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13030012 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20030 STEVENS CREEK BLVD CONTRACTOR:JOHNSTONE MOYER, PERMIT NO: 13030012 INC. OWNER'S NAME: PREG BILTMORE 1720 S AMPHLETT BLVD STE 250 DATE ISSUED:06/04/2013 ER'S PHONE: 6509313457 SAN MATEO,CA 94402 PHONE NO:(650)570-6161 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL11 License Class I JLi�c.#1 L g FOUNDATION ONLY—RETAIL Contracto 17145>16�l d- 1J C4' Date 6"4 —,/] 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 whieh this permit is issued. Sq.Ft Floor Arca: Valuation:$0 I have and will maintain Worker's Compensation Insuranee,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:36903004.00 Occupancy c: permit is issued. P YAP APPLICANT CERTIFICATION 1 certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED eorreet.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 DAY M 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 I'7, granting of this pe it. Addits nally,the applicant understands and will comply Issued by: Date: .r with all non-poi s urce re ons per the Cupertino Municipal Cod Section 9.18. • RE-ROOFS: Sigp�t>ars - T 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: Ilse 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 strueture 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 uuder 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 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 i performance of the work for which this permit is issued, will maintain compliance with t uperti unicipal Code,Chapter 9.12 d I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sec 'on 2550 533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this er orAltli. Mcd(agent a, ,.. Dat . L permit is issued. • -�--:��,i, 5:..�,r3�pyFr I certify that in the performance of the work for which this permit is issued,1 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(See.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 pians 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 1� COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 C PERTIIVO (408)777-3228• FAX(408)777-3333•building(Wcupertino.org 1 r1 NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION I TI ❑ REVISION 1 DEFERRED ORIGINAL PERMIT II ^ -- Z PROJECT ADDRESS�?w 4ml- 03 36't—b3—lot OWNERNAMECO-1.1 vv , PHONE ,1 E-MAIL E o STREET ADDRESS � L � r`-_`• CITY,STATE,ZIP t /+ (\ FAX / �L b CONTACT NAME STVqepC'I.S./N o4_V'Ck\e_* �'� '�C -may CA- OWNER ❑ OWNER.BLRLDER ❑ OWNER AGENT L CONTRACTOR ❑CONTRACTOR AGETTr ❑ ARCHTCECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT C L E N Ir3l=� J=t LICENSE TYPE BUS.LIC 9 kA41E V`�`��wl� 6�VilaaAll '�v!@ .cs� � no r r�T�CT� NGI¢IEER)� �w BUm `r �.�� �Y•� G��Vf�J .CAW" VGY'i � V\Y �"G ,STATE•ZCP �j ) DESCRIPTION OF WORK E=,111t 1 ECUUSS CONITR TYPE ISTORIES USE TYPE OCC, SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER VAN REMODEL AREA REMODEL AREA FL REMODEL AREA V�yN PORCH AREA DECK AREA TOTAL DE9K/POf RICH AREA GAR.�GE AREA:•�ATTACH IAvt'-1�]`1 `'"gw'�d ~Wl 4�—'laaph ❑ATTACH !S DWELL�IU T5: ISA SECOND UNIT ❑ACES SECOND STORY 5 BEING ADDED? �"O ADDITION? Be'l PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF Is THE$LOG AN ❑YES =RECEI C]32BY r TOTAL VALUATION: PIANNINGAFPLi! ❑NO PLANNING Al OVAL LETTER EICHLERHOME? ffNO By my signature below,I certify to ac f e following: I am the property owner or authorized agent4o act on the property owner's behalf. I have read this application and the information I h e p vi d is correct. I have read the Description of Work and ve it is accurate. I agree to comply with all applicable local ordinances and state laws relating bui in c stru Fon I authorize representatives of Cupertino to enter the abov-identifiel property for inspection purposes, Signature of Applicant/Agent: Date: // //� SUPPLEMENT C)"10N REQUIRED ~PLAN CHECK TYPE ROUTINGSLIP —New Sl~D or Multifamily Wellings: Apply for demolition permit for [] OVER-THF COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance ofbuilding permit for new building. ❑ 'EXPREs'S1 ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ' ❑ STANDARD E) PUBLICWORKS 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 E ` ❑ ❑ SANITARYSENVER•DLSTRICr' submittal of Building Permit application. - �._❑ ENVMONMENTA.LHEALTA' B1dgApp_2011.dac revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 20030 Stevens creek blvd DATE: 03/04/2013 REVIEWED BY: Mendez APN: BP#: *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1GENCOMA WORK BILTMORE PROJECT- FOUNDATION ONLY FOR RETAIL BUILDING A-C SCOPE Xfech. Plan Check Phunb,Plan Check Elec.Plan Check 1W111&Permit ree Plr+mb. Permix Fee., F.lec.Permit Fee: other ble&hup• Other Plural:1nsp. Other Glee,Insp. Akeh.tnsp.Fee: Plumb.hrsp.Fee: Elce,Imp.Fee: NOTE:This'estimate does not include fees due to other Departments(ie.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'l info. FEE ITEMS(Fee Resolution 11-053 Eft" 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? ©Yes Q No $0.00 16 hours Plan Check,Hourly Suppl.PC Fee: E) Reg. Q OT 0.0 1 hrs $0.00 $2,128.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: Hourly Only? ©Yes (F)No $0.00 Suppl. Insp.Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Constratc:lion Tax: ldminisfrative Fee: Q Work Without Permit? Yes Q No $0.00 Advanced Planning Fee: $0.00 16 hours Inspections d Trmel Docuinenlatlon Fees: $2,128.00 ISTINSP Inspection,Hourly Strong Motion Fee: $0.00 Select an Administrative Item Bldg_Stds Commission Fee: $0.00. y SUBTOTALS:° $0.00 $4,256.00 TOTAL FEE:; $4,256.00 Revised: 01/0112013 DEVELOPER'S PROJECTS--GENERAL NOTES - I. All work shall be in accordance with the State o. .Californiatepartment of Transportation Standard Specifications (dated May 2006),Standard Plans(dated May 2006), and City of Cupertino Standard Details. The Contractor shall perform the work described in the specifications,and as shown on the drawings,and to the satisfaction of the City Engineer. 2. The Contractor is required to notify the Public Works Inspector two (2)working days prior to requiring an inspection. Two (2)working days prior to installing permanent striping,the Contractor shall call for review and approval of the proposed striping by the City Traffic Engineer. The City shall have the right to make changes in the location of the alignment of lane stripes and pavement markings. 3. All underground utilities shall be installed and adequately backfilled before placement of the base material and surface structures. If-utilities are to be installed subsequently, a written notification from the affected utility company indicating its commitment to bore or tunnel shall be submitted to-the City Engineer before proceeding with the work.Underground utilities, except storm and sanitary sewer,will not be permitted in pavement area,with the exception of-street crossings, otherwise specifically approved and authorized by the City Engineer. 4. The Contractor shall have all of the utilities, underground mains,and services that may-conflict with the project, located in the field. The Contractor shall contact Underground Service Alert(USA) two(2)working days in advance of any work, for location of the underground facilities, at(800)642-2444. 5. All trench backfill,fill areas,and base material shall-attain a minimum 95% compaction as per Standard Specifications. For typical trench sections,refer to the City Standard Details, with-the exception of sanitary sewers. 6. All trees,roots and foreign matter in existing or proposed Right of Way shall be removed to a depth of two (2)feet below subgrade and disposed of 7. All existing pavement removed or damaged shall be replaced as required by the City Engineer. S. - All concrete used for all structures mustbe Class"A"(6 sacks per cubic yard)as per Standard Specifications and shall attain a strength of 3,000 p.s.i.in 28 days. SidewalIcs, curbs and gutters shall be Class"B" (5 sacks per cubic yard)as*per Standard Specification and shall attain a strength of 3,000 p.s.i. in 28 days. CITY OF CUPERTINO APP O D BY: `DAT 49-0.10 4 STANDARD DETAILS. CITY ENGINEER Developer's Projects - General Notes (Continued) 9. Drop inlets installed shall be City of Cupertino Standard unless otherwise noted on the plans. The boxes shall be installed at the same time the P.C.C. curb and gutter is installed. Class"A"P.C.C. shall be used. 10. A minimum thickness of six(6)inches of P.C.C. shall be required for commercial driveway approaches and five(5)inches for residential. Locations shall be determined prior to the installation of the curbs. The driveway shall be installed at the same time as the curb. 11. All street curbs shall be vertical P.C.C. curbs. 12. Install City of Cupertino street name signs, four(4) blades each per assembly as shown on the plans. 13. Install City of Cupertino standard monument box(es) and monument(s) as shown on the plans. 14. All grade.stakes and laths required by the City Engineer shall be installed by the Developer's Engineer as directed. Minimum off-sets for cut stakes shall be five (5) feet. Developer's Engineer to certify that location of new sidewalk, curb and gutter is in accordance with the approved plans. 15. Prior to commencing work,the Contractor shall have cut sheets approved by the City Engineer. Notify the City Engineer two (2)working days prior to requiring inspection. M. The Contractor shall submit a written request for final inspection. 17. One pound of dispersing black shall be mixed with each cubic yard of concrete at the batch plant. 18. Grading of lots outside of RIW as per typical section and for cross-section, shall be completed and approved bythe City Engineer before proceeding with preparation of the subgrade and placement of surface structures on lots. All lots shall be graded to the street elevation, or as shown on the plans,or as determined by the City Engineer. 19. Notify the City Engineer two (2)working days in advance of requiring services for checking field staking. At this time,three(3) copies of the cut sheets will be famished. CITY OF CUPER11NOAPPROV C FE� � 5 STANDARD DETAILS CI4YEM�G[ E Developer's Projects -General Notes (Continued) 20. All standard street monuments, lot comer pipes, and other permanent monuments disturbed during construction shall be replaced before acceptance of the improvements by the City of Cupertino. 21. Manhole frames and covers shall be brought to finish grade before final paving. 22. The Developer shall pay all costs for moisture-density curves (Calif.Test No. 216E)and any other tests required by the City Engineer during street construction. 23. Approval of these plans does not release the Contractor of the responsibility for the corrections of mistakes, errors, or omissions contained therein. If, during the course of construction of improvements, public- interest requires a modification of/or a departure from the City of Cupertino specification or these improvements plans, the City Engineer shall have the authority to'require such modification or departure and to specify the manner in which the same is to be completed. 24. Septic tanks shall be pumped and backfilled to the satisfaction of Santa Clara County Health Department prior to construction. 25. For all five(5)foot monolithic sidewalks, all fire hydrants and electroliers shall be installed behind sidewalk. 26. It shall be the responsibility of the Contractor, and all Subcontractors to insure they are fun-Ashed with approved plans or the latest revised plans. 27. All water lines,valves,hydrants, and appurtenances thereto installed within the City of Cupertino Municipal Water Utility's services area, shall be the property of said water utility. 28. Construction signing shall be installed prior to beo nning of work. 29. Notify City•of Cupertino Traffic Signal Maintenance for inspection of foundation excavations, (408)777-3.380,two (2)working days prior to pouring any cabinet or signal foundations relating to this job. 30. Any and all storm lines installed as part of the work on these plans shall be cleaned of all excess material, debris and obstructions. Storm lines shall be flushed as directed by the City Engineer. F-CITY OF C7ERTIN0 APPROVE D � 6 STANDARD DETAILS CITY ENGINES