12050046 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10200 S DE ANZA BLVD CONTRACTOR:TECHNICAL.BUILDERS PERMIT NO: 12050046
INC
OWNER'S NAME: SEAGATE TECHNOLOGY LLC 310 W HAMILTON,AVE DATE ISSUED: 10/23/2012
OWNEWS PHONE%'4086581408 CAMPBELL,CA 95008 PHONE.NO:(408)378-6500
❑ LICENSED.CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ElCOMMERCIAL11
License Class Lie..#' p D_ CONSTRUCT 800 SQ FT EMERGENCY GENERATOR
ENCLOSURE
Contractors J(�11L Date IN UNDERGROUND GARAGE, EXHAUST STACK
I hereby affirm that+l am licensed under'the provisions-of Ch oter 9 W%ENCLOSURE
(commencing with Section 7000)of Division 3 ofthe Business&Professions
Code and that,my,license;is in full force and effect. REVISION#1-400 AMP PANEL UPGRADE,ADD 3 EVC STATION
I"hereby affirm.-under penalty of perjury one ofthe following two declarations: (2)DUAL AND(1).S_INGLE AT ACCESSIBLE STALL.-36 ISDD
1 have and will maintain a certificate of consent to self-insure for Worker's 5/31/2013
Compensation,as provided for'by Section 3700 of the Labor.Code„for tfie�
performance of the work�for which this permit is'issued. Sq.Ft FI Area, Valuation:'$500000
I;have_and=will maintain Worker's.Compensation Insurance,as."provided for by
Section 3,700-of the Labor Code,for'the performance of.the.work forwhich.this
_
er:36901035.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
]-certify that_I haveread this application and state thatthe above i ation'is PERMIT'EXPIRES IF WORK IS NOT STARTED
correct.)agree to comply with all city and county ordinances'and state laws relating WITHIN 0 YS 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, M LAST CALLED INSPECTION,
indemnify and keep harmless the City of Cupertino+against,IiabiIities,judgments,
costs,and expenses which may accrue against said City in consequence.of the .�
granting of:this permit. Additionally,the applicant;understands and.wilI.comply, Issued by: Date:
with all non-point sourc egul'ations perthe Cupertino Municipal Code,Section
9:18.
?� RE-ROOFS:
Si nature, Date J/ 7�!
g All roofs-shall:be.inspected prior to;any.roofrng material being installed.]f 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..[am exempt fromthe 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 thestructure is not intended or offered-for sale(Sec.7044,
Business&,Professions"Code)
1,as owner'of theiproperty,.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'afliirm'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[ ore 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 providedfor by$ection'3700 of the.Labor Code,for the air contaminants as-defined by the Bay Area.Air Quality Management District)
performance of the workfor which this permit is issued. will'.'maintain eompliance>with the Cupertino'Municipal Code,Chapter 9.12 and
I have and will maintain Wo'rker's Compensation.hnsurance,as provided for by the Health;&Safety Code,.Sections 255 5,'25533,.arid 25534..
Section 3700 of,the:Labor Code,for the performance of the work for which this,
permit is,issued.
Owner-or-authorized agent: ate:
I certify thaEin 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,Califorriia. 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:info"rrnation is
correct.(agree to comply with all cityand 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,harm1ess�the City of Cupertino!against'liabilities,.judgments, ARCHITECT'S DECLARATION
costs,and expenses:which may accrue"against:said City in consequence of the L-understand:my'plans shall be used•as public records.
granting ofthis.permit.Additionally,the-applicant understands and will comply
with,all non-point source,regulations perthe Cupertino Municipal Code,Section Licensed Professional
9.18,
Signature Date
CI ,
TY OF CUPERTINO
FEE,
ESTIMATOR-B'UILDI'N,G DIVIShON.
ADDRESS: 10200 s de;anza blvd; DATE: 05/29/2013 REVIEWED B,Y: .mendez°
APN: BP#: 1:2050046 "-`VALUATION:, $"50,000
FPERMIT'TVP.E:: Building'Permit, PLAN'CHECK TYPE: Tenant Improvement
PENTA
PSE': ARY Comrnercial,Building PERMIT T PEN SOLAR=COMM.
U
WORK 4.0'O;am anel upgrade, add 3,evc station
SCOPE
i
W
U
tilech. Flan("heck 7 1'('urfiG. 1?lirn Check Elec'.Plan Check 0.0 hrs $O:QO
tilech. Pci'rnitTee: Plumb.peon(Fee, Elec.Permit-Fee: IEPERMIT
rl��',k
iti9wkInsp. nilre�a P/e✓mli ln.tip. E17-- Other'Elec,,Insp. 0.0 hrs-Jnslii.f'ee.: Z'hihib.'lnsp.T',,,?:
NOTE: This�esiimgtefdoes;notlinclude fees,due to otherDepartments,(i:e.Planning;,Public�Works,.Fire;Sanitary Sewer District;School
District;eta), 'These ees,arebased.onthe' ielihdfia..,in ormation,:available,and dreionl`wh,estim4te. Contact the De t: or dddn'1 info.
FEE.ITEMS,(Fee"IZesoluti6n11=053 Eff: 7%1%121. FEE QTY/FEE MIS CIITE MS'
P1an..Check Fee: $0.00. 3 # Alternative Energy System
Suppl. PC Fee:. e)"Reg:, 0 OT 0:0 his $0,00 $306.90 1,CFIRG9TA. EV Charging Station
PME Plan Check: $0.00 400 amps Electrical"
P-ermitFee:
$0,00 $6:7,.00 .13ELECI:o-
oo. Services
Supp/:InspQReg. ( OT firs
$0.00
PN E:Uhitfee: $0.00
PMEPermif Fee: $45.00
Gcrosir crc`tiun.Tcr%:
Adminisfrative"Fee: ]ADMIN $42..00 '
Work,Without:Peririit? .'Yes, No $0.00
Advanced f.1dgnin&Fee: $0.00 Select a Non=Resident a'l G'
Travel.Documentation.Fee ITRA; Moe $45.00
Building.or;Structute Q'
Strong;Motion F.ee:. ]BSEIS C.0 $10.50 Select an-Administrative Item."
.Bldg Stds.Commission'Eee: 1BCBSO $2..00
'. SUBTOTALS:t $144.50 $373.00' TOTAL FEE• $517:5.0
Revised:. 04/29/2013
CITY OF CUPERTINO`BUILDING PERMIT
,BUILDING ADDRESS: 10.200 S'DE-ANZA BLVD CONTRACTOR:TECHNICAL BUILDERS, PERMIT NO: 12050046•
INC
OWNER'S NAME: SEAGATE TECHNOEOGY'LLC 349 S MONROE ST DATE ISSUED: 10/23/201.12
OWNER'S.PHONE: 4086581408 SAN;JOSE,CA 95128, PHONE.NO:(408)554-1011
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL❑ COMMERCIAL11
License Class Lic.# / 'o CONSTRUCT 800 SQ FT EMERGENCY GENERATOR
�-� , 4 � ENCLOSURE
'Contractor're }_HW CAI 80,1-0*L Date Z IN UNDERGROUND GARAGE, EXHAUST"STACK
hereby affirm,that I am.licensed under the provisions of Chapter 9 W/ENCLOSURE
(commencing,with:S.eetion 7000)of Divisiorr3 of the,B'usiness&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,8 provided.for by Section 37001of the Labor Code,for.the
.performance of the work for which this`permit.is issued. Sq.Ft Floor Area: Valuation:$500000
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:36907035.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
Lcertify that I have read,thisapplication and state that..the above information is PERMIT EXPIRES'IF WORK ISNOT STARTED
correct._I agree to comply with all cityand county ordinances and stateaaws relating WITHIN DAYS OF PERMIT ISSUANCE OR
to build in&construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for,inspection purposes. (We)agree to save 18O DAM".LAST CALLED INSPECTI N.
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: AZAdditionally,the applicant understands,and will comply Issued by:. %�% Date: 119.
with all nori-point_sou ations per the Cupertino Municipal Code,Section
9:d 8. .
RE-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 materialsf&
inspection.
❑ OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
hereby affirm that.1-am exempt from the Contractor's,License Law for one of-
the following;two reasons: ALL.ROO_ F 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. l4iR
I herebyafffrm 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),shou1d 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'bySection 3700 of the Labor Code,for the air contaminants as defined.bythe:Bay Area Air Quality Management District-.1
performance of the work for-which this permit is issued. will'maintaim.compliance with'the Cupertino Municipal Code,Chapter 9.12 and
1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&SafetyCode,Sections 25 ,25533,and 25534.
Section,3700 ofthe Labor"Code,.for the performance of theswork for which this
Owner or authorized agent: * 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;inanymanner 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;subjebt to'the'Worker'.s Compensation provisions ofthe"Labor.C.ode;,,limust '1 hereby affirm that there_i's 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 Lhave;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 buildingconstruction,and hereby authorize representatives of this:city to enter
'upon:the;above mentioned property for inspection purposes.(W.e).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 ofthe 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 CUPERTING
FEE ESTIMATOR—BLTI'"LDING DIyISION
ADDRESS: 1'0200 DeAnza:BlVd DATE: 06/03/2012 REVIEWED BY. Sean
APN: BP#: 10�0500 -VALUATION: $500',000
WRMIT TYPE: Building Permit PLAN ellECK TYPE;. Tenant"Improvement
PRIMARY --------------- PENTAMATION
USE: 'Commercial,Building 1 B TI
PERMIT TYPE:
WORK Construct 8Ws g ftemergency enerator encl8sifre in under"""round•,&a i e.
SCOPE
OCCUPANCY TYPE: TYPE OF' FLR.AREA PC FEES PC--FEE,ID` 'FillFEES BP-FEE ID
CONSTR.. .- s.f. - ..
B (Tenant Improvements) 11-B,111-BjV—,V-B 800 $'1,936:00 1BTIPLArCK $847.60 1BTHNSP
TO,.TALS.� 800. $1,93600 $847 60 MIN '
gMECH HOURLY Yes � No PLUMB H®URLY 1 Y.esQF No" ELE'C,HOiTRLYN �® Yeses
a � ��� ,._ .� Fx _ �
Xfec1r. Ilan(`,heck k'riimh r'lcor C'r eci L, :. Pran
Lfech. Permit P'ee:• 111fad;! Pc an Fee.< I lc.r. p'nrrlit Fee:
C)lhEi 1fea:rr:Insp. O(h&Plumb"!n"sp: Lj
OJher~I 'e,:.Rasp,
tHoch Ins;F e?:' 1?1innb n,`-)_Fee
NOTE: Thinestimate:doesynot'include fees,dtie to other Departments(i e.Planning,;Public Works,Fire,•Sanitary Sewer District,School
District,ete : 'These ee"s.are based on.the ieliinirtd: 'in ormation availab•le;.andare,onl y ani&-iimhte., Contact the Dept. or addii'lan fo.
FEE ITEMS (Fee Resolutibr;11.-053:1 f' M1111 FEE QTV'/FEE NIISC,ITEMS
Plan Che&,Fee $1;936100 Select a•,Misc Bldg/Structure
Sup0L,PC:Fee: 0 Reg. 0 O 0.,0 hm $0.00 or.Element,of-aBuilding
PME_Plan Check; $0:00
Permit Fee':.' $847.60
Suppl. Insp. Fee: 0rs .00: OTQ Reg
PME Unit Feer, $0.00'
PME:Permit Fee: $0.00,
Cans"tr7.lci�n Ttir
1-T
�icrrnirlisFr;alivc,.Fec�: ®
Work Without-Permit? Yes No
AdvancedPlanning Fee: $0:00 Select;a Non-Residential
I iscn l I)ourrirciturrcirr I'E`es: - Building or Structure,
'Strong:Motion Feer IBSEISMICO. :$105.04 Select an Administrative;Item
Bldg* Stds Comn'i'ssion.Fee 1BGBSC $2:0 LL00
W, m ' asuBTOTALs
'908.60 $0.00 TOTAL F,E'E� $2,908.60:
j.
Revised` 04/01/2012