Loading...
14020059 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 16 RESULTS WAY CONTRACTOR:HILLHOUSE PERMIT NO: 14020059 CONSTRUCTION OWNER'S NAME: ECI TWO RESULTS LLC 140 CHARCOT AVE DATE ISSUED:04/10/2014 OWNER'S PHONE: 4087839940 SAN JOSE,CA 95131 PHONE NO:(408)467-1000 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL E] _ RECONFIGURE (E) EMPLOYEE SHUTTLE AREA TO License Class Lic.# 5 �3tjt� � INCLUDE (N)ACCESSIBLE RAMP,2(N) BUS SHELTERS,2 (N) Contractor �xSC •.S}[e Date �� t�{ PERMENANT BENCHES AND ASSOCIATED HARDSCAPE I hereby affirm that I am licensed under the provisions of Chapter 9 (700 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. DEFERRED#2-STRUCTURAL ANCHORAGE-ISSD OTC 6/26/2014 1 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:$70000 I have and will maintain W'orker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35720042.16 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. 1 agree to comply with all city and county ordinances and state laws relating WITHIN 18P 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 180 DAYS FROM 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 /„�(0 r granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: CY with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature ��'t/'� ti Date �' i ' 1`I 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 l 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). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will 1 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 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 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 1 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 25505,2,Q 5,533,and 25534. Owner or authorized agent: Section 3700 of the Labor Code,for the performance of the work for which this '7� Y + Date:C/—2 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 CONSTRICTION 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 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. Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333 • building(d)cupertino.org CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION EFERRED ORIGINAL PERMIT# PROJECT AD RESS (( APN# 14 L J (I)U (J �� \(1 a 0 ER NA E P ONE �3 I E- AIL S ELADESS Q CITY, STATE,ZIP FFAX__- CONTACT NAME Cd L11 ^ _ PHONE Y' - j36 Wig. , C O.r1 STREET DRESS CITY,STATE, ZIP l FAX C7 LC90 t-4►, a v u� C ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAM LIC ENS UMjEg LICENS YPE BU LI'# s p 1 p/2A Q C PA NAME U �� E-i�:AIL _ Zm.J�r��;oA.C> F�(66 - `l6' - ,>a0 � ' S o S;REo ADDRESS 6 n U c �� Y,STATE,ZIP ^�� 3 $ Ol L 67 — l vv4 All MTECTIENGINEERNAME M c I [C W- LICENSE.�UJMBER "( BUS.LIC# SS t C PANY NAME �_1l E-MAIL F So6C.Cc Y, 6 P Ck iCC,n c, q.5�T^q .2.�1 STREET ADDRESS CITY,STATE,ZIP PI30jJE -�-7 DESCRIPTION OF WORK t l EXISTING USE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. sQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ATTACH D\VELLING UNITS: IS A SECOND UNIT 1]YES SECOND STORY ❑YES BEING ADDED? ❑No ADDITION? ❑NO PREJAPPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN El YES RECEIVEDBY -:I TOTAL- U-_AIOIJ; _ PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO By my signature below,I certify to each of the following: I am the property owner or authorized agent to ac on the property owner's behalf. I have read this application and the information 1 have provided is correct. I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: _ +'UW Date: 401 SUPPLEMENTAL INFORMATION REQUIRED " PLAN CHECK TYPE ROUTING SLIP' New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building ovER RE-C8,uNTER ❑ sUUDrNG�PLAN RE�rEW permit for new building. ❑ E}�PRE$S ❑ <PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDnRD ❑ ruBLIC� oxxs form if any Hazardous Materials are being used as part of this project. D LARGE' ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. D tvlAaoR ❑ SAAITARY SE�VERDisTRICT ❑ ENVIROI,'11MENTAL HEALTH BIdgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 16 RESULTS WAY CONTRACTOR:HILLHOUSE PERMIT NO: 14020059 CONSTRUCTION OWNER'S NAME: ECI TWO RESULTS LLC 140 CHARCOT AVE DATE ISSUED:04/10/2014 OWNER'S PHONE: 4087839940 SAN JOSE,CA 95131 PHONE NO:(408)467-1000 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL RECONFIGURE(E)EMPLOYEE SHUTTLE AREA TO License Class_ Lic.# 6��� INCLUDE Contractor (N)ACCESSIBLE RAMP,2(N)BUS SHELTERS,2(N) `ViO�'JC Cc n S`� CU, Date I—�—(7 — ]t{ PERMENANT BENCHES AND ASSOCIATED HARDSCAPE I hereby affirm that I am licensed under the provisions of Chapter 9 (700 (commencing with Section 7000)of Division 3 of the Business&Professions DEF#1-RELOCATE LIGHT POLE(LIGHT POLE BASE DETAIL)-ISSUED Code and that my license is in full force and effect. 4/17/14 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:$70000 fifir I 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;35720042.16 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.1 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 mentioned property for inspection purposes. (We)agree to save 180 ALLED 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 Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. /� �/, RE-ROOFS: Signature —Ind "� Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection,l 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 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) 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(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 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this 4A PA* Date:L w/7_( permit is issued_ Owner or authorized agent: 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,l 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 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 COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTlNO (408)777-3228• FAX(408)777-3333• building(ckgoertino.org 00 ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TIREVISION EFE� ORIGINAL PERMIT 4 GEO PROJECT ADDRESS APN 4 ` ,�,D -o Ll I (,6 OWNER NAME C /Cc -f ,e>�:+ �S wR PHONE O S �a o E-MAIL /1', 1`� T STET ADDRESS `� ` -F ` O CITY,tSTTATE,ZIP \ l q r� V FAX -^ r\ G (/L? Cor ONE 1E ONE MAIL C.1 C, e ` C ©8 q6 3 - c a ,n"C v ST ET ADDRES CITY,STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGLNIEER ❑ DEVELOPER ❑ TENANT C N'IRACTOR NAME LICENSENUMBER LICENSE TYPE BUS.LIC k �C: e L, V0� MPANY NAME E-MAIL F qC) L 6'7^ 7ez ST ADDRESS C7,STATE,ZIPI f PHONE y Ave- 5 [ - TECT/ENGINEE N E rLCL � �r�}S`h LICENSENUMB BUS.LIC k Cp # Cctick C PANY NAME E-MAIL F�q X/�'p Q - ,n W D 2S7 2 ST T �RESS �. _o C A-` CIS STATE, r cu q 0 3 PHONE ^ Z DESCRIPTION OF WORK h > J EXISTING USE PROPOSED USE CONSTR TYPE S 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 AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH C3ATTACH t.'DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY []YES -- BEINGADDED? ❑NO ADDITION? PRE-APPLICATION El YES IF YES,PROVIDE COPY OF I - - -'-- TOTAL VALUATION: PLANNING APPL£ ❑NO PLANNING APPROVAL LE EICHLER HOME? - = By my signature below,I certify to each of the following: I aln the property o ane uth agent t the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description ork an I it is accurate. I agree to compfy 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. Signature of Applicant/Agent: Date: 17 (�{ SUPPLEMENTAL INTFORA4ATION REQUIRED PL u�c�cK T=YrE Rotizu.G siiP New SFD or Multifamily dvvellin S: Apply for demolition permit for ; � ❑ BDILDINGIIANRE«vt ❑ 'OVER TIiF COIINTER� � r existing building(s). Demolition permit is required prior to issuance of building it, permit for new building. ❑ ,E73RESS # " ❑ PLAT)\I�GPLgig AxREVSEw NO _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ °sTni.nain� ❑#Ptisilclvoxlts 4 form if any Hazardous Materials are being used as part of this project. fks ❑;.LARGE � `"" �' � ❑ FIRE DEPT �� �r tc � Copy of Planning Approval Letter or-Meeting With Planninag prior to ❑T TIA70R'+ � � ❑ SAATT4ItYSE1'VER STRICT submittal of Building Permit application. *-"•�>. �_ ❑..ENVIRON114ENTAZ:"73EALTHx<..,��„-- 31dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 16 RESULTS WAY DATE: 04/17/2014 REVIEWED BY: MELISSA APN: 357 20 041.16 BP#: 14020059 'VALUATION: Iso PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY Commercial Building PENTAMATION 1GENCOM USE: PERMIT TYPE: WORK DEF # 1 - RELOCATE LIGHT POLE LIGHT POLE BASE DETAIL - ISSUED 4/17/14 SCOPE 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 baser[on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS,(Fee Resolution 11-053 Eff 7/1 i Building Department City Of Cupertino \ 10300 Tone Avenue Cupertino,CA 95014-3255 C U P Ir RT I N O Telephone:408-777-3228 Fax:408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: Iii PERMIT# W®aoos 9 OWNER'S NAME: PHONE# qO qb7-1000 GENERAL CONTRACTOR: BUSINESS LICENSE# a (� ADDRESS: 190 C�\oacort AVe SCLAS05e Ca, X5131 CITY/ZIPCODE: SOL". SOSQ- CA *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) 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 Finishingj CC)o Ij 3S l �j Electrical �JYC� ��� 4 C_ D.� 'a 1j`j"37 Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Benchmark Steel Inc 30433 Heating I Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Dryco Construction Inc 31361 Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Ow er/Cont r Signature Datk CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 16 RESULTS WAY CONTRACTOR: HILLHOUSE PERMIT NO: 14020059 CONSTRUCTION OWNER'S NAME: ECI TWO RESULTS LLC 140 CHARCOT AVE DATE ISSUED:04/10/2014 OWNER'S PHONE: 4087839940 SAN JOSE,CA 95131 PHONE NO:(408)467-1000 Il! LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑ RECONFIGURE(E) EMPLOYEE SHUTTLE AREA TO License Class Lic.# 57 C{3�6H INCLUDE Contractor ;I4.0,4C Ce rS} to„LNC.. Date `ff7'I`I (N) ACCESSIBLE RAMP,2(N) BUS SHELTERS,2(N) PERMENANT BENCHES AND ASSOCIATED HARDSCAPE I hereby affirm that 1 am licensed under the provisions of Chapter 9 (]00 (commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. 1 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:$70000 P1 have and will maintain Worker's Compensation Insurance,as provided for by r Section 3700 of the Labor Code,for the performance of the work for which this APN Number:35720042.16 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 W T STARTED correct.l agree to comply with all city and county ordinances and state laws relating WITHIN 180 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 D RO LLED 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 ue te: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. l `) RE-ROOFS: Signature V`1 f Date d'- 141 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 1 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(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. 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(a)should 1 store or handle hazardous 1 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 1 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 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this l� V-4 Date:L1_ permit is issued. Owner or authorized agent: 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,1 must 1 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 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. CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BOILDING DIVISION 10300 TORRE AVENIJE - CUPERTINO CA 95014-3255 140812 777-3228 - FAX (4081 7177-33,33- buddingli&%uperting ori CUPERTINO i ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION:TI ❑ REVISION,DEFERRED ORIGINAL PLRMIT#- PROJFCT%DDRF.SSAPN2 3f-7 1 it If 7'0 -0�t/ 'J� OWNER NAME 1A 11Cu 4611UL,1-5- lxhl' PHONE E IL Padivli:4 AD 44 fl�e CID W ET4-ADDR�ts P CITY.V��6Z,11` 10 FAX " INT vea C0 tv CONT,.1C-.'T ',Ayr P4namlell qnp 7.P3 q?vv ��Lpotv(c4i Aag If ro OdA v I STREET AD F S CITY STATE ZIP FAX -- 0(y P (Aj 0 (A ❑ OWNER ❑ OWNER-BLILDER 0 OW-\ERA6ENT ❑ CO\TP-A(T()R 0 CONTRACTOR AGENT 0 ARCHITECT 13 ENCANEER 11 DE%ELOPER )ICTENANT CONTRACTOR NAME LICENSE NUMBERLICF11 Ns,TYPE BUS,LIC ILLHOUSE CONSTRUCTION CO., INC. 3332111210 H 593668 CLASS B 521 I I— COMPANY NANIF E-MAIL FAX HILLHOUSE CONSTRUCTION CO., INC BARTL@HILLHCUSECONSTRUCTION.COM (408)467-9700 STREET ADDRESS CITY.STATE.ZIP PHONE 140 CHARCOT AVENUE SAN JOSE, CA 95131 (408)467-1000 ARCHITECT ENGINEER NAME LICENSE NLIABER BUS.LIC CL M1,OPAYNAMF 7I ��7 FAX STREET ADDRESS CITN.STATE.ZIP Z PHONE a 129 p- 44 , 1 CAL i r-174L--::r DESCRIPTION OF WORK C LJ C'P-S ^A�o 00 fe'r,V!f--(V%.c 1"ji-Is J0 EXISTING LSE PROPOSED USE CONSTR.TYPE =STORJFS USE TYPE OCC SQ.FT VALUATION(S) EXISTC, NEN%FLOOR DEW TOTAL AREA AREA %REA NET Af(I,,A BATHROOM KITCHEN )e- OTHER REMODEL ARE X REMODEL AREA I REMODEL ARE PORCIIAREAA OTAL DECK— CH ARFA ARFA; DIT\TT\t'H V-14 DECK ARI. ip 7 IS A SECOND I NIT L])ES SECOND STOP, Ts BEING ADDEW v) %OOITIO-47 (3,W PRE-APPLICATION OYES IF YES.PROVIDE COPY or (STHE OLD(NV ONFS TOT L PLANN1\6 \PPL- E3'40 PLA%\M!APPROVAL LETTER EICHLER H,^ 0-0 ,00 C) By my signature below.I certify to each of the follow Ing: I am the om prop — -eiclt-�rty %1k ner or authorized agent to e read thiN application and the inforination I have provided i-<Zect. have scrip in of Work and verify it is accurate. I agree to comply with all applicable local e-I Cf` ordinance-.and state la%ks relat ng to buildin o tio f Cupertino to enter the abo\ d fi property for inspection purposes. buil*l,n 0 1 c1lo Z�%4 —j rtpt�Arr�e 14 1 u� u Signature of Applicant Agent-i Idi ruc Date, I SUPPLEMENT tLIWOP,MATI())e,rfl*�p F PI-0 CHECK TN PE ROUTING SLIP L000� Ne\v SFD or Multifamily d",ellings: Apply for demolition pen-nit for ❑ OtERA HE-COUNTER C3 BLILDINGPI.ANREM%1 existing building(s). Demolition permit is required prior to issuance ol'building permit for new building. C1 EXPRESS ❑ PLANNING PLAN R.EVIEVI Commercial Bldgs: Protide a completed Hazardous Materials Disclosure " kLDe11T%ND%RD 0 Ft BLIC'i4ORKS form if any Hazardous Materials arc being used as part of this project.. 7 13 LARGE C) FIRE DEPT Copy of Planning Appro\al Letter or Meeting\%ith Planning prior to C3 MAJOR ED SANITARN'SIENVIER DISTRICT submittal ol'Building Permit application. C1 ENVIRONMENTAL HEALTH BIJgAj;p_201 Ltfi)c revise(l 06 21 11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 16 RESULTS WAY DATE: 02/11/2014 REVIEWED BY: MELISSA APN: 357 20 041 BP#: a96 `VALUATION: 1$70,000 "PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building PENTAMATION 1GENCOM USE: PERMIT TYPE: WORK RECONFIGURE E EMPLOYEE SHUTTLE AREA TO INCLUDE N ACCESSIBLE RAMP 2 N BUS SCOPE SHELTERS, 2 (N) PERMENANT BENCHES AND ASSOCIATED HARDSCAPE F] I E17-- Ll 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 11-033 Eff 7;1.,13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? ®Yes 0 No $0.00 2 hours Plan Check,Hourly Suppl. PC Fee: Q Reg. Q OTT 0.07 firs $0.00 $278.00 1STPLNCK PME Plan Check: $0.00 Permit Fee: Hourly Only? 0 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 0 Work Without Permit? 4 Yes ) No $0.00 Advanced Plannin, Fee: $0.00 hours Inspections $278.00 ISTINSPInspection, Hourly 0 Strong Motion Fee: IBSEISMIC0 $14.70 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $3.00 SUBTOTALS: $17.70 $556.00 TOTAL FEE: $573.70 Revised: 01115/2014