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12050081
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20833 STEVENS CREEK BLVD CONTRACTOR: DEVCON CONSTRUCTION PERMIT NO: 12050081 INC OWNER'S NAME: MILPITAS, CA 95035 PHONE NO: (408)942-8200 LICENSED CONTRACTOR'S DECLARATION r r r (� License Class Lic. 4 7) 7 9 BUILDING PERMIT INFO: BLDG ELECT PLUMB r r � MECH RESIDENTIAL COMMERCIAL Contractor f� 4C C na (IlM f Date 1 hereby affirm that 1 am licensed under the provisions of hapt r 9 JOB DESCRIPTION: I ST & 2ND FLOOR -COMMERCIAL T.1 18,341 SQ FT- TO (commencing with Section 7000) of Division 3 of the Business & Professions INCLUDE DEMOLITION, NEW NON -RATED INTERIOR Code and that my license is in full force and effect. PARTITIONS, CEILING MODIFICATIONS, ADDITION OF I hereby affirm under penalty of perjury one of the following two declarations- 1 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 Sq. Ft Floor Area: Valuation: $2100000 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APN Number: 32632053.20833 Occupancy Type: APPLICANT CERTIFICATION l 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 PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the WITHI 80 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply 180 DA OM LAST CALLED INSPECTION. with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signatu Date S Issued by: Date: IV ❑ UILDER 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, 1 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: 1 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 1 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. contaminants as defined 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 maintain compliance 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 Health & Safety Code, Sections 25505, 25533, and 25534. 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 t. 1 Date: forthwith comply with such provisions or this permit shall be deemed revoked. oC APPLICANT CERTIFICATION ION LEND. G 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 ARCHITECT'S DECLARATION with all non -point source ons per the Cupertino Municipal Code, Section 9.18. 1 understand my plans shall be used as public records. Signatur Licensed Professional CITY OF CUPERTINO BUILDING PERMIT REVISION-' BUILDING ADDRESS: 20833 STEVENS CREEK BLVD CONTRACTOR: DEVCON CONSTRUCTION HLq0M.dMT1 INC OWNER'S NAME: STEVENS CREEK OFFICE CENTER ASSOC 690 GIBRALTAR DR DATE ISSUED: 09/052012 OWNER'S PHONE: 4157103063 MILPITAS, CA 95035 PHONE NO: (408)942-8200 ❑ LICENSED CONTRACTOR'S DECLARATION r r— r— License Class Lic. # � BUILDING PERMIT INFO: BLDG ELECT PLUMB F F r / MECH RESIDENTIAL COMMERCIAL Contractor }�� // 1 �o� R �/� Date / I hereby affirm that I am licensed under the provisions of Che ter 9 JOB DESCRIPTION: IST & 2ND FLOOR -COMMERCIAL T.1 18,341 SQ FT -TO (commencing with Section 7000) of Division 3 of the Business & Professions NG INCLUDE DEMOLITION, NEW NON -RATED INT 12-REVARTITI REVISETWO ROOMS MODIFCATIONS,ADDITON OF ELEC AREA I l/7/12-REV# 1 -REVISE TWO ROOMS ON FIRST Code and that my license is in full force and effect. FLOOR #111, PLACE ANCHORED EQUIPMENT WITHIN ROOMS-REV#I ISS'D I IM12 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. Sq. Ft Floor Area: Valuation: $2100000 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number: 32632053.20833 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. A itionally, the applicant understands and will comply with all non -point sour regulations per the Cupertino Municipal Code, Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. Signature Date Issued by j Date4/-7— ❑ 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 I, 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 will do the work, and the structure is not intended or offered for sale (Sec.7044, inspection. Business & Professions Code) Signature of Applicant: Date: I, 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 California. If, after making this certificate of exemption, Date: APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is 1 eby affirm that there is a construction lending agency for the performance of Hork'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 Isl FEE ESTIMATOR - BUILDING DIVISION Ar ADDRESS: 20833 stvns crk blvd. DATE: 11/07/2012 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 revise two rooms on first floor #111 lace anchored equipment within rooms . SCOPE c 1,fec3). Plan Check Plumb. Plum ciwck Elec. Plan Check lfech. Permil Fee: Plrrmh. Permil Fee: Dec. Permit Fee: Orhev Akuh. Insp. Other PhImh Ins[).Ll Other Elec. Insp, 9&,ch. Insp. Fee. Plumb. hlsp. Fee: Elec. Insp, fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These Pees are based on the Preliminary information available and are only an estimate, Contact the Dept for addn 7 info. FEE ITEMS (Fee Resolution 11-053 ETf 711112) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes 0 No $0.00 2 7 hours Plan Check, Hourly $266.00 ISTPLNCK 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 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction .TcIx. Adlninislrative Fee: 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 i Travel Documentulion Fees: Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $266.00 TOTAi, FEE: $266.00 Revised: 10/01 /2012 12o5-06 9- i FM-7 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20833 Stevens Creek Blvd DATE: 05/07/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: 1$2,100,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement __7PENTAMATION PRIMARY Commercial Building USE: PERMIT TYPE: 1 B l-1 WORK Tenant improvement 18341 sq ft. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 18,341 $2,800.76 IBTIPLNCK $8,447.52 IBTIINSP TOTALS: 18,341 $2,800.76 $8,447.52 MECH, HOURLY 0 Yes 0 No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY © Yes Q No if, Plan Check Ptrrrrrh P;;''v (;•, CA ` : L_ . i ':', ,. c _ c-k Llr•r.1;. it F. ;r,.;i Prr,tr,•'. i' i)li7r1' !t['r•79. �Yrc�' O, ,::; ir):y% 011"'r h7v(. /'Itr+r1;. hi-sp.1 i'cr: F.lrr.. Insp, Fee NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the Preliminary information available and are only an estimate. Contact the Dept for addn 7 info. FEE ITEMS (Fee Resolution 11-053 Eff. 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,800.76 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $8,447.52 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 CO) , rrrtzon 7 c/X. 11r/f;zinist��rtive I'�°e: 0 Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential Q Building or Structure 0 i 7rcael Uoccunenlutio� !'e�c, Stronp- Motion Fee: 1BSEISMICO $441.00 Select an Administrative Item Bldp- Stds Commission Fee: 1BCBSC $84.00 SUBTOTALS: 11,773.28 $0.00 TOTAL FEE: 1 $11,773.28 Revised: 04/0112012