12060105 I
CITY OF CUPERTINO BUILDING PERMIT C
BUILDING ADDRESS: 10000 TORRE AVE CONTRACTOR:XL CONSTRUCTION PERMIT NO:12060105
O'k'VNER'S NAME: TORRE AVENUE PROPERTIES 851 BUCKEYE CT DATE ISSUED:10/05/2012
OWNER'S PHONE: 4089961010 MILPITAS,CA 95035 PHONE NO:(408)240-6000
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❑ _.LICENSED CONTRACTOR'S DECLARATION � r
x BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lie.# e>
MECH RESIDENTIAL COMMERCIAL
Contractor Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:COMM.T.I 40,953 SQ FT-DEMO AND CONSTRUCT 3
(commencing with Section 7000)of Division 3 of the Business&Professions FLOORS,TI TO INCLUDE OFFICES,NON LOAD BEARING WALLS, 10/23/12-REV#1-
Code and that my license is in full force and effect. REMOVAL OF(4)ELEVATOR LOBBY DOORS AND ADDITION OF(8)DOORS ON
SECOND AND THIRD FLOORS
10/23/12-REV#1 ISS'D
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.
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
permit is issued.
Sq.Ft Floor Area: Valuation:$3040000
APPLICANT CERTIFICATION
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 APN Number:36902030.00 Occupancy Type:
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,
costs,and expenses w rch may, crue against said City in consequence of the PERMIT EXPIRES IF WORK IS NOT STARTED
granting of t°`is perm t. Addionally,the applicant understands and will comply
with all non- oint s urc�reg lations per the Cupertino Municipal Code,Section WITHIN 180 DAYS OF PERMIT ISSUANCE OR
9.18• 180 DAYS FROM LAST CALLED INSPECTION.
l/'tlzy/lSignature Date IV ''
Issued by: Date: .
❑ `" WNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons: RE-ROOFS:
I,as owner of the property,or my employees with wages as their sole compensation, All roofs shall be inspected prior to any roofing material being installed.If a roof is
will do the work,and the structure is not intended or offered for sale(Sec.7044, installed without first obtaining an inspection,I agree to remove all new materials for
Business&Professions Code) inspection.
I,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). Signature of Applicant: Date:
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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 HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material.
I certify that in the performance of fine work for which this permit is issued,I shall Additionally,slnuld I use equipment or devices which emit hazardous air
not employ any person in any manner so as to become subject to the Worker's coammants as(1ef red by the Bay Area Air Quality Management District I will
Compensation laws of California. If,after making this certificate of exemption,I mHeal mai &Safetain com i$nc with the Cupertino Municipal Code,Chapter 9.12 and the
become subject to the Worker's Compensation provisions of the Labor Code,I must !Co e,Sections 25505,25533,and 25534. '
forthwith comply with such provisions or this permit shall be deemed revoked. Or ner aut ori a y 1n
_Date: �i !l✓
APPLICANT CERTIFICATION "`
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
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 I herebyI irm that there is a construction lending agency for the performance of-,pork's
upon the above mentioned property for inspection purposes.(We)agree to save for which this permit is issued(Sec.3097,Civ C.)
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Name
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply Lender's Address
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. ARCHITECT'S DECLARATION
Signature Date I understand my plans shall be used as public records.
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Licensed Professional
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CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
W*PERMIT
DDRESS: 10000 TORRE AVE DATE: 10123/2012 REVIEWED BY: SEAN
PN: 369-02-030 BP#: 12060105 *VALUATION: $40,000
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PE: Building Permit PLAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARY PENTAMATION
USE: Commercial Building PERMIT TYPE:
WORK REVISION #1: REMOVAL OF 4 ELEVATOR LOBBY DOORS AND ADDITION OF 8 DOORS ON
SCOPE SECOND AND THIRD FLOORS.
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rklech. Plan Check Phunb, Plun Check Dec.Plan Check
lltec:/t.Permit Fee; Plrnnb.Permit Fee; Ek:c. Permit Fee:
Outer,llech. Insp. Other Plumb hasp. Ot/rer Elec,hrsp. D__L_
jlec/r.Lrsp.Fee: Plumb. hrsp. Fee: 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 ees are based on the reliminar information available and are only an estimate. Contact the De t or addn'l info,
FEE ITEMS (Fee Resolution 11-053 E{f' 7/1/12) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 Select a Mise Bldg/Structure
Suppl.PC Fee: Q Reg. Q OT TO.0 his $0.00 or Element of a Building ,
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
Constrzrefion Tax:
A,Lhnhdsllwl ive Fec:
Work Without Permit? 0 Yes i@ No $0.00
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure
Travel Doctonentotiorr Fees:
Strong Motion Fee: IBSEISMICO $8.40 1 # Revisions
Bldg Stds Commission Fee: IBCBSC $2.00 $799.00 1REVCOMTI Tenant Improvement
SUBTOTALS: $10.40 $799.00 TOTAL FEE: $809.40
Revised: 10/01/2012
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CITY OF CUPERTINO BUILDING PERMIT l
BUILDING ADDRESS: 10000 TORRE AVE CONTRACTOR:XL CONSTRUCTION PERMIT NO: 12060105
OWNER'S NAME: TORRE AVENUE PROPERTIES 851 BUCKEYE CT DATE ISSUED:10/05/2012
OWNER'S PHONE: 4089961010 MILPITAS,CA 95035 PHONE NO:(408)240-6000 !
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❑ LICENSED CONTRACTOR'S DECLARATION r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.#
MECH RESIDENTIAL COMMERCIAL
Contractor � I I���I IYi' Date
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:COMM.T.140,953 SQ FT-DEMO AND CONSTRUCT 3
(commencing with Section 7000)of Division 3 of the Business&Professions FLOORS,
Code and that my license is in full force and effect. TI TO INCLUDE OFFICES,NON LOAD BEARING WALLS,
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.
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 Sq.Ft Floor Area: Valuation:$3000000
permit is issued.
APPLICANT CERTIFICATION APN Number:36902030.00 Occupancy Type:
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 PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep haXn less the City of Cupertino against liabilities,judgments,
costs,and expenses w m accrue against said City in consequence of the WITHIN 180 DAYS O PERMIT ISSUANCE OR
granting of thi perm t. chAddi i nally,the applicant understands and will comply 180 D YS FROM T CALLED INSPECTION.
with all non-p 'nt so roe reg ations per the Cupertino Municipal Code,Section
9.18.
Signature Date Issued by: �a ate:
❑ OWNER-BUILDER DECLARATION
RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of All roofs shall be inspected prior to any roofing material being installed.If a roof is
the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
1,as owner of the property,or my employees with wages as their sole compensation, inspection.
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code) Signature of Applicant: Date:
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three
declarations: HAZARDOUS MATERIALS DISCLOSURE
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 I have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(x)should I store or handle hazardous material.
Additionally,should I use equipment or devices which emit hazardous air
permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued,I shall maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's Health&Safety Code,Sections 25505,25533,and 25534.
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 Owner or authorized agent:
forthwith comply with such provisions or this permit shall be deemed revoked. Date:
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance of Nwrk's
correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C,)
to building construction,and hereby authorize representatives of this city to enter Lender's Name
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, Lender's Address
costs,and expens hich y accrue against said City in consequence of the
granting of is p rmit.Add'Tonally,the applicant understands and will comply ARCHITECT'S DECLARATION
with all non- osource re ulaticns per the Cupertino Municipal Code,Section
9.18. I understand my plans shall be used as public records.
Signatuta� Date v S� Licensed Professional
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WADDRE
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
SS: 10000 Torre Ave DATE: 06/18/2012 REVIEWED BY: Sean
N: BP#: *VALUATION: $3,000,000
PE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building PENTAMATION 1B TI
USE: PERMIT TYPE:
WORK Tenant Improvement 40953 sq ft
SCOPE
TYPE OF FLR AREA
OCCUPANCY TYPE: PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. S-
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B (Tenant Improvements) II-B,111-B,IV,V-B 40,953 $4,245.50 1BTIPLNCK $15,076.70 IBTIINSP
TOTALS: 40,953 $4,245.50 $15,076.70
MECH,HOURLY Q Yes (j) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Q Yes Q No
Wcch, Plum Ch<.ck Plumh, Plum Elec.Plan ChcA
iUech. Permit Fee, P lonh, Permit rce, Tlec. PCn17it reCr
Other Afech, hasp. ET-t- Other Plumb h7sh. Other Elec.Insh, El
Al,�ch. hzsh. Fre: Phimb. help, Fere: Eloy.Insp, Fce:
NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc.). Thesefees are based on the preliminar information available and are only an estimate. Contact the De t or addit7 in o.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/11 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $4,245.50 Select a Misc Bldg/Structure
Suppl.PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 or Element of a Building
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PME Plan Check: $0.00
Permit Fee: $15,076.70
Suppl. Insp.Fee:Q Reg. Q OT 0,0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
(,'onw action Tax:
Adinbliso livcFTG': 0
Work Without Permit? 0 Yes Q No $0.00
Advanced Planning Fee. $0.00 Select a Non-Residential
Tr�tvc:l DO(l,vnretitutinrr l e'e,5: Building or Structure Q
Strong Motion Fee: IBSEISMICO $630.00 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $120.00
SUBTOTALS:; 20,072.20 $0.00 TOTAL FEE: 1 $20,072.20
Revised: 06/30/2012