13030032CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20450 STEVENS CREEK BLVD CONTRACTOR: DOYLE CONSTRUCTION PERMIT NO: 13030032
INC
OWNER'S NAME: CUPERTINO CITY CENTER BUILDINGS 48521 WARM SPRINGS BLVD STE 307C DATE ISSUED: 03/06/2013
OWNER'S PHONE: FREMONT, CA 94539 PHONE NO: (510) 687-1771
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL
License Class Li., t"�
SUITES ��
INSTALL NEW DOOR ON OFFICE- EXITING
�� # � ('1 7 � �
TO SUITE 200
Contractor)0 V) tt'���� 74r U (`�&-Date
I hereby affirm that I am licensed under the provisions of C apter 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. Sq. Ft Floor Area: Valuation: $3000
I have and will in Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor. Code, for the performance of the work for which this APN Number: 36901028,20450 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 DAY M 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 (p ��
granting of this permit. Additionally, the applic t understands and will comply Issued by: Date�
with all non -point source regulations per the C pertino Municipal Code, Section
9.18.
RE -ROOFS:
Signature �i`° "` " , "Date/ ! 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
Signature of Applicant: 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
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 HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code). I 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(a) 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 Municip�►I Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Co�c,,5�-Sectlol 25505, 25533d 25534Section 3700 of the Labor, Code,for the performance of the work for which this permit is issued. Owner or authorized ag' Date: S
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:4 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 ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
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
IOWA L•T: 7T TC'TTM A rV"12 — RTTIT .IIINC iIIVTCT()N
20450 SBC SUITE 207
DATE: 03/06/2013
REVIEWED BY: MENDEZ
APNLNADDRESS:
:
BP#: �,C�c
*VALUATION:
$3,000
*PERMIT TYPE: Building Permit
PLHECK TYPE: Tenant Improvement
PRIMARY .Commercial Building
USE: g
PENTAMATION 1GENCOM
PERMIT TYPE: i
WORK
SUITE 207- INSTALL NEW DOOR ONE OFFICE
SCOPE
Alec:h. Plan Check'
Phrnrh. Plan Check
Elec. Plan Check
tlleeh. Permit Fee:
Plnrrab. Permit l%e'e:
Dec. PermitPee:
Other Alech. Insp.
Other Plrrnrb IrrsP.
Other Elee, Insp,
" !��j
Alech, Insp. Fee.-
Plumb. h;sp. Fee:
Elec. Insp. Fee:
NOTE: This estimate does not include fees aue to otner uepartntents (t.e. rtunntng, ruuttc rrutna, ruC, 4'.u",.y �••
/lts'trtC1, CtC. 1/[CJC GCJ u/c uuJ u! v/. !.l.. .a............
FEE ITEMS (Fee Resolution 11-053 Eff. 711112)
•.. ... .............. .........-
FEE
------ --- -
QTY/FEE
----
MISC ITEMS
Plan Check Fee: Hourly Only? 0 Yes Q No
$0.00
L�J hours Plan Check, Hourly
$266.00 ISTPLNCK
Suppl. PC Fee: Q Reg. () OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee: Hourly Only? ()Yes Q No
$0.00
Suppl. Insp. Fee:(D Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:.
$0.00
PME Permit Fee:
$0.00
Construction Tqx: -17T
AdIninistraiive T, ec:
E)
Work Without Permit? Yes (j) No
$0.00
Advanced PlanninL Fee:
$0.00
ILJ hours Inspections
$266.00 rSTINSP Inspection, Hourly��
TrcwelDocartr7entatfon Fees:
Strong Motion Fee: IBSEISMICO
$0.63
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$1.63
$532.00
TOTAL FEE:
$533,13-1
Kevisea: uituitzu-ia