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B-2018-1640 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1640 19540 VALLCO PKWY STE 130 CUPERTINO,CA 95014(316 20 119) Rockwall Construction Co 4345 Lowell St H Cupertino,CA 95014 OWNER'S NAME: DATE ISSUED:02/15/2019 OWNER'S PHONE: PHONE NO:909-972-8216 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#777138 Contractor Rockwall Construction Co Date 04/30/2020 X BLDG —ELECT —PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH_RESIDENTIAL X COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: IPPUDO T.I.-(2,257 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: REV#1 -RELOCATE KITCHEN EQUIPMENT.REORIENT THE 1. I have and will maintain a certificate of consent to self-insure for Worker's RESTROOM,MANAGERS ROOM AND STORAGE AREA. REVISE Compensation,as provided for by Section 3700 of the Labor Code,for the DINING AREA SEATING TO TO BAR SEATING. REVISE performance of the work for which this permit is issued. ELECTRICAL PLANS TO INCLUDE RELOCATED POWER OUTLET if2 I have and will maintain Worker's Compensation Insurance,as provided for by AND LIGHTING FIXTURES. REVISE PLUMBING PLANS TO ktSection 3700 of the Labor Code,for the performance of the work for which this INCLUDE RELOCATED WASTE AND CW/HW SUPPLY. REVISE permit is issued. MECHANICAL PLANS TO INCLUDE RELOCATED DUCT WORK APPLICANT CERTIFICATION AND MUA UNI certify that I have read this application and state that the above Sq.Ft Floor Area: Valuation:$300000.00 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 APN Number: Occupancy Type: inspection purposes. (We)agree to save indemnify and keep harmless the 31620 119 A(Tenant Improvements) 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 applic understandsAnd will comply with all non-point source ,Section 9.18. PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR Signature f`, �- Date 6-28-2019 180 DAYS FROM LAST CALLED INSPECTION. C ION. OWNER-BUILDER DECLARATION Issued by:Haley McKee I hereby affirm that I am exempt from the Contractor's License Law for one of the Date:02/15/2019 following two reasons: 1. I,as owner of the property,or my employees with wages as their sole RE-ROOFS: compensation,will do the work,and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed.If a roof is sale(Sec.7044,Business&Professions Code) installed without first obtaining an inspection,I agree to remove all new materials for 2. I,as owner of the property,am exclusively contracting with licensed. inspection. contractors to construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: Signature of Applicant: 1. I have and will maintain a Certificate of Consent to self-insure for Worker's Date:6-28-2019 Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 2. 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 HAZARDOUS MATERIALS DISCLOSURE permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 3. I certify that in the performance of the work for which this permit is issued,I California Health&Safety Code,Sections 25505,25533,and 25534. I will shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Worker's Compensation laws of California. If,after making this certificate of Health&Safety Code,Section 25532(a)should I store or handle hazardous exemption,I become subject to the Worker's Compensation provisions of the material. Additionally,should I use equipment or devices which emit hazardous Labor Code,I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Area Air Quality Management District I be deemed revoked. will maintain compliance with the Cupertino Municipal APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is Owner or authorized agen -� --� correct. I agree to comply with all city and county ordinances and state lawsDate:6-28-2019 relating to building construction,and hereby authorize representatives of this city CONSTRUCTION LENDING AGENCY to enter upon the above mentioned property for inspection purposes. (We)agree I hereby affirm that there is a construction lending agency for the performance to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in of work's for which this permit is issued(Sec.3097,Civ C.) consequence of the granting of this permit. Additionally,the applicant understands Lender's Name and will comply with all non-point source regulations per the Cupertino Municipal Lender's Address Code,Section 9.18. ARCHITECT'S DECLARATION Signature Date 6-28-2019 1 understand my plans shall be used as public records. CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-1640 19540 VALLCO PKWY STE 130 CUPERTINO,CA 95014(316 20 119) ROCKWALL CONSTRUCTION COMPANY ONTARIO,CA 91761 OWNER'S NAME: DATE ISSUED:02/15/2019 OWNER'S PHONE: PHONE NO:(909)972-8216 LICENSED CONTRACTOR'S DECLA.R.ATION BUILDING PERMIT INFO: License Class B Lic.#777138 Contractor ROCKWALL CONSTRUCTION COMPANY Date 04/30/2.020 X BLDG _ELECT _PLUMB _ I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH RESIDENTIAL X COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: IPPUDO T.I.-(2,257 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: permit is issued. Sq.Ft Floor Area: Valuation:$300000.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 316 20 119 A(Tenant Improvements) 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Sgnatur �` Date 2/15/19 Issued by:Haley McKee Date:02/15/2019 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1. 1,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:2/15/19 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. 1 certify that in the performance of the work for which this permit is issued'I Health&Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. I understand my plans shall be used as public records. Signature Date 2/15/19 Licensed Professional BUILDING PERMIT CUPERTINO CITY HALL 10300 Torre Avenue • Cupertino, CA 95014-3255 PHONE 408-777-3228 WWW.CUPERTINO.ORG BUILDING ADDRESS: OWNER'S NAME: Not provided OWNER'S PHONE: Not Provided CONTRACTOR: ROCKWALL CONSTRUCTION COMPANY, 4345 E LOWELL STREET SUITE H ONTARIO CONTRACTOR PHONE: DATE ISSUED 11 /25/2019 3:06:01 PM ISSUED BY: HALEYM VALUATION: $300000 JOB DESCRIPTION REORIENT THE RESTROOM, MANAGERS ROOM AND STORAGE AREA. REVISE DINING AREA SEATING TO TO BAR OUTLET AND LIGHTING FIXTURES. REVISE PLUMBING PLANS TO INCLUDE RELOCATED WASTE AND CW/HW WORK AND MUA UNI-ISSUED 6-28-2019 DEF # 1 - FIRE DEPARTMENTS FURNITURE SHOP DRAWINGS , MFG DATA 9-30-2019 REV #2 - ADD A WATER LINE - ISSUED 11/25/19 IPPUDO T.I. - (2,257 S.F.) REV # 1 - RELOCATE KITCHEN EQUIPMENT. SEATING. REVISE ELECTRICAL PLANS TO INCLUDE RELOCATED POWER SUPPLY. REVISE MECHANICAL PLANS TO INCLUDE RELOCATED DUCT AND LISTING SHEETS INCLUDING CLASSIFICATION OF THE FINISHES -ISSUED LICENSED CONTRACTOR DECLARATION 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full CONTRACTOR: ROCKWALL LICENSED B GENERAL LICENSED 777138 EXP 04/30/2020 I hereby force I hereby CONSTRUCTION CLASS: BUILDING NO: DATE: affirm and effect. affirm I have and for which I have and I certify that with COMPANY CONTRACTOR that I am licensed under the provisions of Chapter under penatiy of perjury one of the following three will maintain a certificate of consent to self -insure this permit is issued. will maintain Worker's Compensation Insurance, as in the performance of the work for which this permit laws of California. If, after making this certificate of such provisions or this permit shall be deemed revoked. declarations: for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is is issued, I shall not employ any person in any manner so as to become subject to the Worker's exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith V issued. Compensation comply HAZARDOUS MATERIALS DISCLOSURE 6.95 of the California Health & Safety Code, Sections 25505. 25533, and 25534. I will maintain compliance I have read the hazardous materials requirements under Chapter the Cupertino Municipal Code, Chapter 9.12 and the Health V with equipment Municipal & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino 25505, 25533, and 25534. this project. Firm Certification No: or devices which emit hazardous air contaminants as Code, Chapter 9.12 and the Health & Safety Code, Sections An EPA Lead -Safe Certified Renovator will be responsible for Firm Name: No EPA Lead -Safe Certified Firm is required for this project. Certified v CONSTRUCTION LENDING AGENCY lending agency for the performance of the work which this permit is issued (Section 3097, Civil Code). Lender's Address: I hereby Yes affirm under penalty of perjury that there is a construction No V Lender's Name: APPLICATION CERTIFICATION : ar