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13110152 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20620 HOMESTEAD RD CONTRACTOR:MARKET PERMIT NO: 13110152 CONTRACTORS OWNER'S NANIE: THE SOBRATO ORGANIZATION 10250 NE MARX ST DATE ISSUED:03/31/2014 OWNER'S PHONE: 9254674291 PORTLAND,OR 97220 PHONE NO:(503)255-0977 ' LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL I—] COMMERCIAL ❑ US BANK-LOCATED IN SAFEWAY-COMM.T.I 448 SQ FT License Class 12_ Lic.# �([ TO INCLUDE NEW SET UP M,E Contractor Dat '/ EV# 1 -DETAILS FOR EQUIPMENT ANCHORAGE- I hereby nffirm that I am licensed under the provisions of Chapter 9 ISSUED 4/22/2014 (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 o nmdon,as provided for by Section 3700 of the Labor Code,for the rformance of the work for which this permit is issued. Sq.Ft Floor Arca: Valuation:5100000 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 far which this APN Nnmber:32610066,20620 Occupancy Type: permit is issued. APPLICANT CERTIFICATION 1 certify that 1 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 180 F + 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 + 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 withal?non-point source regulations per the Cupertino Municipal Code,Section 9.18. / RE-ROOFS: Signature Date r r 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-BUILD16 DECLARATION Signature of Applicant: Date: I hereby affirm that I am 4empt 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, 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 Cade). f have read the hazardous materials requirements under Chapter 6,95 of the California Hcalth&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the fallowing three maintain compliance with the Cupertino Municipal Cade,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 f use equipment or devices which emit hazardous Compcnsation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Arca 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 1 have and will maintain Worker's Compensation insurance,as provided for by the Health&Safety Cade,Sectio 2 505,2 it,and 5534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date permit is issued. 1 certify that in the performance of the work for which this permit is issued,l 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 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. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUP1~RTIhIO (408)777-3228• FAX(408)777-3333• buildiing(a ccuperlinO.org [:]NEW CONSTRUC710N ❑ ADDITION ❑ ALTERATION/TI LJ VISI; /DEFERRED ORIGINAL PERMIT 4 PROJECT ADDRESS ? APN 4 OWNERNAME:f�� Q G PHONE E-M(AATL STREET ADDRESS 0,,, 0 CJTY IA�,-P �L� FAX CONTACT NAME [J P D �/KJ� TIE STREET AQ�M/ O #f ` CITYTATE �Q K FAX9 OWNER 13OWNER-BUILDE3t OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT -❑ ARCHITECT ❑ENGWEER ❑ DEVELOPER ❑TENANT O JJ Q!G RyX N C L10EL�v. me ' TYPE BUS.LIC 9 COMPAmE 1Qyx E- L �J!/' P STREETS A D S�� C ,,ST�� /,V' ARC( /ErI�R N � L LION— Ma ( L HUS.LIC tl4 (O COMP A / N e I�� �a�(/ V---5� l G�.ti F / —A –!57 DESCRIPTION OF WORK l C`ar��I TiO L EXISTING USE PROPOSED USE CONSTR TYPE C STORIES USE TYPE OCC• SQFT, VALUATION(S) E=TG NEW FLOOR DEMO TOTAL AREA AREA AREA A'EC AREA BATHROOM KrrCHEN OTHER REMODEL AREA RLNtODEL AREA REMODEL AREA FORI'.HAREA DECK AREA TOTALDECKIPGRCH AREA GARAGEAREA: IIETACH ATTACH S 9 DWELLING UNITS: ISASECOND UNIT YES SECONDSTORY ❑YES BEINGADDED! []NO ADDITION' ❑NO PLANNINGAPPLO ONO PLANNING APPROVAL EFER EICHLERHO�E4 YES W YES,PROWDE copy OF 15 THE BLDG AN El YES ..H '+Y = .'y"•"',Ba;" !�M°:. "`}- ALVALUAT[ON: 5 r'v By my signature below,I certify to each of the following: 1 am the property owner or authorize e o act on the erty owner's behalf. I have read this application and the information 1 have pro 'ded is correct ave read the Description of Work and verily it is rate. I agree to comply with all applicable local ordinances and state laws relating to b i g construe' I authori representatives afCupertino to enter the abo e-identified grope /yr in ion purposes. Signature of Applicant/Agent: Date: V SUPPLEMENT INFOR-MATT =permit D � S'�Ty._�'h-#New SFD Gr Multifamily dwellings: Apply far for OVfiEITfICOp[1TERSiJIIAIhGPLAIREV[Eti{r w. existing building(s). Demolition permit is required prior to issuance of building ^ �4 e tn .l f Ewa_ 3fi permit for new building. �� EaPssaJt�, + ®ztel"dlnvcrL�tt tiEVlEwr „ ,r _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure des naz� nf ei�et IcwxlcS form if any Hazardous Materials are being used as part of this project. _Copy of Planning Approval Letter or Meeting with Pla tnin prior to #s L�.TRf�-s r ® SAtYIT' SElY iDISIkIGT+ 3�' submittal of Building Permit application. t�x r w fah "'. , @WON }=1IFALTFIa B1d&4pp_A11.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 24620 HOMESTEAD RD DATE: 44/22/2014 REVIEWED BY: MELISSA APN: 326 10 066 BP#: 13110152 "VALUATION: Iso *PERMITTYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY PENTAMATION USE: °ri Wil' E ilding PERMIT TYPE: 1GENCOM WOI 'REV# 1 - DETAI S FOR EQUIPMENT ANCHORAGE - ISSUED 4122/2014 S ,' 'Pig 'Ahech Phan("hcck phrnr/7 plan Chccd L"Ice Plan Chick 7Lt1c.17 peosill Fce. PhInTh Peonir Fee, Ga penr7u Fa c'' Onci r MCCh. Inst Orher Plumh Insp Orhur Gler. 111.sp 11cch Insp. Fre' Phur7h. hcvp. Fed. Oce h7sp.FL-C. NOTE: This esfiniale does nol includefees clue to olherDepartmenls(i.e.Planning,Public Works, Fire,Sanitary Se7verDistrict,School District,eta). These ees are based on the relinrinarp information available and are anly an estimate. Contact the Detor adeln 7 info. FEE ITEMS (Fee Resohntion 11-053 E177711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? O Yes Q No $0.00 hours flan Check,Hourly Supp[. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $278.00 1STPLNCK PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee;Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Cw1viniction Tux: ilclrniuictr•crtive Fee: O Work Without Permit? O Yes (F) No $0.00 0 Advanced Planninp-Fee: $0.00 Select a Non-Residential (D Building or Structure 7ru}�rl l�ncrr►nerrtulinrr Fees,- Building � Strong, Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $278.00 TOTAL FEE: 1 $278.00 Revised: 0410 112 01 4 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20620 HOMESTEAD RD CONTRACTOR:MARKET PERMIT NO: 13110152 CONTRACTORS OWNER'S NAME: THE SOBRATO ORGANIZATION 10250 NE MARX ST DATE ISSUED:03/31/2014 O&NER'S PHONE: 9254674291 PORTLAND,OR 97220 PHONE NO:(503)255-0977 • LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL E] { US BANK-LOCATED IN SAFEWAY-COMM.T.I 448 SQ FT � J License Class Lie.# TO INCLUDE NEW SET UP M,E Contractor Date '?-3)20 1 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 Arca: Valuation;$100000 1 have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this APN Number:32610066.20620 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED eorrect.I agree to comply with all city and county ordinances and state laws relating WITHIN PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY OM LA$r 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 2/ granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-paint source regulaf ns per the C ertino Municipal Code,Section 9.18. r ,,. RF.-ROOFS: $ ate�re . _ 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. ❑ O\VNER-BUILDER DECLARATION I 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(Sce.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HA7ARDOUS 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 thi 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 hazardo Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management Districk performance of the work for which this permit is issued, will maintain compliauce with a Cupertino Municipa Code,Chapter 9.I2 anj I have and will maintain Worker's Compensation Insurance,as provided for by the Ilcalth&Safety Codc, c io s 25505,25 ,an 5534. Section 3700 of the Labor Code,for the performance of the work for which this T permit is issued. nct I gent Datc: 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 1 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 aceruc 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 CUPERTIN0 1 (408)777-3228 • FAX (408)777-3333- build inaCdcupertino.orcl 13 ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION `/DEFERRED ORRIQGINAL PERMIT# "'U"'6'20 ROJEC ADD -r IED 7.061) APN 0 J I _ it)s O l OWNERNAME P ONE (� E-MAIL 925) ,/ zy/ STREETADDRESS CITY,STATE,ZIP AX G 57E � � 2 7`L� CONT CTAMEN C '1 P!O� 17w 6,7 WL (F.maC STREET ADDRESS 1TY,STATE, ZIP FAdIJ•GDCy1 D2- 0 >e 5�• r R '77Z2c) iOMSZ 7- ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGLNr CONTRACTOR ❑CONTRACIORAGENr ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTQRNAME �� LIC NU �EQR f LICENSJVPE IBUS.LICl$ O��-r. l; Q J S ]S t{1VQIGt tt �.S NAW-'-f�A C Nt TO S MAIL anie c mQrke�' �r rs aAX . 3 S/7- 7 TREET ADDRESS ,STATE,ZIP PHO D 50 Alm HALN .A. 'TLAN OF, 9-7Z--ZD ARCHITE !ENGINEER NAM LICENSE NUMBER BUS.LIC 1t OM ANY NAME, Q�` E- Al Om .FAX 7/F- I w ^5 STREET ADDRESS 0 CITY,STATE,ZIP JPHONE ! rJi ZAP q 1"1 vz, 15-1a. r-0v 8d 2 !av -1..53G DESCRIPTION OF WORK EXISTING USE PROPOSEDUSE CONSTR.TYPE I 111TORIES USE TYPE OCC. SQ.FI'. VALUATION(S) EXISTG NEW FLOOR DEMO 1 TOTAL I ' AREA L/[/Q AREA L/ e AREA y IIIA NETAREA BATHROOM KITCHEN OTHER REMODELAREA A RENIODELAREA NA REMODFLAREA PORCIIARBA DECK AREA TOTALDECKIPORCIiAREA GARAGE AREA: DEi'ACFi N0\Orr, ❑ATTACII #DWELLING UNITS: IS A SECOND UNIT OYES SECOND STORY OYES BEINGADDEDj _N ONO ADDITION? `lA ONO PR&APPLICATION ❑YES IF YES.PROVIDE COPY OF 1STIIEDLDOAN ❑YES RECEIVE DY• TOT/1 V LUAT[OiTt PLANNINGAPPLd ONO PLANNING APPROVAL LEITER EICHLER1iOT10 f�CNO 8y my signature below,I certify to tach of the following: I am the property owner or authorized a t to net 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 necurate. I agree to comply with all applicable local ordinances and sL aws re! uil 'ng�onstru n. ),authorize representatives of Cupertino to enter the above-idcntiF property For inspection purposes. Signature of App'cantlAgent: Date: L SUP TALI FORMATION ?VD PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-TiIE COUNTER IIUILDING PLAN REVIEW building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS PLANNING PLAN REVIEW _Commercial Rldgs: Provide a completed Hazardous Materials Disclosure TANDARD ❑_ PUBLIC WORKS oonni if any Hazardous Materials are being used as part Of this project ❑ LARCC FIRE DEFT _Copy Of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑ MAJOR SAN[TARY SEWER DISTRICT ❑ ENVIRONMENTAL IIEALTII BIdg,4pp 10ll.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 20620 homestea rd DATE: 11121/2013 REVIEWED BY: MENDEZ APN: BP#: S a� "VALUATION: 1$100,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1 B TI WORK [qLbank-located in safewa -comm. U 448 sq ft to include new set up m e SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B (Tenant Improvements) Il-B,III B,IV,V-B 448 $2,046.22 IBTIPLNCK $703,74 IBTIINSP TOTALS: 448 $2,046.22 $703.74 MECH,HOURLY O Yes Q No PLUMB,HOURLY O Yes 'Q No ELEC,HOURLY Q Yes Q No Mock Plan Check Planth. Plan Check flee.Plan Check Lech,Permit Fee: Plumb.Permit Fee: Elec.Permit Fee: Other Alvch.Insp. =7-- Other Plumb Imp. Other Efec. Insp. tlech.hasp. Fee: Plumb, hap.Fee: Elev.Insp,Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,em). Thesefees are based on lite prefindnary information available and are only an estimate Contact the Det or addit'1 in o. FEE ITEMS(Fee Resoltrflon 11-053 E11' 7/1/131 FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,046.22 Select a Misc Bldg/Structure Suppl.PC Fee: Q Reg. Q OT 0.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $703.74 Suppl. Insp..Fee:Q Reg. O OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 1 Construclion Tax: .4dininistralive Fee: O Work Without Permit? O Yes Q No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential O Travel Documentation Fees: Building or Structure O i Strong Motion Fee: IBSEISAHCO $21.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $4.00 SUBTOTALS: $2,774.96 $0.00 TOTAL FEE: $2}7-7T40.96 Revised: 10/0112013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone:408-777-3228 C U P E RT I N O Fax:408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: �� PERMIT# 1:3140115S OWNER'S NAME: PHONE# 563-2-65-9V GENERAL CONTRACTOR: L22a� BUSINESS LICENSE# Z '' ADDRESS: 167- p d y- CITY/ZIPCODE: Pb 7 Za 'Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSSINESS LICENSE# Cabinets &Millwork C 5T Cement Finishing Electrical Excavation Fencing Flooring/Carpeting L Linoleum/Woody Glass/Glazing Heating s �LQ fact, L� Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbin '�e- -�� i Roofing 13 50 Septic Tank Sheet Metal Sheet Rock Tile ZD/ wne Contractor Signature Date APPLICATION FOR CERTIFICATE OF OCCUPANCY OR CERTIFICATE OF COMPLETION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTlNO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE - CUPERTINO,CA 95014-3255 (408)777-3228-FAX(408)777-3333• building(okupertino.cra COMPLE�T�E�jA SEPARATE APPLICATION FOR EACH BUILDING: �] PROJECT AD+ e6Z'0jq liYL P API / /o/. DATE -L`�/Lr OWNER N.'ffE � PHO ' � �� EMAIL 7 STREETADDR@SS CITY,STATE,ZIP 'f FAX CONT' OR N ME rFlO E-MAIL 51'RE$T ADDRESS C STT ,ZIP FAX d Z � g z zc� �3 Z62- 5`3 MAIL CERTIFICATE TO: (Please allow up to 10 business days for delivery): CONTACrNAMEhc ,e PHONE� STREE' £S�n C ,STATE,ZIP y (2z'CD F -Z,O LIST ALL BUILDING PERMITS ISSUED FOR PROJECT: PERMIT SUBMIT ISSUE DATE INSPECTOR SCOPE NUMBER DATE DATE FINALED / l X0152 3�-1 `7`25-1 -TL- Wei ,d ,---,k ,I�c 2 3 OCCUPANCY DATA: USE OCCUPANCY TYPE FLOOR AREA OCCUPANT LOAD 2 3 4 BUILDING DATA: 0 STORIES d STORIES OVERALL MAX OCCUPANT FIRE SPRINKLERS FIRE SPRINKLERS BELOW GRADE ABOVE GRADE FLOOR AREA LOAD REQUIRED YES OR NO PROVIDED YES OR NO 9 PARKING N STANDARD/COMPACT P ACCESSIBLE R1; UIRFD PARKING PROVIDED PARKING PROVIDED NOTE: ATTACH A COPY OF THE SIGNED INSPECTION CARD TO THIS APPLICATION. - OFFICE USE ONLY(To be completed by inspector of record)- SPECIAL STIPULATIONS OR CONDITIONS: CoJO Applicarion.rloc•revise!0107112 2010 CALGREEN NON-RESIDENTIAL CHECKLIST-- leg MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E. C.BA. BUILDING OFFICIAL CUPERTL#+1<d A A 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 ��[ (408)777-3228•FAX(408)777-3333•buildirtg@cupertino.ora �T 4 �. PURPOSE: The non-residential provisions of the 2010 CalGreen Code outline planning, design and development methods that Include environmentally responsible site selection, building design, building siting and development to protect, restore and enhance the environmental quality of the site and respect the integrity of adjacent properties; establishes the means of conserving water used indoors, outdoors and in wastewater conveyance; outlines means of achieving material conservation and resource efficiency; and outlines meansiof reducing the quantity of air contaminants. 7 Project Name: oL o ,�- ,�� C U-to. Cr &.0 CCL rAVIS Project Address: Q0I�-eco Project Description: _VA-S4N f jPA r f-'0Q .S Pay-y Q;O- 6 o' b ra,k&. Instructions: 1. The Owner or the Owners agent shall employ a licensed professional experienced with the 2010 California Green Building Standards Codes to verify and assure that aii required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2-Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Re uirements CHAPTER 5 MANDATORY MEASURES - :�:., ..;'�., .,,... .. .-,.�!'Y-CiN.,,,;.53Y�'C�•n..f,- - _,_..� �s�.�n,:- -.._-__�� _-:.-:C::y �.a -..-_._"� x..r3�r..9sY_:a:.'fn..,:4....�a�,. ..�',��r�- The project meets all the requirements of Divisions 5.1 through 5.5. © ❑ Division 5.1 PLANNING A ND ! �l r `'�'ft, �aF;s-�...Y-`'`� �'':�_� `��-t��S���. `�''•v-,���. '��"'���.,.- r xa'7� ssa=-�`--.:�^3r'f'�'+ ,.�1'S�'�'`x�.s"` ,��""_�-��+�.. 5.106.1 Storm water pollution prevention plan. For projects of one acre or tj A't ii less,develop a Storm Water Pollution Prevention Plan(SWPPP)that has been designed,specific to its site, conforming to the State Storm water NPDES Construction Permit or local ordinance,whichever is stricter,as is required for �� r projects over one acre.The plan should cover prevention of soil loss by storm water run-off and/or wind erosion, of sedimentation andlor of dust/particulate matter air pollution. Page I of 9 CalGmen Non-Res Checklisl.doc revised OW7111 5.106.4 Bicycle parking and changing rooms.Comply with Sections N X AV ❑ 5.106.4.1 and 6.106.4.2;or meet local ordinance,whichever is stricter. 5.106.4.1 Short-Term bicycle parking. if the project is anticipated to generate visitor traffic,provide permanently anchored bicycle racks within ml A- U1j 200 feet of the visitors'entrance, readily visible to passers-by,for 5 percent X ❑ of visitor motorized vehicle parking capacity,with a minimum of one two- bike capacity rack. ?-0, ,,, 5.106.4.2 Long-Term bicycle parking. For buildings with over 10 tenant- tsl /.i4-' ❑ occupants,provide secure bicycle parking for 5 percent of tenant-occupied motorized vehicle parking capacity,with a minimum of one space. S2,0� 5.106.5.2 designated parking.Provide designated parking for any combination of low-emitting,fuel-efficient and carpooUvan pool vehicles as ❑ shown in Table 6.106.6.2. 0 C 5.106.13 Light pollution reduction.Comply with lighting power requirements in the California Energy Code and design interior and exterior lighting such that ,_ 1 zero direct-beam illumination leaves the building site. Meet or exceed exterior U! light levels and uniformity ratios for lighting zones 1 —4 as defined in Chapter 10 of the Caftmia Administrative Code, using the following strategies: 1. Shield all exterior luminaires or use cutoff luminaires. ❑ 2. Contain interior lighting within each source. © ❑ 3.Allow no more than.01 horizontal foot candle 15 ft beyond the site. &"v © ❑ 4.Contain all exterior lighting within properly boundaries. El Exception: See Part 2,Chapter 12, Section 1206.6 for campus lighting requirements for parking facilities and walkways. 5.106.10 Grading and paving.The site shall be planned and developed to keep surface water away from buildings.Construction plans shall indicate how QX ❑ site grading or a drainage system will manage all surface water flows. �' .� r� F�4X,131�T+,���i7�l.9IIIE5[�t��ti. �', � �^�y.�'� .ti-`"�r��r 1• -••mF��'-.a%�,m.,bra ` -,�,-�.,i�..•. 5.201.1 Scope.The California Energy Commission will continue to adopt mandatory building standards.' "` El DiVisibn 5.303.1 Meters.Separate meters shall be installed for the uses described in Af 'f,\ Sections 503.1.1 through 503.1.3. 1! 5.303.1.1 Buildings in excess of 50,000 square feet.Separate ,�� ❑X a-,/ ❑ submeters shall be installed as follows: 1. For each individual leased,rented or other tenant space within the ,fjU Elprojected to consume more than 104 allda . 4,A, o t,, Page 2 of 9 CalGreen Non-Res Cheeklistdoe revised 08127111 2. For spaces used for laundry or cleaners, restaurant or food service, urs- AUO medical or dental office,laboratory or beauty salon or barber shop projected to consume more than 104 gallday. « 5.303.9.2 Excess consumption.Any building within a project or space within a building that is projected to consume more than 1,000 gal/day. 5.303.2 20 percent savings.A schedule of plumbing fixtures and fixture x f fittings that will reduce the overall use of potable water within the building by 20 percent shall be provided. (Calculate savings by Water Use Worksheets) 5.303.2.1 Multiple showerheads serving one shower.When single shower fixtures are served by more than one showerhead,the combined Ail 1 r�' ❑ flow rate of all the showerheads shall not exceed the maximum flow rates "X specified in the 20 percent reduction column contained in Table 5.303.2.3 or the shower shall be designed to only allow one showerhead to be in operation at a time. 5.303.4 Wastewater reduction. Each building shall reduce the generation of 1Uf # wastewater by one of the following methods; As applicable 1, The installation of water-conserving fixtures or �X 2. Utilizing non-potable water systems. 5.303.6 Plumbing fixtures and fittings. Plumbing fixtures{water closets and 1t A7 M urinals)and fittings(faucets and showerheads)shall comply with the requirements listed for each type in Items listed in Table 5.303.6. As applicable 1.Water closets(toilets)--flushometer type TM 2.Water closets(toilets)—tank type ❑X Q 3. Urinals [X 4. Public lavatory faucets QX 5. Public metering self-closing faucets 0 6. Residential bathroom lavatory sink faucet © [� 7. Residential kitchen faucetsEl 8. Residential shower heads El 9.Single shower fixtures served by more than one showerhead [X] Ol��{I4D1' 8�8T-�Se�' � � �` � �'�� s 1 J- } a� �, ;Ya k ,•, 4 " s x3 a' ", � 5.304.1 Water budget.A water budget shall be developed for landscape A irrigation use. 5.304.2 Outdoor potable water use. For new water service,separate meters or submeters shall be installed for indoor and outdoor potable water use for �X Q landscaped areas between 1,000 square feet and 5,000 square feet. , [ 5.304.3 Irrigation design,In new nonresidential projects with between 1,000 and 2,500 square feet of landscaped area(the level at which the MLO As applicable applies), instal(irrigation controllers and sensors which include the following X criteria and meet manufacturer's recommendations. Page 3 of 9 CalGreen Non-Res Checklistdoc revised 081 7/11 5.304.3.1 Irrigation controllers.Automatic irrigation system controllers 7 installed at the time of final inspection shall comply with the following, 7 c cd~ 1.Controllers shall be weather-or soil moisture-based controllers that automatically adjust irrigation in response to changes in plants'needs as �X weather conditions change. 2.Weather-based controllers without integral rain sensors or �Jl� communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicates with the controllers).Soil moisture-based controllers are not required to have rain sensor input. �J-� t`, ' }�___� x�;- y -.u.g�,.�r•^.�-ham-_._.�3,�`a ��w�.�t��c�s ��r.��-4e,v �t '�{.�-�.� �;�,.�-��+�,.. 5.407.1 Weather protection,Provide a weather-resistant exterior wall and GJ foundation envelope as required by California Building Coda Section 1403.2 and California Energy Code Section 150,manufacturer's installation instructions or local ordinance,whichever is more stringent.' 5.407.2 Moisture control. Employ moisture control measures by the following ri methods; 5.407.2.1 Sprinklers, Prevent irrigation spray on structures. ]X '5.407.2.2 Entries and openings. Design exterior entries and openings to prevent water intrusion into buildings. ", " ^�i vz- "fid ;3,ir .`-k �� "n�' �.•# ,,-� 5,408.1 Construction waste diversion. Establish a construction waste management plan or meet local ordinance,whichever is more stringent , rf 5,408.2 Construction waste management plan. Submit plan per this section to enforcement authority. bQ 5.408.2.1 documentation. Provide documenta5on of the waste management plan that meets the requirements listed in Section 5.408,2 �]X Items 1 thru 4 and the plan is accessible to the enforcement authority. 5.408,2,2 Isolated jobsites.The enforcing agency may make exceptions to the requirements of this section when jobsites are located in areas El beyond the haul boundaries of the diversion facility. 5.408.3 Construction waste.Recycle andlor salvage for reuse a minimum of 50 percent of nonhazardous construction and demolition debris or meet local ordinance,whichever is more stringent. Exceptions; 1. Excavated soil and land-clearing debris. 2.Alternate waste reduction methods developed by working with local agencies if diversion or recycle facilities capable of compliance with this item do not exist. 5.408.4 Excavated soil and land clearing debris. 100 percent of trees, stumps, rocks and associated vegetation and soils resulting primarily from land Q [] clearing shall be reused or recycled. Page 4 of 9 CalGram Non Res ChecklrsLdoc revised 08117/11 Biitlding�SIf��BrlanG£ arid_ ©�3a1'a�i�ri�r��y 4 � y '�a@4 1y4 a�f r i t� }- 5.410.1 Recycling by occupants.Provide readily accessible areas that serve the entire building and are identified for the depositing,storage and collection XC� of nonhazardous materials for recycling. 5.410.2 Commissioning. For new buildings 10,000 square feet and over, �] building commissioning for all building systems covered by T24, Part 6, process systems and renewable energy systems shall be included in the design and construction processes of the building project.Commissioning t)VIP requirements shall include items listed in Section 5.410.2. 5.490.2.1 Owner's Project Requirements(OPR).•Documented before the design phase of the project begins the OPR shall include items listed in Section 5.410.4. 1 LN 5.410.2.2 Basis of Resign (BOD).A written explanation of how the design of the building systems meets the OPR shall be completed at the design phase of the building project and updated periodically to cover the systems �]X listed in Section 5.410.2.2. 5.410.2.3 Commissioning plan.A commissioning plan describing how the project will be commissioned shall be started during the design phase of the building project and shall include items listed in Section 5.410.2.3. 5.414.2.4 Functional performance testing shall demonstrate the correct installation and operation of each component, system and system-to- Q system interface in accordance with the approved plans and specifications. 5.410,2.5 Documentation and training.A Systems manual and systems operations training are required. �kk /T 5.410.2.5.1 Systems manual.The systems manual shall be delivered to 1 C� the building owner or representative and facilities operator and shall ® [] include the items listed in Section 5.410.2.5.1. k 5.410.2.5.2 Systems operations training.The training of the appropriate maintenance staff for each equipment type and/or system F shall include items listed in Section 5.410.2.5.2. El 5.410.2,6 Commissioning report.A complete report of commissioning process activities undertaken through the design,construction and reporting recommendations for past-construction phases of the building ® 0 project shall be completed and provided to the owner or representative. 5.410.4 Testing and adjusting.Testing and adjusting of systems shall be required for buildings less than 10,000 square feet. 5,410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems. Systems to be included for testing and adjusting shall include, as applicable to the project,the systems listed in Section 13 5.410.3.2. 5.410.4.3 Procedures. Perform testing and adjusting procedures in accordance with industry best practices and applicable national standards RL on each system. T,� 5.410.4.3.1 HVAC balancing.Before a new space-conditioning system serving a building or space is operated for normal use,the system Q should be balanced in accordance with the procedures defined by national standards listed in Section 5.410.3.3.1. Page 5 of 9 CulGreen Non-Res Checklisi,doc revised 08121111 5.410.4.4 Reporting.After completion of testing, adjusfing and balancing, provide a final report of testing signed by the individual responsible for performing these services. El 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed operating and maintenance instructions and copies of guarantieslwarranfies for each system prior to final inspection. 5.410.4.5.1 inspections and reports. Include a copy of all inspection verifications and reports required by the enforcing agency. 0 El 5.503.1 Install only a direct-vent sealed-combustion gas or sealed wood- El burning fireplace or a sealed woodstove and refer to residential requirements f in the California Energy Code,Title 24, Part 6,Subchapter 7, Section 150_ 5.503.'1.1 Woodstoves.Woodstoves shall comply with US EPA Phase 11 emission limits. El E- x 5.504.3 Covering of duct openings and protection of mechanical equipment during construction.At the time of rough installation or during storage on the construction site and until final startup of the heating and cooling equipment, all duct and other related air distribution component openings shall be covered with tape,plastic, sheet metal or other methods acceptable to the enforcing agency to reduce the amount of dust or debris which may collect in the system_ 5.504.4 Finish material pollutant control.Finish materials shall comply with Sections 5.504.4.1 through 5.504.4.4. 5.504.4.1 Adhesives, sealants,caulks.Adhesives and sealants used on the projectshall meet the requirements of the following standards. 1.Adhesives, adhesive bonding primers, adhesive primers, sealants, sealant primers and caulks shall comply with local or regional air pollution control or air quality management district rules where applicable or 0 SCAQMD Rule 1168 VOC limits,as shown in Tables 5.504.4.1 and 5.504.4.2. 2.Aerosol adhesives and smaller unit sizes of adhesives and sealant or caulking compounds(in units of product, less packaging,which do not weigh more than one pound and do not consist of more than 16 fluid ounces)shall comply with statewide VOC standards and other ❑X requirements,including prohibitions on use of certain toxic compounds,of California Code of Regulations,Title 17,commencing with Section 94507. 5.504.4.3 Paints and coatings.Architectural paints and coatings shall comply with Table 5.504.4.3 unless more stringent local limits apply. ❑X 5.504.4.3.1 Aerosol paints and coatings.Aerosol paints and coatings shall meet the Product-Weighted MIR Limits for ROC in Section 94522(a)(3) and other requirements,including prohibitions on use of f certain toxic compounds and ozone depleting substances(CCR,Title 17, Section 94520 et seq). " Page 6 of 9 CalGreen Non-Res ChecklisLdoc revised 08 7111 5,504.4.3.2 Verification.Verification of compliance with this section shall be provided at the 'request of the enforcing agency. 5.504.4.4 Carpet systems.All carpet installed in the building interior shall meet the testing and product requirements of one of the standards listed in Section 5.504.4.4. L^� 5.504.4.4.1 Carpet cushion.All carpet cushion installed in the building interior shall meet the requirements of the Carpet and Rug Institute Green Label program. 5.504.4.4.2 Carpet adhesive.All carpet adhesive shall meet the requirements of Table 804.4.1. -N 5.504.4.5 Composite wood products.Hardwood plywood, particleboard and medium density fiberboard composite wood products used on the interior or exterior of the building shall meet the requirements for Q [] formaldehyde as specified in Table 5.504.4. 5.504.4.5.2 Documentation.Verification of compliance with this section ' shall be provided as requested by the enforcing agency. Documentation shall include at least one of the following: As applicable 1. Product certifications and specifications nX 2. Chain of custody certifications © [� 3.Other methods acceptable to the enforcing agency 5.504:4.5 Resilient flooring systems.Comply with the VOC-emission limits defined in the 2009 CHIPS criteria and listed on its Low-emitting r-/ Materials List(or Product Registry)or certified under the FloorScore J program of the Resilient Floor Covering Institute. 5.504.5.3 Filters. In mechanically ventilated buildings, provide regularly �1 occupied areas of the building with air filtration media for outside and [� return air prior to occupancy that provides at least a MERV of 8. 5.504.7 Environmental tobacco smoke(ET5)control.Prohibit smoking within 25 feet of building entries, outdoor air intakes and operable windows where outdoor areas are provided for smoking and in buildings;or as enforced by ordinances,regulations or policies of any city,county, city and county, California Community College, campus of the Califomia State University or campus of the University of California,whichever are more stringent. ST��4V#/Tf4f tli V37��)'G Vit L��R'������nL�'V!J I t � y.S -� C,�i:-. �aY.�. t � f�ia'-" ,� C/f— Z" �.-, lam' y/ 'f. � . 3� Y"•'Yf - y�:, 5.505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of Callfamia Building Code, CCR,Title 24, Part 2, Sections 1203 and Chapter 14.1.' ,l�17T�+17��tt�f'�1�L��Xf1�#1a� 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings, meet the minimum requirements of Section 121 of the California Energy Corte, CCR, Title 24, Part 6 and Chapter 4 of CCR,Title B or the applicable local code,whichever is more stringent.' Page 7 of 9 CalGreen Non-Res Checklisl.doc revised ON7111 i 5.506.2 Carbon dioxide(CO2)monitoring. For buildings equipped with demand control ventilation,CO2 sensors and ventilation controls shall be r�YJ ❑ specified and installed ih accordance with the requirements of the latest edition of the California Energy Code, CCR,Title 24, Part 6,Section 121(c). '- -��}• yam„fi ,' .:vr, "� � £ --a h-�. 2. C� „i � - �,r F�, � ' ^-z`' x '_"" 7,"tr"�''1'F 'tc s"r - +rr' '.r b M �� _10 RX-MMA Y`z � "l �y ,;. ''3t .. --_:N PRE-- _. 5.507.4 Acoustical control. Employ building assemblies and components with STC values determined in accordance with ASTM E 90 and ASTM E 413. El 5,507.4.1 Exterior noise transmission.Wall and floor-ceiling assemblies making up the building envelope shall have an STC of at least 50 and f exterior windows shall have a minimum STC of 30 for any of the building r +a QX locations listed in Items 1 through 3 in Section 5.507.5.1. 5.507.4.2 Interior sound.Wall and floor-ceiling assemblies separating tenant spaces and tenant spaces and public places shall have an STC of at least 40. El r- y rYy�xSa `,{ ie L r�%Y d� �x s C s3FaFdyµ3x sx� 2t'kyya s�,g � . 'Tr '2`y �'�• 5.506.1 Ozone depletion-and global warming reductions. installations of HVAC,refrigeration and fire suppression equipment shall comply with Sections 5.508.1.1 and 5.508.1.2. pip Ad-applicable 5.508.1.1 CFCs. Install HVAC and refrigeration equipment that does not ® ❑ contain CFCs.' 5.508.1.2 Halons.-Install fire suppression equipment that does not contain Halon.' 1.These measures are currently required elsewhere in statute or in regulation. Page 8 of 9 CalGreen Non-Res Checklist doc revised 48127//1 CALGREEN SIGNATURE DECLARATIONS Project Name: 10 Project Address: 20 6 20 orneE:A--!�,-ead 6,oe-Anq CIS -se?I y Project Descdption: L/yS -5oun e_ Coad SECTION 1 — DESIGN VERIFICATION Complete all lines of Section 1 —'Design Verification'and submit the completed checklist(Columns 1 and 2)with the plans and building permit application to the Building Department. The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project pians and will be implemented into the project in accordance with the requirements set forth in the 2010 California Green Building Standards Code as a ed by a City of Cu erti , ff .c, 1 I Owner's Signa re Date Owners a (P ase Print) (f 1 Design Professional's Signature Date K2Et4 H C_CAA-Z_-{_1 Design Professional's Name (Please Print) ��Wr Comas' X (mac Signature of License Profe'ss`ional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance(Please Print) Phone Email Address for License Professional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERIFICATION Complete,sign and submit the competed checklist,including column 3,together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2010 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Dale Name of License Professional responsible for CalGreen compliance(Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 9 of 9 CalGreen Non-Res Ched l&doc revised 08127/11 I CALGREEN SIGNATURE DECLARATIONS- Project Name: U a .5A N IL 5 P-11 N C-1-4 { i hI S J D12 c--) C ��`� !1\1 L) . A I CA Project Address: r �(.��'�� �'� O�jL-Si�A T� ��• Cy1����! C.� Project Description: 1/,J•- -TDP- <. IM I TL`n -5L-�V Ia-E BAi\J K DP-A^� SECTION 1 - DESIGN VERIFICATION Complete all lines of Section 1 —°Design Verification"and submit the completed checklist(Columns 1 and 2)with the plans and building permit application to the Building Department. I The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will Abe implemented into the project in accordance with the requirements set forth in the 2010 California Green Building Standards Code as adopted by the City of Cupertino. Owners Signature Date Owners Nam Please Print) f /I Design Professional's Sig7�� Date 0-� M 0, /-J Design Pr sional's Na a (Please Print) 7 Signature of License Professional responsible for CalGreen compliance Date 91DI -3��c2 Name of License Professional responsible for CalGreen compliance(Please Print) Phone _f _4 C&_ P �N _ , Co Email Address for License Professional responsible for CalGreen compliance SECTION 2 - IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3,together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify t at the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2010 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Name of License Professional responsible for CalGreen compliance(Please Print) Phone Email Address for License Professional responsible for CalGreen compliance Page 9 of 9 CalGreen No]l Res Chec4list.doc remised 08/27/11 CITY OF CUPERTINO BUILDING PERMIT INSPECTION CARD BUILDING ADDRESS:20620 HOMESTEAD RD CONTRACTOR:MARKET PERMITNO: 13110152 CONTRACTORS OWNER'S NAME:THE SOBRATO ORGANIZATION 10250 NE MARX ST DATE ISSUED:03/3112014 ONVNER'S PHONE: 9254674291 PORTLAND, OR 97220 PHONE NO: (503)255-0977 INSPECT10NSi:MT:. '>;? :5�_. iia DATE;$c :kaiY`f INSPECTOR }FOUNDATION/PIERS/H.D.S. BUILDING PERMIT INFO: BLDG r ELECT F PLUMB F 111ECH F UFER GROUND r RESIDENTIAL r COMMERCIAL PADISET BACK-CERT JOB DESCRIPTION: US BANK- LOCATED IN SAFEWAY- COMM. T.I 448 SQ FT GARAGE SLABS/PREGUNITE 0 INCLUDE NEW SET UP M,E P,OI1R NO.CONCRETE;UNTIL'ABOYE'HAS:BEENSIGNEDi!-=-,`.,'ra': I UNDERGROUND/SLAB i 'UNDERGROUND PLUMBING 'UNDERGROUND ELECTRICAL b0'NOT'POUR`FLVOR-UNTILABOVE-HASBEENSIGNED;9&).`Z ,r !UNDERFLOOR PLUMBING UNDERFLOOR MECHANICAL UNDERFLOOR ELECTRICAL WILDLAND URBAN INTERFACE FIRE AREA r ERI! UNDERFLOOR FRAMING VENT'S TO ARRANGE INSPECTION UNDERFLOOR INSULATION Cell 777-3228 between 7:30 am and 3:30 pm Monday through Friday,at least 24 hours PLACE';:.NO.SURF.LOORUNTILABOVE'HAS-BEEN!SIGNED 't:;:` before required inspection.Job address and Permit Numbers are needed when �ROOFSHEATHING requesting an inspection. ROUGH PLUMBING CUPERTlNO SANITARY DISTRICT STUBS&SHOWER PAN Closed circuit video inspection of property line cleanout,point of connection ROUGH MECHANICAL and street lateral required prior to passing FINAL CITY PLUMBING _ INSPECTION. Call the District(408-253-7071)for an appointment. ROUGH ELECTRICALIPOOL BOND y t k J FRAMIT4G/STAIRSiF.EGRESS '�?�. NO BUILDING FINALS INSPECTIONS UNTIL ALL REQUIRED 1 NQS L LAT I ONIVEN TI L ATiON BUSINESS LICENSES ARE OBTAINED COV.£R'I?0 3VORt{UNTIL"ABOVE:HAS,B)rEiySIGNEDaxK"„'3:i , EXTERIOR SHEAR/HOLD DOWN PERMIT EXPIRES IF WORK!S 1tOT STARTED WITHIN 180 DAYS OFPERMIT ISSUANCE OR I80 DAYS FROM LAST CALLED INSPECTION. INTERIOR SHEARMHOLD DOWN i SHEETROCK/SHEETROCK SHEAR IMPORTANT (EXTERIOR LATH�WSCREED When a permit has expired,a charge totaling one-half the fees to obtain a new permit must be paid in order to reactivate the permit.if a permit has been expired for more INTERIOR LATH than one year,a charge totaling the full fees to obtain a new permit must be paid NOTAPE:OR PLASTER UNTIL'ABOVE11XS'BEENSIGNED;";2,x::-u to reactivate the permit. }SCRATCH COAT NOTES: j SEWER/WATER T-BARIMECIVELECT ABOVE CE1L 11 '1 , !FINA1:St., ::ys•,.: ` Sa2;S!'1"5 ^�-?sib° .c .z, ;y �ELECTRICMETER RELEASE SPECIAL INSPECTIONS Inspector: Date: GAS TEST/METER RELEASE ROOF INSPECTIONS j GRADE.PUBLIC WORKS PRE-INSPECTION:Inspector:_ Date: j FIRF-CALL(408)378-4010 l - U TEAR-OFF: Inspector: Date: PLANNING(408)777.3308 _ PLYWOOD: Inspector: Date: _ SANITARY(408)253.7071 I BATTENS: Inspector: _ Date: ELECTTRIGAL .Z + 111 PROGRESS: Inspector: Date: MECHANICAL PLUMBING FINAL: lusperaor:_ Date: HANDICAP OTE:OSHA APPROVED ACCESS TO ROOF SHALL BE PROVIDED FOR INSPECTION. ENERGY "OCCUPANCY OF BUILDING NOT PEILNIITTED UNTIL BUILDING FINAL IS SIGNED BY iN5PE_CI'OTt BUILCING CERTIFICATE OF OCCUPANCY• St Lo►�Y� GyAR q C, °o FIRE DEPARTMENT SANTA CLARA COUNTY INSPECTION NOTICE 14700 Winchester Blvd.,Los Gatos,CA 95032-1818 ❑ Annual - Cycle (408)378-4010(phone)•(408)378-9342(fax) ❑ Reinspection ❑ Constr3ugtioPn� [ PC #t 3' Z 8' 'Final Z Page—L.of— Street# S ire t Name 8 Suffix ! Suite# City Occ. Date: ZD(Zo �'i 4 P,I if" Class .11 _Zso /L Occupancy I1 Occ. Phone SL4 - S Z5 ! Load: Issued by f Issued to { Signature ITEM# r- 1 a I`r /--.I A C7 s 3P e-r c.. Af�P 2 oar -VD 3 c= r J J FORM#20 .r (Certi, fiftate t-i This Certificate is issued pursuant to the requirements of Section-11-1:2`of the 2010'.California Building Code certifying that { at the time of issuance, the portion of this_strucfufe described below'has been"inspected for compliance with the requirements of this code and with the various ordinances of the City,r`egulating.building;.construction for the occupancy and division of occupancy. and the use forwhichthe'proposed'occia"pancy is classified. f Building Permit Number(s): 13110152 Application`Date(s)'. -11=2:1_=20.13 = Issuance Date(s): 03-31-2013 I Address of Building: 20620 Home_ stead Rd. Portion of Building: Tenant Improvement (448 sq.ft.) — US'Bank #:325=9--.(101 ide Safeway) Use: Bank Occupancy Classification: B = Occupant Load: 4 occ. Floor Area: 448 sq.ft. Type of--Construction: II-B Fire Sprinklers System: Throughout Ll Current Property Owner: The Sobrato�Organization Current Owner Address: 10600 N..De Anza Bivd:--Suite 2. 00 Final Inspection By: Larry Squarcia, Senior Building,lnspe.cto.r Final Inspection Date. 04-25-2014 - *SPECIAL STIPULATIONS OR CONDITIONS:; Albert Salvador, P.E.,C.B.O., Building Official Date Issued �l NOTICEIPOSTING: No changes shall be made in the character of occupancy. This certificate shall-be posted in a conspicuous place on the premises, and shall not be removed except.",�y the a.uthoritk of the Building'Official. 1' f r