12090186CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10460 BANDLEY DR
CONTRACTOR: BARRON BUILDERS INC
PERMIT NO: 12090186
OWNER'S NAME: CUPERTINO INDUSTRIAL ASSOCIATE
415 CLYDE AVE STE 104
DATE ISSUED: 10/09/2012
OWNER'S PHONE: 4089961010
MOUNTAIN VIEW, CA 94043
PHONE NO: (650) 269-7061
❑ LICENSED CONTRACTOR'S DECLARATION
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BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.
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OMft� U ` L0e(-5
MECH RESIDENTIAL COMMERCIAL
Contractor Date
1 hereby affirm that 1 am licensed under the provisions of Chapter 9
JOB DESCRIPTION: APPLE - INSTALLATION OF APPROX 172 LINEAR FT OF
(commencing with Section 7000) of Division 3 of the Business & Professions
NEW ROOF SCREEN TO THE NORTH EAST & SOUTH SIDES OF
Code and that my license is in full force and effect.
THE ROOF LIKE FOR LIKE
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: $60000
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APN Number: 32633105.00
Occupancy Type:
APPLICANT CERTIFICATION
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
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 '"`�� Date 101.1 lit
,, / '
Issued by:(V�li Date: �Q • �' j
❑ OWNER -BUILDER DECLARATION
RE -ROOFS:
I 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, 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
1 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
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(x) 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
Health & Safety Code, Sections 25505, 25533, and 25534.
Compensation laws of California. If, after making this certificate of exemption, )
become subject to the Worker's Compensation provisions of the Labor Code, I must
Ow err or !utbprued a
Date: L9__L112
forthwith comply with such provisions or this permit shall be deemed revoked.
_V0
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
I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 10460 BANDLEY DR I CONTRACTOR: BARRON BUILDERS INC I PERMIT NO: 12090186
OWNER'S NAME: CUPERTINO INDUSTRIAL ASSOCIATE
415 CLYDE AVE STE 104 1 DATE ISSUED: 10/09/2012
OWNER'S PHONE: 4089961010 1 MOUNTAIN VIEW, CA 94043 1 PHONE NO: (650) 269-7061 1
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. N
Contractor s -q,/ & U� Date —
1 hereby affirm that I am licensed under the 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.
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
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
1 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 Date
❑ ,R -BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
1, as owner of the property, or my employees with wages as their sole compensation,
wil I 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 (Sec.7044, Business & Professions Code).
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
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. .r�
APPLICANT CERTIFICATION
I 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
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 Date
BUILDING PERMIT INFO: BLDG r— ELECT PLUMB
MECH r RESIDENTIAL r COMMERCIAL
JOB DESCRIPTION: APPLE - INSTALLATION OF APPROX 172 LINEAR FT Of
NEW ROOF SCREEN TO THE NORTH EAST & SOUTH SIDES OF
THE ROOF LIKE FOR LIKE
Sq. Ft Floor Area: I Valuation: $60000
APN Number: 32633105.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by�:. Date/2^
RF. -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. 1 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 1 use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
Or or itho ' . ent: �_ n
Da te:
CONSTRUCTION LENDING AGENCY
1 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 Add
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professiona
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). 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 11-053 H f. 7/7112)
ADDRESS: 10460 Bandley Dr
DATE: 11/21/2012
REVIEWED BY: Sean
h� ch. Perrzit Nee.
APN:
BP#:
'VALUATION: Iso
"PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY Commercial Building
USE:
1'lrrr.rf, irzs .
PENTAMATION 1GENCOM
PERMIT TYPE:
WORK
Deferred Submittal #1: Roof screen submittal.
SCOPE
Suppl. Insp. Fee:Q Reg. Q OT
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). 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 11-053 H f. 7/7112)
Iiech. T'l:.rr C'hec.k 1 1
If"7'!, :;b. P, ._. ,: _
i.;lr?c. Flar, t„'heuA
h� ch. Perrzit Nee.
Phrw.b. 1'G1.rnr! V-:
67e(-. Permit 1,
otd.e, :keel. !ns p.
Ocher P7rr1ft6 `,.<,>
1.)ihe,l,i; . :. insp. Li
A1c,;;a. IrnT . I ,.:
1'lrrr.rf, irzs .
f=er:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District. eta). 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 11-053 H f. 7/7112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes (F) No
$0.00
2 hours Plan Check, Hourly
$266.00 1STPLNCK
Suppl. PC Fee: •; Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Conslr"rtL"licm 74%
Af[mbli.slra ik•C, Fec:
Q
0
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Plannine Fee:
$0.00
Select a Non -Residential 0
Building or Structure 0
'rrxtc:l
Strong Motion Fee:
$0.00
Select an Administrative Item
Bldg Stds Commission Fee:
$0.00
SUBTOTALS:
$0.00
$266.00 TOTAL FEE:
$266.00
Revised: 10/01/2012
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
Lfcch. Plan Check
ADDRESS: 10460 BANDLEY DR
DATE: 09/20/2012
REVIEWED BY: SYLVIA
Phimb. Permil Fec':
APN:
BP#:
'VALUATION: 1$60,000
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
Islet. Insp, I,ce:
PENTAMATION 1GENCOM
PERMIT TYPE:
WORK
APPLE INSTALLATION OF APPROX. 172 LINEAR FT OF NEW ROOF SCREEN TO THE NORTH
SCOPE
EAST & SOUTH SIDES OF THE ROOF LIKE FOR LIKE
Lfcch. Plan Check
P17110. Plan ChccA
Ink
f lec. Plan Check
Lr,111 Perwil Fee
Phimb. Permil Fec':
Elec. Permit Fee.
Other AFerh. Insp.
Olhcr Plumb Inch.
Other Elec. Insp.
.1'kch. Insp. Fce:
Plumb. brsp. Fee
Islet. Insp, I,ce:
NOTE. This estimate does not inchide fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District. etc). These fees are based on the oreliminary information available and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 E . 7/1/11)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? Q Yes Q No
$0.00
F-27 hours Plan Check, Hourly
$266.00 ISTPLNCK
Suppl. PC Fee: Q Reg. Q OT0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? 0 Yes Q No
$0.00
Suppl. Insp. Fee:Q Reg. Q OT0,0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Conslniction Tax.
T -F
Administrative Fee:
Q
E)
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
0 hours Inspections
$399.00 ISTINSP Inspection, Hourly
E)
0
Travel Documentation Feces:
Strong Motion Fee: IBSEISMICO
$12.60
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$3.00
SUBTOTALS:
$15.60
$665.00
TOTAL FEE:
T
$680.60
Revised: 07/01/2012