05050110 CITY OF CUPERTINO LV��AC�`&R`-. ' w ° ".- r
BUILDING DIVISION PERMIT CgIN�Di+f'/1nTION
lis.
BUILDING ADDRESS: DPR 'CONSTRUCTION INC PERMIT ND05050110
19000 HOMESTEAD
OWNER'S NAME: PERMIT ISSUE DATE
nk KAISER PERMANENTE 1450 VETERANS B 2 O5
NE: SANITARY NO. CONTROL NO.
(650) 474-1450
ARCHITECDENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
uoo LICENSED CONTRACTOR'S DECLARATION
e F I hemby affirm Nat 1 am licensed under provisions of Chapmr 9(commencing �. / Job Description
mai with Sec,ion70(X))uf Division Sof Ne Business and Pmfessinns Code,and mylicenm is t7
_�N inmBmmeand efrecl. /'s % REVISION--ROOF SCREEN
J L9i License Class Li, �i�O7i
`mow Dam Cantrretor Vill NO NEW PERMIT ISSUED/ ORIG. #05010092
ARCHITECTS DECLARATION
�d a I underhand on,plans shall he used as public records
JyU
3 Licensed Professional
"O< OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for the
0 o following mason.(Secuun 1031.5.Business and Professions Code:Any City art county
K m which requires a permit an construct,eller,improve,demolish,or repair any smumutn
poor to its issuance.also ox,tioes the applicant for such permit to file a signed statement
that he is licensed puraaant to the provisions of the Contractors License Law(Chapter 9 Sq.Ft.Floor Area Valuation $0
x~a (commencing with Section 7000)of Division 3 of the Business and Professions Code)or
y .. that he o exempt therefrom and the basis for Ne allcgnd exemption.Any violation of
(Section 7031.5 by any applicant for a permit subjects the applicant to a Civil penalty of APN Number Occupancy Type
not more than five hundred dollars(S500). 31609037 . 00
I,as owner of the property,or my employees with wages az their sole compensation,
will do the wak and me sanctum is not intended of offered for sale(See.7064,Business Required Inspections
and Professions Cador
e:The Contract 's License Law does net apply to an owner of q P
property who builds or improves thereon,and who does such work himself or through his
Own employees,provided that such improvemenu am not intended or.RerCB forsale.IL
WvvCvef,the buildingar improvement is sold within ane year ofcCmplction,Nc owner- y '1
builder will have the burden of proving and he did not Wild or improve for purpose of A i�,• t
1,as owner of the property,am exclusively contracting with licensed commetors tor y( :r 0 t (y
construct the pr (See.7064,Business and Professions Code:)The Contractor's IJ I` V 2005
cense law docs not apply to an owner of property.who builds or improves themon,and L d
who conuacm for such projects with a contracrr(s)licensed pursuant o the Contractors
License Law.
❑I am exempt under Sec. ,B&PC far Nis mason
Owner Date It®tt��1l_ If, •fix x
WW RT R'S COMPENSATION DECLARATION t'f
I hereby anon under penalty of perjury one of the following deductions:
I have and will maintain a Ccnlficum of Consent to self-insum for Worker's Cooper.
come,az provided for by Section 37W of the Labor Codc,for Ne perfmmana of the
work far which Nis Por mit is issued.
I have and will maintain Workers Compensation Insurance,az required by Section
3700 of Nc labor Code,for me p,othrmance of the work for which this permit is issued.
My Workers Com pensau n Insurance Cartier and Polio berate:
Carier: NB�io rGun(Dt� FIYNrr�✓RANCE � 336E3 /� �13 �63Z
CERTIFICATE OF EXEMPTION FROM WORKERS' p rre�f
COMPENSATION INSURANCE -
(This section need not he completed ifthe permit is foram hundred dollax(EI00) 1
les,)
1 ccnify Nat in the performance,of the work for which this permit is issued.I shall not
employ any person in any manner so az to become subject o the Workers'Compensation
Laws of California.Date
•Applicant
NOTICE TO APPLICANT:IL after making this Cenlfieate of Exemption,you should
become subject to the Workers Compensation provisions of the labor Code,you must
.J O forthwith comply with such provisions or this Permit shall be d=med medical.'Z'�,. CONSTRUCTION LENDING AGENCY
°'[r I hereby affirm Nat there is a construction lending agency for the performance of
C! r7 Ne,work for which this perTjtsissued(Sec,3097,Civ.C.)
W Q Lendert
's Name CNV
0, Lenders Address
V O 1 ccnify Nat 1 have read this application and sato Nat the above information is
correct.l agree to comply with All city and county andmnces and sum laws relating to
OU building construction,and hamby authors.minammutive,of Nis city or auto,upon thc
W above-mentioned pmperty for inspection purposes.
(We,)agree to save,indemnify and keep harmless the City of Cupertino asams,
.F.r rjj liabilities,judgmenu.cosu and expenses which may in any way accrue against said City
U in consequence of the granting of this permit.
�-r APPLICANT UNDERSTANDS AND WILL C MPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS. / J
Re-roofs
Signature Or Aoplmanvor Dam
HAZARDOUS MATERIALS DISCLOSURE Typo Of ROOF
Will the applicant lir future building e.Chapter
erre or handle havardo and Safer l
az defined by the Cupertino Municipal Cade Chapter 9.12.and to Health and Safety
Code,Se❑ct�ion 25532(x)? O All roofs shall be inspected prior to any roofing material being installed.
es G�X
Will thea rumor O,future building ,ase a ant medcviaes which If a roof is installed without first obtaining an inspection,I agree to remove
np g, the
quip.
emit hazardous fur canmmmants Herne by the Bay Arca Air Quality Management all new materials for inspection.
Disvia?
❑Yes Nu
I have read Ne hmmdous materials a:quiremems under Chapmr6.95 of the Califon
ria Health&Safny Code,Sections 25505,25533 and 25534.1 understand NaifNe building
docs not currently have a tenant,Nat it is my renpomfoloy to ma dy the occupant of Ne
requirements whieyytnpyst metetpdortois CO-Ofa cruficareart2cup any , Signature ofApplicant Date
E7 3/-S All roof coverings to be Class "B"or better
O,rcr or adhorizcdgcm Date
CITY OF CUPERTINO
BUILDING DIVISION PERMIT > CON-TRACTOR INFORMATION �
BUILDING ADDRESS: DPR CONSTRUCTION INC PERMIT NOD 5050110
19000 HOMESTEAD RD
ERSNAME: PERMrp ISSUE DATE
KAISER PERMANENTE 1450 VETERANS 5
PHONE:
SANITARY NO. CONTROL NO.
(650) 474-1450
ARCHITECTirENGINEER: BUILDING PERMIT INFO
BLDG EIFCr PLUMB MECH
O O O O
U0, LICENSED CONTRACTOR'S DECLARATION lob Description
x u C I lureby affirm mat I an liwrsed under provisions of Chapter 9(commencing / P
Sze withS fion7")Of Division3ofthe Busin .%a mfcWoms Coda,and mYlicc`nx o
imm�mneand erz«L /'S�/ REVISION--ROOF SCREEN
,Ejz Lkcrse Clan Lk.a 13 Z'
Zga Dam Con wmr DSP G"NIT -c NO NEW PERMIT ISSUED ORIG. #05010092
ou
ARCHITECTS DECLARATION
y5 of< 1 understand my Plain shall W used as public ecords
tau
;u.y Licensed Profnsional
i in OWNER-BUILDER DECLARATION
nu<3 I hereby affmh that 1 am exempt from dw Convenors License Law for the
x
00 following reason.(Section 7W 1.5,Business and Pmfesdms Cock:Any city ter county
K m which equies a Permit to construct,alter,improve,demolish,or repair any structure
prior to its issuanec,also requires the applicant for such permit to file satiated auement
that he in licensed Immorl W the provisions of fare Cantmcmr's License Law(CWper 9 Sq.Ft.Floor Area Valuation $0
yN0 (commencing with Section 7000)of Division 3 of the Business and Professions Cede)or
i
that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.5 by any applicant for.permit subjects the applicant to a civil penalty of APN Number Occupancy Type
net more than five hundred dollars(M). 31609037 . 00
❑I.as owner ofthe preperty,or my employees with wages as their sole compensation,
will do the work and the swcture is not intended or offered formic(Sec.7654,Business
and Profusions Code,:The Chronicler's License Law don not apply W an her of Required Inspections
pmperty who builds or improves thereon,and whodeas such work himself or through his
own employees,provided that such improvements are not intended oroRered formic.If.
however,the building or improvement is sold within one year of completion,the owner,
builder will have the burden Of proving That he did not build or improve for purpose of
Calc.).
❑Lu owner of ct ce.7(14irdiftiry,.B sinesiv ad convecting Ciil:) hedmaracr 's i- f"
come La the project(Sec.o in Business and Profusions Code:)The Comneen's Li- V r
cense law cts f not apply loan owner of property who Wilde rs improves Comme mil.
who contracts for swM1 projects with a eenvemor(q licensed pursuant to the Conuxtor'e \\\v
Liecox Law.
dl am exempt under sec. .B&P C Thr this sawn
Data
WW KER-S COMPENSATION DECLARATION
1 hereby arziml under penally of perjury one of the fallowing deeluations: ,
El I ham and will maintain a Cali foam of Coascnl seself-mun,ror Worke(sCompen-
sation,as provided for by Section 37M of the labor Code,for the perfarmance Of the
work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Inwranco.as required by Section
37W of the labor Code,far the performance oftle wank for which this permit is issued.
My Workch Compersati nlnw7c Tc,All,
Poliry npm. r -
Cartier. 340gg% /�L uNIDPf All,No:( .00�33663�// /�3 ,163b
CERTIFICATE OF EXEMPTION FROM WORKERS' C ( O _l
COMPENSATION INSURANCE
(rho section wed not accomPlced if the F(omit is for ase hundred dnllus(SIM)
orIt
I certify loot in the perfomtawe of be work for which this permit is issued,1 shall ata
employ any Nixon in any romper an as W become subject to the Workers'Compensation
Laws Of California.Data
Applicant
NOTICE TO APPLICANT:If.efts,making this Cenificau of Exemption,you should
become subjcm to she Worker's Compensation provisions of Ne labor Chile,you must
.J O foMwifa comply with such provisions Or Otis Permit shall be deemed revoked.
^' CONSTRUCTION LENDING AGENCY
I hereby affirm Nat Nese is a construction lending agency for the Performance of
(Yv 7 the work for which this pi:V Is_gy_gd(Sec.3099,Civ.C.) .
W Lender's Name, IVO IV F
=z lender's Address
O 0 1 certify that 1 have mad this application and since fail the about information is
correct.l agree,to comply with all city and county ordinances and sure laws relating to
�U building conswetion,and hereby authorise represeeadmis or this city to enter upon the
W above-mentioned properly for inspection purposes. 17
(We)spec to save,indemnify and keep hermlcu the City of Cupertino against
V z in consequence of the granting of this Permit.
liabilities,judgments,costs and expenses which may in any way accrue against said City
APPLICANT UNDERSTANDS AND WILL C MPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS. / / 2 �
/ g Re-roofs
Signature of ApplinnVCenpac Date
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or future Wilding wcupant sloe or handle hazardous onward
as defined by the Cupenino Municipal Codc.Chapter 9.12,and the Heahh and Safety
c.Section 25532(x)?
❑Yes 6:34. All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future Wilding occupant UX equipment Of devices which If a roof is installed without first obtaining an inspection,I agree to remove
ami:hazardous air contaminants zdcfncd by the Bay Area Air Quality Managcmcnt all new materials for inspection.
District?
0 c Nu
I have mad the ho sudous materials requiemcnu under Chapter Q95 or the Califon
ria Hnalth h Safety Code.Sumas 25505.25533 and 25534.1 unwsuM that irthe Wilding
does Out currently haw a tenant that it is my mspensibility to notify the occupant of the
egaiementswhm x mcLpn.lWi cadre reireamar0aapan SignatureofApplicant Date
[� 6T3/-t All roof coverings to be Class 'B"or better
Owner m amhoriz<d�cm Dec
,U City of Cupertino
Plan Check Transmittal
Permit# 05050110 Plancheck# 2
Project REVISION-ROOF SCREE FileDate 5/23/05
Address 19000 HOMESTEAD RD
Owner KAISER
Description
Plan Check Status (attach comments and return to Building with plan set)
Plan
Dept check# Date Due Date Staff Comment Date Approval?
BERRYMAN 2 6/10/05 6/17/05 BERRYMAN ❑
Planning 2 6/10/05 1 6/17/05 VERA I
Fire 1 5/23/05 6/6/05 GOB 6/3/05 0
Assessor 2 6/10/05 6/17/05 ❑
J caj
lJ 1 9i 4- -�orn "qbq q-J p-i ��y�g( C vL�
Additional Plan Check Fee ❑ Hours
Planning Fees
Housing Mitigation Fee Amount
Heart of the City Specific Plan Fee Amount
CITY OF C,UPERTINO
BUILDING DIVISION PERMIT s CONTRACTOR INFORMATION
BUILDING ADDRESS: DPR CONSTRUCTION INC PERMITNO.05050110
1 9000 14OMPSTRAD Rn
OWNER'S NAME: PERMIT ISSUE DATE
KAISER PERMANEN
ONE: SANITARY N0. CONTROL NO.
'
(650) 474-1450
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
uoo LICENSED CONTRACTOR'S DECLARATION
F❑ I hereby affirm Nat 1 am licensed under provisions of Chapter 9(commencing Job Description
iW with Section 7")of Division 3 of the Business and Professions Code,and my license is
neR imm�tomeanderc«f. REVISION--ROOF SCREEN
? License ClassLic.N
Date connaelnr NO NEW PERMIT ISSUED/ ORIG. #05010092
ARCHITECTS DECLARATION
ei I undcuund my plainshall W used as public rands
Jto
te 3 or Liccreted Professional
ApOWNER-BUILDER DECLARATION
<f I hereby affirm that I am exempt from the Conuno
aYs License Law for the
p o following margin.(Section](131.5.Buairv_u and Profmaimu Calc:Any city or county
K m which technics a permit to andri.[Mr.imporm,demolish.or mpair any strvcture
L¢i prior in its issuance.also mquims the applicant for such permit to Glc a signed samment
< Nat W is licensed Pursuouuo the provision of the Contractors Liconse Law(chapter 9 Sq. Ft. Floor Area Valuation $0
(commencing with Section 7")of Division 3 of the Business and Portaging Code)or
that he is exempt therefrom and the bazu for the alleged exemption.Any violation of
Section 7031.5 by any applicant for a permit subjects the applicant o a civil penalty of APN Number Occupancy Type
not mom than I,,hundred dollar.(SSW).
❑1,a owner of the property,or my employees with wages a their aide compensation, 31609037 . 00
will do the work,and the rtmnum isnot intended or o@red for said(See.7W.Buainera
_and Professions code:The Co micm:g Liam Law does net apply to an owner or Required Inspections
Property who builds erimproves thereon,and who doesauch work himself or through his
own empioyces.provided thmarmh improvements arc not intended o hRerM for ale.If.
however.she building or improvement is sold within one year of completion,the owner.
builder will Ma the Wrden of proving Nat he did not Wild 91 improve for purpose of
old.).
❑1.as Owner of On,property,and exclusively contracting with licensed anuanaa to
convect the pmjea(Sec.70a1,Bu iness and Prafesuiotu Cade:)The Conuacmri Li
cease law it=not appy In an nwMr or property who Wilco or improves themon,and.
who contracts for such projects with a argaacmr(s)Iieaysed pursuant to the Contractor's
License Law.
0 1 am exempt under Sec. .B A P C for this reason
Owner Data
WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's Compcm
tion,as provided for by Section 37W of the Labor Code,for the performance of the
work(or which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,az required by Section
37W of Ne Labor Code,for Ne performance of the work for which this permit is issued.
My Worker's Compensation Insurance carrier and Policy number am:
Carrier. Policy No.: _
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section rred net hocompleud if the permit is(done hundred dollars(SIM)
or less.)
I mmifv Nat in the pertomhmec of the work for which this Permit is issued.I shall not
employ any person in any mannerso az m Warta subject o the Workers Compensation
Laws of californis,Data
Applicant
NOTICE TO APPLICANT:If.after making Nis Cenifieme of Exemption,you should
become subject to the Worker's Compcnation provisions of the Labor Code,you must
.JO forthwith comply with such provisions or this permit shall W deemed revoked.
zN CONSTRUCTION LENDING AGENCY
I hereby affirm Nat them is a co struction lending agency I'm the pcoformance of
!Yi the work fur which this permit tangoed(S..3097.Civ.C.)
W Q lender's Name
z lenders Addless
V Q 1 cenify Nat 1 have read this application and sues that she shove information is
connect.1 agree,as comply with all city and county ordinances and star laws relating in
�(J Wilding convection,and hereby aurhorire reprernutiva of this city to enter upon the S
}LU ahovc tion re property for inspection pugwes.
(~ It. (W(We).gra to cove,indemnify and kap harmless the City of Cupertino again
Tat liaangeluen me the lnuandof this s mit. may in any way acme agoing aid City Y �_
t.) z A APPLICANT
of thegranting of this permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
HAZARDOUS
SigSignatureof AppliwDau
HAZARDODO US MATERIALS DISCLOSURE Type of Roof
Will the min or(Muco Wilding occupant store or tie rd
aous material
az defined by thea CuCuand He
pertino Municipal Code.Chapter 9.12.and the Health and Safety
Code,Section 25533(a)? All roofs shall be inspected prior to an roofing material being installed.❑Yea ON.
40 Will the applicant or future Wilding occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
if hxvardous air conuminanu n declined by Ne Bay Area Air Quality Management all new materials for inspection.
triad?
❑Yes ON.
I have mail the harardous maurialsmquisemener under Chapter S95 of the Califon,
nuHoul"Safety CoJk.Satiate 25505,25533 arx12553a.lundcrgand thatifuse Wilding
deq not Currently Wm a rant that it Y my responsibility b notify the neeupNt of the
mquir mems which mug W met prior to Issuance of a Certificate of Occupancy
Signature of Applicant Date
Owner or aurhorircd agent Date All roof coverings to be Class"B"or better
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
0 PERMIT INVOICE OPERATOR: christya
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31609037 . 00
INVOICE DATE. . . . . . : 06/21/2005
REFERENCE ID # . . . : 05050110
SITE ADDRESS . . . . . : 19000 HOMESTEAD RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : KAISER PERMANENTE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3548
CONTRACTOR . . . . . . . : NOSLER, PETER C LIC # 13302
COMPANY . . . . . . . . . . : DPR CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 1450 VETERANS BLV
CITY/STATE/ZIP . . . : REDWOOD CITY, CA 94063
TELEPHONE . . . . . . . . : (650) 474-1450
OF DESCRIPTION ACCT NUM CHK TOTAL FEE PD TO DATE BAL DUE
--- --------------------- -------- ---- --- --- - - ----- ---------- -- - - - - ----
PLAN CHECK REPEAT FEE 4111 A 87 . 14 87 . 14 0 . 00
------- ----- ------------ ---------- --
87 . 14 87 . 14 0 . 00
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
-------- ---------------------------- -------- ----------------------------
101 FOUNDATION 102 PIERS
•103 UFER 104 REBAR
105 ANCHOR BOLTS 106 SEWER & WATER
202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL
'204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
301 ROUGH PLUMBING 302 TUB & OR SHOWER
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
305 FRAME 306 HOLDOWNS
307 INSULATION 308 SHEETROCK
309 EXTERIOR LATH 310 INTERIOR LATH
311 SCRATCH COAT 313 ROOF NAIL
501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY
503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY
505 FINAL ELECTRICAL 506 GAS TEST
507 FINAL PLUMBING 508 FINAL MECHANICAL
509 FINAL GRADE 510 FINAL PLANNING
0
514 FINAL PUBLIC WORKS
4,U Vf9
OBerryman&Hcnigar
LETTER OF TRANSMITTAL
To: City of Cupertino - Building Division Date: June 17, 2005
Community Development Dept. B&H P.C. o.: 280-132-16037-02
10300 Torreve. Agency P.C. No.: 0 5011
upertino, Description: Kaiser
CC: Sue Winslow - Administrative Clerk Address: 19000 Homestea R .
va: ❑ Messenger ❑ Express ❑ Pickup ❑ Mail ® Cal Overnight ®Email
We are forwarding herewith:
1 Plans Energy Calcs. Other
Correction List Soil Report
Structural Calcs. Acoustical Report
Plans have been reviewed for:
• ® Architectural ® Structural ® Plumbing ® Mechanical ® Electrical
® Disabled Access Regulations ® Energy Regulations ❑ Fire Code
Remarks: Plans have been reviewed and APPROVED in compliance
with the 2001 CBC, 2001 CPC, 2001 CMC, 2001 CEC
requirements, 2001 Title-24 Energy and Disabled Access
Requirements.
If enclosures received are not as listed, please notify us at once.
From: BERRYMAN & HENIGAR
Code Compliance
�--% Date: June 17, 2005
�T! Bailey, P.E.
® Received by: Date:
6150 Stoneridge Mall Road, Suite 370• Pleasanton, California 94588• (925)468-7400 • FAX(925)468-7413
\\SIERRA\BSS4ojmps CupeNno\28GU80-82-16037-02.doc
05 - 1573
(� City of Cupertino
� Plan Check Transmittal
Permit# 05050110 Plancheck# 1
Project REVISION-ROOF SCREE FileDate F5/23/05
Address 19000 HOMESTEAD RD
Owner KAISER
Description
Plan Check Status ttach comments and return to Building with planset)
Plan
Dept check# Date Due Date Staff Comment Date Approval?
BERRYMAN 1 5/23/05 6/6/05 ❑
Planning 1 5/23/05 1 6/6/05 ❑
Fire 1 5/23/05 6/6/05 6 O
Assessor 1 5/23/05 6/6/05 ❑
•
i
Additional Plan Check Fee ❑ Hours
Planning Fees
Housing Mitigation Fee Amount
Heart of the City Specific Plan Fee Amount
^�,y2324 2 5262j2
Nom n TO
tp
`�Ay 2065, 0
® � S;,;IiA CLARA C.ODtlry v
S FIRE DEPT. w
At 21, p
�r�<<LOL6a�9
FIRE DEPARTMENT,(Q'G CSG PLAN REVIEW No. 05 1573
z} �a SANTA CLARA COUNTY BLDGPERMITNo. 05050110
14700 Winchester Blvd., Los Gatos, CA 95032-1818
• (408)378-4010 • (408) 378-9342 (fax) a vJww.sccfd.org
CONTROL No.
PLAN REVIEW COMMENTS
CODEBEC. SHEET NO. REQUIREMENT
Review of plans for proposed new roof screens.
Plans are approved as submitted.
OK to issue Bldg. Dept. permit.
City PLANS SPECS NEW RMDL AS OCCUPANCY CONST.TYPE AppllcantName DATE PAGE
CUP N ❑ ❑ N ® B/A-3 V-N Cuschieri Horton Architects 6/3/2005 1 DF 1
SECJFLOOR AREA LOAD DESCRIPTION By
Two stories Commercial Construction O'brien, Gilery
NAME OF PROJECT LOCATION
_e KAISER 19000 Homestead Rd
Organized as the Santa Clara County Central Fire Protection District
Serving Santa Clam County and the communities of Campbell, Cupertino,Los Altos,
Los Altos Hills, Los Gatos, Monte Sereno,Morgan Hill, and Saratoga
FIRE DEPARTMENT PLAN REVIEW Na. 0 5 15 7 3
SANTA CLARA COUNTY BLDG PERMITNI. 05050110
FIRE
® 14700 Winchester Blvd., Los Gatos, CA 95032-1818
(408)378-4010 e (408) 378-9342 (fax) e vnvvJ.sccfd.org CONTROL No.
PLAN REVIEW COMMENTS
CODE/SEC. SHEET NO. REOUIREMENT
Review of plans for proposed new roof screens.
Plans are approved as submitted.
OK to issue Bldg. Dept. permit.
City PLANS SPECS NEW RMDL AS OCCUPANCY CONST.TYPE ApplimatName DATE PAGE
CUP ® ❑ ❑ ® ® B/A-3 V-N Cuschieri Horton Architects 6/3/2005 1 OF 1
SECJFLOOR AREA LOAD DESCRIPTION BY
Two stories Commercial Construction O'brien, Gilery
NAME OF PROJECT LOCATION
KAISER 19000 Homestead Rd
Organized as the Santa Clara County Central Fire Protection District
Serving Santa Clara County and the communities of Campbell. Cupertino. Los Altos,
Los Altos Hills,Los Gatos, Monte Sereno,Morgan Hill,and Saratoga
2005
CITY OF CUPERTINO
BUILDING PERMIT PLAN CHECK COMMENTS
CONTACT PERSON -9fG/V>,-4t l FAX NO: S46- 1063
PROJECTDESC: U X44eRfD SugMTL, DATE: 6 ` ? S—
A D D RE S S:
ADDRESS: 80'90 'k 17U4-"t L C Ie --C OWNER:,k4Q .s i-A0-,e6,ern*
PERMIT NO: O t 06 Ol 1 O CONTROL NO:
The departments/agencies checked below have reviewed your plans. Attached are copies of
the comments. Please review and make the required changes.
'
Resubmit `- copies of the plans with written responses to the
comments attached to each set of plans. Incomplete submittals will
not be accented.
Note: All departments who previously reviewed the plans will need to re-check them
regardless of prior approval.
NOT APPROVED/APPROVED BY: BUILDING (job, office)
u 4 OUTSIDE (job, office)
1,14 PLANNING
PUBLIC WORKS
CENTRAL FIRE
SANITARY DISTRICT
HEALTH DEPT
HOOD
ASSESSOR
Note: Initial plan check fee includes I" plan check and 2 re-checks. Additional re-
submittals may be subject to additional fees.
Berryman&Henigar
LETTER OF TRANSMITTAL
To: City of Cupertino Date: June 3, 2005
Community Development Department B&H P.C. No.: 280-B1-16037-02
10300 Torre Avenue Agency P.C. No.: 05050110
Cupertino, California 95014 Description: Kaiser
CC: Sue Winslow - Administrative Clerk Address: 19000 Homestead Rd.
Via: r-1 Messenger [] Express ❑ Pickup ❑ Mail ® Cal Overnight ®Email
We are forwarding herewith:
1 Plans Energy Calcs. Other
1 Correction List Soil Report
1 Structural Calcs. Acoustical Report
Plans have been reviewed for:
® Architectural ® Structural ® Plumbing ® Mechanical ® Electrical
• ❑ Disabled Access Regulations N Energy Regulations ❑ Fire Code
Remarks: Plans have been reviewed and NOT APPROVED in
compliance with the 2001 CBC, 2001 CPC, 2001 CMC,
2001 CEC requirements, 2001 Title-24 Energy
Requirements. Please revise plans to comply with the
correction list items.
If enclosures received are not as listed, please notify us at once.
From: BERRYMAN & HENIGAR
Code Compliance
Date: June 3, 2005
. Bailey, P.E.
Received by: Date:
® 6150 Stoneridge Mall Road, Suite 370 • Pleasanton, CA 94588-3238 - (925)468-7400 - Fax(925)468-7413
An Equal Opportunity Employer • www.us.bureauveritas.com
PSIERRA%a&SX$P ojecls\CupeNnok280UB0.B1.16037-02.dm Page 1 of 3
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Berryman&Henigar
AGENCY: CITY OF CUPERTINO
AGENCY PERMIT: 05050110 Architect of Record:
JOB ADDRESS: 1900 Homestead Rd. Cuschieri Horton
CORRECTION LIST FOR: New Roof Screen/Kaiser 950 S.Bascom Ave. Ste.3118
UBC OCCUPANCY: Group B/A-3 San Jose, CA 95128
TYPE OF CONSTRUCTION: V-N (except waiting Rm 408-995-0611
2040)
V-1 HR (waiting Rm 2040)
VALUATION: N/A
AREA (SQ. FT.): N/A
NUMBER OF STORIES: N/A Engineer of Record:
TYPE OF PLAN CHECK: Complete Mesiti-Miller Engineering
APPLICANT NAME: Kaiser Permanente 224 Walnut Ave., Ste. B
PLAN CHECKER: Mel Tolentin Santa Cruz, Ca 95060
DATE REVIEWED: June 3, 2005 (831)426-3186
B & H No.: 280-B1-16037-02
FORWARD:
This plan review is only for the purpose of determining compliance with the
requirements contained in the 2001 C.B.C., 2001 C.M.C., 2001 C.P.C., 2001 C.E.C.,
and 2001 T-24 Energy Requirements. Please address all of the following items and
• return a copy of this list, along with a response sheet, indicating the location of all
required changes to the plans, specifications and/or calculations. Be as specific as
possible in your responses so that we may expedite your recheck. If any changes have
been made other than those required by this list, please list those changes on a
separate sheet and attach with re-submittal.
All changes shall be made to the original drawings and calculations, reflecting
the last revised dates. Contact the City of Cupertino to verify the required
number of new sets, wet stamped and signed by the architect or engineer of
record to be submitted to:
City of Cupertino
Attention: Sue Winslow
10300 Torre Avenue
Cupertino, CA 95014
Please contact Berryman & Henigar concerning any questions regarding this
Correction List.
BEFORE APPROVAL FOR CODE COMPLIANCE OR ISSUANCE OF A BUILDING PERMIT, THE PLANS AND APPLICATION
FOR THIS CONSTRUCTION REQUIRE THE INFORMATION, REVISIONS AND CORRECTIONS INDICATED BELOW. THE
APPROVAL OF PLANS AND SPECIFICATIONS DOES NOT PERMIT THE VIOLATION OF ANY SECTION OF THE BUILDING
CODE,OR OTHER ORDINANCE OR STATE LAW.
• 6150 Stoneridge Mall Road, Suite 370 - Pleasanton, CA 94588-3238 • (925)468-7400 • Fax(925)468-7413
An Equal Opportunity Employer - www.us.bureauveritas.com
\\SIERRA\BBSI$P ojecm%Cup.dn.UB0\2BD-B1-16037-02.d. Page 2 of 3
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Ocrryman&Henigae
•
CORRECTIONS
General
No comment noted.
Architectural
No comment noted.
Title 24Title 24 Energ
No comment noted.
Mechanical/Plumbing/Electrical
No comment noted.
Structural
1. Provide calculations to show existing roof framing can sustain added loads imposed
by roof screen.
Additional
2. Resubmit for plan check.
3. Have changes been made to the plans that are not as a result of corrections on this
correction list?
• Please check: ❑ Yes F-1 No
If so, provide a brief description and note where on plans the changes occur.
•
6150 Stoneridge Mall Road, Suite 370 • Pleasanton, CA 94588-3238 • (925)468-7400 • Fax(925)468-7413
An Equal Opportunity Employer • www.us.bureauveritas.com
k\SIERRA\B8S4$Proleois\Cupeaino12801280-Bi-16037-02.dw Page 3 of 3
VALUATION AND PLAN REVIEW FEE DETERMINATION
TO: Sue Winslow DATE: June 3, 2005
City of Cupertino
10300 Torre Ave.
• Cupertino, CA 95014
B&H PLAN CHECK NO.: 280-B1-16037-02 AGENCY PLAN CHECK NO.: 05050110
Project Name: Kaiser
Address: 19000 Homestead Rd.
Occupancy: _Group B/A-3
Type of Construction: V-N (except waiting Rm 2040), V-1 HR (waiting Rm 2040)
Sprinklers: No
Date of 1" Check: June 3, 2005 By: Mel Tolentin
Valuation Determination:
Building Portion Type Building Area Valuation Regional Building
Const Sq. Ft. Sq. Ft. Modifier Valuation
HVAC
• Commercial
Residential
Sprinkler Systems
TOTAL VALUATION: $.00 SUBMITTED VALUATION: $.00
Additional Fee Required: ❑ YES ® NO
FEE CALCULATION:
Building Permit Fee (from 1997 UBC Table No. I-A) -
Cupertino Plan Check Fee: - $
B&H Fee @ 75% of Cupertino Plan check fee: - $65.36
Hourly Fee Reviews ( X $55.00/hour) = 0
Other Comments *Fee per City
It
Berryman&Henigar
6150 Stoneridge Mall Road, Suite 370 • Pleasanton,CA 94588-3238•(925)468-7400• Fax(925)468-7413
An Equal Opportunity Employer•w .us.bureauveritas.com
\\sierra\b&s\$projects\cuperli no\280\280-ft-16037-02.doc
t PROJECT SPECIFICATION-
ARCHITECTURAL SECTIONS
SUBMITTAL
S APR U 1 1005 KAISER PERMANENTE
141-941 AS03
PLEASAN�TpNfl ILD-OUT FOR
69 ADULT AND CHILD P H PROVIDERS
19000 Homestead
Cupertino, CA
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BY
CUSCHIERI HORTONARCHITECTS-- -. February 23; 2005
Architecture. -.Alarming - Interaas �,�, +=1_---
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City of Cupertino
® Q - Plan Check Transmittal
Permit# 05050110 Plancheck# 1
Project REVISION-ROOF SCREE FileDate 5/23/05
Address 19000 HOMESTEAD RD
Owner KAISER
Description
Plan Check Status (attach comments and return to Building with pian set)
Plan
Dept check# Date Due Date Staff Comment Date Approval?
BERRYMAN 1 5/23/05 6/6/05 ❑i
Planning 1 5/23/05 6/6/05 1 Q
Fire 1 5/23/05 6/6/05 O
Assessor I I 1 5/23/05 6/6/05
® U v0p— me nct bD- OJc.U-�-CL
LJ � Ct/l.�,z✓1 �ZJ
Additional Plan Check Fee ❑ Hours
Planning Fees
Housing Mitigation Fee Amount
Heart of the City Specific Plan Fee Amount
CITY OF CUPERTINO
�m l of 1 PERMIT RECEIPT OPERATOR: conniew
COPY # 3
Sec : Twp: Rng : Sub : Blk: Lot :
APN . . . . . . . . : 31609037 . 00
DATE ISSUED. . . . . . . : 05/23/2005
RECEIPT 4 . . . . . . . . . : 29732
REFERENCE ID # . . . : 05050110
SITE ADDRESS . . . . . : 19000 HOMESTEAD RD
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : KAISER PERMANENTE
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-3548
RECEIVED FROM . . . . : SOECHGEN MULIA
CONTRACTOR . . . . . . . : NOSLER, PETER C LIC # 13302
COMPANY . . . . . . . . . . : DPR CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 1450 VETERANS BLV
CITY/STATE/ZIP . . . : REDWOOD CITY, CA 94063
TELEPHONE (650) 474-1450
4EE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -- - ---------- --- - -- -- - -- - ------- -- - --------- -
BPLANCKREP HOURS 1 . 00 87 . 14 0 . 00 87 . 14 0 . 00
TOTAL PERMIT 87 . 14 0 . 00 87 . 14 0 . 00
METHOD OF PAYMENT AMOUNT NUMBER
- - - - ----------- -- -- ---------- -- -- --
OTHER 87 . 14 VISA
TOTAL RECEIPT 87 . 14