The URL can be used to link to this page

11080038 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19376 STEVENS CREEK BLVD CONTRACTOR:G SWANSON PERMIT NO: 11080038 CONSTRUCTION OWNER'S NAME: SIMPKINS PHYLLIS TRUSTEE&ET AL 1658 WATSON CT DATE ISSUED: 11/16/2011 i I OWNER'S/PHONE: 7143093705 MILPITAS,CA 95035 PHONE NO:(408)946-3311 i ❑ / LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# L4oS1`4 Lo i MECH RESIDENTIAL COMMERCIAL Contractor G Su�w^^�Sov. Ca>"�t Date I l• 4r I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:BANK OF AMERICA-INSTALL BANDIT BARRIER AT (commencing with Section 7000)of Division 3 of the Business&Professions EXISTING TELLER LANE 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. 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:$60000 permit is issued. APPLICANT CERTIFICATION APN Number:37501018.19376 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 harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply 180 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Signature ate V ' l/ Issued by: Date: D ❑ 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(a)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 Heanor ty 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 Owori ent: A 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-work'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 expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 U��tTINC� (408)777-3228• FAX(408) 777-3333•buildincCa,cupertino.ora El NEW CONSTRUCTION ❑ ADDITION ALTERATION 1 TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# _ 7 rV PROJECT ADDRESS APN# OWNER NAME ' l � PHONE E-MAIL -Sol 3 _J STREET ADDRESS CITY, STATE,ZIP �y ( F 15 2. C f CONTACT NAME PHONE E-M IL STREET ADDRESS CITY,STATE, ZIP FAX 6t1 a r 2-1 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 1:1CONTRACTOR AGENT ARCHITECT El ENGINEER El DEVELOPER El TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# L COMPANY NAME Cti Sw��'w,3�" E-MAIL ,y SW�—''�S O ALO�) FAZe D J �i_*I, 5�f G S 3 5 v STREET ADDRESS (�SQJ W l� 1 S 0� `�1 CITY,STATE IP i C g PHONE SV` 3 ARCHITECT/ENGBJEER NAMELICENSE NUMBER BUS.LIC# A. 2 COMPANY NAME � E-MAIL/,y,(/� v//�_f I/1�M � Q,//��(�,t�' FAX STR ET ID SS CITY,STATE, IP PHONE l P 5 tsL C ZS.2 04. 2-10 0 DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT, VALUATION($) EXISTG NEW FLOOR '' "', DEMO TOTAL AREA 2. t✓g" AREA 160 AREA NET AREA BATHROOM KITCMN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: DETACH []ATTACH #DWELLING UNITS: �ISASECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: TOTAL VAj,UATIO PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLERHOME? ❑NO ! it 2L_ 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 behalf. I have read this application and the information I have provided's corre t. I�bave read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating tb I3u'ding coStructi n. I aut}�lorize representatives of Cupertino to enter the above-idenf fled properly for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ®`PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosures ANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE El FIRE DEPT j _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doe revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 19376 stvns crk blvd DATE: 08/04/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: $60,000 j 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Buildin PENTAMATION 1 B TI USE: g PERMIT TYPE: WORK �,I.= Install bandit barrier at existing teller lane. SCOPE TYPE OF FLR AREA OCCUPANCY TYPE: CONSTR. (s.f.) PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,111-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 MECH,HOURLY 0 Yes G) No PLUMB,HOURLY 0 Yes Q No ELEC,HOURLY 0 Yes Q No •,i`d'.lf rfctt;{ 7.r::i;. r`icft3f? r ,c:-, C sji'E"Fq L�£:.,�tlFll� -.r, E3 t1,tztf'i'tilt't-it ,;;,�;. �'?t:'te: r'iraffiir lar:;; ET � a Ir.lrasti. 1�2?rt: i7„,zt! '..Ef3,1 ec: r r.Te�sj>, l�ts NOTE: These ees are based on the preliminary information available and are only an estimate. Contact the De t or addn'1 info. FEE ITEMS Fee Resohttio 111-053 fff 7/Illl,� FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes 0 No $0.00 ® hours Plan Check,Hourly Suppl.PC Fee: G Reg. 0 OT 0.0 1 hrs $0.00 $520.00 ISTPLNCK PME Plan Check: $0.00 Permit Fee: Hourly Only? Q Yes 0 No $0.00 Suppl.Insp.Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes 0 No $0.00 0 Work Without Permit? 0 Yes G No $0.00 Pla�ee: $0.00 ®hours Inspections Q $520.00 ISTINSP Inspection,Hourly 0 i Strong Motion Fee: IBSEISMICo $12.60 F-0-.51 hrs Admin./Clerical Fee Bldg Stds Commission Fee: IBCBSC $3.00 $41.00 1ADMIN SUBTOTALS: 1 $15.601$1,081.001 TOTAL FEE: $1,096.60 Revised: 07/04/2011 Gensler i 6111 Bollinger Canyon Road lei 925.904.2100 Suite 540 Fax 925.904.2.199 San, Ramon CA 94583 USA October 21, 2011 City of Cupertino Building Division 10300 Torre Avenue Cupertino, CA 95014 Subject: Bank of- America — Vallco Park 19 73 6-Stevens-Creek Blvd. Permit number 110800338� Dear Arnold: I have reviewed the cost estimate.provided by GSvranson Construction, Inc. in regards to the accessible upgrades to the existing restrooms, dated Octoberl21, 2,011 and signed by Carl Swanson. I have reviewed the cost estimate provided by GSvranson Construction, Inc and found the cost.estimate to be within reasonable construction costs. Should you Any questions, gAse call me at 925.904.2100 Michael Downey Architect c \users \14663 \desktop \Itd111021m.dmx