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13010088I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRE SS: .10 150 N WOLFE RD ( CONTRACTOR: :W.L. BUTLER I PERMIT NO: 13010088 I OWNER'S NAME: J C PENNEY PROPERTIES INC 1204 FRANKLIN ST I DATE ISSUED: 03/20/2013 I OWNER'S PHONE: 9724311693 1 REDWOOD CITY, CA 94063 ( PHONE NO: (650) 361-1270 1 ❑ LICENSED CONTRACTOR'S DECLARATION License Class 5' Lic. Contractor `,YFl ! _ 1_L2i r fv ss _ Date /' � rtC I hereby affirm that am licensed under fhe provisions of Chapter 9 (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. 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. 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 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 which may accrue against said City in consequence of the 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. % Signature ✓ ��i�, ls' G� Date / 7 ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). I hereby affirm older penalty of perjury one of the following three 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. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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 which may accrue against said City in consequence of the 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. JOB DESCRIPTION: RESIDENTIAL COMMERCIAL JCPENNY'S 150 SQ FT TENANT IMPROVEMENT ON 2ND FLOOR (JOE FRESH). Sq. Ft Floor Area: Valuation: $9500 I APN Number: 31620094.00 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAB FROM LAST CALLED INSPECTION. Issued by: Dat1% RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE. 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 compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: x�7� �° r� /1 Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Signature Date CONSTRUCTION IT APPLICATION IKI%l COMMUNITY DEVELOPMENT DEPARTMENT ^ BUILDING DIVISION 1.16 10300 TORRE AVENUE , CUPERTINO, CA 05014-3255 l�� Fti It�l (408) 777-3228 a FAX (408) 777-3333 a h,_IiIc4�g,-- r, ipr}¢Fi �g_�arc#, ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # P O G aEs /1 t EAP14 # y— o o 944ham( ) OWNERNAME LI l E-MAIL 1„� STREET ADDRESS CITY, STATE, ZIP FAX ( CONTACT NAME PHONE. M IL �C11(1`�nG� - 77 r1 C%3 (Y11 C'j V 1; ST D RESS U i 1/ V d . 0 1� 8u 1 I 701 d F�X '- � ` ( `` I , J ! / ❑ OWNER ❑ OWNER -BUILDER Ild OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT 1�TR�gTQR_ SIAMF� �� ) I d LICENSE NUMBER 7CENSETYPE BUS. LTC # -P8ANE C E-MAIL FAX �. �� RES't- ., kL r w L C ` ^ ^ l STATE, ZIP �� ,` � PHONE HITEeN INEE N�A�MEj LICENSE NUMB ! ' s BUS. LTC # GQMPA 1VAME ,,, /5I.✓�A- E-MAIL FAX(6j N -' -��y C C RE TY � � , ST T , ZIP � !� 1 �L�l� ✓� JE \0 ''`t DESCRIPTION OF WORK C l i k f e t 1 EXISTING USE PROPOSEIJUSE CONSTR. TYPE !I STORIES /Y USE TYPE OCC. SQ.FT. VALUATION VY (S) I EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA no BATHROOM KITCHEN REMODEL ARFA REMODEL AREA OTHER REMODEL AREA AD PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ Y�8 BEING ADDED? O SECOND STORY ❑ YjS ADDITION? O PRE -APPLICATION �❑--�YES 1F YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BY: TOTAL VALUATION: PLANNING APPI, # 0"0 PLANNING APPROVAL LETTER EICHLER HODIE? 2qH 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 is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relati�to/�b ilding construction. I authorize representatives of Cupertino to enter the able-identred property for inspection purposes. Signature of Appiicant/Agent: i i�J (t� 6-1(-J-0 Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER B ILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXRESS PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE FIRE WEPT _ Copy Of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO IPPI . Fi.CTIMATOR — IIITII,DING DIVISION ADDRESS: 10150 N WOLFE RD DATE: 01/07/2013 REVIEWED BY: SEAN APN: BP#: V *VALUATION: $50 9,0 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 1 M TI PERMIT TYPE: i USE: WORK FOR JCPENNY (2ND FLR JOE FRESH),150 SQ FT �TI SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID M (Tenant Improvements) II-B,III-B,IV,V-B 150 $2,676.00 IMTIPLNCK $535.00 IMTIINSP TOTALS: 150 $2,676.00 $535.00 MECH, HOURLY 0 Yes E) No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY ®Yes ' Q No j,fcu:h. Ptara C72ec'h Piiuuh, Ptciir Cherk Eke. Phw? Check },fech. Perwa Fee,, Phmib. Permit Fee: Llec. Pernrill ee: Other Heeh. hasp. Other Phimb In, Usher Dec. hasp, /I'IeCti. has17. fee: Ptimih. hap. Fee: Elec. LYSIJ, Fee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Yubnc works, clre, Sanitary newer utsuzcy vc.owc ,. .. L,......1 41. ,...,...Nw:..nr.r i..f r...n/inaf nvnilnhlo and are nn1v an estimate. Contact the Dept for addn'I info. visrrici, eec . lnese Ives die based on .ne .�........... FEE ITEMS (Fee Resohition 11-053 Eff. 711112) ... ........ ........... FEE .- - QTY/FEE - - MISC ITEMS Plan Check Fee: $2,676.00 Select a Misc Bldg/Structure or Element of a Building, Suppl. PC Fee: 0 Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $535.00 Suppl. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C611S101C1i011 T41A". A(110idstrative Fee.: 0 E) Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential G Building or Structure 0 Trovcl Doco71 entolio l Fees. StrongMotion Fee: IBSEISWCO $2.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $3,214.001 $0.00 TOTAL FEE: $3,214.00 Revised: 10/01/2012 Customer: Mike Curren Project Manager WL Butler Construction, Inc. 140 Frank West Circle, Suite 100 Stockton, CA 95206 i 1821 fl ..i Street, Suite rnn 'Sa --"'-_ C nq nr 15 h.i,t {-_4_r �s n 1 I�JVVaIU Sit e+'i�.[, VUlla JJ�, Vali it! iGlll.l`ui..i) �A �41 VJ 4 17.o IYt 3 t J V 4 i5.5LV.i7294 F FIELD REPORT �) 0f 0-0 1� Job Addresses: JCP Store, 10150 N. Wolfe Rd., Cupertino FILE Job Date: 04/24/2013 Job Scope: Concrete slab scan for rebar and post -tension cable at merchandise wall structure to verify if conflict exists between Hilti fastener bolts and reinforcement tendons. Equipment: Hilti Ferroscan PS/1000 Findings: Scanned slab around perimeter of merchandise wall structure. No post -tension cable detected. Confirmed rebar reinforcement at 3' depth. Horizontal distance from rebar to Hiltl bolt locations is approximately 5" or greater. Summary: There is no vertical or horizontal location conflict between the Hilt! fastener bolds and the rebar reinforcement. t' Ica contact m f: arras haV_— .-, d la c findings. i rcc7'S,e c"�.i'iircui.a i1rV� it yvc.i ridva any q�.i'�.otlUli� Ui need iidr�ii(:at�tiii Lir viir ifn�iings. Thank you. Report prepared & submitted by: Ernie Villanueva West Coast Locators, Inc. 415.314.94 55 office 415,520,5294 fax &'! �IE3(C�WLS(GCJiI=t�OC�i�(Jff_5,C:CJrII e_