14010082 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10200 S DE ANZA BLVD CONTRACTOR:VULCAN PERMIT NO: 14010082
CONSTRUCTION INC
OWNER'S NAME: SEAGATE TECHNOLOGY LLC 346 MATHEW ST DATE ISSUED:02/13/2014
OWNER'S PHONE: 8314395457 SANTA CLARA,CA 95050 PHONE NO:(408)499-6039
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL [:]u. ❑
ID ,
SEAGATE-MODIFY DOCK AREA FOR ADDITIONAL
License Class Lic.# STORAGE
SPACE,CREATE STORAGE SPACE FOR FOOD AREA 554
Contractor(/f�(I r', C_r) K— —
SQ
I hereby affirm that I am licensed under the provisions of Chapter 9 ,T
(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 die Labor Code,for the
lerformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$99763
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:36901035.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 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 DAYS FR LED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments, two
costs,and expenses which toy accrue against said City in consequence of the '
granting of this permit. Ad i al y,the applicant understands and will comply
with all non-point r e r a ns per the Cupertino Municipal Code,Sect'
9.l8.
AE-ROOFS:
Signature Date All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
1 hereby affirm that i am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1,as owner of the property,or my employees with wages as their sole compensation,
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE
construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. 1 will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
1 have.and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use eq pment 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 rea Air Quality Managcment District I
performance of the work for which this permit is issued. will maintain compliance with t r Municipal Code.,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se ton 5 533,1 nd 25534.
Section 3700 of the Labor Code,for the performance ofthe work for which this l
permit is issued, Owncr or authorized ager : D,ete:
1 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,l CONS UCTION 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.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 1�V
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �}
LUPI=RTINO (408)777-3228• FAX(406)777-3333•buildingCftupertino.org
❑NEW CONSTRUCTION ❑ ADDITION Q ALTERATION I Tl ❑ REVISION/DEFERRED ORIGINAL PERMIT#
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❑OWNER ❑ OWNER-BUEMM ❑ OIAWERAGET CTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGDm m ❑ DEVELOPER ❑TENANT
CO CTOR AMt /I LICENSE ER _ LICENSE TYPE BUS.LIC f!
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EXISTING USE PROPOSED USE CO 5 TYPE #STO�tL•E�
USE TYPE OCC. SQ.Fr. VALUATION(S)
F.,7QST�'*_ NEW FLOOR DEMO TOTAL
A'` F AREA AREA NEr AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA f�
PORCH AREA DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: DETACH
EIATTACH
NDWELLINGUNITS: ISASECDNDUNrr ❑YES SECONDS-TORY YES
BEINGADDED! []NO ADDITION! ❑NO
PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RP.CEIVEDBY:' - ox VIUUATION;,�,
PLANNING APPL# []NO PLANNING APPROVAL IXTIER EICHLERHOASE! C]NO
By my signature below,l certify to each of the followi I am the property owner or authorized agent to act on the property owner's behalf. 1 hake-read this
application and the information I have provim is co c. h e read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local
ordinances and state laws relatin to bu' m onst u rite representatives of Cupertino to en er-the above-identified pr perty for inspection purposes.
Signa t �n�`,.pplicall � t'
SUPPLEMENT ORMATION REQUIREDPLAN,-CHECIC,TYPE, -ROUTINGS • _.
_New SFD or Multifamily dwellings: Apply for demolition permit for ,p OVER-TIIE-COITATER 0 BUILDIIVGPLAN REVIEIv.
existing building(s). Demolition permit is required prior to issuance of building i
permit for new building. D';EXPRESS 0 PLANNING PLAN REvfEw 1
_Coritmercial Bldgs: Provide a completed Hazardous Materials Disclosure 0i srANdARD „ Peel ic,woR14.
form if any Hazardous Materials are being used as partof this project. I..El`LARGE D FLAE Dl
_Copy of Planning Approval Letter or Meeting with Planning prior to 0,.j� -R -❑''scala i.�Ri'sEwi R DISTRICP ,
Submittal of Building Permit application.
ENVTRONMENTALHEALTH,_-_ .
Bldgrtpp 2011.doc revised 06121111
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 10200 5'De Anza Blvd DATE: 01/14/2014 REVIEWED BY: Mendez
APN: BP##: 'VALUATION: 1$99,763
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY PENTAMATION
USE: Commercial Building PERMIT TYPE: 1 B 7I
wORK Seagate- modify dock area for additional storage space, create storage space for food area 5
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
B (Tenant Improvements) II-B,111-B,IV,V-B 554 �D6�11+33y' 1BTIPLNCK $770.11 IBTIINSP
TOTALS: 554 $2,051.33 $770.11
MECH,HOURLY Q Yes No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes .Q No
Nfech. Plan CheckF-F Phunb.Plan Check Elec.Plan Check
F111fcclr. Perini!Fee Phimb. permit Fee: Elec,Permit Fee:
Other He& Insp. Other Plumb Inrp, Ea7 Other Elec. lnsp, Lj
r1tech. Insp. Fec.• Plumb, hasp. Fee: Elcc.Insp, Fee:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc). Thesefees are based on the prefinifina information available and are on an estimate- Contact the Dept-for addn'l info.
FEE ITEMS(Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,051.33 Select a Misc Bldg/Structure
SuppI. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $770.11
Suppl.Insp.Fee:Q Reg. Q OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tai':
Administrative,I"ee: Q
Work Without Permit? Q Yes Q No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential G .
Travel Documentation Fees: Building or Structure O
Strong Motion Fee: 1BSEISMICo $20.95 Select an Administrative Item
Bldp,Stds Commission Fee: IBCBSC $4.00
SUBTOTALS: $2,846.39 $0.00 TOTAL FEE: `, ,BE 3 F3:9 r
Revised: 01/01/2014
o -
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: O a S u PERMIT#
OWNER'S NAME: PHONE# --��
GENERAL CONTRACTOR: InGe= U ,l BUSINESS LICENSE#
ADDRESS: Z6%�4�'ejCITY/ZIPCODE:
*Our municipal code requires all businesses working in the city to have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
✓ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/Carpeting
Linoleum/Wood
Glass/Glazing
Heating
Insulation
Landscaping
Lathing '
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Co r ignature Date