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11060036CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20572 HOMESTEAD RD I NONTRACTOR: DEVCON CONSTRUCTION I PERMIT NO: 11060036 OWNER'S NAME: CAMPUS PARK ASSOCIATES 690 GIBRALTAR DR I DATE ISSUED: I IB0/2011 :O"ER'S PHONE: 4084460700 I MILPITAS, CA 95035 I PHONE NO: (408)942-8200 C� LICENSED CONTRACTOR'S DECLARATION License Class R Lic. # Qontractor ? (i l�Cbl7 Date ' 3� 1 fgreby affirm that 1 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 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 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/ J 0 ❑ 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) 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: 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, Section 9.18. BUILDING PERMIT INFO: BLDG r ELECT r— PLUMB r MECH r RESIDENTIAL r COMMERCIAL F_ JOB DESCRIPTION: RITE AID -NEW 18,203SQFT RETAIL BUILDING LOCATED IN A PARKING AREA OF HOMESTEAD SQUARE RETAIL CENTER. ALSO INCLUDED IS THE CONSTRUCTION OF NEW PARKING Sq. Ft Floor Area: Valuation: $1500000 APN Number: 32610063.20572 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: 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. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 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 I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Date: i/'.?a +// 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 Signature Date I understand my plans shall be used as public records. Licensed Professiona CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20572 HOMESTEAD RD CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 11060036 INC OWNER'S NAME: CAMPUS PARK ASSOCIATES 1 690 GIBRALTAR DR I DATE ISSUED: 11/30/201 1 1 OWNER'S PHONE: 4084460700 1 MILPITAS, CA 95035 I PHONE NO: (408)942-8200 1 ❑ LICENSED CONTRACTOR'S DECLARATION License Class_ Lie. # �3 99Z6 Contractor De Date o2 I hereby affirm that I am licensed under the provisions of Char4r 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 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. 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 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 "!Z '2 I)—/ ❑ 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, Section 9.18. BUILDING PERMIT INFO: BLDG , ELECT r PLUMB r MECH F_ RESIDENTIAL r COMMERCIAL JOB DESCRIPTION: RITE AID -NEW 18,203SQFT RETAIL BUILDING LOCATED IN A PARKING AREA OF HOMESTEAD SQUARE RETAIL CENTER. ALSO INCLUDED IS THE CONSTRUCTION OF NEW PARKING 12/7/11 DEFERRED SUBMITTAL # I METAL CANAPIES FOR EXTERIOR ONLY ISSUED 12/22/11 Sq. Ft Floor Area: Valuation: $1500000 APN Number: 32610063.20572 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued b Date'` Z� RE -ROOFS: All roots 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 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. authorized ?� Date: 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. Signatu Date Licensed Profession CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION W1APN: ADDRESS: 00000 Homestead Rd. :;0 DATE: 05/18/2011 REVIEWED BY: A. Salvador 1 - BP#: "VALUATION: 1$1,500,000 %PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE: Commercial Building Civil / Religious activities in BQ zone? 0 Yes 0 No PENTAMATION PERMIT TYPE: 1 M1 WORK SCOPE FA OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP EES BP FEE ID M (Market) II-B,III-B,IVN-B 18,203 $4,778.86 IMPLNCK $8,082.69 IMINSP TOTALS: 18,203 $4,778.86 :' ..... ........ $8,082.69 NOTE-- Thrcr fPrc arr htnod nn 1hv nrvliminary infarmatinn ary nnly an pdimnly_ d-nmarl 1hv nant far add"11 info FEE ITEMS flee Resolution 09-051 Eff 7/1/10) E TY/FEE MISC ITEMS Plan Check Fee: $4,7 8.8 Select a Mise Bldg/Structure or Element of a Building Suppl. PC Fee: 0 Reg. 0 OT 0.0 $0 PME Plan Check: $ .00 Permit Fee: $8,0 2.69 Suppl. Insp. Fee.e Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 35 %wJ Constr. Tax: IBCONSTAXC $ .20 Acoustical Fee: 0 No $0.00 S//1 Ce. &j),(,,6� %o 0 (� / 0 Work Without Permit? 0 Yes 0 N $0.00 Planning Fee: PLLON $4,550.75 Select a Non -Residential Q Building or Structure 0 Strong Motion Fee: IBSEISMICO $315.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $60.00 :.....:.:;::.:...:........:....... . :................ V. Revised: 04/29/2011 y�Nt TAB / WAytc� CITY OF CUPERTINO Fm_� FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20572 homestead rd. DATE: 12/07/2011 REVIEWED BY: bobs. APN: BP#: "VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: PENTAMATION 1GENCOM PERMIT TYPE: WORK deferred submittal exterior metal canopies. 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 hated on the nrelininary information available and are ank an estimate. Contact the DeDt for addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef/.' 711,111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 5 # $1,635.00 Awning / Canopy (Support'd by Bldg) IAWNATTBLD Canopy Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hrs $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 Permit Fee: $0.00 rrPME ------------- 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 0 F ,av Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 ' B'I' :::....::::.........: ,;; ;. Sl} $0.00 $1,635.00 O. L.kE. "`"`:::::::.::::................ $1,635.00 Revised: 10/01 /2011 CO 0 ;emu Up 00, 1NG i4S CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 00000 Homestead Rd. DATE: 06/06/2011 REVIEWED BY: A. Salvador APN: BP#: VALUATION: 1$1,500,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY Commercial Building USE: Civil / Religious activities in BQ zone? Yes O No PENTAMATION 1 M1 PERMIT TYPE: WORK SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID M (Market) II-B,III-B,IV,V-B 18,203 $4,778.86 1MPLNCK $8,082.69 1MINSP TOTALS: O 18 203 77 $4, 8:86 $8 082.69' l •tii M1\ice. \� r k�i M1ti �'�'��f:�� ��•r M1 f • / i.'. ti� is i� , iJ..... . .... - -------- - ....... ....... NOTE: These fees are based on the Preliminary information available and are onlv an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resohition 09-051 E . 7,11/10) FEE QTY/FEE MISC ITEMS Plan Check Fee: $4,778.86 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Reg. OT -- hrs $0.00 PME Plan Check: $0.00 Permit Fee: $8,082.69 Suppl. Insp. Fee-.0 Reg. 0 OT 1 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Constr. Tax: IBCONSTAw $44,597.35 Acoustical Fee: © Yes E) No $0.00 Q 0 Work Without Permit? © Yes 0 No $0.00 Planning Fee: PLLONGRNGC $4,550.75 Select a Non -Residential 0 Building or Structure i Strong Motion Fee: IBSEISMICO $315.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $60.00 <:: ,, ; r:;:::,:':' ?;• .' ',." ; ';; D `r_ 62,384.65 $0.00 62 384.65 Revised: 04/29/2011