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13070106 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20425 STEVENS CREEK BLVD CONTRACTOR:DEVCON PERMIT NO:13070106 CONSTRUCTION INC OWNER'S NAME: WESTWOOD COMPANY-CUPERTINO LLC 690 GIBRALTAR DR DATE ISSUED:07/16/2013 OWNER'S PHONE: 7078884367 MILPITAS,CA 95035 PHONE NO:(408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL L1 COMMERCIAL License Class---- �� Lic.# APPLE-2ND FLOOR-CONVERSION OF CONFERENCE nt-� Ce.�# rl �(W7�1� (/I�"D'ate' I 4 ROOM TO Contractor R ` LAB, NO HAZARDOUS MATERIALS 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 which this permit is issued. Sq.Ft Floor Area: Valuation:$57000 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:31626094.20425 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I 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 80 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 DA F OM 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 granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point sour i egulation der e jC rtino Municipal Code,Section 9.18, j,{ f j G�j RE-ROOFS: Signatu t Date '1 1 Yi 1 ` All roofs shall be inspected prior to any roofing material being installed.If a roof is 17 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 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 Magement District I performance of the work for which this permit is issued. will maintain compliance with the Cu ino Munic'. aly,C e,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,FSec4on 2 505,25533, $ 4. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized age ate.o 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 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 die 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 1 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 (l�\ 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTCNO (408)777-3228 • FAX (408)777-3333• building Qcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS zo �y APNH�)3 l (�J 2 OWNER NAME 'O J PHONE /f�y� l yjI. E-MATIN / STREET ADDRESS L CITY, STATE,IZIP FAX CONTACT NAME (� \/� I,.( PHONE''}!) KP „�t7pO/,�,,�2( &///M���AII I_ 1- f STREET ADDRESS ^ (� I^ UV CTIY,STATE, ZIP(�/I o �y� FAX / ❑ OWNER ❑ OWNER-BUILDER OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT' `❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR N O f/' LICENSE NUMBER /�)I t n LICENSE TYPE BUS.LIC N COMPANYNAtvLE� 1 L ”` vc� I,G `r�►(�1"' � E��ml�t^^AIY� STREET ADDRESS o A V CITY STATEHO ZIP r I I+P , ' v ARCHITECT/EN'GIN'EER NAGE LICENSE NUMBER BUS.LIC N N\AJ VV KFYI 11�-� COMPANYNAME �l lh E-MAIL( y-ajy 112 D +V� FAX 01 STREET ADDRES - 0 b 6"r ir CKCTTI„ST v ZIP1 11 1 T. Go,-,4r V P O DESCRIPTION OF WORK Ute^VV rn V (Y J Y fz V Io L /KW i I It Ino VdLA V EXISTING USE PROPOSED USE CONSTR TYPE 9 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 R DWELLING UNITS: ISASECOND UNIT E]YES SECOND STORY C]YES BE,I\'G ADDED? []NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY Of IS THE BLDG AN ❑YES RECEI D OTAL,VALUATION: PLANYINGAPPLH EJ M1 PLANNING APPROVAL LEITER EICHLER HOME? ❑NO - 0 By my signature below,I certify to each of the following: I am the property owner or authori e ent to act on the property owner's behalf. I have 6d this application and the information I have provided is correct. I have re the Desc' do f Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to build'nz c nstruction. I author' e r pres to v s f Cupertino to enter the above-identified roperty for inspection purposes. . SignatureofApplicandAeent: Date: SUPPLEMENTAIPORMATIONREQUIRED PLAN cxFcxTYPE _ ROLrIG:silr _New SFD or Multifamily dwellings: Apply for demolition permit forE`X v ` OBR-I.Hl COUNILR — �MBLH,llI?NGPL4Nt2EN[EW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ FXP>ESS ❑ P1...AnT.[Nc PLAN KEVIFW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure O STANDARD ❑ rUHI.ICw6RK- form if any Hazardous Materials are being used as part of this project. 1,ARGF. n.E IiEP'r _Copy of Planning Approval Letter or Meeting with Planning prior to f� hr.iacu SANITARY SEWER I,1sTrucT submittal of Building Permit application. L1.'ENS N rRo.N'TIE\TAI HEALTH. BldgApp_201].doe revised 06/21/11 n Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 C U P S RT I N O Telephone: 408-777-3228 Pax: 408-777-3333 CONTRACTOR / SUBCO CTOR LIST JOB ADDRESS: 2-o L5 Ste VeY)s C V' 2 r ;VVCJ . PERMIT OWNER'S NAME: � � PHONE # � '�j GENERAL CONTRACTOR:Pe VWnC o C NO �1 BUSINESS LICENSE# ADDRESS: V I O (0,1 WA CITY/ZIPCODE: ►' *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical ,Q woo eltaY1 G On 2. 1 10 Excavation Fencing Flooring /Carpeting �iV-QI'Sl ��► 5�-�,�msj�p(p L�f Linoleum/Wood Glass /Glazing Insulation Landscaping Lathing Masonry yl Painting/Wallpaper M AMY)1 12 V Paving Plastering Plumbing ✓ Roofing S fi �, 23�0� V Septic Tank Sheet Metal V Sheet Rock M(/t ANYYj Wol 2-j-2,) Z- Y1UDINWLI 2�J 212 SAP Own /Contractor Signature Date CITY OF CUPERTINO FEE ESTIMATOR -BUILDING DIVISION ADDRESS: 20425 SCB DATE: 0711612013 REVIEWED BY: mendez AP BP#: Q��l VALUATION: $57,000 'l P�PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 113 TI USE: PERMIT TYPE: WORK apple-2nd floor- conversion of conference room to lab no hazardous materials SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.r. B (Tenant Improvements) II-B,III-B,IV,V-B 312 $2,041.11 IBTIPLNCK $637.37 IBTIINSP TOTALS: 312 $2,041.11 $637.37 MECH,HOURLY © Yes (F) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes Q No Uech.Plan Check Phrnrb. Plan Chceb f�lec Pla,° heck Meek Pertreil Fee: Plumb. Permit Fee. Elec, Pennit Fee: Other A.iech.Insp. Other Ph✓mh InV'r' Other Elec. Insp- Mech. hap. Fee: Phnrrb. Insp. "e". Elee.Insp, Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These-fees are based on the prefiminary information available and are on an estimates Contact the De t or addn 7 info. FEE ITEMS (Fee Resolution 11-053 Eff 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,041.11 Select a Misc Bldg/Structure Suppl. PC Fee: (F) Reg. Q OT F071 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $637.37 Suppl. Insp. Fee:Q Reg. Q OT Q,Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tux: A(lininistrative Fee: Q Work Without Permit? Yes (F) No $0.00 O Advanced Planning Fee: $0.00 Select a Non-Residential E) Travel Documentution Fees: Building or Structure .© i Strong Motion Fee: IBSEISMICO $11.97 Select an Administrative Item BldgStds Commission Fee: IBCBSC $3.00 SUBTOTALS: $2,693.45 $0.00 TOTAL FEE: 1 $2,693.45 Revised: 07/01/2013