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11100034I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10050 N WOLFE RD I CONTR CTOR: CUPERTINO FINANCIAL I PERMIT NO: 11100034 OWNER'S NAME: CUPERTINO FINANCIAL CTR PARTS LLC OWNER'S PHONE: 4085679900 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic.4 Contractor Date I 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. I hereby affirm under penalty of perjury one of the following two declarations: I have and wil I 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 Date 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 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 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, ection 9.18. /� / Signature Date / / 2901 TASMAN DR STE 200 SANTA CLARA, CA 95054 DATE ISSUED: 12/20/2011 PHONE NO: BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: SW2-130-SUGAR CRM; COMMERCIAL TENANT IMPROVEMENT (9256SQF r)NON-STRUCTURAL-DEFERRED MECHANICAL ELECTRICAL & PLUMBING Sq. Ft Floor Area: Valuation: $500000 APN Number: 31620086.10050 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued Date/"2.Z!�, �_I 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 , authorized a t ` 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 Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CITY OF CUPERTINO FM_ FEE ESTIMATOR - BUILDING DIVISION imiADDRESS: 10050 n. wolfe rd. DATE: 10/05/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: 1$500,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAATION 1 B TI MPERMIT TYPE: WORK t.i. comm. offices ace non structural defer M E Ps. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 9,256 $2,429.02 IBTIPLNCK $5,748.65 IBTIINSP TOTALS: 9,256 $2,429.02 $5,748.65 MECH, HOURLY 0 Yes (F) No PLUMB, HOURLY 0 Yes Q No ELEC, HOURLY 0 Yes Q No lVall i'r rrttit T.. :)"7{s'v, 4lf., li ii:Sl;_ Slrn<, „P.StiED f.�'%•p. �- _ .LJ NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc). These fees are based on the Dreliminary information available and are only an estimate. Contact the Dent for addn7 info. FEE ITEMS (Fee Resolution II-053 £:f`. 711 II) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,429.02 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $5,748.65 Suppl. Insp. Fee-0 Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E, 0 i T�'Ivo, I.1rx rare nr tri arz F::.. Strong Motion Fee: IBSEISMICO $105.00 Select an Administrative Item Bldg; Stds Commission Fee: IBCBSC $20.00 SUBTOTALS: $8,302.67 $0.00 TOTAL FEE: 1 $8,302.67 Revised: 10/01/2011 nCLr_00M # CITY OF CUPERTINO BUILDING PERMI6qTE BUILDING ADDRESS: 10050 N WOLFE RD CONTRACTOR: CUPERTINO FINANCIAL PERMIT NO: 11100034 CTR PARTS LLC OWNER'S NAME: CUPERTINO FINANCIAL CTR PARTS LLC 2901 TASMAN DR STE 200 DATE ISSUED: 12/20/2011 OWNER'S PHONE: 4085679900 SANTA CLARA, CA 95054 PHONE NO: LICENSED CONTRACTOR'S DECLARATION r PLUMB r- PERMIT INFO: License Class ) i Lie. # (d!5 4Z3c) BUILDING BLDG'F ELECT r - Contractor 'I_F MC GuC KJ AJ Date-7 - Z `'nt - 6 �. MECH RES[DENTiAL COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: SW2-130-SUGAR CRM; COMMERCIAL TENANT (commencing with Section 7000) of Division 3 of the Business & Professions IMPROVEMENT (9256SQFT)NON-STRUCTURAL DEFERRED MECHANICAL Code and that my license is in full force and effect. ELECTRICAL & PLUMBING [ 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 P v,,,mb —/�q / a Compensation, as provided for by Section 3700 of the Labor Code, for the le c-h(•�� 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: $500000 permit is issued. APPLICANT CERTIFICATION APN Number: 31620086.10050 Occupancy Type: 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, 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. Signature Date 2 ,Z q _ / 2 Issued by: ❑ 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 1, 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) 1, 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 I 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 & Safety Code, Sections 25505, 25533, and 25534. become subject to the Worker's Compensation provisions of the Labor Code,1 must forthwith comply with such provisions or this permit shall be deemed revoked. lhvner or 9�ized agent: nn J� (!I%��c1 Date: Z-2T " /Z. APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of work's to building construction, and hereby authorize representatives of this city to enter for which this permit is issued (See. 3097, Civ C.) upon the above mentioned property for inspection purposes. (We) agree to save Lender's Name indemnity 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. 1 understand my plans shall be used as public records. Signature Date Licensed Professional WW��,,�--,,�� CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION i&ADDRESS: 10050 n wolfe rd. DATE: 01/31/2012 REVIEWED BY: bobs. APN:3jQ0�0WjBP#: 1110U0JL1 "VALUATION: $0 ' PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: PENTAMATION 1GENCOM PERMIT TYPE: WORK deferred M E Ps. SCOPE NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District etc). These fees are based on the nrelininary information available and are anly an estimate_ Contact the Dent foraddn'l info. FEE ITEMS (Fee Resolution 11-053 L . 711,111) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes © No $0.00 4 hours $520.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: (F) Reg. () OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? G Yes ® No $0.00 Suppl. Insp. Fee Q Reg. Q OT Q.0hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 G Work Without Permit? Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) Strong Motion Fee: $0.00 4.0 hrs $520.00 Inspections ISTINSP Inspection, Hourly BldgStds Commission Fee: $0.00 SUBTOTALS: $0.00 $1,040.00 TOTAL FEE: 1 $1,040.00 Revised: 1119/2012