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11100096L CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10050 N WOLFE RD STE SWI -160 I CONTRACTOR: TF MCGUCKIN INC PERMIT NO: 11100096 OWNER'S NAME: CUPERTINO FINANCIAL CTR PARTS LLC 1777 FOLSOM CIR I DATE ISSUED: 11/10/2011 1 OWNER'S PHONE: 567-9900 1 MILPITAS, CA 95035 1 PHONE NO: (408)263-5614 1 ❑ LICENSED CONTRACTOR'S DECLARATION License Class�H/ / ic. # Contractor' ►T 614 40 1 r Date 1 � � Y � 1 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 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. ( % IN : 1 \Dr ❑ 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. Signature Date BUILDING PERMIT INFO: BLDG r ELECT r PLUMB I— MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: COMM. T.1- 6,154 SQ FT- DEMO OF EXISTING SUSP.CEILING , LIGHTING, SELECT PARTITIONS, NEW NON -LOAD BEARING PARTITIONS, CEILING SYSTEM, Sq. Ft Floor Area: I Valuation: $330000 APN Number: 31620086.1160 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://,�_ RE-ROOFS: 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 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 25150055, 25533, and 25534. ) 1 tho e � 'Hate: 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10050 N WOLFE RD STE SWI -160 CONTRACTOR: TF MCGUCKIN INC PERMIT NO: 11100096 OWNER'S NAME: CUPERTINO FINANCIAL CTR PARTS LLC 777 FOLSOM CIR DATE ISSUED: 11/10/2011 OWNER'S PHONE: 567-9900 MILPITAS, CA 95035 PHONE NO: (408)263-5614 ❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License Class ��')-A% C_1 Lic. # MECH r RESIDENTIAL r COMMERCIAL r __91 Contractor�--_M<&UL4 r i f tie , I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: COMM. T.I- 6,154 SQ FT- DEMO OF EXISTING (commencing with Section 7000) of Division 3 of the Business & Professions SUSP.CEILING , LIGHTING, SELECT PARTITIONS, NEW NON -LOAD Code and that my license is in full force and effect. BEARING PARTITIONS, CEILING SYSTEM, LIGHTING & RE -LOCATE DOOR AND FRAME, NEW CASEWORK, AND FINISHES I hereby affirm under penalty of perjury one of the following two declarations: THROUGHOUT. NON-STRUCTURAL 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 REV#1 ISSUED 1/13/12 - REVISE/RECONFIGURE OFFICE AREAS 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. Sq. Ft Floor Area: Valuation: $330000 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number: 31620086.1160 Occupancy Type: 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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 180 DA FR LAST CALLED INSP CTION. 9.18. Signat t ) � ^�� l� ` Issued by. Date:�� 3- ❑ 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 wiI I do the work, and the structure is not intended or offered for sale (Sec.7044, inspection. 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 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 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(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 Califomia. 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, I must e : , forthwith comply with such provisions or this permit shall be deemed revoked. Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I 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 with all non -point source regulations per the Cupertino Municipal Code, Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10050 N WOLFE RD STE SWI -160 CONTRACTOR: TF MCGUCKIN INC PERMIT NO: It 100096 OWNER'S NAME: CUPERTMO FINANCIAL CTR PARTS LLC 777 FOLSOM CIR DATE ISSUED: 11/10/2011 OWNER'S PHONE: 567-9900 MILPITAS, CA 95035 PHONE NO: (408)263-5614 ❑ L'I'CENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL License Clash 5 4) 3q Llic. # COMM. T.I- 6,154 SQ FT- DEMO OF EXISTING Contractor V� �' l�= ��-- M �l�l Date SUSP.CEILING , LIGHTING, SELECT PARTITIONS, NEW NG SYSTEM, NON -LOAD BEARING PARTITION^-LC�ADTERNATE I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions 7/10/12 REVISION #3 NON-STRUCT. Code and that my license is in full force and effect. MATERIALS AND METHODS 50EIET SU ITTED-OK 7/12/12 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 Sq. Ft Floor Area: Valuation: $330000 performance of the work for whichthis permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by.40�14r�_ Section 3700 of the Labor Code, for the performance of the work for which this APN Number: 31620086,tp Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by: Date: with all non -point source regulations per the Cupertino Municipal Code, Section RE -ROOFS: 9.18. Signat a1) 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. ❑ OWNER -BUILDER DECLARATION 4�... Signature of Appli Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, 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 HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will. I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(x) should I store or handle hazardous I have and will maintain a Certificate of Consent to self -insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Co e, ections 25505, 255 3, and 2 34. Section 3700 of the Labor Code, for the performance of the work for which this; 1 ' permit is issued. Owner or authorized ag Date: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date CITY OF CUPERTINO F_7MFEE 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. etc). These fees are based on the nrelininary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711111) ADDRESS: 10050 n. wolfe rd. sw1-160 DATE: 12/07/2011 REVIEWED BY: bobs. APN: BP#: 11100096 "VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: --lPENTAMATION 1GENCOM PERMIT TYPE: WORK revise office areas. SCOPE $0.00 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 nrelininary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 0 Work Without Permit? 0 Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure i •7*r��,i,;:,i f')rx,i.�,rP .,;,in�; ..,'e'.. Strong Motion Fee: $0.00 1 # $783.00 Revision 1nEVCOAIT1 Tenant Improvement Bldg Stds Commission Fee:$0.00 .::::::::-:::.;:..:.:...:...........::.........: . : :..:..:..... •::::::::.:...........:: ..... $0.00 $783.00 '6 ::::::;.:.::::.:.:::::.::::::. •... ....: At, .. $783.00 Revised: 10101/2011 M--1 CITY OF CUPERTINO . �I FEE ESTIMATOR - BUILDING DIVISION ';:!".. l -7. { i'ax1•._..:. epi: r ..2 ., �, r 1/:....; .-.:::.i::::: ::ii:.:i;:o?•n?^.::.::.�: f :r 10050 N Wolfe Road DATE: 07/10/2012 REVIEWED BY: Sean 4FADDRESS: APN: BP#: *VALUATION: $0 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: ';t;r,. ea: PENTAMATION 1GENRES PERMIT TYPE: WORK Alternate materials and method to provide ADA automatic door openers at bathrooms in -lieu of SCOPE providing the 48 inch landing. ';:!".. l -7. { i'ax1•._..:. epi: r ..2 ., �, r 1/:....; .-.:::.i::::: ::ii:.:i;:o?•n?^.::.::.�: f :r FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 i ffr'iiz . 01her 1,: Imp. E3 . '>;ar> Fc- ';t;r,. ea: i :.e. $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. © OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 �l.:arccr.�: V] ';:!".. l -7. { i'ax1•._..:. epi: r ..2 ., �, r 1/:....; .-.:::.i::::: ::ii:.:i;:o?•n?^.::.::.�: f :r FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 i ffr'iiz . 01her 1,: Imp. E3 . '>;ar> Fc- ';t;r,. ea: i :.e. 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 nreliminary information available and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (D Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. © OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 �l.:arccr.�: 0 Work Without Permit? 0 Yes Q No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) 0 i Strom; Motion Fee: $0.00 F 1-1 # $174.00 Alternate Materials and Methods IALTMAT Bldg; Stds Commission Fee: $0.00 lysi .ii•, r.� :as:r ; o•: cc�� :f: €$174.00 rail: '� 0.00 17 4.0 s�7 174.00 Revised: 07/01/2012