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10080078CITY OF CUPERTINO BUILDING PERMIT r BUILDING ADDRESS: 19875 STEVENS CREEK BLVD CONTRACTOR: CINDY CHENG PERMIT NO: 10080078 OWNER'S NAME: CINDY CHENG I9875 STEVENS CREEK BLVD DATE ISSUED: 11/23/2010 OWNER'S PHONE: CUPERTINO, CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATIONr BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# MECH r RESIDENTIAL COMMERCIAL r Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: KIDDIE ACADEMY- T.I.REMOVE ALL EXISTING INTERIOR (commencing with Section 7000) of Division 3 of the Business & Professions CONSTRUCTION -NEW INTERIOR WALLS, Code and that my license is in full force and effect. MECH/ELEC/PLMBING, ADD FRONT & REAR DOOR -NO 10/18/11 - REVISION #2- REVISE ELECTRICAL & STRUCTURAL DETAIL FOR I hereby affirm under penalty of perjury one of the following two declarations: RELOCATED LIGHT POLE -11/04/201 I REV#2 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 Sq. Ft Floor Area: Valuation: $550000 permit is issued. APPLICANT CERTIFICATION APN Number: 31621031.00 Occupancy Type: I certify that I have read this application and state that the above information is correct. 1 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 which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non -point source regulations per the Cupertino Municipal Code, Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signatu Date 7_1 Issued bar' < - Date: ,��— -17- 91 OWNER -BUILDER 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, am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 Section 3700 of the Labor Code, for the performance of the work for which this compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & 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 contaminants as defined by the Bay Area Air Quality Management District 1 will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Compensation laws of California. If, after making this certificate of exemption, I Health Sections 25505,25533, and 25534. become subject to the Worker's Compensation provisions of the Labor Code, I mustforthwith comply with such or this shall be deemed revoked. q&Code, Own zed agent: /Date: provisions permit 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 affirm that there is a construction lending agency for the performance of Hork'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 applic t understands and will comply with all non sour regulations per the pertino Municipal Code, Section ARCHITECT'S DECLARATION 9.18. / (/� I understand my plans shall be used as public records. SignatuSignature.Date t 1 / Licensed Professional CITY OF CUPERTINO BUILDING PERMIT-�-E 1 O BUILDING ADDRESS: 19875 STEVENS CREEK BLVD CONTRACTOR: ELITE FORCE PERMIT NO: 10080078 CONSTRUCTION OWNER'S NAME: CINDY CHENG 10128 DENNIS CT DATE ISSUED: 11/23/2010 OWNER'S PHONE: SAN JOSE, CA 95127 PHONE NO: (408) 926-7641 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL II License Class Lic. # KIDDIE ACADEMY- T.LREMOVE ALL EXISTING INTERIOR Contractor Date CONSTRUCTION -NEW INTERIOR WALLS, I hereby affirm that I am licensed under the provisions of Chapter 9 MECH/ELEC/PLMBING, ADD FRONT & REAR DOOR -NO (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 4/8/11 REVISION #1 SITE PLAN SHOWING NEW HC I hereby affirm under penalty of perjury one of the following two declarations: ACCESS, NEW ELECTRIC ROOM, ELECTRICAL SWITCH I have and will maintain a certificate of consent to self -insure for Worker's GEAR DRAWING SHOWING NEW SWITCHGEAR AND Compensation, as provided for by Section 3700 of the Labor Code, for the NEW SUB PANELS, TRASH ENCLOSURE DETAILS performance of the work for whichthis permit is issued. SHOWING NON-COMBUSTABLE ROOF- ISSD 10/18/2011 1 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: $550000 permit is issued. APN Number: 31621031.00 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We) agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 180 DAYSFP M LAST CALLED INSPECTION. granting of this permit. Additionally, the applicant understands and will comply , with all non -point source regulations per the Cupertino Municipal Code, Section Issued by: Date: lU i 9.18. 1-4 Signatur Date RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is OWNER -BUILDER DECLARATION installed without first obtaining an inspection, I agree to remove all new materials for inspection. 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: Signature of Applicant: Date: 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, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 6LI HAZARDOUS MATERIALS DISCLOSURE 1 hereby affirm under penalty of perjury one of the following three have read the hazardous materials requirements under Chapter 6.95 of the declarations: California Health & Safety Code, Sections 25505, 25533, and 25534. I will I have and will maintain a Certificate of Consent to self -insure for Worker's maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Compensation, as provided for by Section 3700 of the Labor Code, for the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous performance of the work for which this permit is issued. material. Additionally, should 1 use equipment or devices which emit hazardous I have and will maintain Worker's Compensation Insurance, as provided for by air contaminants as defined by the Bay Area Air Quality Management District 1 Section 3700 of the Labor Code, for the performance of the work for which this will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections permit is issued. I Date: I certify that in the performance of the work for which this permit is issued, I shall Owner or authorized agent:` l l 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 CONSTRUCTION LENDING AGENCY forthwith comply with such provisions or this permit shall be deemed revoked. 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.) APPLICANT CERTIFICATION Lender's Name 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 Lender's Address 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 ARCHITECT'S DECLARATION granting of this permit. A itionall , the applicant understands and will comply with all non -point sour ula ' s per the Cu o Municipal Code, Section I understand my plans shall be used as public records. 9.18. `� (U ( f Licensed Professional Signature Date[ 1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19875 STEVENS CREEK BLVD CONTRACTOR: PERMIT NO: 10080078 OWNER'S NAME: CINDY CHENG LSO d2r• i DATE ISSUED: 11/23/2010 OWNER'S PHONE: PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION r r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic. #�Q)6 r r r _ r' 2J/l40 MECH RESIDENTIAL COMMERCIAL Contractor {< �: �-VCL° [pwrsifell pate 1 hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION: KIDDIE ACADEMY- T.LREMOVE ALL EXISTING INTERIOR (commencing with Section 7000) of Division 3 of the Business & Professions CONSTR INTERIOR WALLS, Code and that my license is in full force and effect FRO MECH/ELEC/PLMBQVG, ADD FRONT &REAR DOOR -NO EC/P MBIN 1 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 Sq. Ft Floor Area: Valuation: $550000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 31621031.00 Occupancy Type: APPLICANT CERTIFICATION 1 certify that 1 have read this application and state that the above information is correct. 1 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. Issuedby:�— Date: Signature Date « ❑ OWNER -BUILDER DECLARATION RE -ROOFS: hereby affirm that 1 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, 1 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: I, 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 1 hereby affirm under penalty of perjury one of the following three declarations: 1 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 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. 1 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 1 store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District 1 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 Health & Safety Code, Sections 25505, 25533, and 25534. Compensation laws of California. if, after making this certificate of exemption, l become subject to the Worker's Compensation provisions of the Labor Code,1 must Owner or hor' ed agent: forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that 1 have read this application and state that the above information is 1 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. 1 understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO F -M-7 FEE ESTIMATOR - BUILDING DIVISION OCCUPANCY TYPE: ADDRESS: 19875 Stevens Creek Blvd. DATE: 08/10/2010 REVIEWED BY: Larry S BP FEES APN: BP#: *VALUATION: 1$550,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement $7,169.06 PRIMARY USE: Commercial Building 7,07.1 L F1 -00R 4REA. APPLICATION TYPE: 1 E TI MECHANICAL Q Yes Q No PLUMBING Q Yes 0 No I ELECTRICAL Q Ye, (F) No 9 w Remove all existina int const new interior walls mep, add front door and rear door, restri a parking lot p c accessible parking, front and rear. Detached trash enclosure. 0.0 3� $0.00 OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s - PC FEES PC FEE ID BP FEES BP FEE ID E (Tenant Improvements) II-B,111-B,IV,V-B 8,845 $4,608.12 IETIPLNCK $7,169.06 IETIINSP $0.00 PME Plan Check: $0.00 Permit Fee: $7,169.06 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 8,845 $4,608.12 Curnslruclion Tax $7,169.06 I'lech, Plan Check F,,,,-/, . Usher Afec:h. hup. Plumb. Plmi Check Plumb. Permit Fce: Other PIUMb. hl -S/). c>t:. Plun Check Ele(. Pomil Fc<e: Otho Elec. blip. NOTE: These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 09-051 E f. 7/1109) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,608.12 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $7,169.06 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Curnslruclion Tax Acoustical Fee: Q Yes (D No $0.00 Work Without Permit? Q Yes (E) No $0.00 Planning Fee: PLLONGPNGC $2,211.25=] # $0.001 Lighting Pole 1 Q 0 Truti'el Documentation Fees: Strong Motion Fee: IBSEISMICO $115.50 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $22.00 SUBTOTALS: 14,125.93 $0.00 TOTAL FEE: 1 $14,125.93 Revised: 8/06/2010 WAN CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE. This estimate does not inehide fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc ). These fees are hated an the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (I ee Resolution 11-053 L'ff. 711111) ADDRESS: 19875 stvns crk blvd. DATE: 10/18/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: $300 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: Suppl. PC Fee: Q Reg. Q OT PENTAMATION 1 GENCOM PERMIT TYPE: WORK revise electrical and structural detail for relocated light pole. SCOPE NOTE. This estimate does not inehide fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc ). These fees are hated an the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (I ee Resolution 11-053 L'ff. 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: ;.)"hes' Aft -.1t ET Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT 0.0 NOTE. This estimate does not inehide fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc ). These fees are hated an the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (I ee Resolution 11-053 L'ff. 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Q 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 r rW"I' C T)0<41nnrrrl iol3 F rc , Strong Motion Fee: IBSEISAECO $0.50 1 # $783.00 Revision IREVCOMNEW Commercial New Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $783.00 TOTAL FEE: 1 $784.50 Revised: 1 0101 /201 1 FM_7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION 166J;00 -7S"' LMADDRESS: 19875 St. Creek DATE: 04/07/2011 REVIEWED BY: APN: 31621031 BP#: "VALUATION: $100 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: Suppl. PC Fee: G Reg. ©OT PENTAMATION PERMIT TYPE: WORK Site plan revison showing new HC access new elec room. new elec switch gear and sub panels, trash SCOPE enclosure details showing non combustible roof, NOTE. These fees are based on the nreliminary information available and are only an estimate. Contact the Dent for addn 7 info. FEE ITEMS (Fee Resolution 09-051 Eff. 7/117 0) FEE QTYIFEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: G Reg. ©OT 0.0 hs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (,'oii iructiun Tax Acoustical Fee: 0 Yes (F) No $0.00 Q E) Work Without Permit? 0 Yes 0 No $0.00 Planning Fee: $0.00 Select a Non -Residential Building or Structure Q Travel1)ocurnentati,t'm 1, Strom Motion Fee: IBSEISMICO $0.50 1 # $760.00 Revision 1REVCOM7'1 Tenant Improvement Bldg; Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $760.00 TOTAL FEE: 1 $761.50 Revised: 01/15/2011