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12110005CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18880 HOMESTEAD RD OWNER'S NAME: CUPERTINO OFFICE PARTNERS LLC CONTRACTOR: CUPERTINO ELECTRIC INC PERMIT NO: 12110005 1132 N 7TH ST DATE ISSUED: 11/01/2012 OWNER'S PHONE: 4088088000 SAN JOSE, CA 95112 PHONE NO: (408)991-1000 LICENSED CONTRACTOR'S DECLARATION License Class Li Lic. # 1-4 Af (o J6 - Contractor �1.,Y? A • Date � - �i I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for i spection purposes. (We) agree to save indemnify and keep harmless the City Cupertino against liabilities, judgments, costs, and expenses which may accru-idgainst said City in consequence of the granting of this permit. Addit - nally a applicant understands and will comply with all nn*oce re ati per the Cupertino Municipal Code, Section 9.18. Signature ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: I have and will maintain a Certificate of Consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH r- RESIDENTIAL COMMERCIAL F JOB DESCRIPTION: APPLE - COMMERCIAL OFFICE SPACE POWER POLE RELOCATIONS POWER FEEDS 28 TOTAL Sq. Ft Floor Area: Valuation: $25000 APN Number: 31609037.18880 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: — Date;%Z/— RE -ROOFS: . All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I se equipment or devices which emit hazardous air contaminants as defyiep by the Bay Area Air Quality Management District I will maintain compli n96 Vith the Cupertino Municipal Code, Chapter 9.12 and the Health &?Safety , Sections 25505, 25533, and 25534. Owns o ani r' e ) Jl Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of vmrk's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building c0cuDertino.org []PLUMBING ❑MECHANICAL ELECTRICAL ❑MISCELLANEOUS MISC PROJLCTADDRESS A.FNR � % � ✓ raj \Cjj f (� 3� � � � '�i� �E„-/NAZI U OWNER NAIvM _ PHONE STREET ADD SS CITY, STATE ZIP C I FAX CONTACT NAME PHONE E-MAIL STR.=ADDRESS CITY, STATE, ZIP FAX ❑ cwga- ❑ OWNER-BL'Il.DER ❑ OWNER AGENT .,,CONTRACTOR ❑CONTRACTORAG"ENT. ❑ ARC'=cT ❑ ENGiamER ❑ DE\EL.OPER ❑ TENAIN'T CONTRACTOR NAME LICENSENUMBER L10EN5 TYPE da BUS. LIC COMPANY NAME � p I e `�� F/•.X STREET ADDRESS � - CITY, STATE ZIPS" � j0 PHONE + y ARC.=_,CT/ENGIN'EERNAME / LICENSENUNSER �i BUS. LIC COMPANY NAME ' E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD a ❑ MULTI -FAMILY PROJECT IN WILDLAND ❑ SES PROJECT IN BL=ING: MM_RCIAL - URBAN IN ERFACE ARFA ❑ NO FLOOD ZONE ❑ YES ❑ NO IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK G� ai l�l� TOTAL VALUATION: �/� RECEIVED BY: J S By my signature below, I certiy't'oo each of the feller ing: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information Vnave p " "'ded is correct. I have read the Description of Work and verity it is accurate. I agree to comply with all applicable local ordinances and state laws relatirfg to b n `nsa-uc on. I a7tfho z= representatives of Cupertino to enter the above -identi5edp ope.,y for inspection pus`s eses. Signanr,e of Applicart/Agent ` - ate: t' J (/ T SUPPLEMENTAL INFORMATION REQUIRED OFPeE USE ONLY OYER -THE -COUNTER Y F •J ❑ EXPRESS V ❑ STANDARD U ❑ L .RCE ❑ MAJOR MEPLfucA.pp_2011.doc revised 06121111 CITY OF CUPERTINO lm -i FEE ESTIMATOR - BUILDING DIVISION APPLIANCE / EQUIP TYPE ADDRESS: 18880 homestead rd. 1st floor DATE: 11/01/2012 REVIEWED BY: bobs. UNITS APN: BP#: *VALUATION: $25,000 xPERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: Commercial Building # PENTAMATION PERMIT TYPE: 10EAP1 WORK comm offices ace power pole relocations power feeds 28 total. SCOPE APPLIANCE / EQUIP TYPE FEE ID QTY/FEE QTY UNITS BP FEES IELCPLNC Elec. Permit Fee: IEPERMIT Recep/Switch/Outlets 1 BREMRECEP Other Elec. Insp. 0.0 1 hrs $45.00 28 # $77 PME Unit Fee: $77.00 PME Permit Fee: $45.00 77 Administrative Fee: IADMIN $42.00 Work Without Permit? 0 Yes 0 No $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC $77.00 Strong Motion Fee: IBSEISMICO 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 preliminary information available and are only an estimate. Contact the Deptfor addn'l info. FEE ITEMS (Fee Resolution 11-053 a.' /1i12) FEE QTY/FEE Elec. Plan Check 1.0 1 hrs $133.00 Plan Chcck z IELCPLNC Elec. Permit Fee: IEPERMIT PC 11.1, Other Elec. Insp. 0.0 1 hrs $45.00 PME Plan Check: $133.00 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 preliminary information available and are only an estimate. Contact the Deptfor addn'l info. FEE ITEMS (Fee Resolution 11-053 a.' /1i12) FEE QTY/FEE MISC ITEMS Plan Chcck PC 11.1, PME Plan Check: $133.00 PME Unit Fee: $77.00 PME Permit Fee: $45.00 77 Administrative Fee: IADMIN $42.00 Work Without Permit? 0 Yes 0 No $0.00 Travel Documentation Fee: ITRA VDOC $45.00 Strong Motion Fee: IBSEISMICO $5.25 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $348.251 $0.00 TOTAL FEE: $348.25 Revised: 10/01/2012 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: j PERMIT OWNER'S NAME: �, / � Cr�4t PHONE # &IaO GENERAL CONTRACTO : (P ,.�, � BUSINESS LICENSE # Cdt. ADDRESS: 2 ,� . It CITY/ZIPCODE: Sa , , / *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SU N RAC ,ORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. / r I am not using any subcontractors: Si nature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINE S NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date 1:14.0 L I I &I Mew Properties: i Issued Permit #: 112110005 Status: lExpired Permit App #: 112110005 Submittal Date: 111/01/2012 ------- Issue Date: 11/01/2012 Last Inspection: Eviration Date: Permit Type: 110EAP10 Permit Subcases: No configred s kw, -s. Project Valuation: 25000,00 Date Closed: Scope of Work: APPLE - COMMERCIAL OFFICE SPACE POWER POLE RELOCAMONS POWER FEEDS 28 TOTAL ,gyve, 40 3p1�� rpe:10EAP10 tart Date: 11/01/2012 I Expired :sued Date: 11/01/2012 cope of Work: APPLE - COMMERCIAL FFICE SPACE POWER POLE LOCATIONS POWER FEEDS 28 TOTAL Applicant CUPERTINO OFFICE PARTNERS LLC ) 901 TASMAN DR UNIT 220 SANTA CLARA, :A 95050 Property Owner ( CUPERTINO OFFICE PARTNERS LLC ) 2901 TASMAN DR UNIT 220 SANTA CLARA, CA 95050 Email: M ate Exp: 12/31/2016 tatus: Active ontractor #: 697 tate License #: ontractor Type: CONTRACTOR - LECTRICAL