HomeMy WebLinkAbout15010006 Permit DocsCITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 10300 N TANTAU AVE I INCNTRACTOR: CUPERTINO ELECTRIC I PERMIT NO: 15010006
I OWNER'S NAME: CAMPUS HOLDINGS INC 11132 N 7TH ST I DATE ISSUED: 01/0520/5
I OWNER'S PHONE: 4089968181 I SAN JOSE, CA 95112 I PHONE NO: (408)991-1000
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. # 70 6 20
Contractor 7t7_? .r4,a+ / : 6 - /6
I hereby affirm t'at 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 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-poin}source re ton Tr the Cupertino Municipal Code, Section
Date
❑ OWNER-BUILDER-DBCLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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
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.
JOB DESCRIPTION: RESIDENTIAL 0 COMMERCIAL
APPLE- INSTALL TEMP POWER
Sq. Ft Floor Area: I Valuation: $10000
APN Number: 31618025.00 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAY OF PERMIT ISSUANCE OR
180 DAYS FR LAST CALLED INSPECTION.
Issued by: Date: I ' c. ]
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
Signature of
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the uper icipal Code, Chapter 9.12 and
the Health & Safety Code, S4t1on f 2 05, 25533,a 25534.
Owner or authorized agent:
Date: (- 5-(i
I hereby affirm that there is a construction lending agency for the performance of
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name _
ARCHITECTS DECLARATION
I understand my plans shall be used as public records.
Licensed
CITY OF CUPERTINO
TIFF FCTTMATOR- RIJILDING DIVISION
ADDRESS: 10300 n Tantau
DATE: 01/05/2015
REVIEWED BY: Mendez
APN:
BP#: Y%yt
VALUATION:
I$io,000
*PERMIT TYPE: Electrical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY
USE: Commercial Building
PENTAMATION 10EAP14
PERMIT TYPE:
WORK
a le- install temp ower
SCOPE
APPLIANCE / EQUIP TYPE
FEE ID
QT\
UNITS
BP FEES
Temporary Power
1ECT>1K
1,600
Amps
$84
TOTALS:
$84.00
Elec. Plan Check 0.0 hrs $0.00
P ,,M,.r T, ,:
Elec. Permit Fee: 1EPERMIT
o
Other Elee. Insp. 0.0 hrs $48.00
,N h OTE: 1/us estimate does not include fees due to other vepartments (I.e.Planning, ruuuc r.urnj, II,", .,...,..,..y
---------------------------r _..,.:..., .,anAto and nro nnIu nn nvti,ntde_ Contact the Dent for addn'l info.
District, eta). taese era nre awcn o...nc .o ...........
FEE ITEMS (Fee Resolution 11-053 Elf 711113)
.............S...
FEE
QTY/FEE
MISC ITEMS
PME Plan Check:
$0.00
PME Unit Fee:
$84.00
PME Permit Fee:
$48.00
Consn-¢ction Tar:
Administrative Fee: 1ADMIN
$45.00
Work Without Permit? o Yes O No
$0.00
4
Travel Documentation Fee: ITRAVDOC
$48.00
Strong Motion Fee: IBSEISMICO
$2.80
Select an Administrative Item
Bldg Stds Commission Fee: IRCBSC
$1.00
SUBTOTALS:
$228.80
$0.00
TOTAL FEE:
$228.80
Revised: 10/01/2014