Loading...
11080178I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 10500 N DE ANZA BLVD OWNER'S NAi`IE: BERG FAMILY PARTS LP OwN'ER'S PHONE: 4088629799 ri LICENSED CONTRACTOR'S DECLARATION License Class- Lie.# Contractor it !yo / eii � / 'i �, ate M 1 , L 1 hereby affirm that 1 am licensed Under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code antl 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 indenoury 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, he applicant understands and will comply with all non -point source regulation er the Cupertino Municipal Code, Section 9 18 Signature Date le.V i I IN 1 hereby affirm that 1 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). 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 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 certity 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 ofexemption, 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 indemnity 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. CONTRACTOR: DEVCON PERMIT NO: 11080178 CONSTRUCTION INC 690 GIBRALTAR DR DATE ISSUED: 09/13/201 1 MILPITAS, CA 95035 PHONE NO: (408)942-8200 r !- BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH RESIDENTIAL CONIMERCIAL JOB DESCRIPTION: APPLE - COMM, T.I (289SQFT) CONVERT MECHANCIAL ROOM TO CONFERENCE ROOM, INCLUDE INSTALL OF SINGLE SHAFT, ADD I ADDITIONAL HVAC UNIT AT EXISTING Sq. Ft Floor Area: I Valuation: $500000 APN Number: 31622017.00 Occupancy'I'ype: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LASST� CALLED INSPECTION. Issued by: � �;t,, -tip Date: -:�-/ 3 - / 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 1 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 Qua tty Management District 1 will maintain compliance with the Cupertino Ntunic' al Code, Chapter 9.12 and the Health & Safety Code, : 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 Professional Signature Date CITY OF CUPERTINO TTT r�cmTTii A mnn 121T1r nTNr_ nTVTCTnN I' 1J' 1J XJ1J x xlvx�- ADDRESS: 10500 n de anza blvd. DATE: 08/24/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: $500,000 '''PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building PENTAMATION 1 B TI PERMIT TYPE: WORK t.i convert mechanical room to conference room include install of single shaft add 1 additional Hvac SCOPE unit at exisiting rooftop. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) I-A,I-B 289 $2,868.00 IBTIPLNCK $804.00 IBTIINSP TOTALS: 289 $2,868.00 - $804.00 MECH,'HOURLY © Yes 0 No PLUMB, HOURLY Q Yes - 0 No ELEC, HOURLY 0 Yes 0 No Mech. Plan Check 0.0 hrs $0.00 a,,,. Mech. Permit Fee: 1MPERMIT Other Mech. Insp. 0.0 hrs $44.00 t_,';;::. /'n"inf/ iho nonf fnr addn'l Info. NOTE. These fees are basea on rite preitnunary nt uinuluun FEE ITEMS (Fee Resolution 11-053 E�'. 71f 1111) uvuuuu•c FEE •••••• ••• �••• QTY/FEE ••-• - -- MISC ITEMS Plan Check Fee: $2,868.00 C� # $130.00 Mechanical 1BCAIRHA A/C Units (<=10K cfm) Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $804.00 Suppl. Insp. Fee:O Reg. 0 OT 0.01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $44.00 f7II;;11''iti.'titJ3; i'17,'; Acoustical Fee: 0 Yes 0 No $0.00 0 Work Without Permit? 0 Yes 0 No $0.000 Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 Travel Documentation Fee: ITRAVDOC $44.00 Strong Motion Fee: IBSEISMICO $105.00 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $20.00 SUBTOTAL— $3,885.00 $130.00 TOTAL FEE: $4,015.00 Revisea: ut /u4tLu i i