13010126 MY OF cCUP EllB'I<'M BUIDLWNG PERWT
T
BUILDING ADDRESS: 10297 S DE ANZA BLVD CONTRACTOR:NOVO CONSTRUCTION PERMIT NO: 13010126
OWNER'S NAME: ROBERT ALLARIO 1460 O'BRIEN DR DATE ISSUED:06/04/2013
OWNER'S PHONE: 4088673060 MENLO PARK,CA 94025 PHONE NO:(650)701-1500
❑
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
License Class_ Lic.#_1* O Z Z FIRST REPUBLIC B LIC BAN1K T.I.(4235 SQ]FT)
/ REVISION APADD ROOF MECHANICAL SCREEN DUE TO
Contractor N OQO CC)N-rb(WZ` nc-J Date /N! 3 equipment
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. Ite �
I hereby affirm under penalty of perjury one of the following tw r{
I have and will maintain a certificate of consent to self-insure fore b
Compensation,as provided for by Section 3700 of the Labor Code fqt
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$752500
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:35917001.10297 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES j0[i WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating ���,��. ]I ����®�PERMIT ISSUANCE®�
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 DAYJr(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 � 0
granting of this permit. Additionally,the applicant understands and will comply Issued by: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
(0 ¢ RE-ROOFS:
Signature ` Date ��/ ?j All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
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)
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
1 have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with 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,Sec' r 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this f �
Owner or authorized agent: Date:
permit is issued. l
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 1 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 1 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.I8.
Signature Date
CITY OF CUP ERTINO
FUY E]E ]ESTIMATOR- BUILDING DIVISION
A
DDRESS: 10297 S. ®e Ansa Blvd DATE: 0810112013 REVIEWED BY: Sean
P#: (Q *VALUATION: Iso
*PERMIT E: Building ermit PIAN CHECK TYPE: Alteration/ Repair
PRIMASFD or Duplex PENTAMATION 1GENRES
USE: PERMIT TYPE:
WODeferred Submittal #1: Interior anil exterior glazing shop drawings.
SCO E
Ifech. Plan Check Phwib.. Plan Check Elec.Pian Cheack.
Mech. Permit F'ee: Plumb.1'ermit Fee: Eiec,Permit Fee:
Other iVech.Insp. Other Plumb Insp. 011ier Elec.Insp.
Mech.Lisp. Fee: 1'Iuuzb. Insp. h'ee: Elec.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,Lees are based on the prelimina information available and are onl an estimate. Contact the De t or addn'l info.
FEE ITEMS (Fee Resolution 11-053 E : 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? Yes 0 No $0.00 F-1- hours Plan Check,Hourly
Suppl. PC Fee: (D Reg. 0 OT 0.Q hrs $0.00 $139.00 1STPLNCx
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Fee-0 Reg. 0 OT 0 Q hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
(;onstr rection Tax:
Adininistrative Fee:
Work Without Permit? 0 Yes E) No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential E)
T/Ylvel Dot:utnentafion fees: Building or Structure 0
Strong Motion Fee: $0.00 Select an Administrative Item
Bld&Stds Commission Fee: $0.00
SUBTOTALS: $0.00 $139.00 TOTAL FEE: $139.00
Revised: 07/01/2013
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10297 S DE ANZA BLVD CONTRACTOR:NOVO CONSTRUCTION PERMIT NO: 13010126
OWNER'S NAME: ROBERT ALLARIO 1460 O'BRIEN DR DATE ISSUED:06/04/2013
OWNER'S PHONE: 4088673060 MENLO PARK,CA 94025 PHONE NO:(650)701-1500
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIALE]
License Class _ - Lic.# 4 ?— FE RST REPUBLIC BANK T.I.(4235 SQ FT)
DEF#I -INTERIOR&EXTERIOR G LASING SHOP
Contractor !"a1° l�r��1Y�'�4 'r'QDate //� DRAWINGS-1SSUED 8/1/2013
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:$752500
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:35917001.10297 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXPIRES ILF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating W=N 180
DAYS g
� �,� ISSUANCE ®�
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 DABS F CAILILIEIlD INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I
granting of this permit. Additionally,the applicant understands and will comply ass y: Date:
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18.
C �., Q ? RE-ROOFS:
Signature _-✓ Date U l v All roofs shall be inspected prior to any roofing material being installed. if a roof is
installed without first obtaining an inspection,1 agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
Il hereby affirm that Il 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..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 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,Sec' 25505,25533 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Owner or authorized agent: Date:
I 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,I CONSTRUCTION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must 1 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 1 have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION
costs,and expenses which.may accrue against said City in consequence of the I 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
CITY OF CUP ERTINO
FEE ESTRMATOIB- BUILDING DIVISION
ADDRESS: 10297 S DE ANZA BLVD DATE: 06/12/2013 REVIEWED BY: MENDEZ
APN: BP#: M *VALUATION: 1$2,500
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARYPENTAMATION
USE: Commercial Building PERMIT TYPE: 1GENC0
WORK REVISION#1- ADD 10FT TALL TEMP FENCE
SCOPE
.Mach. Plan Check Plnnrb. Plan Check El"C',Plan Check
Nhl ch. Perrrut flee: Plumb.Penwit Fee' Elec. Permit Fee:
Orher.Uech.Insp. . Other Plumb Insp. Other Elect,Insp.
A/cch. hssp. /Fe.' Plumb. Insp. Fee: Lilec,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.). TheseLees are based on the prelimina information available and are onl an estimate Contact the De t or addn'1 info.
FEE ITEMS(Fee Resolution 11-053 E . 7/1/12) FEE QTS'/FEE MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes E) No $0.00 2 hours Plan Check,Hourly
Suppl. PC Fee: 0 Reg. 8 OT 0.0 hrs $0.00 $266.00 1STPLNCK
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl. Insp.Feel@ Reg. OT Q Q hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Construction Tire:
Administrative Fee:
Work Without Permit? 0 Yes E) No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential E)
Travel Documentation Fees: Building or Structure 0
Strong Motion Fee: 1BSEISMICO $0.53 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
SUBTOTALS: $1.53 $266.00 ;TOTAL FEE: $267.53
Revised: 04/29/2013
BUILDING ADDRESS: 10297 S DE ANZA BLVD CONTRACTOR:NOVO CONSTRUCTION PERMIT NO: 13010126
OWNER'S NAME: ROBERT ALLARIO 1460 O'BRIEN DR DATE ISSUED:06/04/2013
OWNER'S PHONE: 4088673060 MENLO PARK,CA 94025 PHONE NO:(650)701-1500
❑ LICENSED CONTRACTOR'S/DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL0
License Class Lic.# ` ® I- -Z ]FIRST REPUBLIC BANK T.I.(4235 SQA]FT)
Contractor N®M® r0b*6M-C'fiQ0 Date 44(Z B REVISION#I-ADD 10 FT TEMP FENCE-ISSID OTC
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 deet io
I have and will maintain a certificate of consent to self-insure for °
Compensation,as provided for by Section 3700 of the Lab
performance of the work for which this permit is iss Sq.Ft Floor Area: Valuation:$752500
1 have and will maintain Worker's Compensatio as provided for by
Section 3700 of the Labor Code,for the performan a of the work for which this APN Number:35917001.10297 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 �����. ��®����®�PERMIT ISSUANCE ®�
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 ADAMS FROM]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 source regulations per the Cupertino Municipal Code,Section
9.18.
RE-ROOFS:
Signature Date bg t/ All roofs shall be inspected prior to any roofing material being installed.If a roof is
installed without first obtaining an inspection,I agree to remove all new materials for
inspection.
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date:
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(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 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.I2 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Se0iqq 25505, 533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
Owner or authorized agent: Dat
permit is issued. e:
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 1 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.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