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12060100 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20680 HOMESTEAD RD CONTRACTOR:SOUTH BAY PERMIT NO: 12060100 CONSTRUCTION,INC OWNER'S NAME: THE SOBRATO ORGANIZATION 1711 DELL AVE DATE ISSUED:03/07/2013 OWNER'S PHONE: 4084460700 CAMPBELL,CA 95008 PHONE NO:(408)379-5500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL IJ License Class /� Li.. CONSTRUCT 6,859 SQ FT SHELL BUILDING FOR RETAIL Contract T� ' Dat SPACE 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 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:$520000 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:32610051.20680 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 18 RMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter r upon the above mentioned property for inspection purposes. (We)agree to save 180 D T 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 Iss Date: with all non-point source re ons per the Cupertino Municipal Code,Section 9.18* .l8. RE-ROOFS: Signature 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 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(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 Cu r unicipal Code,Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Sa ty Code,Sectio 5533,and 2553 . Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorr D 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 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 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 regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Date Building Department City Of Cupertino 10300 Tone Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS:20680 Homestead Square PERMIT#12060100 OWNER'S NAME:Sobrato Organization PHONE # GENERAL CONTRACTOR:South Bay Construction BUSINESS LICENSE#5655 ADDRESS:1711 Dell Ave CITY/LIPCODE: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 35161 Fencing Pacific Security Fencing See receipt#1 Flooring/ Carpeting McGinness Flooring 34750 Linoleum/ Wood McGinness Flooring 34750 Glass/Glazing USA All Glass See receipt#2 Heating The Trillo Company 29816 Insulation Central California Insulation 557 Landscaping Jim Roberts Company 28615 Lathing Ageless Plastering 35164 Masonry McCurley and Day 35159 Painting/ Wallpaper NJ Kann Painting 35160 Paving Blue Top Construction 35161 Plastering Ageless Plastering 35164 Plumbing Master Craft Plumbing 35162 ,- Roofing Statewide Roofing 23509 Septic Tank NA NA Sheet Metal The Trillo Company 29816 Sheet Rock South Bay Interiors 25499 Ti Fischer-file and Stone 35157 6/17/14 Contractor Sign ure Date n Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR / SUBCONTRACTOR LIST JOB A2IP, PERMIT,#',Z!�/Op'=D OWNER'S]NAME: PHONE# GENERAL CONTRACTOR_ T,r-�4�9&T- BUSINESS LICE SE# ADDRESS/7//v�=��/�N�� CITY/ZIPCODE P�--.�= 9� *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 Excavation Fencing Flooring/ Carpeting Linoleum/Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date CONSTRUCTION PERMIT APPLICATION Is COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333• building(akupertino.org Loop ®NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ /DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 20680 HOMESTEAD ROAD 7REVISION N# 326-10-051,44Q-r"3 140 OWNERNAME 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 CONTACT NAME JEFF OPAROWSKI PHONE 408-496-0676 E-MAIL JOPAROWS KI @ARCTEC INC.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 a 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 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 COLD SHELL RETAIL BUILDING EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES NONE RETAIL V-B ONE OCC. TYPE DESCRIPTION SO.Fr_ VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL y A AREA AREA 6,$59 AREA NErAREA 6,859 a"? V p-7?a j. (Qt BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREADECK AREA TOTAL DECKTORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH #D WELLING ONI S� 11 A SECOND UNIT' ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION ❑ YFS IF YE1.1ROVR1P,1OPYO1 I PI.ANNER'SNAMR RECEIVED BY: _ / TOTAL ION: PLANNING APPI.# ❑NO PLANNING APPROVAL LETTER 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 haver ad the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin ons ion. I auth ze representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of AppIicant/Agent: Date: SUPPLEMENTAL WFfTM141 TION FEQ! LAI RED 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 ofbuilding 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.doc revised 03/16/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 20680 Homestead Rd DATE: 06/18/2012 REVIEWED BY: Sean APN: BP#: `VALUATION: 1$520,000 RPERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY Civil/Religious activities PENTAMATION USE Commercial Building in BQ Zone? 0 Yes No PERMIT TYPE: 1 M1 WORK Construction of a 6859 sq ft shell building for retails ace. SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. M (Mercantile) II-B,III-B,IV,V-B 6,859 $4,492.83 IMPLNCK $3,770.05 IMINSP TOTALS: 6,859 $0.00 $0.00 El 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 addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef' 7'1!111 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure Suppl. PC Fee: (j) Reg. 0 OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-0 Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BC0tvSTAxC $17,421.86 _ 0 Work Without Permit? Q Yes Q) No $0.00 E) Advanced Planning Fee: PLLONGRNGC $1,783.34 Select a Non-Residential E) Building or Structure 0 Strong; Motion Fee: IBSEISMICO $109.20 Select an Administrative Item Bldg, Stds Commission Fee: IBCBSC $21.00 SUBTOTALS: 19,335.40 $0.00 ' TOTAL FEE: $19,335.40 Revised: 06/30/2012