANTAU 9-1ST FLOOR;T.I.-INTERIOR MODIFICATIONS
I hereby affirm under penalty of perjury one of the following two declarations: OF THE EXISTING OFFICE SPACE TO INCLUDE NEW PARTITIONS,
i. I have and will maintain a certificate of consent to self-insure for Worker's FINISHES,FURNITURE,RELOCATION OF LIGHT FIXTURES AND
.Compensation,as provided for by Section 3700 of the Labor Code,for the ASSOCIATED ELECTRICAL.
performance of the work,for'wliich this permit is issued.
1 I have and will maintain Worker's Compensation Insurance,as provided for by •
,5 Section 3700 of the Labor Code,for the performance of the work for which this
�-1 permit is issued. Sq.Ft Floor Area: Valuation:$200000.00
APPLICANT CERTIFICATION
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 316 06 064 A(Tenant Improvements),B(Tenant Improvements)
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree tolsave indemnify and keep harmless the
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
----- Additionally,the applicant understands and will comply with all non-point
source regulations per the Cu. ino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signatu I Date 09-08-2017 Issued by:)•Cir Dunbar
C Date:09/08/2017
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: ,
following two reasons: All roofs shall be inspected prior to any roofmg material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:09-08-2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 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. HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Woiker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air •uality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cuperti,, unic,al Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code, ecti t I 2.533,an 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall r
be deemed revoked. lop
Owner or authorized agent::,, i 1..,�
APPLICANT CERTIFICATION Date:09-08-2017 t ID‘
I certify that I have read this application and state that the above information is CO- S t I" _ 0 LE I ING 4 G , _
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending age y for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097, v C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this.permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. I understand my plans shall be used as public records.
Licensed
Signature Date 09-08-2017
Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION B,
f,,
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 buildin @cu ertino.or PEMIT#B-
CUPERTINO REV# DEF#
❑ NEW CONSTRUCTION ❑ADDITION ❑X ALTERATION X❑T.I. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA
PROJECT ADDRESS --let. ISS
10435 NORTH TANTAU AVE APN# 3(
(e ^ 0 lL/ —0 Li
OWNER NAME . PHONE E-MAIL
APPLE(ATTN:LEE ANN DEPEW) 650-324-5316 leeann@novapartners.com
STREET ADDRESS CITY, STATE,ZIP
201 MOFFETT BLVD. • MOUNTAIN VIEW,CA 94043
❑tt CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE
GREG BURDA SC BUILDERS, INC. 1 (al (J
ISTREET ADDRESSCITY.STATE, ZIP I
910 THOMPSON PLACE SUNNYVALE, CA 94085
_ E-MAIL
gburda@scbuildersinc.com 1PHONE
408-328-0688
0ARCHITECT ❑OWNER ❑OWNER AGENT 0 CONTRACTOR AGENT':ENGINEER 0 DEVELOPER 0 TENANT BUS.LIC N
CONTACT NAME E-MAIL .
SCOTT COLSON scolson@hga.com
STREET ADDRESS CITY,STATE,ZIP PHONE
84 W SANTA CLARA ST,SUITE 200 SAN JOSE,CA 95113 - 408-288-7833
•
DECRIPTON
Interior modifications of the existing office space to include new partitions,finishes,furniture,relocation of light fixtures and associated electrical.
•
❑SINGLE-FAMILY/DUPLEX ❑MULTI-FAMILY ❑INDUSTRIAL ❑x COMMERCIAL I
EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES# TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($)
OFFICE - - 4 10,500 SF
REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE ❑ATTACHED
BATHROOM SF - SF _ SF SF- ❑DETACHED B 10,500 200,000
•
EXISING I]YES EICHLER YES SECOND STORY ADDTITON El YES
FIRE'SPRINKLERS❑NO IN❑ NO IN NO
DWELLING SECOND DWELLING ❑YES 0 ATTACHED 0 DETACHED OTHER
UNITS# UNIT ADDITON: 0 NO S F
POOLS' ❑'FIBERGLASS 0 VINYL-LINED 0 GUNITE 0 PREFABRICATED
POOL-SF SPA-SF SPA ATTACHED 0 YES El NO TOTAL-SF
elikCEIVED BY: TQTALLVVALUATION:
Commercial or Multi-Family Buildings with Public Swimming Pools rehires Department of Environmental Heath avproval Z
RE-ROOF EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY)
REMOVE/REPLACE 0 NO IF NO PLYWOOD 1111/2" ❑3/8" PLYWOOD TYPE: PITCH: 121 ROOF CLASS
ElYES #OF LAYERS THICKNESS Li5/8" OTHER ❑OSB ❑CDX OTHERw A
PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES ❑OTHER
*Provide a signed copy of the Cupertino's Tear-Off Policy ` SF #of SQUARES
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 building construction. I authorize representatives of Cupertino to
enter the above-identified property for inspection purposes. I acknowledge and authorize all information contained on this application form
to be made available for public record. i�����1
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED
*New SFD/Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction.
*Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project.
*Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application.
*HOA-Provide a letter of approval from the Home Owner's Association •
BldgApp_2017.doc revised 08/01/17