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14080249 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10381 BANDLEY DR CONTRACTOR:DEVCON PERMIT NO: 14080249 CONSTRUCTION INC OWNER'S NAME: LV CUPERTINO LLC 690 GIBRALTAR DR DATE ISSUED:08/26/2014 OWNER'S PHONE: 4086666614 MILPITAS,CA 95035 PHONE NO:(408)942-8200 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL E] APPLE-ADD (2)CONFERENCE ROOMS; RE-DIVIDE (2) License Class Lic.# 3 �� LABS INTO (3)VENDOR ROOMS; (2)NEW STOREFRONT Contractor TPIl /��, DOORS. ;/ l �' �1Date � 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 Jp rformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$125000 I ave 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:32633079.000 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 ISO 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 Igo DAYS ST CALLED INSP CTION. 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. Ll// with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. p RE-ROOFS: Signature _ Date C? 2 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, wil I 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(See.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 with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections O5,25533,i 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. 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 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 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 12 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 r 1 CUPERTINO (408) 777-3228• FAX(408) 777-3333•buildinq( cupertino.org ❑NEW CONSTRUCTION ❑ ADDITION dZ ALTERATION!TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROTECT ADDRESS/0 ry I �� APN / �� 9 OWNERNAME ) �. , �'a�hS� PHONE 11 { r E-MAIL C F Gf STRF,ETADDRESS / Ln�nJ CITY, STATE,ZIP, FAX CONTACT NAME / �� f � PHONE r,�� '��G�G �� E-M IL �� L�N L_ / STREET ADDRESS CITY,STATE, ZIP FAX G- ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT Ck-CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ,3I,a�J// LICENSE NUMBE4 LICENSE TYPE BUS LIC 4 COMPANYNAME j E-MAIL FAX STREET ADDRESS n.„ . CITY,STATE,ZIP / CIA /^�-- - PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER �^ l=� %J\ BUS LIC# COMPANY NAME (/ E-MAIL /'Y FAX STREE ADDRESS ^ .,DG! CITY IP � c�t.fO/ -Z PHONE &S _O�00 DESCRIPTION OF WORK - / ! (j�� ..�G EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC, SQTT. VALUATION(S) EXISTG /� NEWFLOOR DEMO TOTAL AREA 4J AREA AREA NET AREA BATHROOM(( KITCHEN OTHE REMODEL AREA REMODEL AREA DE7REA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GAR.A GE AREA. DETACH [I ATTACH #DW ELL]NG UMTS. ISA SECOND UNIT ❑YES SECOND STORY []YES BEING ADDED? �NO ADDITION? jrNO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEI D BY: TOTAL VALUATION: PLANNING APPL k�.h0 PLANNING APPROVAL LETTER EICHLER HOME? �'RO 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 bui ing construe ion. I authorize representatives ofCupertino to enter the above-identif d property for inspection purposes. Signature of ApplicanUAgent L Date: 2� y 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. t 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 ya. FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to submittal Of Building Permit application. ❑ MAJOR ❑ SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BIdgApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10381 bandley dr DATE: 08/26/2014 REVIEWED BY: Mendez APN: BP#: �� 'VALUATION: 1$125,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1 B T� WORK a le- add 2 conference rooms; re-divide 2 labs into 3 vendor rooms 2 new storefront doors. SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B (Tenant Improvements) II-B,III-B,NN-B 1,310 $2,154.86 IBTIPLNCK $1,339.96 IBTIINSP TOTALS: 1,310 $2,154.86 $1,339.96 MECH,HOURLY 0 Yes E) No PLUMB,HOURLY 0 Yes Q No ELEC,HOURLY Q Yes Q No 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: 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,154.86 Select a Misc Bldg/Structure Suppl. PC Fee: Q Reg. Q OT0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $1,339.96 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fe: $0.00 Select allon-Residential Building or Structure 0 i Stronk, Motion Fee: IBSEISMICO $35.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $5.00 SUBTOTALS: $3,534.82 $0.00 TOTAL FEE: 1 $3,534.82 Revised: 07/10/2014 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 ADDRESS: 103 X PERMIT# /-/,/) OWNER'S NAME: hmLer UPHONE# " GENERAL CONTRACTOR: Pt'.-1r0-217. BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *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: t/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing �( Electrical Excavation Fencing Flooring /Carpeting XD5 Linoleum/Wood OZ Glass/Glazing falr) pC. Heating ��,Z ' / ' ,k,�/e:W �? Insulation Landscaping Lathing Masonry Painting /Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal �-- Sheet Rock Tile !p �� Owner/ ontractor Signature Date