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12060078
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20576 HOMESTEAD RD CONTRACTOR: SOUTH BAY PERMIT NO: 12060078 CONSTRUCTION, INC OWNER'S NAME: THE SOBRATO ORGANIZATION 1711 DELL AVE DATE ISSUED: 03/05/2013 OWNER'S PHONE: 4084460700 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL �31�t ADDRESS CHANGED TO 20574 HOMESTEAD (FORMERLY License Class_ Lie. # 20576) CONSTRUCT NEW PARKING LOT, LANDSCAPE, �V� �S�zj� 4 Contractor— >>. Date UNDERGROUND UTILITIES, 22 PARKING LIGHTS, 6 TRASH I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions 7/24/2014- REVISION #4- MISC. PARKING LOT REVISIONS, NEW Code and that my license is in full force and effect. COMPACTOR ENCLOSURE ADDED FOR MAJOR 2- ISSD 8/22/2014 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 Sq. Ft Floor Area: Valuation: $5000000 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by tion 3700 of the Labor Code, for the performance of the work for which this APN Number: 32610060.20576 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 1g DAY F 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 DAYS F OM T CALLED IN SP CTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the ally, the applicant understands and will comply granting of thi • ermAeafions Issued by: Date: v with all n - of it soper the Cupertino Municipal Code, Section 9.18 RE -ROOFS: Signature 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(x) 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 wit the Cupertino unicipal Code, Chapter 9.12 and 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 the Health & Safety Code, Se ns 55 _, 3, and 25534. Owner or authorized agent: Date: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, 1 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. 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 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 CUPERTINO CONSTRUCTION PERMIT APRLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION P 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build ingPcupertino.org -1 U ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑X REVISION /DEFERRED ORIGINAL PERMIT # 12060078 PROJECTADDRESS 20576 HOMESTEAD ROAD 7APN# 326-10-066 OWNERNAME THE SOBRATO ORGANIZATION PHONE408-446-0700 E-MAIL RTRUEMPLER@SOBRATO.COM RICH TRUEMPLER STREET ADDRESS CITY, STATE, ZIP CUPERTINO, CA. 95014 FAX 408-866-6638 10600 N. DE ANZA BLVD. CONTACTNAME JEFF OPAROWSKI PHONE 408-496-0676 E-MAIL JOPAROWSKI@ARCTEC INC. COM STREETADDRESS 99 ALMADEN BLVD., SUITE 840 CITY, STATE, ZIP SAN JOSE, CA 95113 FAX 408-496-1121 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT EI CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME LARRY PATERSON LICENSE NUMBER B336974 LICENSE TYPE BUS. LIC# COMPANYNAME SOUTH BAY CONSTRUCTION E-MAIL LPATERSON@SBCI.COM FAX (408) 379-3256 STREETADDRESS 1711 DELL AVE. CITY,STATE,ZIP CAMPBELL, CA 95008 PHONE (408) 379-5500 ARCHITECT/ENGINEERNAME JEFF OPAROWSKI, AIA LICENSENUMBER C-21289 X BUS. LIC# COMPANYNAME ARC TEC INC. E-MAIL JOPAROWSKI@ARCTECINC.COM FAX 408-496-1121 STREET ADDRESS 99 ALMADEN BLVD. CITY, STATE, ZIP SAN JOSE, CA 95113 PHONE 408-496-0676 DESCRIPTION OF WORK MISC. PARKING LOT REVISIONS, NEW COMPACTOR ENCLOSURE ADDED O MAJOR 2 EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES OFFICE USE NLY NONE RETAIL II -B ONE OCC, TYPE -n FT VATITATIQN(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA 4 8 0 AREA NET AREA 4 8 BATHROOM KITCHEN OTHER 6' REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH , �. ❑ ATTACH p DWELLING IrNI I S IS A SECOND UNIT ❑ YES .SECOND STONY ❑ YES BEING ADDED? ❑ NO ADDITION? ❑ NO PRLAPPuc ArION ❑ YES IF YES PROVIDE COPY OF PLANNER'S NAW?, RECEIVED BY: _ �. � - - -�'--� - ��� +� TOTAL VAL ATION: PLANNING APPLN ❑ NO PLANNING APPROVALIXI`TER �..^" $ OPO By my signature below, I certify to each of the following: I am the property owner or authorized agent t act on the property owne s behalf. 1 have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to bui d' structi I authoL*eepresentatives of Cupertino to enter the above -identified prop/errttyy for inspection purposes. Signature of Applicant/Agent Date: N `t , A-15 I SUPPLEMENTAL MATION QUIRED PLArteH CK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW —Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 1-1STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 03116111 CITY OF CUPE, RTINO FM -7 FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20576 homestead rd FEE DATE: 07/24/2014 REVIEWED BY: Mendez APN: BP#: 'VALUATION: 1$85,000 'PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: 0.0 hrs PENTAMATION PERMIT TYPE: WORK 7/24/2014- REVISION #4- MISC. PARKING LOT REVISIONS NEW COMPACTOR ENCLOSURE SCOPE ADDED FOR MAJOR 2 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the areliminary information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E '. 7%1,13 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Feer Reg. Q OT0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 4 Q Work Without Permit? Q Yes ) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) i Strong Motion Fee: 1BSEISMICO $23.801 # $859.00 Revisions IREVCOMNEW Commercial New Blda Stds Commission Fee: IBCBSC $4.00 SUBTOTALS: $27.80 $859.001 TOTAL FEE: 1 $886.80 Revised: 07/10/2014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20576 HOMESTEAD RD CONTRACTOR: SOUTH BAY PERMIT NO: 12060078 CONSTRUCTION, INC OWNER'S NAME: THE SOBRATO ORGANIZATION 1711 DELL AVE DATE ISSUED: 03/05/2013 OWNER'S PHONE: 4084460700 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E]COMMERCIAL ❑ CONSTRUCT NEW PARKING LOT, LANDSCAPE, License Class Lic. # (� ��� UNDERGROUND Contractor � Date 3 UTILITIES, 22 PARKING LIGHTS, 6 TRASH ENCLOSURES I hereby affirm that I am licen's d under the provisions of Chapter 9 9/3/13 - REVISION # 3 - REVISE PARKING LOT WITH (N) (commencing with Section 7000) of Division 3 of the Business & Professions LO G DOCK & (N) TRASH ENCLOSURE- ISSD 3/5/2014 Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two decla . I have and will maintain a certificate of consent to self -insure for Compensation, as provided for by Section 3700 of the Labor Co or! Sq. Ft Floor Area: Valuation: $5000000 performance of the work for which this permit is issued. Q 0 ave and will maintain Worker's Compensation Insurance, as proZided for by or 3700 of the Labor Code, for the performance of the work for which this APN Number: 32610060.20576 Occupancy Type: perm 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 WIT HI180 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 IgO DA S FO I.A I`CALLED INSPC ION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 2 granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: with all non -poi so e u tions per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature 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-1311ILDER DECLARATION Signature of Applicant: Date: [ 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) I, 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 Municipal Code, Chapter 9.12 and 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 the Health & Safety Code, StVtJonj 25505, 25P33, and 25534. '—" Owner or authorized ag t Date: 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must 1 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. 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 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 �/" (408) 777-3228 • FAX (408) 777-3333 • buildin-g(cDcupertino.org \ ❑ NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI 0 REVISION/DEFERRED ORIGINAL PERMIT# 12060078 PROIECTADDREss 20576 HOMESTEAD ROAD APN# 326-10-066 OWNERNAME THE SOBRATO ORGANIZATION PHONE408-446-0700 E-MAIL RTRUEMPLER@SOBRATO.COM RICH TRUEMPLER STREET ADDRESS 10600 N. DE ANZA BLVD. CITY, STATE, ZIP CUPERTINO, CA. 95014 FAX 408-866-6638 CONTACT NAME JEFF OPAROWSKI PHONE 408-496-0676 E-MAILJOPAROWSKI@ARCTECINC. COM STREET ADDRESS 99 ALMADEN BLVD., SUITE 840 CITY, STATE, ZIP SAN JOSE, CA 95113 --F408-496-1121 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ® CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME RANDY AWALT LICENSE NUMBER B3 3 6 974 LICENSE TYPE BUS. LTC # COMPANYNAME SOUTH BAY CONSTRUCTION E-MAIL RAWALT@SBCI.COM FAX (408) 379-3256 STREETADDRESS 1711 DELL AVE. CITY,STATE,ZIP CAMPBELL, CA 95008 PHONE (408) 379-5500 ARCHITECT/ENGINEERNAME JEFF OPAROWSKI, AIA LICENSENUM13ER C-21289 X BUS. LIC# COMPANYNAME ARC TEC INC. E-MAIL JOPAROWSKI@ARCTEC INC. COM FAX 408-496-1121 STREET ADDRESS 99 ALMADEN BLVD. CITY, STATE, ZIP SAN JOSE, CA 95113 PHONE 408-496-0676 DESCRIPTION OF WORK PARKING LOT REVISIONS, NEW LOADING DOCK AND TRASH ENCLOSURES ADDED TO MAJOR 5 EXISTING USE PROPOSED USE CONSTR. TYPE ;q STORIES OFFICE USE NLY NONE RETAIL II -B ONE OCC TYPE DESCRIPTION SOXT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA 827 AREA NET AREA 827 BATHROOM KITCHEN OTHER REMODEL AREA REMODEL .AREA REMODEL. AREA PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH I DWELLING UMTS IS A SECOND UNIT ❑ YES SECOND STORY ❑ YE. BEING ADDED? ❑ NO ADDITION? ❑ NO PRP -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNER'S NAME IVED BY: TOTAL VALUATION: PLANNINGAPPLK ❑ NO PLANNINGAPPROVALLETIPR By my signature below, I certify to each of the following: I am the property owner or autho ' agent to act the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building co tructi I authori e representatives of Cupertino to enter the above -id ntified property for inspection purposes. Date: Signature of AppIicant/Agent: 41 11- SUPPLEMENTAL F ATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 03/16111 CITY OF CUPERTINO FM__1 FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. 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 Dept_for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Elf 711/12) 20576 HOMESTEAD RD DATE: 09/03/2013 REVIEWED BY: MELISSA326 10 1WADDRESS: APN: 32610 060 BP#: *VALUATION: Iso *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building USE: bl"!% ". . PENTAMATION 1GENCOM PERMIT TYPE: 14 WORK REVISION # 3 - REVISE PARKING LOT WITH N LOADING DOCK & N TRASH ENCLOSURE SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. 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 Dept_for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Elf 711/12) frc.rt_ Pi QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? © Yes Q No $0.00 2 hours Plan Check, Hourly $278.00 /STPLNCK Ll Suppl. PC Fee: C) Reg. Q OT 0.0 bl"!% ". . NOTE: This estimate does not include fees due to other Departments (i.e. 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 Dept_for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Elf 711/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? © Yes Q No $0.00 2 hours Plan Check, Hourly $278.00 /STPLNCK Suppl. PC Fee: C) Reg. Q OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? ® Yes Q No $0.00 Suppl. Insp. Fee:Q Reg. Q OT O Q hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 07 r40:: 4' 1"Cu. 4 E) Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure 0 'ri f" t3netu�;I�a,��h���i� `t't-;- Strong Motion Fee: $0.00 0.0 hrs $0.00 Inspections Inspection, Hourly Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $278.00 TOTAL FEE. $278.00 Revised: 07101/2013 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20576 HOMESTEAD RD CONTRACTOR: SOUTH BAY PERMIT NO: 12060078 CONSTRUCTION, INC OWNER'S NAME: THE SOBRATO ORGANIZATION 1711 DELL AVE DATE ISSUED: 03/05/2013 OWNER'S PHONE: 4084460700 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIAL 11 License Class Lie. # p�%� CONSTRUCT NEW PARKING LOT, LANDSCAPE, UNDERGROUND Contrac Date O UTILITIES, 22 PARKING LIGHTS, 6 TRASH ENCLOSURES I hereby affirm that I am licens under the pro ' wns of apter 9 5/29/2013- REVISION #2- REVISE UNDERGROUND (commencing with Section 7007, of Division 3 of the Busi ss & Professions UTILITIES - ISSUED 7/10/2013 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 Sq. Ft Floor Area: Valuation: $5000000 performance of the work for which this permit is issued. 1 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. APN Number: 32610060.20576 Occupancy Type: 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. l agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS O ERMIT 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 DAYSyA0TVn CALLED INSPECTION. indemnify and keep harmless the Ci of Cupertino against liabilities, judgments, costs, and expenses which m cc r against said City in consequence of the p 1 granting of this permit. ition the applicant understands and will comply Iss Date: th all non -point sour re ions er the Cupertino Munici Co Section 8. .- RE -ROOFS: Signa e 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. 11OWNER-BUILDERDECLARATION 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 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) 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(x) 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 /Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cuper, ' nicipal Code, Chapter 9.12 and 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code, Sections , an�25534. 3700 of the Labor Code, for the performance of the work for which this �Section Owner or authorize ent: Dat/-�J 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must 1 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. 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, ARCHITECT'S DECLARATION 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 CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(aDcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION [:]ALTERATION/ TI ❑X REVISION/DEFERRED ORIGINAL PERMIT# 12060078 PROJECTADDREss 20576 HOMESTEAD ROAD APN# 326-10-066 ONVNERNAME THE SOBRATO ORGANIZATION PHONE408-446-0700 E-MAIL RTRUEMPLER@SOBRATO.COM RICH TRUEMPLER STREET ADDRESS CITY, STATE, ZIP CUPERTINO, CA. 95014 FAX 408-866-6638 10600 N. DE ANZA BLVD. CONTACT NAME JEFF OPAROWSKI PHONE 408-496-0676 E-MAILJOPAROWSKI@ARCTECINC.COM STREET ADDRESS 99 ALMADEN BLVD., SUITE 840 CITY,STATE, ZIP SAN JOSE, CA 95113 FAX 408-496-1121 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT IZI CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME RANDY AWALT LICENSE NUMBER B 3 3 6974 LICENSE TYPE BUS. LIC # COMPANYNAME SOUTH BAY CONSTRUCTION E-MAIL RAWALT@SBCI.COM FAX (408) 379-3256 STREETADDRESS 1711 DELL AVE. CITY,STATE,ZIP CAMPBELL, CA 95008 PHONE (408) 379-5500 ARCHITECT/ENGINEERNAME JEFF OPAROWSKI, AIA LICENSENUMBER C-21289 X BUS. LIC# COMPANYNAME ARC TEC INC. E-MAIL JOPAROWSKI@ARCTECINC.COM FAX 408-496-1121 STREET ADDRESS 99 ALMADEN BLVD. CITY, STATE, ZIP SAN JOSE, CA 95113 PHONE 408-496-0676 DESCRIPTION OF WORK UNDERGROUND UTITLIY REVISIONS TO PROVIDE UTILITIES FOR MULTIPLE TENANTS EXISTING USE PROPOSED USE CONSTR. TYPE #STORIESOFFICE NONE RETAIL II -B ONE occ, TYPE DESCRIPTION SO.Fr_ VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL 1,766 AREA AREA 11766 AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA PORCH AREA DECK AREATOTAL DEC—ORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH k DWELLING 1,mrs. IS A SECOND UNIT' ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑ NO ADD11']ON? ❑ NO PRH-APPLICA]'ION ❑ YES TF YES, PROVIDE COPY OF I PLANNER'S NAME RECEIV J TOTAL VALUATION: PLANNING APPI. P ❑ NO PLANNING APPROVAL LETTER r T 7 r,% By my signature below, I certify to each of the following: I am the property owner or authorize .0"t to act on the property owner's behalf. I have read this application and the information 1 have provided is correct. 1 have read the Description of Work verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to build construc 'on. I authorize representatives of Cupertino to enter the above -identified operty for inspection purposes. / Signature of Applicant/Agent:L Date: SUPPLEMENTA124NAMMATift REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doc revised 03/16/11 CITY OF CUPERTINO FEW FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School I)ivtrirt otr_ L Thovo foov aro ha.vod an tho nroliminary information availahle and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff 711;112) 20576 homestead rd DATE: 05/29/2013 REVIEWED BY: MENDEZ 1WADDRESS: APN: BP#. *VALUATION: 1$60,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: Suppl. PC Fee: (F) Reg. Q OT PENTAMATION PERMIT TYPE: WORK REVISION #2- REVISE UNDERGROUND UTII-ITIES SCOPE NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School I)ivtrirt otr_ L Thovo foov aro ha.vod an tho nroliminary information availahle and are only an estimate. Contact the Dent for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff 711;112) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.0 Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 C`or7c�;rutir;r� lu.�.° rIL/i 1iilF.i'l!'Gd7PiC 1 C'{': Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure E) Strong Motion Fee: 1BSEISMICo $12.60 F 1 # $799.00 Revisions 1REVCOMNEW Commercial New Bldg Stds Commission Fee: IBCBSC $3.00 SUBTOTALS: $15.60 $799.00 TOTAL FEE $814.60 Revised: 04/29/2013 CUPERTINO / �k/-\ CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build ing(a.cupertino.org [N NEW CONSTRUCTION ❑ ADDITION []ALTERATION /T1 Q REVISION/DEFERRED ORIGINALPERMIT# 12060078 PROJECTADDRESS 20576 HOMESTEAD ROAD APN# 326-10-066 OWNERNAME THE SOBRATO ORGANIZATION PHONE408-446-0700 E-MAIL RTRUEMPLER@SOBRATO.COM RICH TRUEMPLER STREET ADDRESS 10600 N. DE ANZA BLVD. CITY, STATE, ZIP CUPERTINO, CA. 95014 FAX 408-866-6638 CONTACT NAME JEFF OPAROWSKI PHONE 408-496-0676 E-MAILJOPAROWSKI@ARCTECINC.COM STREET ADDRESS 99 ALMADEN BLVD., SUITE 840 CITY, STATE, ZIP SAN JOSE, CA 95113 FAX 408-496-1121 ❑ OWNER ❑ OWNER—BUILDER ❑ OWNERAGENT ® CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME RANDY AWALT LICENSE NUMBER 13336974 LICENSE TYPE BUS. LIC N COMPANYNAME SOUTH BAY CONSTRUCTION E-MAIL RAWALT@SBCI.COM FAX (408) 379-3256 STREETADDRESS 1711 DELL AVE. CITY,STATE,ZIP CAMPBELL, CA 95008 PHONE (408) 379-5500 ARCHITECT/ENGINEERNAME JEFF OPAROWSKI, AIA LICENSENUMBER C-21289 X BUS. LIC# COMPANYNAME ARC TEC INC. E-MAIL JOPAROWSKI@ARCTECINC.COM FAX 408-496-1121 STREET ADDRESS 99 ALMADEN BLVD. CITY, STATE, ZIP SAN JOSE, CA 95113 PHONE 408-496-0676 DESCRIPTION OF WORK REVISION TO MAJOR 1 AND 2 BUILDINGS TO PROVIDE UTILITIES FOR MULTIPLE TENANTS HARDSCAPE REVISIONS TO FRONT ARCADE AREA. EXISTING USE PROPOSED USE CONSTR. TYPE 0STORIES OFFICE USE. :)N LY NONE RETAIL II -B ONE TYPE DESCRIPTION SOTT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA 1,766 AREA 1,766 NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH N DWELLING UNI'1'.S ISA SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED'. ❑ NO ADDITION". ❑ No PRE—APPLICATION ❑ YES IF YE.S, PROVIDE COPYOE 1'1--FWS NAME' TOTA VALUATIGN: PLANNING APPI, ❑ NO PLANNING APPROVAL LETTER D By my signature below, I certify to each of the following: 1 am the property owne or autho d ent to act on erty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it i ate. I agree to comply withal] applicable local ordinances and state laws relating to buil ing constr tion. I aut rize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: X Date: I-15 SUPPLEMENTAL IT9FOWA7110N REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW New SFD Or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT Copy of Planning Approval Letter Or Meeting with Planning prior to ❑ ❑ submittal of Building Permit application. MAJOR SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_20/ 1.doc revised 03116/1 l CITY OF CUPERTINO FM_7 FEE ESTIMATOR - BUILDING DIVISION imADDRESS: 20576 HOMESTEAD RD DATE: 03/1212013 REVIEWED BY: MELISSA MISC ITEMS APN: 32610 060 BP#: 'VALUATION: 1$90,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: 0.0 PENTAMATION 1GENCOM PERMIT TYPE: WORK REVISION # 1 - RELOCATION OF UTILITY SERVICES FOR SITE. SCOPE NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School ll:ctrint om 1 Thoco fa aro haeod nn tho nrolim;"any iafnrmatinn availahlo and aro n"k nn octimnto_ Cnntart tho Dont fnr addn'l info_ FEE ITEMS (Fee Resolution 11-053 E j: 7/I/12� FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 hours $0.00 Plan Check, Hourly Suppl. PC Fee: Q Reg. () OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -(E) Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 OtiSlCi-(('L1011 Tcl.`;: r1C�111U1t51/'[llll'� /''[: G Work Without Permit? Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure , Iroi c I�car r.n;t� °zrr;irrr cr�.1: Strong Motion Fee: IBSEISAffCO $18.90 F-1-1 # Revisions $799.00 IREVCO�MTI7 Tenant Improvement Bld;? Stds Commission Fee: IBCBSC $4.00 SuBTOT'ALS: ' $22.90 $799.00 TOTAL FEE: $821.90 Revised: 01/01/2013 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20576 HOMESTEAD RD CONTRACTOR: SOUTH BAY PERMIT NO: 12060078 CONSTRUCTION, INC OWNER'S NAME: THE SOBRATO ORGANIZATION 1711 DELL AVE DATE ISSUED: 03/05/2013 OWNER'S PHONE: 4084460700 CAMPBELL, CA 95008 PHONE NO: (408)379-5500 ❑ LICENSED CONTRACTOR'S DECCLLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL License Class 4�5 Lic. # CONSTRUCT NEW PARKING LOT, LANDSCAPE, UNDERGROUND Contracto 6/ Date � UTILITIES, 22 PARKING LIGHTS, 6 TRASH ENCLOSURES I hereby affirm that I am licensed u rder the prov' tuns o 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 Sq. Ft Floor Area: Valuation: $5000000 performance of the work for which this permit is issued. 1 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 APN Number: 32610060.20576 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 to building construction, and hereby authorize representatives of this city to enter WITH 80 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DA ROM LAST CALLED IN SP CT ON. 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 Issued by: Date: with all non -point so re lations per the Cupertino Municipal Code, Section 9. 8. Signature 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. ❑ 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) I, 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 comp Vance with the Cu no Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safe Code, Sectio , 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized age Da 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 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. 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, ARCHITECT'S DECLARATION 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 l �(` Waste Management Plan Environmental Programs Division Construction Et Demolition Debris 408 777-3354 City of Cupertino environmentat@cupertino.org CUPERTINO GREEN MUST BE SUBMITTED WITH PERMIT APPLICATION. All projects which exceed 3,000 square feet must recycle 60% of the material generated. Permit applicants that fall within the Covered Project' guidelines are required to complete the following Waste Management Plan for the City of Cupertino. At the conclusion of the project, the permittee must file a "Construction Recycling Report" with the Public Works Department/Environmental Division showing the tons recycled and disposed by material type. Use tonnage information from weight tags provided by facilities to quantify total estimated waste and percentages for materials. Ask your hauler, recycler or site cleanup vendor to assist you with this plan. Weight tags of all material recycled and disposed must be submitted once the project is completed in order to receive a Final Building Inspection. Project Name: _ -� , g _p n 5 (a A jL owt C, Permit No: Location: '1.o L•4o 171,11ML Sf6-An N4 t Lttn. Prepared By: rLTtAA_.=� �AeL t VL tz�-2 Phone: I Company Name: , �� n� 0-IvLd4 _Lno, Email:in.. 2� Company Address: ,,,Lm c2 ..`- cpm. Ca �i a roject Squar—__ `��----- Project Type: 11 New Construction 11 Demolition Renovation Pe Footage: 2 I p(.G A. Material to Recycle or Reuse. The facility to which the materials will be hauled should be chosen from the attached list of facilities. Alternative facilities, special salvage or reuse options may be requested by the Environmental Programs Division, Public Works. Check all boxes that apply for each material type Z. This is your plan—you can make changes on your final report. MATERIAL Mixed C&D Debris Asphalt & Concrete Brick / Masonry / Tile Cabinets, Doors, Fixtures, Windows Carpet Carpet Padding/ Foam Cardboard Ceiling Tile (acoustic) Dirt / Sod Drywall (unpainted) Landscape Debris Metals Roofing Materials Wood / Lumber Other Material (list): Trash W W fA Q W U Q o W LU ,n a cc X x J 4A DESTINATION FACILITY a(indicate "to Newby Island LandfillZ by Recology" or provide name of 'p facilityforself-haul) O N S t Tt� p► c..�l,L.c.. g lllillililLiLLIJAL61=T :1111110 Lei r )5( Self -Haul ❑ Roll -off Box (franchised w/ City of Cupertino) ❑ Both Approval by the Environmental Programs Division, Public Works of this Waste Management Plan as complying with CMC 16.72.050 shall be a condition of any building or demolition permit for all covered projects. NOTE: If you enlist the services of a hauler or clean-up company to take the materials to a facility for you, ensure they are aware of the Construction and Demolition Recycling Program and CMC 16.72.050 and can provide you with the required information. Inform the hauler they must take material to an approved facility and are required to provide weight tickets showing proof of recycle. I understand I am responsible for complying with the requirements of the Cupertino C&D Ordinance. I agree to submit a Final Report for this project wi in 0 calendar ays after completion. Applicant Signature: Date: 'Z - 2__T • Q, A01- ' Covered Projects include all construction, demolition and renovation projects that are 3,000 square feet or greater. Applicants seeking building or demolition permits for the above mentioned projects are required by Ordinance 16.72 to recycle or reuse 60% of the material discarded. 2 The City of Cupertino contracts with Newby Island Landfill, owned by Browning-Ferris Industries (BFI) for waste disposal. Revised:'/10/12 & 0 Crane PEST CONTROL® December 18, 2012 HOME OFFICE: 2700 GEARY BOULEVARD / SAN FRANCISCO, CA 94118-3498 Serving Northern California and Western Nevada (415) 922-1666 / (800) 592-7777 FAX (415) 922-1789 Ms. Felicia Trueba Assistant Property Manager The Sobrato Organization 10600 N. De Anza Boulevard, Suite 200 Cupertino, CA 95014 Dear Ms. Trueba: Crane has inspected and monitored the vacant spaces at 20580, 20590, 20620, 20650 and 20680 Homestead Road in Cupertino. As of Monday, December 17, 2012 there are no rodents or other vermin in these spaces. Please do not hesitate to contact us if you have any questions or if we may be of further assistance. Sincerely, CRANE PEST CONTROL Ray C. Busley Vice President RCB/sln Randy Await From: Piu Ghosh <PiuG@cupertino.org> Sent: Thursday, August 30, 2012 10:55 AM To: Jeff Oparowski Cc: Rich Truempler Subject: RE: Homestead Jeff, Please consider this email clearance that the buildings at Homestead Square are not historical landmarks. On a separate note, I was going to meet with DPR at the site to go over the final requirements and possibly sign off on the permit card. However, I waited for 20 mins and no one showed up. I am assuming we will reschedule. Regards, Piu From: Jeff Oparowski fmailto:jooparowski(a)arctecinc.com] Sent: Thursday, August 30, 2012 10:09 AM To: Piu Ghosh Cc: Rich Truempler Subject: Homestead Piu, One of the requirements in the Procedure Checklist for Demolition Permits (item no. 4) is to verify that the proposed demo'd buildings at Homestead Square are not historical landmarks and to obtain clearance from Planning Dept. Could you please process this clearance? Thanks, Jeff Oparowski, AIA, LEED GA ARC TEC, Inc. 99 Almaden Blvd., Suite 840 San Jose, CA 95113 ioparowski aaarctecinc.com P (408) 496-0676 F (408) 496-1121 -- ply, (l Waste Management Plan Environmental Programs Division Construction Et Demolition Debris 408 777-3354 City of Cupertino environmentat@cupertino.org CUPERTINO GREEN MUST BE SUBMITTED WITH PERMIT APPLICATION. All projects which exceed 3,000 square feet must recycle 60% of the material generated. Permit applicants that fall within the Covered Project' guidelines are required to complete the following Waste Management Plan for the City of Cupertino. At the conclusion of the project, the permittee must file a "Construction Recycling Report" with the Public Works Department/Environmental Division showing the tons recycled and disposed by material type. Use tonnage information from weight tags provided by facilities to quantify total estimated waste and percentages for materials. Ask your hauler, recycler or site cleanup vendor to assist you with this plan. Weight tags of all material recycled and disposed must be submitted once the project is completed in order to receive a Final Building Inspection. Project Name: Ha MC_'c. r c b, t3 '5" a&c- Permit No: Location: IOU50 Ad MIiSTe"30 RAM o,Lh TA Ma Prepared By: -,��t T, I t ILt�'Z Phone: &5g-�i -' '1 Cl Company Name: ()uec_1�,k r,,�_�7t', v��L ��nu� Email: �rr-Z kcce,...��lP��-�Ipn Company Address: 57 n C" Project Type: ❑ New Construction ❑ Demolition Renovation Project Square Footage: $ , pgQr A. Material to Recycle or Reuse. The facility to which the materials will be hauled should be chosen from the attached list of facilities. Alternative facilities, special salvage or reuse options may be requested by the Environmental Programs Division, Public Works. Check all boxes that apply for each material type 0. This is your plan—you can make changes on your final report. W MATERIAL a H J XD W N Q K Mixed C&D Debris Asphalt & Concrete Brick/ Masonry/ Tile Cabinets, Doors, Fixtures, Windows Carpet Carpet Padding/ Foam Cardboard Ceiling Tile (acoustic) Dirt / Sod Drywall (unpainted) Landscape Debris Metals W W K Vi J H DESTINATION FACILITY a(indicate "to Newby Island Landfill' by Recology" or provide name of p facility for self -haul) Roofing Materials Wood / Lumber Other Material (list): Trash HAULING • . Self -Haul ❑ Roll -off Box (franchised w/ City of Cupertino) ❑ Both Approval by the Environmental Programs Division, Public Works of this Waste Management Plan as complying with CMC 16.72.050 shall be a condition of any building or demolition permit for all covered projects. NOTE: If you enlist the services of a hauler or clean-up company to take the materials to o facility for you, ensure they are aware of the Construction and Demolition Recycling Program and CMC 16.72.050 and can provide you with the required information. Inform the hauler they must take material to an approved facility and are required to provide weight tickets showing proof of recycle. I understand I am responsible for complying with the requirements of the Cupertino C&D Ordinance. I agree to submit a Final Report for this project wi m 60 calen�a 49ys after completion. Applicant Signature: C� Date: 2 - Z'1 • l� ' Covered Projects include all construction, demolition and renovation projects that are 3,000 square feet or greater. Applicants seeking building or demolition permits for the above mentioned projects are required by Ordinance 16.72 to recycle or reuse 60% of the material discarded. 2 The City of Cupertino contracts with Newby Island Landfill, owned by Browning-Ferris Industries (BFI) for waste disposal. Revised:1110/12 0 Crane PEST CONTROL® December 18, 2012 HOME OFFICE: 2700 GEARY BOULEVARD / SAN FRANCISCO, CA 94118-3498 Serving Northem CaliPomia and Western Nevada (415) 922-1666 / (800) 592-7777 FAX (415) 922-1789 Ms. Felicia Trueba Assistant Property Manager The Sobrato Organization 10600 N. De Anza Boulevard, Suite 200 Cupertino, CA 95014 Dear Ms. Trueba: Crane has inspected and monitored the vacant spaces at 20580, 20590, 20620, 20650 and 20680 Homestead Road in Cupertino. As of Monday, December 17, 2012 there are no rodents or other vermin in these spaces. Please do not hesitate to contact us if you have any questions or if we may be of further assistance. Sincerely, CRANE PEST CONTROL jeAr 6 44A$t Ray C. Busley Vice President RCB/sln Randy Await From: Piu Ghosh <PiuG@cupertino.org> Sent Thursday, August 30, 201210:55 AM To: Jeff Oparowski Cc: Rich Truempler Subject: RE: Homestead Jeff Please consider this email clearance that the buildings at Homestead Square are not historical landmarks. On a separate note, I was going to meet with DPR at the site to go over the final requirements and possibly sign off on the permit card. However, I waited for 20 mins and no one showed up. I am assuming we will reschedule. Regards, Piu From: Jeff Oparowski[mailto:joparowski(darctecinc.com] Sent: Thursday, August 30, 2012 10:09 AM To: Piu Ghosh Cc: Rich Truempler Subject: Homestead Piu, One of the requirements in the Procedure Checklist for Demolition Permits (item no. 4) is to verify that the proposed demo'd buildings at Homestead Square are not historical landmarks and to obtain clearance from Planning Dept. Could you please process this clearance? Thanks, Jeff Oparowski, AIA, LEER GA ARC TEC, Inc. 99 Almaden Blvd., Suite 840 San Jose, CA 95113 iooarowski(@arctecinc.com P (408) 496-0676 F (408) 496-1121 OFT, ((� Waste Management Plan Environmental Programs Division pip Construction Et Demolition Debris 408 777-3354 City of Cupertino environmentat@cupertino.org CUPERTINO GREEN MUST BE SUBMITTED WITH PERMIT APPLICATION. All projects which exceed 3,000 square feet must recycle 60% of the material generated. Permit applicants that fall within the Covered Project' guidelines are required to complete the following Waste Management Plan for the City of Cupertino. At the conclusion of the project, the permittee must file a "Construction Recycling Report" with the Public Works Department/Environmental Division showing the tons recycled and disposed by material type. Use tonnage information from weight tags provided by facilities to quantify total estimated waste and percentages for materials. Ask your hauler, recycler or site cleanup vendor to assist you with this plan. Weight tags of all material recycled and disposed must be submitted once the project is completed in order to receive a Final Building Inspection. �l Project Name: {aMC S Tf Zn Permit No: Location: 10LOU C, a.us0 — Prepared By: M _ _)�.� I L Phone: _(40-a"LCt— Company Name: . ��c i�_R�►,�c -nu✓ Email: 1S L.r� � [�b.,� Ila& Company Address: 1 S �? Ja .q S L u___ _ Project Type: ❑ New Construction ❑ Demolition Renovation Project Square Footage: A. Material to Recycle or Reuse. The facility to which the materials will be hauled should be chosen from the attached list of facilities. Alternative facilities, special salvage or reuse options may be requested by the Environmental Programs Division, Public Works. Check all boxes that apply for each material type 0. This is your plan—you can make changes on your final report. W MATERIAL a L" _J C DESTINATION FACILITY I=j CL H (indicate "to Newby Island Landfill' by Recology" or provide name of H O p facility for self -haul) Mixed C&D Debris 'Zc:, � k—f, Asphalt & Concrete '4 Brick / Masonry / Tile Cabinets, Doors, Fixtures, Windows Carpet Carpet Padding/ Foam Cardboard Ceiling Tile (acoustic) Dirt / Sod Drywall (unpainted) Landscape Debris Metals Roofing Materials Wood / Lumber Other Material (list): Trash METHOD:HAULING Self -Haul ❑ Roll -off Box (franchised w/ City of Cupertino) ❑ Both Approval by the Environmental Programs Division, Public Works of this Waste Management Plan as complying with CMC 16.72.050 shall be a condition of any building or demolition permit for all covered projects. NOTE: if you enlist the services of a hauler or clean up company to take the materials to a facility for you, ensure they are aware of the Construction and Demolition Recycling Program and CMC 16.72.050 and can provide you with the required information. Inform the hauler they must take material to an approved facility and are required to provide weight tickets showing proof of recycle. I understand I am responsible for complying with the requirements of the Cupertino C&D Ordinance. I agree to submit a Final Report for this project within 6calendar da r completion. Applicant Signature: ld Date: '2 �'Zi ' 13 1 Covered Projects include all construction, demolition and renovation projects that are 3,000 square feet or greater. Applicants seeking building or demolition permits for the above mentioned projects are required by Ordinance 16.72 to recycle or reuse 60% of the material discarded. z The City of Cupertino contracts with Newby Island Landfill, owned by Browning-Ferris Industries (BFI) for waste disposal. Revised:1110/12 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(Dcupertino.org CUPERTINO NFWCONSTRI)CTInN F AnnITI()N F AI.TFRATION /-ri ILI RFVICION'nFFPRRFr) 0PIL44d1r'" PkAIT!! PROJECT ADDRESS_ APNk 326-10- , 060, 063 OWNERNAME THE SOBRATO ORGANIZATION PHONE 408-446-0700 EMAIL RTRUEMPLER@SOBRATO.COM RICH TRUEMPLER STREET ADDRESS 10600 N. DE ANZA BLVD. CITY, STATE, ZIP CUPERTINO, CA. 95014 FAX 408-866-6638 CONTACT NAME JEFF OPAROWSKI PHONE 408-496-0676 E-MAILJOPAROWSKI@ARCTECINC.COM S)"RUErADDRESS 99 ALMADEN BLVD., SUITE 840 CITY, STATE, ZIP SAN JOSE, CA 95113 FAX 408-496-1121 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ® CONTRACTOR ❑ CONTRACTOR AGENT 9 ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS LIC H COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME JEFF OPAROWSKI , AIA LICENSE NUMBER C-21289 BUS LIC # COMPANYNAME ARC TEC INC. F -MAIL JOPAROWSKI@ARCTECINC.COM FAX 408-496-1121 STREETADDRESS 99 ALMADEN BLVD. CITY, STATE, ZIP SAN JOSE, CA 95113 PHONE 408-496-0676 DESCRIPTION OF WORK CONSTRUCTION OF A NEW PARKING LOT, WITH SITE LIGHTING, UNDERGROUND UTILITIES, AND NEW TRASH ENCLOSURES. 19- p/ K( L -VA L1 iI u "5 I & Vb& K EXISTING USE PROPOSED USE CONSTR TYPE ISEORIES OFFICE SE NLY NONE PARKING LOT V -B ONE c. TYPE DESCRIPTION s FT VALUATION EXISTG NEW FLOOR DEMO TOTAL AREA AREA 1,800 AREA NETAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA 1"OTAL DECK/PORCH AREA GARAGE AREA ❑ DETACH ❑ ATTACH n l)%L1 I.NO IINI IS IS A SECOND UNIT YFS SFCONDSTORY ❑YI"S BEING ADDED" N'1 ADDITION' No PRr-APPI A1(()N ❑ YrS Hns,PROVIDI:O)],"I PLANNIR'SNAM] RFCEIVEDBY TOTAL VALUATION Pf.ANNINO APPI.# ❑ NI' I'LANNIN(V APPROVAL M IIr.R By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building constructio . I autho ize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant Agent. Date' SUPPLEMENTAL I 'O ATIO .EQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER -THF C'OUNT'ER JRUIEDINC, PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building ��// w�/ permit for new building. L7 F,XPRESS E� PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD Id PUBIC WORKS form if any Hazardous Materials are being used as part of'this project. ❑ ,��/� LARGE I�F'IR _ Copy ol'Planning Approval Letter or Meeting with Planning prior to ❑ DISTRICT submittal of iullding Permit application. MAJOR SANITARY S@:NER ❑ EN41RONMF.NTAL UFALTH RldgApp 20/ /aloe revised 0346 /1 CITY OF CUPERTINO FM -W FEE ESTIMATOR - BUILDING DIVISION NOTE. This estimate does not inchcde fees due to other Departments (i.e. 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 Devt for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7%1/11) ADDRESS: 20576 homestead rd. DATE: 06/1312012 REVIEWED BY: bobs. APN: BP#: *VALUATION: 1$5,000,000 ,' PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY Commercial Building USE: 1 hrs PENTAMATION 1GENCOM PERMIT TYPE: WORK construct new parking lot landscape, underground utilities 22 parking lights, 6 trash enclosures. SCOPE F 22 Electrical $308.00 1BREMPOLE Fixtures, Platform NOTE. This estimate does not inchcde fees due to other Departments (i.e. 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 Devt for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7%1/11) FEE Plumb. Plan Check 0.0 1 hrs $0.00 Plumb. Permit Fee: IPPERMIT Other Plumb Insp.0.0 hrs $44.00 Elec. Plan Check 0.0 1 hrs $0.00 Elec. Permit Fee: IEPERMIT Other Elea Insp. 0.0 hrs $44.00 NOTE. This estimate does not inchcde fees due to other Departments (i.e. 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 Devt for addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7%1/11) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes 0 No $0.00 4 hours Plan Check, Hourly $520.00 ISTPLNCK Suppl. PC Fee: 0 Reg. 0 OT 0.0 1 hrs $0.00 PME Plan Check: $0.00 F 22 Electrical $308.00 1BREMPOLE Fixtures, Platform Permit Fee: Hourly Only? (E) Yes 0 No $0.00 Suppl. Insp. Fee.0 Reg. OT 0.0 hrs $0.00 ©# Shed 1 $2,346.00 ]SHED PME Unit Fee: $0.00 PME Permit Fee: $88.00 = # Plumbing $44.00 IPCSEWER Sewer, Sanitary Administrative Fee: IADMIN $41.00 E) Work Without Permit? Yes 0 No $0.00 Advanced Planning Fee. $0.00 4 hours Inspections $520.00 ISTINSP Inspection, Hourly E) Travel Documentation Fee: ITRAVDOC $44.00 Stronp, Motion Fee: IBSEISMICO $1,050.00 Select an Administrative Item 1 Bldg Stds Commission Fee: IBCBSC $200.001 SUBTOTALS: $1,423.001$3,738.00 TOTAL FEE: 1 $5,161.00 Revised: 06/05/2012 CUPERTINO PROJECT DATA - COMMERCIAL COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build ing(acupertino. org PROJECTADDRESS SW CORNER N. DE ANZA BLVD. & HOMESTEAD RD. APN # 326-10-051,060,063 OWNERNAME THE SOBRATO ORGANIZATION PHONE 408-446-0700 E-MAIL RTRUEMPLER@SOBRATO.COM RICH TRUEMPLER STREET ADDRESS 10600 N. DE ANZA BLVD. CITY, STATE, ZIP CUPERTINO, CA 95014 FAX 408-866-6638 APPLICANT NAME ARC TEC INC. PHONE 408-496-1076 E-MAIL JOPAROWSKI@ARCTECINC.COM JEFF OPAROWSKI, AIA STREETADDRESS 99 ALMADEN BLVD. CITY, STATE, ZIP CUPEETINO, CA 95014 FAX 408-496-1121 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ® ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT TENANT CONTACT NAME PHONE E-MAIL BUSINESS NAME FAX DESCRIPTION OF WORK CONSTRUCTION OF A NEW PARKING LOT WITH SITE LIGHTING,_ LANDSCAPING, UNDERGROUND UTILITIES, AND NEW TRASH ENCLOSURES. EXISTING USE(S): NONE PROPOSEDUSE(S): PARKING LOT OCCUPANCY(S): M OCCUPANT TYPE OF __[PARCEL LOAD: CONSTRUCTION V B AREA: 15.07 ACRES AREA OF 1, 800 S F FLOOR(S) HAZARDOUS Y N REMODEL SPACE: OF REMODEL SPACE: MATERIALS? FIRE Y N WUI Y N FLOOD Y N SIESMIC Y N SPRINKLERS: AREA: AREA: AREA: NUMBER OF CHILDREN < 2 YRS OLD: LEARNING CENTERS AND 24 HO URS CARE? Y N NUMBER OF STUDENTS >= 2 YRS OLD UP TO 12'"GRADE: EDUCATIONAL OPERATIONS: NUMBER OF ADULT CLIENTS: Governing Codes: 2010 California Building Code (based on the 2009 International Building Code) 2010 California Residential Code (based on the 2009 International Residential Code) 2010 California Plumbing Code (based on the 2009 Uniform Plumbing Code) 2010 California Mechanical Code (based on the 2009 Uniform Mechanical Code) 2010 California Electrical Code (based on the 2009 International Electrical Code) 2010 California Energy Code 2010 California Green Building Standards Code Cupertino Municipal Code ProjeclDala-Commercial. doc revised 03,01/11 Pla_=nlan 925, 462.5151 Sacramento 916.414.4747 CONSTRUCTION aac!sc cFrano413:,134.4747 9 �19GKt4x3Y,5�7,7555 TESTING SERVICES Sara Jose 408.675.6992 Los Vegas 702.257.4747 cOond 510.414.4747 www.cts-].com 11/06/2014 04:07 pm Field Work Order No. 244,853 Technician: Cortez, Robert` Gauge: pp Date/Time Called In: 11/06/2014 09:50 am Call nTer )48-658-5164 Caller Phone: Client: The Sobrato Organization Inspection Date: 11/07/2014 Project: Safeway Site Work including Trash Enclosures Inspection Time: 10:00 am P Project Mgr: Chhoun, Yate Duration: Ap04 Project Lo Contact: Michael LaFontaine Sr — Phone: (408) 679-4359 Fax: Offsite Location: Jobsite Location: Cupertino Driving Directions: Comments: grout at 11 am Cell: Alt Cell: ICC Concrete Sampling Instructions: ATTACH PAPERWORK TO CYLINDERS WITH PACKING SLIP - Please make sure contractor has had a Concrete F_i Mortar 7 Grout n Yds. Placed Area Placed No. Cyls Made Test @ Days 3 5 7 14 28 56 90 _]Other Spec. @ Days CALL DISPATCH FOR SAMPLE PICK-UP AND LOCATION High Strength Grout (NS) Sampling All PO4&4 rt)ta2 Instructions: LEAVE PAPERWORK WITH SAMPLES / GROUT BLOCK. PLEASE NOTIFY DISPATCH IF YOU NEED A GROUT BOX OR SAMPLE CONTAINER DELIVERED TO JOB -SITE. CALL DISPATCH FOR SAMPLE PICK-UP AND LOCATION Field Reinforcing Steel Inspection Field Welding Inspection - ICC Instructions: Please referance approved structural plans or specs on ALL REPORTS! Include page number from structural plans. CTS Form online has specific section for this, thank you. Also please leave a copy of your report daily 6W C209 OA'f— a rl jsiA rop 5 5 4)�- it ?057 `FI, +155 t— x 6 m c- i ;L y- 3 7'0 ►/y. " ?/Ws Z1,04, �l it ' , ,,,alb► 5/y, a�> S grF1+a 4.5acrQ- '°+ K a,4. "� y"Ls't- �CONSTRUCTION -TESMNG SERVICES Laboratory Compression Test Data Information. to be provided by Field Technician Job Name: t;oAajj64 Permit #:. "'k W I • -. � Job M. Mix #; 1� Sup I Contractor: Date: %I L7� Tec' cian 464e True: Deslg W O n9) Izp$i 16: ria Sh Flexural Beams Grout Cubes ancrete c Iinder masonry Prism Masonry Grout Masonry Mortar Shotcrete Panel Type of Structure 5OG Footing Grade Bolam Tilt Up Panel PT Deck Piles Deck Piers t column Wall Pile -Caps Location in Structure Line: Row: fo,"vorall out Floor/Bldg: 1 N Cj c5u)a hocetlon In Structure Line: Row: when'Sam led Floor/Bldg: Sample Information: coBP�g ua itv Actual Req'ment Actua . Mix Temperature(OF)'. Z 54-90 Slum In. y Req'men) T 1 Actual Req'ment Unit Weight Air Temperature °F : ' > 40 Air content Bio : Time Sampled: 111/ A Aggregate size in : Time Batched: % D `" ! Time In Truck: lLi� < 1:30 hrs Inf' i ori to be auPplted by Laboratory Technician Date-Recsivod: technician that recelvs am le: Test# Age of bate Technician Dlm nslona (Inch), T s DIa.1W dth Lein th X -Section Area(In') compressive Typo of Load ib. Stren th sf Fracture A 8 C f' D E: Date 28 Day Avg. ASTM Stangords Used: C31 C39 C42 .C78 C1Q9 C174 C51 G617 G1-019 C1077 C1231 E4 & E447. FrBCture 8 5 on e s a a feature no 1.2twell ad cone on one en a acturet a of om . 1.3 Columnar vertical cracimy Wow 5M ends le slavlaro. ano of wunder ou on e it pointed 4774DuckhjM Don. 3&Cr9M6ete. CA 95834 (919) 419-4747 office I (916) 41"774 tax 2) 74 i cit Dft Sults A, PWMEO , CA 94591 (9251462-5151 office 1 (925) 462.5163 fox MINIM CONOTRUCTION TESTING SERVICES DAILY FIELD REPORT CTS Project #: � Project Name �4LU 2 Ci►I :', y ��. Project Location xcto 7 t -v CTS Representative ?ob*j�- ,art C,a Weather t7-:1Atk4 TESTING • INSPECTING • ENGINEERING Date 11-7-/4- Permit 11-7-1 Permit * Appl. #: UVOCIG 7 v Time Arrived Time Departed Reported to (Z.1 Pq r., A,fJ with 5 Cir atArry-),W Asnmt cancelled by Concrete datch Plant Operations Observed concrete batch plant operations at for mix no. 28 -day strength Specified slump _ inches. Monitored loads leaving for Concrete/Shotcrete Observed placing of C t for 1 mil. �^�C�o9v� t 'S mix no. 5 60610 day strength _psi, specified slump -I inch s, 1(,t total cubic yards placed. Monitored loads for mix no., slump, temp. and time limit. Prepared .5 y,c test specimens sampled from ex)b aF 'TTwlr- Set# Set# Set# Set# get# Set# Set# Set# Set# Slump 41/7- i Mix Temp. Air Temp. Air Cont. Unit Wt. Truck # Location -rp% -!5 Per Set _�_ Sets Total Masonry Observed placing of masonry units for Observed placing of lift grout for Prepared samples from Prepared masonry prisms for Mortar Per Set Sets _Total Grout Per Set Sets _Total Prisms Sets of Rebar / Post -Tensioning / Epoxy -Set Bolts and Dowels Observed placing of for Observed stressing of PT Tendons for Reviewed calibration data for jacking equipment Monitored stressing forces and tendon elongation. Recorded data on PT Report _ Enclosed On File Observed placing of Anchor Bolts Epoxy -Set Bolts Epoxy -Set Dowels, for Epoxy: Material Depth Diameter Holes cleaned Yes - No Performed —Pull—Torque -test on epoxy -set _Bolts i Rebar Dowels, for Material Reviewed Material Identification and MTR's for Obtained samples of Cement Aggregate Rebar PT Tendons Masonry Units Soil AC identified as Picked up samples at job site consisting of Conformance X,'( Work observed was, to the best of my knowledge, in conformance with approved plans, specifications and applicable standards of workmanship. With the following exception (s). See attached Non -Compliance Report. Non-compliance conditions noted were brought to the attention of for corrective action. Additional Notes: it 6 a III' 747 Duckhorn Drive j Sacramento, CA 95834 1 Phone ('916) 419-4747 1 Fax (916) 419-4774 2118 Rheem Drive Pleasanton, CA 94588 1 Phone (925) 462-5151 1 Fax (925) 462-5183 CONSTRUCTION '`' " h' TESTING SERVICES Welding Observation Report • TESTING • INSPECTING • ENGINEERING • CONSTRUCTION MANAGEMENT Project Name �a� ,�! 610- 60CkK ;.� �,.,,ti, nlk�ij Job No. 6KI Date %1-17 !� CL Project Location ��4✓ �em�r l44 ' 'tfhPE bImit No: Appt ti �x> 76 CTS Representative . tyl Lv►�fK Time In: Time Out Reported to I with 2 at 3. Time err _4._ dep 5 . Time reobserving _L retesting _L_. Assignment cancelled by _L due to9J „� h % " WELDING w, S- a P 11 Reviewed welder qual papers 12 name _ 13 $SN _ 14 Observed welding 15 In progress 16 completed 17 performed by_ weider(s) 28 previously reported 18 using 19 SMAW 20 FCAW 21 GMAW 22 — process(es) with 23 E electrodes 24 E wire. 25 Verified proper electrode storage. 26 Verified preheat temp. maintained at _ F. 27 Weldments observed consisted of the following: tLvR T!lAr,{, pS.�yti,t STRUCTURAL STEEL 29 CP 30 PP 31 Multipass 32 Single Pass Fillet Welds Joining 33 Girder to Column 34 Beam to Girder 35 Column to Base Plate (WF TS PIPE) 36 Stiffner Plate to WF TS (column or beam) 37 Gusset to WF TS PIPE (column or beam) 38 Plate to Plate 39 Plate to Column (WF TS PIPE) 40 Plate to Beam (WF TS Channel) 41 Plate to Angle or Channel 42 Splice to WF TS Angle Channel Plate I�r •� REBAR it 43 Flare -Bevel Groove Indirect Butt Splide 44 Bevel Groove Direct Buff Splice joining 45 No _ 46 Grade ! rebar for_. Joining 47 Splices (chord bars, wall, beam, column and slab 48 embeds 49 Verified preheat per AWS D1.4 CE requirements. A"f-1 MG I �L 1L +' A•1k a _.,......_ DECKINGISTUDS }- 60 Arc spot Si Intermitant Stitch Welding of metal decking 52 Arc stud welding 53 Checked studs for soundness 54 Performed _ bend tests on a total of studs with ,_ fallure(s) 55 embeds studs to plate WF TS angle channel. 4'P$ U Tn #42 A-40 5 LOCATION mAOXK Pdj44A.4pn J?A;OX ra FV 56 at the following locations _ 67 floor _ 68 column line _ 59 wall line _ 60 piece no. 61 member check list 62 on file 63 attached MATERIAL 64 Identified material against 65 MTR's 66 and Ht. Nos. 67 Collected copy of MTR's 68 on file 69 attached 70 Obtained _ samples of 71 Steel 72 rebar 73 HS bolts 74 Identified as 75 list attached q CONFORMANCE 76 Non Compliance conditions noted were brought to the attention of ! for corrective action. 77 Work observed was, to my knowledge, in conformance with 78 approved plans and specifications 79 and applicable standards of workmanship 80 with the exceptions 81 as follows 82 contained in the attached Non Compliance report 83 Acceptable members were marked with identification 84 tags 85 stamp ter% Limitation; This inspecdon was performed In accordance wilt► requiraments, but please note that this report shelf not be relied upon by otheT, as acceptance or guarantee of the work. Even wffh diligent lnspecdon techniques, dte contractor Is solely liable for Oofects or failures to adhere to the code. l" Y Inspector Sign tore nl7/1 1233 East Beamer Street, Unit B . Woodland, CA 95776 • Phonei, (530) 666-4774 Fax: (530) 666-4749 2174 Rheem Drive, Suite A . Pleasanton, CA 94588 • Phone: (925) 462-5151 Fax: (925) 462-5183 One Embarcadero Center, Suite 535 a San Francisco, CA 94111 • Phono: (415) 438-2357 . Fax: (415) 334-4747 246 30th St., #101 9 Oakland, CA 94601 a Phone: (510)1444-4747 9 Fax: (510) 835-1825 CONSTRUCTION TESTING "ER VICES November 3, 2014 The Sobrato Organization Attn: Rich Truempler (email) 10600 N DeAnza Blvd, Ste 200 Cupertino, CA 95014 Job No: J8805C Summary Report #23 Job Name: Safeway Site Work (incl. Trash Enclosures) Homestead Square 20620 Homestead Road Cupertino, CA Permit #: 12060078 TESTING a INSPECTION ENGINEERING No field reports were made this week; however, we are enclosing laboratory test results. Limitations: These inspections were performed in accordance with requirements, but please note this report shall not be relied upon by others, as acceptance or guarantee of the work. Even with diligent inspection techniques, the contractor is solely liable for defects or failures to adhere to the code. t yt 41Z - F0.2 11/6/2014 Reviewed by Andrew Peters Date Staff Engineer Technical Contact: Timothy Casey, P.E. (tcaseya`ets-I.com) Administrative Contact: Yolanda Deras (ydera acts-Lcom) cc: Building Department — City of Cupertino Contractor— South Bay Construction, Inc. (email) Architect — Arc Tec, Inc. (email) Structural Engineer — Hohbach-Lewin, Inc. (email) CTS PM — Yate Chhoun (email) CTS Staff Engineer — Andrew Peters (email) Xvu RECEIVED NOV 12 2014 2118 Rheem Drive, Pleasanton, CA 94588 0 Phone (925) 462-5151 Fax (92.5) 462-5183 4770 Duckhorn Drive, Sacramento, CA 95834 0 Phone (916) 419-4747 Fax (916) 419-4774 One Embarcadero Center, Suite 535, San Francisco, CA 94111 9 Phone (415) 334-4747 Fax (415) 438-2357 246 30° St., Suite 101, Oakland, CA 94601 0 Phone (510) 444-4747 Fax (510) 835-1825 CONSTRUCTION TESTING SFRACTS Field Number: 4 Masonry Grout Compression Test Project Name: Safeway Site Work including Trash Enclosures Appl No: 12060078 Project No.: J8805C Sampled By: Fernando Llamas Report Date: 11/03/2014 Client: The Sobrato Organization Date of Sampling: 10/22/2014 Lab Log No.: 101593 Information provided by Field Technician Mix #: KPG6 Supplier: Kell s Contractor: Sobrato Set: 1 of 'l JTruck #: 323 Design Strength (psi): 2,000 @ 28 days Sample Material/Shape: Masonry Grout Type of Structure: Wall Location: Onsite Location for overall Safeway trash enclosure CMU wall pour: Location Safeway trash enclosure, CMU wall when sampled: Concrete Quality Actual Req'ment Mix Temperature (°F): 74 50-90 Actual Req'ment Slump (in.): 8 8 Actual Unit Weight (pct): N/A Req'ment N/A Air Temperature (°F): 70 >40 Air Content (%): N/A N/A Time Sampled: 1:00 pm N/A Aggregate Size (in): 1/8 N/A Time Batched: 11:55 am N/A Time in Truck: 65 mins <90 Mins. Information supplied by Laboratory Technician Date Received: 10/23/2014 Technician that received: RT Test # Age of Dimensions (inch) X -Section Ultimate Load Compressive 1 Test (Days) Date Technician Width Width Height Area (int) (lbs) Strength (psi) A 7 10/29/14 CH 3.25 3.25 6.25 10.56 31,820 3,010 B 28 11/19/14 3.25 3.25 6.25 10.56 C 28 11/19/14 3.25 3.25 6.25 10.56 D I 28 1 11/19/14 1 3.25 3.25 6.25 I 10.56 Remarks: L230 26' Day Avg.: NOV , 2 ..,•� err _ '� - _. 11/03/2014 Reviewed by: John Harms - Staff Engineer Date OSTM Standards Used: Unless noted, material was sampled and tested in accordance with ASTM C1.72, C1019, C31, C143, C231 or C173, C470, C511, C617, C1077, C1231,C1064, C138 and E4. Compressive strength tests perASTM C39. Testing was performed by qualified personnel in accordance with generally accepted industry practice, material testing consultants procedures and the above reference standards. This report is applicable only to the items listed herein. The tests performed and in this report are not intended to be considered as any guarantee or warranty of suitability for service or fitness of use of items tested and it should not be relied on as such. The report has been prepared for the exclusive use of the client and any partial or whole reproduction without the consent of the client is prohibited. CONSTRUCTION TESTING SERVICES Summary Report #21 October 20, 2014 The Sobrato Organization Attn: Rich Truempler (email) 10600 N DeAnza Blvd, Ste 200 Cupertino, CA 95014 Job No: J8905C Job Name: Safeway Site Work (incl. Trash Enclosures) Homestead Square 20620 Homestead Road Cupertino, CA Permit #: 12060078 October 13, 2014 TESTING INSPECTION ENGINEERING TWo✓ 3 2,o Jason Alberts reported to Terry with Hyltons Fabrication at the shop. Reviewed welder qualification papers for Terry Hylton, ID #33-W. Observed welding in progress, performed by (1) welder using SMAW process with 71A85 dual shield electrode and FCAW process with E7 IT wire. Weldments observed consisted of partial penetration, multi -pass and single pass fillet welds. Visual inspection in shop welding consisted of HSS 6x6x1/4" columns with PL 3/4"x12" welded. HSS 6x6xl/4" columns with PL'/z"x7xll" welded. '/4" minimum fillet welds. All passed with no failures. These items are complete. Location: Homestead Safeway trash enclosure. Per AWS D 1.1; 2010, D 1.1. Acceptable members were marked with identification. Work observed was, to the best of Jason's knowledge, in conformance with approved plans, specifications and applicable standards of workmanship. October 14, 2014 Fernando Llamas reported to Michael with South Bay at the jobsite. Observed placement of concrete (mix no. S6050P, 28 -day strength of 4000 psi, specified slump of 4±1 inch, 30 total cubic yards placed) for footings for trash enclosure/ south east corner behind building. Refer to Adam Cherrie's report for sampling information. Verified placement of rebar and #5 epoxy set dowels for (16) footings total. Epoxy material: Simpson Set -XP. Holes drilled to a depth of 10" and diameter of 3/4". Holes checked for cleanliness. Per plan S5.1. All work is complete. Checked clearances and cleaned debris. Adam Cherrie reported to Terry with South Bay at the jobsite. Sampled concrete (mix no. S6050P, 28 -day strength of 4000 psi, specified slump of 4±1 inch, 30 total cubic yards placed) for footings for trash enclosure/ south east corner behind building. Monitored loads for mix no., slump, temperature and time limit. jZr(!TvVEkD specimens sampled from end of truck. 2 l 18 Rheem Drive. Pleasanton, CA 94588 4770 Duckhorn Drive, Sacramento, CA 95834 One Embarcadero Center, Suite 535. San Francisco, CA 94111 246 30°i St.. Suite 101, Oakland, CA 94601 • Phone (925) 462-5151 • Phone (916) 419-4747 • Phone (415) 334-4747 • Phone (510) 444-4747 OCT 2 7 2014 BY_________ • Fax (925) 462-5183 • Fax (916) 419-4774 • Fax (415) 438-2357 • Fax (510) 835-1825 e TESTING CONSTRUCTION e INSPECTION t TEST Ii 1G SERVICES a ENGINEERING Work observed was, to the best of Fernando and Adam's knowledge, in conformance with approved plans, specifications and applicable standards of workmanship. October 15, 2014 Jesus Martinez picked up (5) 4x8 cylinders from the jobsite. Laboratory test results are enclosed if testing was done during the period covered by this report. Limitations: These inspections were performed in accordance with requirements, but please note this report shall not be relied upon by others, as acceptance or guarantee of the work. Even with diligent inspection techniques, the contractor is solely liable for defects or failures to adhere to the code. 10/23/2014 Reviewed by Andrew Peters Date Staff Engineer Technical Contact: Timothy Casey, P.E. (tcasejgets-I.com) Administrative Contact: Yolanda Deras (yderas@cts-1.conr) cc: Building Department — City of Cupertino Contractor — South Bay Construction, Inc. (email) Architect — Arc Tec, Inc. (email) Structural Engineer — Hohbach-Lewin, Inc. (email) CTS PM — Yate Chhoun (email) CTS Staff Engineer — Andrew Peters (email) RECEIVED OCT 2 7 2014 BY JKB 2174 Rheem Drive, Suite A. Pleasanton, CA 94588 Phone (925) 462-5151 Fax ('925) 462-5183 4770 Duckhorn Drive, Sacramento, CA 95834 Phone (916) 419 4747 Fax (916) 419-4774 One Embarcadero Center, Suite 53.5, San Francisco, CA 94111 9 Phone (415) 334-4747 Fax (415) 438-2357 246 30`x' St.. Suite 101, Oakiand, CA 94601 • Phone (510) 444-4747 • Fax (510) 83 5- 1825 Set 1 Slump (in.) 4 Mix temp. (°F) 79 Air temp. (°F) 73 Truck No. 45 Location Overall Location 5 Per Set, 1 Set, 5 Total Work observed was, to the best of Fernando and Adam's knowledge, in conformance with approved plans, specifications and applicable standards of workmanship. October 15, 2014 Jesus Martinez picked up (5) 4x8 cylinders from the jobsite. Laboratory test results are enclosed if testing was done during the period covered by this report. Limitations: These inspections were performed in accordance with requirements, but please note this report shall not be relied upon by others, as acceptance or guarantee of the work. Even with diligent inspection techniques, the contractor is solely liable for defects or failures to adhere to the code. 10/23/2014 Reviewed by Andrew Peters Date Staff Engineer Technical Contact: Timothy Casey, P.E. (tcasejgets-I.com) Administrative Contact: Yolanda Deras (yderas@cts-1.conr) cc: Building Department — City of Cupertino Contractor — South Bay Construction, Inc. (email) Architect — Arc Tec, Inc. (email) Structural Engineer — Hohbach-Lewin, Inc. (email) CTS PM — Yate Chhoun (email) CTS Staff Engineer — Andrew Peters (email) RECEIVED OCT 2 7 2014 BY JKB 2174 Rheem Drive, Suite A. Pleasanton, CA 94588 Phone (925) 462-5151 Fax ('925) 462-5183 4770 Duckhorn Drive, Sacramento, CA 95834 Phone (916) 419 4747 Fax (916) 419-4774 One Embarcadero Center, Suite 53.5, San Francisco, CA 94111 9 Phone (415) 334-4747 Fax (415) 438-2357 246 30`x' St.. Suite 101, Oakiand, CA 94601 • Phone (510) 444-4747 • Fax (510) 83 5- 1825 i CONSTRUCTION v}� TESTING SERVICES Summary Report #22 October 27, 2014 The Sobrato Organization Attn: Rich Truempler (email) 10600 N DeAnza Blvd, Ste 200 Cupertino, CA 950147 Job No; J8805C Job Name: Safeway Site Work (incl. Trash Enclosures) Homestead Square 20620 Homestead Road Cupertino, CA Permit #: 12060078 October 22, 2014 TESTING INSPECTION e ENGINEERING EC TIeED Nov 0 3 2014 BY Fernando Llamas reported to the jobsite. Observed placement of grout (mix no. KPG6, 28 -day strength of 2000 psi, specified slump of 8", 5 total cubic yards placed) for Steinmart trash enclosure CMU wall. Monitored loads for mix no., slump, temperature and time limit. Prepared test specimens sampled from onsite mixer. 4 Per Set, 1 Set, 4 Total Verified placement of rebar at trash enclosure wall. Work complete per S5.1. Work observed was, to the best of Fernando's knowledge, in conformance with approved plans, specifications and applicable standards of workmanship. October 23, 2014 Jesus Martinez picked up (1) masonry grout box from the jobsite. 2118 Rheem Drive, Pleasanton, CA 94588 0 Phone (925) 462-5151 0 Fax ('925) 462-5183 4770 Duckhorn Drive, Sacramento, CA 95834 0 Phone (916) 419-4747 & Fax (9 16) 419-4774 One Embarcadero Center, Suite 535, San Francisco, CA 94111 • Phone (415) 334-4747 A Fax (415) 438-2357 246 30`x' St., Suite 101, Oakland, CA 94601 0 Phone (510) 444-4747 0 Fax (510) 835-1825 Set 1 1 Slump 8 (in.) 74 Mix temp. (°F) Air temp. 70 (°F) Truck # 323 Location Trash Enclosure 4 Per Set, 1 Set, 4 Total Verified placement of rebar at trash enclosure wall. Work complete per S5.1. Work observed was, to the best of Fernando's knowledge, in conformance with approved plans, specifications and applicable standards of workmanship. October 23, 2014 Jesus Martinez picked up (1) masonry grout box from the jobsite. 2118 Rheem Drive, Pleasanton, CA 94588 0 Phone (925) 462-5151 0 Fax ('925) 462-5183 4770 Duckhorn Drive, Sacramento, CA 95834 0 Phone (916) 419-4747 & Fax (9 16) 419-4774 One Embarcadero Center, Suite 535, San Francisco, CA 94111 • Phone (415) 334-4747 A Fax (415) 438-2357 246 30`x' St., Suite 101, Oakland, CA 94601 0 Phone (510) 444-4747 0 Fax (510) 835-1825 CONSTRUCTION TESTING SERVICES + TESTING + INSPECTION + ENGINEERING Laboratory test results are enclosed if testing was done during the period covered by this report. Limitations: These inspections were performed in accordance with requirements, but please note this report shall not be relied upon by others, as acceptance or guarantee of the work. Even with diligent inspection techniques, the contractor is solely liable for defects or failures to adhere to the code. 6V-1-- 1-- — 10/2812014 Reviewed by Andrew Peters Date Staff Engineer Technical Contact: Timothy Casey, P.E. (tcasey@cts-I.com) Administrative Contact: Yolanda Dera.s (yderase?ets-Loom) cc: Building Department — City of Cupertino Contractor — South Bay Construction, Inc. (email) Architect — Arc Tec, Inc. (email) Structural Engineer — Hohbach-Lewin, Inc. (email) CTS PM — Yate Chhoun (email) CTS Staff Engineer — Andrew Peters (email) LH 2174 Rheem Drive, Suite A. Pleasanton, CA 94588 L Phone (925) 462-5151 Fax (92 5) 46? -5183 4770 Duckhorn Drive, Sacramento, CA 95834 Phone (916) 419-4747 Fax (916) 419-4774 One Embarcadero Center, Suite 535, San Francisco, CA 94111 Phone (415) 334-4747 Fax (415) 438-2357 246 30i° St._ Suite 101, Oakland, CA 94601 • Phone (510) 444-4747 • Fax (5 10) 835-1825 CONSTRUCTION TESTING SERVICES Field Number: 5 Laboratory Compression Test Project Name: Safeway Site Work including Trash Enclosures Appl No: 12060078 Project No.: J8805C Sampled By: Adam Cherrie Report Date: 10/25/2014 Client: The Sobrato Organization Date of Sampling: 10/14/2014 Lab Log No.: 101198 Information provided by Field Technician Mix M S6050P Supplier: Star Contractor: Noah Concrete Set: 1 of 1 JTruck M 45 Design Strength (psi): 4,000 @ 28 days Sample Material/Shape: Concrete Cylinders 4x8 Type of Structure: Footing Location: Onsite Location for overall Footings for SE trash enclosure behind building pour: Location Footings for SE trash enclosure behind building when sampled: Concrete Quality Actual Req'ment Actual Mix Temperature (°F): 79 50-90 Slump (in.): 4 Req'ment 4+/-1 Actual Unit Weight (pct): N/A Req'ment N/A Air Temperature (°F): 73 >40 Air Content (%): N/A N/A Time Sampled: 1:40 pm N/A Aggregate Size (in): 1"x#4 1"AM Time Batched: 12:43 pm N/A Time in Truck: 57 mins <90 Mins. Information supplied by Laboratory Technician Date Received: 10/15/2014 Technician that received: AP Test # Age of Dimensions (inch) X$ection Ultimate Load Compressive Type of 1 Test (Days) Date Technician Diameter Length Area (int) (lbs) Strength (psi) Fracture A 7 10/21/14 JT 4.00 1 8.00 12.57 39,530 3,150 Type 5 B 28 11/11/14 4.00 8.00 12.57 C 28 11/11/14 4.00 8.00 12.57 D 28 11/11/14 4.00 8.00 12.57 E H f i Remarks: L16 28 Day Avg.: I I Reviewed by: John Harms - Staff Engineer 10/25/2014 Date ASTM Standards Used: Unless noted, material was sampled and tested in accordance with ASTM C172, C31, C143, C231 or C173, C470, C511, C617, C1077, C1231,C1064, C138 and E4. Compressive strength tests per ASTM C39. Fracture Key: 1. Well -formed cones on both ends 3. Columnar vertical cracking through both ends 5. Side fractures at top or bottom 12. Well -formed cone on one end 14. Diagonal fracture with no cracking through ends 16, Similar to Type 5 but end of cylinder is pointed Testing was performed by qualified personnel in accordance with generally accepted industry practice, material testing consultants procedures and the above reference standards. This report is applicable only to the items listed herein. The tests performed and in this report are not intended to be considered as any guarantee or warranty of suitability for service or fitness of use of items tested and it should not be relied on as such. The report has been prepared for the exclusive use of the client and any partial or whole reproduction without the consent of the client is prohibited. ALTERNATE MATERIALS AND METHODS / MODIFICATION FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building a—cupertino.org CUPERTINO ❑ REQUEST FOR MODIFICATION OF CODE (CBC 104.10) ❑x REQUEST FOR ALTERNATE MATERIAL, DESIGN OR METHOD OF CONSTRUCTION (CBC 104.11, CFC 1.11.2.4) Tn annly fnr this rpnupst rmmnlptp cprtinnw 1 9 A 3 link nr tvnpl SITE 20576 Homestead Road ADDRESS APN 326-10-066 DATE 08/05/2014 The Sobrato Organization - Owner................................................Rich.........Truempler...................................................................... We propose to apply 2013 CBC Section 11 B-502.3.4 which allows the loading aisles to be located on Parking Lot PC #:.,................................... Type:..................................... Address10600 N. De Anza Blvd., Cupertino, CA 95014 ......... .............................................. 12060078.............. No. of Items ............................... Fee Due: $................................. Date Paid: ................................. ReceiptNo .: .............................. Processed by: .........�..................... ...................................................................... Permit #: ................. Stories:.................................. Emai0yem..p..l.e..r.@....sobrato.com 408-866-638 .........................................Phone........................................... BuildingOfficial:...... ......Print:..... . PLN #: ....................... ........... Dept./Div................................ Occupancy:............................ Floor Area:............................. Arc Tec Inc. - Jeff Oparowski AIA Architect Applicant...................................................................Title................................ . Address.99 Almaden Blvd., San Jose, CA 95113 ............................................................................................................. Job Status: ............................ Occ. Load:.........................,... ................................................... Emailoparowski....arctecinc.com..... ..........................Phone.408-496-0676...... . Use of Bldg: ............................ 2 I REQUEST: For code modifications, please state the applicable code requirement and the extent of relief desired. For alternate requests, state the type of system ......d ....d a....�......,,.a...:., c.ti...a ..i,. -..:a ................. ... :u.......,�,........,.... nda:.:......: ..ti,.,.... ,., a............ h,...«....�.,.a v standard stalls to accessible stalls. Due to the existing configuration QkIkeOtkinq lot this results in one new accessible stall having the loading aisle on the driv s" favehicle which does not comply withSection tem no. ., � 1 t ,1 3 JUSTIFICATION/FINDINGS OF EQUIVALENCY: For code modi s, pplicant shall demonstrate that special, individual reasons exist that make compliance with the strict letter o iFie ordinance impractical and that equivalency is provided. For alternate requests, applicant shall demonstrate suitability, strength, effectiveness, fire resistance, durability, safety and sanitation that is equivalent to the code for a similar use. Code Section(s): 2013 CBC section 11 B-502.3.4 Attach additional sheets if necessary. We propose to apply 2013 CBC Section 11 B-502.3.4 which allows the loading aisles to be located on either side of the vehicle. Petitioner'sr/sl �' Si nature: ... ..... .r.. Position:... . . re.G(.... Date :................. Reviewed By: ............... r,....y .. ...`.........Date:.j............. .. V WV V I-411AV V�W The Request is: XGRANTED ❑ DENIED Dept. Comments: CONDITIONS OF APPROVAL: ZO No. of Items ............................... Fee Due: $................................. Date Paid: ................................. ReceiptNo .: .............................. Processed by: .........�..................... BuildingOfficial:...... ......Print:..... . . � ........... Date..1.......�............. FireMarshal: ........................................................................................Print:................................................................................... Date:................................... DEPARTMENT ACTION: Atter determination, copies to: 1) applicant, 2) permit the Altform_2014.doe revised 01/15/14 37� a 7 y D L 0 U � a Z Q Z CL Nei ccW oC ® CL J LU mum mum (, VJ O Z Lw - m iQ O N O O ca c0 L O CL M Z d- O a E Liz Cl) � o �U Q CO o W a o o Q=2U I V W u d ACCESSIBILITY TO PUBLIC BUILDINGS, PUBLIC ACCOMMODATIONS, COMMERCIAL BUILDINGS AND PUBLIC HOUSING IIB -502.3 Access aisle. Access aisles serving parking spaces shall comply with Section IIB -502.3. Access aisles shall adjoin an accessible route. Two parking spaces shall be per- mitted to share a common access aisle. IIB -502.3.1 Width. Access aisles serving car and van parking spaces shall be 60 inches (1524 mm) wide mini- mum. I1B-502.3.2 Length. Access aisles shall extend the full required length of the parking spaces they serve. 11B-502.3.3 Marking. Access aisles shall be marked with a blue painted borderline around their perimeter. The area within the blue borderlines shall be marked with hatched lines a maximum of 36 inches (914 mm) on center in a color contrasting with that of the aisle surface, prefer- ably blue or white. The words 'NO PARKING" shall be painted on the surface within each access aisle in white letters a minimum of 12 inches (305 mm) in height and located to be visible from the adjacent vehicular way. Access aisle markings may extend beyond the minimum IIB -502.3.4 Location. Access aisles shall not overlap the vehicular way. Access aisles shall be permitted to be placed on either side of the parking space except for van parking spaces which shall have access aisles located on the passenger side of the parking spaces. ac 8$s aisle 60 min t0:4 (8) perpendiadar parav FIGURE 118-02.3 PARKING SPACE ACCESS AISLE 2013 CALIFORNIA BUILDING CODE rAW,VMb ak'+sfrttf KC (ALL R01T8RCSEMAD; Ae IN W4e.L. Rlav96xaEle Y.1f 573