11110169CITY OF CUPERTINO BUILDING PERM
BUILDING ADDRESS: 20525 MARIANI AVE CONTRACTOR: XL CONSTRUCTION PERMIT NO: 11110169
OWNER'S NAME: 20525 MARIANI DRIVE LP 851 BUCKEYE CT DATE ISSUED: 02/29/2012
OWNER'S PHONE: 408996 10 10 MILPITAS, CA 95035 PHONE NO: (408) 240-6000
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. # Q
Contractor �CL reV74 Date
I hereby affirm that I am licensed under the provision 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
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 ode Section
9.18.
Signature 'PVDate v"
❑ OWNER -BUILDER DECLARATION
I 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,
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 Are 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. 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.
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB F
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: APPLE - FLR I - DEMO AND COMM T.1 (9645SQFT)
CONSTRUCTION OF NEW NON -LOAD BEARING WALLS,
CEILINGS & FIXTURES
4/20/2012- DEF# 1 - HIGH DENSITY STORAGE- DEF# I ISS'D 4/20/2012
Sq. Ft Floor Area: Valuation: $2017000
APN Number: 32656001.20525 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. 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 255
!�4
o 'zed a ent:
Date -
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of mrk'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.
Date I Licensed Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20525 MARIANI AVE
CONTRACTOR: XL CONSTRUCTION
PERMIT NO: It 110169
OWNER'S NAME: 20525 MARIANI DRIVE LP
851 BUCKEYE CT
DATE ISSUED: 02/29/2012
OWNER'S PHONE: 4089961010
MILPITAS, CA 95035
PHONE NO: (408) 240-6000
❑ LICENSED CONTRACTOR'S DECLARATION
�
�
r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic. #�O A ` 1p
T— r i
� nP , n,, ,, f
Contractor YL, l.�uv �Ivv`-Ll�`"'Date � �
MECH RESIDENTIAL COMMERCIAL
[ hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: APPLE - FLR I - DEMO AND COMM T.1(9645SQFT)
(commencing with Section 7000) of Division 3 of the Business & Professions
CONSTRUCTION OF NEW NON -LOAD BEARING WALLS,
Code and that my license is in full force and effect
CEILINGS &FIXTURES
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
Sq. Ft Floor Area:
Valuation: $2000000
Section 3700 of the Labor Code, for the performance of the work for which this
pennit is issued.
APN Number: 32656001.20525
Occupancy Type:
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 prop y for inspection purposes. (We) agree to save
PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and eep harmless t City of Cupertino against liabilities, judgments,
costs, and exp ses which ma "rue ainst said City in consequence of the
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this -it. Addi ally, applicant understands and will comply
180 DAYS FROM LAST CALLED INSPECTION.
with all non -poi t source reg ions the Cupertino Municipal Code, Section
9.18. -7
cq� qq
Issued by Date:
Signature Date �/ r!Z�
❑ NER-BUILDER DECLARATION
RE -ROOFS:
I hereby affirm that I 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
I, 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
I hereby affirm under penalty of perjury one of the following three
declarations:
[ 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.
Additionally, should I use equipment or devices which emit hazardous air
permit is issued.
co taming s d ed 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
m ntain m lia 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
H Ith & a ty fie, Sections 25505, 25533, and 25534.
Compensation laws of Califomia. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I must
r or uthor' d a e t: (/ l
forthwith comply with such provisions or this permit shall be deemed revoked.
Date:
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
1 certify that I have read this application and state that the above information is
[ r y affirm that there is a construction lending agency for the performance of vark'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
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 20525 Marian! Ave
DATE: 04/20/2012
REVIEWED BY: Sean
APN:
BP#: 11110169
*VALUATION: 1$17,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY Commercial Building
USE:
PENTAMATION 1GENCOM
PERMIT TYPE:
WORK
Deferred Submittal #1: High densitey storage.
SCOPE
i, : ' flan Check
11hollb. Alan Cficcl,
L :; '- ( ,cic
.rVvch' Porwil Fe",
Phin2h, pF..'l n7f1 I
i:h(c. Pempir Fve.
()jI1L'+' �-1C'L'h'. 17i.5'�a,
!)Il7rY /�j l/r7l ii 17i.5'j7
E17--
p1tw1h, Fc°e:
Uec. Lisp. PcO,
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'1 info.
FEE ITEMS (Fee Resolution 11-053 Eff 711111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes 0 No
$0.00
F7 7 hours Plan Check, Hourly
$130.00 1STPLNCK
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee-0 Reg. 0 OT
0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
C r .; b 1 it(1)7 1iix
A(Jlnivi.s (I wive Fec:
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
0
�1"cJYL'1 I.�DC1111'i['niU/11117 Fees:�
Strong Motion Fee: 1BSEISMICO
$3.57
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$4.57
$130.00
TOTAL FEE:
1 $134.57
Revised: 04/01/2012
CITY OF CUPERTINO
F-M-7- FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20525 mariani ave.
DATE: 11/30/2011
REVIEWED BY: larry s
APN: v
BP#:
"VALUATION: 1$2,000,000
*PERMIT TYPE: Building Permit
�Z#011aq
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
PENTAMATION 16 TI
PERMIT TYPE:
WORK
demo of entire space. ti including construction of new non load bearing walls ceilings and fixtures
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.0
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
II-A,III-A,V-A
9,645
$3,061.66
IBTIPLNCK
$7,356.09
IBTIINSP
TOTALS:
9,645
$3,061.66
$7,356.09
MECH, HOURLY 0 Yes (F) No
PLUMB, HOURLY Q Yes (F) No
ELEC, HOURLY Q Yes Q No
.
r'iC17
_
fTr
f. I?ili'.
C;. `1i'�' 1'aulb i;:El�
a
?i. MAP. l�'[:r�
�'{ �,�i%. (na>, ! �:'c':
11r'�. Irr !?
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'1 info.
FEE ITEMS (!ee Resolution 11-053 Lf, 711,111)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$3,061.66
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. Q OT
O, 01
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$7,356.09
Suppl. Insp. Fee-.0 Reg. Q OT
0.0
1 hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
T-T
,`�lt4itril:l'ff"r7tlYt•? Fee.
0
E)
Work Without Permit? 0 Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
0
C�
i
T rage( Docilm entarion
Stronp, Motion Fee: IBSEISMICO
$420.00
Select an Administrative Item
Bldg; Stds Commission Fee: IBCBSC
1 $80.00
SUBTOTALS:
10,917.75
$0.00
TOTAL FEE:
$10,917.75
Revised: 10101 /2011