11080160 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20400 STEVENS CREEK BLVD CONTRACTOR:GIDEL AND KOCAL PERMIT NO: 11080160
OWNER'S NAME: CUPERTINO CITY CENTER BUILDINGS 574 DIVISION ST DATE ISSUED:09/02/2011
OWNER'S PHONE: 4088730121 CAMPBELL,CA 95008 PHONE NO:(408)370-0287
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL[]
License Class Lie.# STE 150-COMM T.I(2000SQFT)INTERIOR
/' �/ ALTERATIONS:DEMO OF NON-BEARING
Contractor [9i Date PARTIONS,DOORS,FRAMES,MILLWORK
I hereby affirm that I am licensed under the provisio s o Chapter 9 &CONSTRUCTION OF
(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:$125000
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:36901028.00 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 WITHIN 180 DAYS 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 DAYS 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 2
Issued by: Date:
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. --'"'J�
yy 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 materials for
inspection.
[� OWNER-BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
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(Scc.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
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 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Owner or authorized agent:
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 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 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
I
I
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20400 STEVENS CREEK BLVD CONTRACTOR:GIDEL AND KOCAL PERMIT NO: 11080160
OWNER'S NAME: CUPERTINO CITY CENTER BUILDINGS 574 DIVISION ST DATE ISSUED:09/02/2011
OWNER'S PHONE: 4088730121 CAMPBELL,CA 95008 PHONE NO:(408)370-0287
❑ LICENSED CONTRACTOR'S DECLARATION '
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.# X ,_— F
i
MECH RESIDENTIAL COMMERCIAL
Contractor Date
JOB DESCRIPTION:STE 150-COMM T.I(2000SQFT)INTERIOR
I hereby affirm that I am licensed under the provisions of Chapter 9
ALTERATIONS:DEMO OF NON-BEARING
(commencing with Section 7000)of Division 3 of the Business&Professions PARTIONS,DOORS,FRAMES,MILLWORK&CONSTRUCTION OF
Code and that my license is in full force and effect. 12/12/2011-DEF#1-DEFERRED MECHANICAL-ADD 5 TON HVAC UNIT AT
INTERIOR LOCATION-1/5/2012 DEF#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:$150000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36901028.00 Occupancy Type:
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, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses w c ay accrue against said City in consequence of the
granting of this perm' . A ditionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point so rce r gulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. / I
Dat4�_ l"
Signature Issued 43'_ Date• �-
❑ OWNE - UILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(See.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
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:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
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.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaimi
ed by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's mainwith the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Heale,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must Onvnagent: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 iscorrect.I agree to comply with all city and county ordinances and state laws relating I hereere is a construction lending agency for the performance of�wrk's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
e
CITY OF CUPERTINO BUILDING PERMIT yN
BUILDING ADDRESS: 20400 STEVENS CREEK BLVD CONTRACTOR:GIDEL AND KOCAL PERMIT NO: 11080160
OWNER'S NAME: CUPERTINO CITY CENTER BUILDINGS 574 DIVISION ST DATE ISSUED:09/02/2011
OWNER'S PHONE: 4088730121 CAMPBELL,CA 95008 PHONE NO:(408)370-0287
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
License ClassLic.#
�09 MECH RESIDENTIAL COMMERCIAL
Contractor �Q� R�'WtC! Date I '
JOB DESCRIPTION:STE 150-COMM T.I(2000SQFT)INTERIOR
I hereby affirm that I am licensed under the provisions of Chapter 9 ALTERATIONS:DEMO OF NON-BEARING
(commencing with Section 7000)of Division 3 of the Business&Professions PARTIONS,DOORS,FRAMES,MILLWORK&CONSTRUCTION OF
Code and that my license is in full force and effect.
REVISION#I-REVISE ELECTRICAL LAB,ADD 2 NEW PANELS W/ADDITIONAL
I hereby affirm under penalty of perjury one of the following two declarations: OUTLETS/RECEPTACLES-11/01/2011 REV#I ISS'D
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:$125000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36901028.00 Occupancy Type:
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 mentione operty for inspection purposes. (We)agree to save
indemnify and keep har less the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses wh' h ma accrue against said City in consequence of the
granting of this permit. ddi onally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point sourc re lations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature DateI Issued by. Date:
I�
❑ OWNE -B DER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
I,as owner of the property,amexclusively contracting with licensed contractors to Signature of Applicant: Date:
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:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
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.
permit is issued. Additionally ould I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall co stamina s a defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain c mpl' nce with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&S fet Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or orized agent:
forthwith comply with such provisions or this permit shall be deemed revoked. Date: I I 0
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 I hereby a tat there is a construction lending agency for the performance of«ork's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 20400 stuns crk blvd DATE: 12/12/2011 REVIEWED BY: bobs.
APN: BP#: *VALUATION: $25,000 j
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARY Commercial Buildin PENTAMATION IDS
USE: g PERMIT TYPE:
WORK deferred mechanical add 5 ton hvac unit at interior location.
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
Deferred Submittal (Not R-3) II-B,111-B,IV,V-B 0 $0.00 $0.00
TOTALS: 0 $0.00 $0.00
MECH HOURLY 0 Yes (E) No PLUMB,HOURLY Q Yes (2) No ELEC,HOURLY 0 Yes Q No
Ah:;z sa 1-'?tt+t# rt r�3� Farrar=t # dtrE'..Phil?
L
Lj
:h.
NOTE:This estimate sloes not include fees Clue to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . These ees are based on the prelinina information available and are oi!iE an estimate. Contact the Dept-for addit'l info.
FEE ITEMS (F(,e Resolution 11-053 Eff 711111) FEE QTY/FEE MISC ITEMS
Plan Check Fee: Hourly Only? Q Yes 0 No $0.00 4 hours Plan Check,Hourly
Suppl.PC Fee: Q Reg. 0 OT 0.0 1 hrs $0.00 $520.00 1STPLNCK
PME Plan Check: $0.00
Permit Fee: Hourly Only? Q Yes G No $0.00
Suppl.Insp.Fee:Q Reg. Q OT 0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
F-71
0
Work Without Permit? 0 Yes Q No $0.00 G
Advanced Planning Fce: $0.00 Select a Non-Residential
( tr,.,,f}r tr t3 z 1 ;{;: Building or Structure
i
Strom Motion Fee: IBSEISMICO $5.25 4.0 hrs Inspections
Bldg Stds Commission Fee: IBCBSC $1.00 $520.00 1STINSP Inspection,Hourly
SUBTOTALS': $6.25 $1,040.00 TOTAL FEE: 1 $1,046.25
Revised: 12/04/2011
i
I
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 20400 stvns crk blvd DATE: 10/24/2011 REVIEWED BY:
APN; BP#: 11080160 "VALUATION: 1$25,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY Commercial BuildingPENTAMATION 1GENCOM
USE: PERMIT TYPE:
WORKrevise electrical at new lab adding2 new panels, additional outlets/receptacles.
SCOPE
p 2?;. i17Sj3,
C�-i7c'i ff
fav"', 'Fee.,
NOTE:This estimate does not include fees due to outer Departments(i.e.Planning,Public Works,Fire,Sanitary Server District,School
District,etc. . Theseees are based on the relirrina in ormntion available and are onl an estimate. Contact the De t or addn'I in o.
FEE ITEMS (Fee Resolution 11-053 L'ff. 7/1/11) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $0.00 Select a Misc Bldg/Structure
Suppl.PC Fee: 0 Reg. Q OT 0.0 hrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $0.00
Suppl.Insp.Fee:Q Reg. 0 OT Q,Q lus $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
- 0
Work Without Permit? 0 Yes 0 No $0.00 0
Advanced Planning Fee: $0.00 Select a Non-Residential 0
Building or Structure 0
7';`tf;%cl iiriF'ii}i7 'i'%li t`I,f3i1 'f'1"i:
Strong Motion Fee: IBSEISMICO $5.25 1 # Revision
Bldg Stds Commission Fee: IBCBSC $1.00 $783.00 IREVCOMTI I Tenant Improvement
SUBTOTALS: $6.25 $783.00 TOTAL FEE: $78925
Revised: 10/01/2011
i
CITY OF CUPERTINO
FEE ESTIMATOR—BUILDING DIVISION
ADDRESS: 24000 stvns crk blvd#150 DATE: 08/22/2011 REVIEWED BY: bobs.
APN: BP#: "VALUATION: 1$125,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement
PRIMARY PENTAMATION 1 B TI
USE: Commercial Building PERMIT TYPE:
WORK U. comm. offices ace non load bearing partition and doors t-bar, include M Es.
SCOPE
OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID
CONSTR. s.f.
B (Tenant Improvements) I-A,I-B 2,000 $3,053.90 IBTIPLNCK $2,475.15 IBTIINSP
TOTALS: 2,000 $3,053.90 $2,475.15
MECH,HOURLY 0 Yes (F) No PLUMB,HOURLY 0 Yes Q No ELEC,HOURLY 0 Yes ONO
t'ttP
Ll
E3
P,
NOTE.Thesefees are based on the preliminary information available and are only an estimate. Contact the Dept./or addn'l info.
FEE ITEMS Fee Resolution 11-053 Fff. 7l1i111 FEE QTY/FEE MISC ITEMS
Plan Check Fee: $3,053.90 Select a Misc Bldg/Structure
Suppl.PC Fee: G Reg. 0 OT 0.0 hrs $0.00 or Element of a Building
PME Plan Check: $0.00
Permit Fee: $2,475.15
Suppl.Insp.Fee:O Reg. 0 OT F0.0 hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
Tax FA
Acoustical Fee: 0 Yes G No $0.00 0
Work Without Permit? 0 Yes 0 No $0.00 0
Planning Fee: $0.00 Select a Non-Residential 0
ra�,��Il:� r,itr;��:� r�tftat.r. 'c��s: Building or Structure 0
A
Strong Motion Fee: IBSEISMICo $26.25 Select an Administrative Item
Bldg Stds Commission_Fee: IBCBSC $5.00
SUBTOTALS: $5,560.30 $0.00 TOTAL FEE: 1 $5,560.30
Revised: 07/04/2011