12100188 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20573 STEVENS CREEK BLVD CONTRACTOR:FRANS CONSTRUCTION PERMIT NO: 12100.188
OWNER'S NAME: JP MORGAN CHASE BANK 134410 POWAY RD APT 221 DATE ISSUED:01/04/2013
OWNER'S PHONE: 2136253700 POWAY,CA 92064 PHONE NO:(858)748-3040
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL®
License Class_ Lic.# TENANT IMPROVEMENT-INTERIOR REMODEL,NEW
OFFICES,TELLER LINE,&INSTALLING A TV MONITOR
C
Contractor V BEHIND TELLER LINE
I hereby affirm that I am licensed under the provisions of Cha I pter 9 REVISION#I-REVISE ADA EXTERIOR CONCRETE-ISSI)
(commencing with Section 7000)of Division 3 of the Business&Professions OTC 6/6/2013
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:$125500
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:32634064.00 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 C LED 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 s y:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signator 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.
n 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
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) HAZARDOUS MATERIALS DISCLOSURE
1,as owner of the property,am exclusively contracting with licensed contractors to
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
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 Owner or authorized agent: ate:
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 CONSTRUCTION LENDING AGENCY
Compensation laws of California. If,after making this certificate of exemption,I
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 Nam
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
CUPERTINO (408)777-3228-FAX(408)777-3333•buildingCU)cupertino.org
ONEW CONSTRUCTION El ADDITION El ALTERATION TI f�—REVISION/DEFERRED ORIGINAL PERMIT#_L?L0_C_)J
PROJECT ADDRESS #
OWNERNAME q PHONE EMAIL
'.ice'
STREET ADDRESS InP&- Ck. CITY,STATE,ZIP =FAX
CONTACT NAME PHONE
STREET ADDRESS CITY,STATE,ZIP FAX
11 OWNER 171 OWNER-BUELDER n OWNERAGENT 1:1 CONTRACTOR OCONTRACTOR AGENT 11 ARCHITECT 13 ENGINEER 1:1 DEVELOPER 11 TENANT
CONTRACTOR NAME I 1kri- LICENSE NUMBER LICENSE TYPE BUS.LIC#
COMPANYINAMEE-MAIL FAX
A&A& (_OA62&t4rfv� I
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS,Lie#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK^'; /I
C61
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES
USE TYPE CC. S XT. VALUATION
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA I NET AREA
BATHROOM KITCHEN OTHER
REMODELAREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH ARE I GARAGE AREA: rl DETAC_H_
0 ATTACH
#DWELLING UNITS: ISA SECOND UNIT OYES SECOND STORY nYES
BEING ADDED? ONO ADDITION? r1NO
PRE-APPLICATION 0 YES- IF YES,PROVIDE COPY OF IS THE BLDG AN
I L V ATIO
PLANNING APPL# ONO PLANNING APPROVAL LETTER EICHLER HOME? O0
By my signature below,I certify to each of the following: I am the property owner or onzed agent to act 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 accurate. I agree to comply with all applicable local
ordinances and state laws relating to bus conzan
I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTXI INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit forEl OVER-THE-COUNTER 0 BUILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building -1 PLANNING PLAN REVIEW
permit for new building. 0 EXPRESS I
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD 0 PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project. -1 FIRE DF
0 LARGE r PT
Copy of Planning Approval Letter or Meeting with Planning prior to El MAJOR El SANITARY SEWER DISTRICT
submittal of Building Permit application. El ENVIRONMENTAL HEALTH
_J
BldgApp_2011.doc revised 06121111
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20573 STEVENS CREEK BLVD CONTRACTOR:TSD-TO BE PERMIT NO:12300188
DETERMINED
OWNER'S NAME:.JP MORGAN C14ASE BANK } C` DATE ISSUED:01104/2013
OWNER'S PHONE: 2136253700 PHONE NO:
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL® COMMERCIAL0
License Class e Lic.# 'moi TENANT IMPROVEMENT-INTERIOR REMODEL,NEW
OFFICES,TELLER LINE,&INSTALLING A TV MONITOR
Contractorte BEHIND TELLER LINE
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:$125500
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:32634064.00 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 00 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 184 DAYM 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 Issued by:
Date: ! fr
granting of this permit. ditionally,the applicant understands and will comply
with all non-point sou regulati p the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature_�4ate 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 am exempt 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)
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. 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 CodeASecti 25 ,25533,and25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agenie Date:
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 CONSTRUCTION LENDING AGENCY
Compensation laws of California. If,after making this certificate of exemption,I
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
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 20573 Stevens Creek Blvd DATE: 10/25/2012 REVIEWED BY: Sean
APN: BP#: �° ,r�� VALUATION: $125,500
�PERM[T TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building PENTAMATION 113 TI
USE: PERMIT TYPE:
WORK Tenant Improvement at Chase Bank 2208 sq ft).
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.)
B (Tenant Improvements) 11-8,111-B,IV,V-B 2,208 $2,116.60 1BTIPLNCK $1,907.44 IBTIINSP
TOTALS: 2,20=$2,116.60 � � $1,907.44 r 3
,6 '?£'Z. Pt,`£.12 .!"P2t:d„1f $dbt,wb, TlaI I(17;,,J £';i L'.1111,n i ifC el,
a .€-/,,,`
�'3t.F£ IR.! .f�CTf 3�d£S �f�l. ✓�� 7, 3✓" 5 f3
L1 , L1
F..zx Fee: }31tfr?a''r. 'r,v>. 11`e'e:>:
NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Server District,School
District,etc.). These,Lees are based on the relinainar information available and are only an estimate. Contact the De t or addrz'l In o.
FEE ITEMS {Fee Resolution 11-053 Eff Z IJ12, FEE QTY/FEE MISC ITEMS
Plan Check Fee: $2,116.60 Select a Misc Bldg/Structure
Suppl. PC Fee: (E) Reg. 0 OT 0.0 hrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $1,907.44
Suppl. Insp,Feer Reg. 0 OT 0.0 hrs $0.00
PME Unit Fee: $0,00
PME Permit Fee: $0.00
a.
°% ;iitsi tsar;,` Lj
Work Without Permit? 0 Yes ) No $0,00 G
Advanced Planning Fee: $0,00 Select a Non-Residential 0
Yag,A=vel Docif nienwion Fees: Building or Structure 0
Strong Motion Fee: IBSEISMZCO $26.36 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $6,00
StTBTC3TALS;,' $4,056.40 $0.00 TOTAL SEE;' $4,056.401
40
Revised: 10/01/2012
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228-FAX(408)777-3333•buildinaftucierfino.ora 9"
E]NEW CONSTRUCTION [] ADDITION ALTERATION TI El REVISION/DEFERRED ORIGINAL PERMIT#
PROJECI'ADDRESS22 PH NE 0�AIN# V
OWNER AME P E-MAIL
, 37co
STREET ADORES FAX
2x c1J -7—x
CONTACT NAME MAIL
la�>k
STREET ADORE TTY, TATE ZIP F X
lmi '�VUMAIA WAP I5
0 OWNER 0 OWNER-BUILDER OWNERAGENT 13 CONTRACTOR 13 CONTRACTOR AGENT 13 ARCHITECT 0 ENGINEER 11 DEVELOPER 13 TENANT
CONTRACTOR N LICENSE NUMBER LICENSE TYPE BUS.LIC 4
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCHITECT/ENGINFERR NAMBUS.LIC 9
chri ts LZ
Cn7off E-nL FAX
ou *)rn
STREET ADDREwo CITe,STATE IP
PHONE
22D V4-
DESCRIPTION
:?C)JFWOR,K
A
4 J�! JKJ1Z-RAn& oQg�e C:E a)q�- 15,6�L�or= 10
consjrur��tnia view Ace AA a�
be�)-rrA 4.e'A' Aex- INLQ,
EXISTING USE PROP USE TR. #STORIES
h
USE TYPE OCC. SQ.FT. VALUATION
I
EXISTG01++1 NEW FL04DR DEMO TOTAL
AREA AREA AREA NET AREA
( ,
BATHROOMKITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: LJ DETACH
0 ATTACH
DWELLING 1SA SECOND UNIT 0`YES_ SECONDSTORY ❑YES
-----
BEING ADDED? []NO FADDITION? ONO I
PRE-APPLICATION []YES IF YES,PROVIDE COPY OF IS THE BLDG AN 0 YES rRECEIVED BY- TAI,VALUATION:
PLANNING APPL# n NO PLANNING APPROVAL LETTER EXCHLERHOME? []NO I 6GO
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behAf4 I have read this
application and the information I have pr is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to Ilding con ruction. I a orize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature ofApplicant/Agent: NPP Date:
SUPPLEME&TAL INFORMATION REQUIRED PLAN'CHECKTYPE ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for 0 OVER-TH&COUNTER 9+-IMLDING PLAN RENTEW
eXisting building(s). Demolition permit is required prior to issuance of building
permit for new building. 0 EXPRESS (1 PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 2?`STANDARD 171 PUBLIC WOPxS
form if any Hazardous Materials are being used as part of this project.
0 LARGE 2-7-IRE DEPT
Copy of Planning Approval Letter or Meeting with Planning prior to 13 MAJOR F1 SANITARY SEWER DISTRICT
su_bmittal of Building Permit application.
El ENVIRONMENTAL M11ZM.__J
BldgApp Ml.doc revised 06121111
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: &RMIT#
OWNER'S NAME: ""`" PHONE# -Z- I
GENERAL CONTRACTOR: �"' BUSINESS LICENSE#
ADDRESS: �AY � '",j> 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:
j/ 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
180
'eoz�' (c— A 4r
O r/Contractor Signature Date
City of Cupertino December 20, 2012
Attn: Sean Hatch
10300 Torre Avenue
NR 0 E L Cupertino, CA 95014
RE: Chase CPC: Stevens Creek
Existing Retail Banking Center: Tenant Improvement
20573 Stevens Creek Blvd. Cupertino, CA 95014
Nadel Project#12-086
City of Cupertino Permit No: 12100188
Dear Sean,
175 East Warm Springs Road This letter serves as authorization for Sean Hatch to make minor changes to
Suite 100 the drawings per the Plan Review Stop Report, dated 12/19/2012, as
Las Vegas,NV 89119 required by the City of Cupertino for a permit of the above referenced project.
T 702,896,20W If you have any questions please don't hesitate to call, (702) 896-2000.
F.702.896.7170
www.nadelarc.com Thank you,
Prepared by,
Mark B. Mikelson, AIA, LEED AP
Senior Vice President
Division Director
G:\2012\12086 Stevens Creek\Admin\l 05 Public Agency Correspondence\1 2085-Auth
Ltr—Sean Hatch-12-20-12.doc