12090002 CITY'OF-CUPERTINO BUIL�IING`PERMLT
BUILDING ADDRESS`<:20688 STEVENS-CREEK BLVD CO/NTRACTOR:, PERMIT NO:'12096002'--•'
iowUNER;S NAME:;BYER PROPERTIES LP DATE, ISSUED':02/26/2013
OWNERS PHONE:;41'56262937; PAONE'NO:'
CD , LICENSED CONTRACTOR'S DECLARATION, JOB DESCRIPTION: RESIDENTIAL ElCOMMERCIALIJ
:'�
License'Class Lic:rf FREEBIRDS RESTAURANT-COMMERCIAL TENANT
O
P
IMRV T F S ,
EMENT`2366'SQF ORNEW'R'E TAURANT;
Contiactoiy WITH.
hereby'affirm,that Fam licensed under`ttie,provisio_ns.oG,Chapter 9• OUTDOQR E-ATINO PATI0;302 S,QFT
commencm with Section 7.000 of Division3 of the,Busincss&iProfessions
Cod'e+anaa6ahmy'li`cense is in'4ull.force;and:cffect:
I hereby affirm undcr°penalty of perjury one of the';following tw,o;declarations:
Fhave:and.will maintain a certificate,of consent-fo self-,insure fot Worker's
Compensaiion,:as provided for by Secii6n3760 of the Code,for';thel
performance of the work for which this permit is•issued:
. - Sq.FkFloor'Area: Valuation:y$200000
fh.4,e and'will maintain Worker's,Compensation Insurance;a.s provided for by
Section:3700 of
the:Labor•Code,for the performance of the work-forwhich this
APN'Numbci:-35908020.20688 Occupancy Type:
jpermit.is issued.
APPLICANT CERTIFICATION
Tcertify that I_haveread this.,applieation an-&state that tficabovc information is PERMIT'EXPIRES'IF WORK IS NOT STARTED'
correct.I`agrecoto complyaWiih all city andscounty ordma"nces and state'laws Pel'ating WITHIN 180 DAYS OF PERMIT ISSUANCE,OR.
to:buildiqg`constr&tion,,and'hereby.authorize xepresen taiives,of"this city to.cnter
upon the:abovcrmentloned property'for inspection purposes (We)agree to:save 180 DAYS FRO -ALLED INSPECTION.
q .
indemnify and*ccp;harmlcssthe,Cityof Cupertino against habiliiies judgments,
costs and,expenses which may accrue:agamst said City im;consequence of the - Z
rantiri of this,"ermit. Additional) the hcant understands"and"I comp,I Issu = Date:` �3
g g, P Y, Pp. P,Y
with all.non-point'source-;regulations'per the'Cupertino Municipal Code,Section
RE-ROOFS-
Date
Signature; Date Com` L-�J ��; All roofs;shall be;insp'ected:pnor'to any roofing
,material being.,installed.if a roof is
installed withouf,firstobtaining'an inspection,].agree to removeiall.new.materials for, `
- :inspection:
CD �' ONIMER-BUILDER DECLARATION_.
;Signature of Applicant; Date:
I h-ereby,affi�m'ttiat I,am•exempt from the Coidractor's:License Law,forpric,of
the follow ngawo reasons: l ALL-ROOF COVERINGS,.T.O BF-CLASS'-'A"OR.BETTER.:'. '.
I;asowner;ofthe,p._-perty;orm em rlo ees with wa es;as the grs-ole compensation,
ro Y _P Y g
will do the'work,.anil the stiucturc js'not intended'or offered for sale:(Sec:7044,
Business&Professions Code) .
I,.:as owner;ofthetproperty,am exclusivelyrcoritracting with,licensed contractorsto HAZARDOUS MATERIALS`DISCLOSURE
• construct;the`project;
CITY OF CUPERTINO.
FEE ESTIMATOR—BU.ILDIN.G DIVISION
ADDRESS: 20688`Stevens;Creek Blvd DATE: 09/0412012 REVIEWED BY: Sean
APN: BP#: 'VALUATION: $200;000
%PERMIT TYPE: Buildiri'g Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARYPENTAMATION
Commercial Building 7 1A TI
USE:; PERMIT TYPE':
WORK' Tenants Im rovement for fireebirds t&`e taurant 2366 sq ft).with oiatdo(or eatin.:patio 302'sq ft).
SCOPE '
TYPE.OF' FLR AREA
OCCUPANCVTYPE: CONSTR. s.f: PC FEES PC FEE ID BP.-FEES BP FEE`ID
A;(Tenantimproverhents) II-6;111=B,IU U=B 2,366. $2,331.79, .1ATIPLNCK $1,281.55 ]ATIINSP
TOTALS: 2.,366 $2331.79. IN WEPON
':' $1;28,1,.55 �s
`arj - • . >.�- .ire : —1 ,, ".,� � % ,.a&#
1YIsECHHOUY O yY�es � No PLUMB,H®U,rRLY OYes -LLO ELEC�HOURLY Wes Q No
�• ,._ ..
; MM
Llf>ch. Pion Check C liee '.;'lec. Plan-Chr:ck
n.
rLlecli. /c>rniit,F`ee; l'ltrnL:,Per`rnuF:e: l:/c:r•:Pei'rnii.l�e<rr
C)rlrer'ri9ec.rh.lnsji• ET--j
C)fiZr F?itn?r1 Incl. ED7-- 01hef f-,7
lec;,Insp.
1%Iech:.Irrs :.F7rrL'=. 1'irm7b.:irt',i. Fcce= Oeu..insp..l''r:e:
NOTE:This estimate does ndt include fees due'..to other..Departments(i.e:Planning,Public Works,Fire,.SanitarySeWer District,School'
District;.etc . These•ees,are..based on the, relimina. inf orrnddon available anda'are onl <an,estimate: Contact the,De t or addn''1 in o.
'FEEATEMS.-Eee Re"solution 11-053 Eff' 7f /1%1.1) 'FEE QTY/FEE, MISC ITEMS
Plan Check Fee:; $2,331.79 :Select a Misc:,Bldg/Structure
;Suppl.'PC Fee: Q Reg. ® OT 0.0 hrs $,0".00 or Element of a�Building
'PME Plan Check: $.0:00
;Permit Fee: $1,281.55
S:up1nFeQReg. OTQ plhrs $0.00
PME,Unit Fee:. $0.00°
PME'Rermi't Fee:
�Canstrrerction'Ici:>=:
I:Anlcriszrari.ve.E,ec: 0
Work`WithoutPermit? Q Yes (j) No $0.00
AdwancedlYlanning Eee , $0.00 Select a Non-Residential �
7aiel Doc:%ri>ieniulirirr a-cE s Building or Structure 0
A
Strong Motion-.Fee: IBSEISMICO $42.00 S'elect,an Adrnini'strative Item
Bldg Stds Comini'ssion Fee: 1BCBSC ;$8'.00
I NO '�SUMT ALS TOT�ALFEE
,i, " $3,663:34 $0:00 � $3,663.34
Maltea. , . k � r ,.
Revised: 07/01/2012