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12020009CITY OF CUPERTINO BUILDING BUILDING ADDRESS: 20682 STEVENS CREEK BLVD OWNER'S NAME: BYER PROPERTIES LP OWNER'S PHONE: 4156262937 J LICENSED CONTRACTOR'S DECLARATION License Class _ Contractor,�1Jnqg,�2— T 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. Signat__ _ '� ! �� ❑ 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 he 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 9.1& CONTRACTOR: W.L. BUTLER PERMIT NO:12020001 CONSTRUCTION, INC 204 FRANKLIN ST DATE ISSUED: 04/l6/2012 REDWOOD CITY, CA 94063 PHONE NO: (650) 361-1270 JOB DESCRIPTION: RESIDENTIAL u COMMERCIAL 20682,20684,20686,20688 STEVENS CREEK CONSTRUCT NEW 8011SQFT COMMERCIAL SHELL BUILDING PAD E INCLUDES ADJACENT FOUNTAIN, AND SITE WORK FUTURE 9/28/12- REVISION #1- ENLARGE ELECTRICAL ROOM, I NFILL PARTIAL STOREFRONT @ N. ELEVATION WITH WALL DECORATIVE TILE ISSUED @ COUNTER Sq. Ft Floor Area: Valuation: $1250000 APN Number: 35908020.20682 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: 21_—_A N % T<-- 14 Date: 9- 2d 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 Appl 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 715534. 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional Signature Date CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20682 STEVENS CREEK BLVD OWNER'S NAME: BYER PROPERTIES LP OWNER'S PHONE: 4156262937 ❑ LICENSED CONTRACTOR'S DECLARATION License Class Lic. N 313.S �)53 Contractor wk--18 ct-- Date '{ [HP I 1 z 1 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. Signature Date `� f ((P l Z 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). 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. 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. CONTRACTOR: W.L. BUTLER CONSTRUCTION, INC 204 FRANKLIN ST REDWOOD CITY, CA 94063 PERMIT NO: 12020009 DATE ISSUED:04/16/2012 PHONE NO: (650) 361-1270 BUILDING PERMIT INFO: BLDG T_ ELECT T_ PLUMB r MECH RESIDENTIAL F COMMERCIAL r— JOB DESCRH'TION: CONSTRUCT NEW 8011 SQFT COMMERCIAL SHELL BUILDING PAD E INCLUDES ADJACENT FOUNTAIN, AND SITE WORK. FUTURE TENANTS (20682,20684,20686,20688 STEVENS Sq. Ft Floor Area: Valuation: $1250000 APN Number: 35908020.20682 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_///2 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 1 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. Owt authorized agent: � I ►(e / r 1Z 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 Signature Date I understand my plans shall be used as public records. Licensed 9FW����,�CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20750 stvns crk blvd. bidg E. DATE: 02/02/2012 REVIEWED BY: bobs. APN: W9 d 8 010 1 BP#: 0a 000 "VALUATION: 1$1,250,000 xPERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY USE Commercial Building Civil / Religious activities in BQ zone? 0 Yes No PENTAMATION PERMIT TYPE: 1A2 WORK construct new 8011 s.f. comm. shell bldq includes adjacent fountain and site work. SCOPE OCCUPANCY TYPE: TYPE R. CONSTR. FLI( s.f.AREA PC FEES PC FEE ID BP FEES BP FEE ID A-2 II-B,III-B,IV,V-B 8,011 $6,268.27 IA2PLNCK $8,949.17 IA21NSP TOTALS: 8,011 $6,268.27 $8,949.17 Lj Li NOTE. This estimate does not include fees due to other Departments (I e. Planning, Public Works, Fire, Sanitary Sewer District, School Didrirt-etr. )_ Cnn1nM thv Dent for nddn'l infn_ FEE ITEMS (Fee Resolution 11-OS.i E . 7/1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: $6,268.27 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: E) Reg, OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $8,949.17 Suppl. Insp. Fee:(• Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONSTAXC $20,107.61 r, . 1 srSFFi�iliJ [�ie3k: t.':.'. Work Without Permit? Yes Q No $0.00 Advanced Planning Fee: PLLONGRNGC $2,082.86 Select a Non -Residential Q Building or Structure Strong Motion Fee: 1BSEISMICO $262.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $50.00 SUBTOTALS: 37,720.41 $0.00 TOTAL FEE: 1 $37,720.41 Revised: 111912012