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13010045 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10181 BUBB RD - CONTRACTOR:REDWOOD ELECTRIC PERMIT NO: 13010045 . GROUP INC OWNER'S NAME: DEVCON/BUBB RD INVESTORS 2775 NORTHWESTERN PKWY DATE ISSUED:01/08/2013 OWNER'S PHONE: 4089961010 SANTA CLARA,CA 95051 PHONE NO:6503695555 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL LJ COMMERCIAL License Class C' (V LL Lie.X :3`a1:ui33) APPLE-TEMP POWER FOR CONSTRUCTION TRAILER Contractor k_.Ct X14 V�'Cek(� Gdr'Ltete 1 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 1 hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$500 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:35720005.10181 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 00 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 save180 DAY OM LAST CALLED INSPFyd C ,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 t` / granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-poi n sourcere ions per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date t � 13 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 I hereby affirm that 1 am exempt from the Contractor's License Lew for one of Signature of Applicant: Date: 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. 1 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 1 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 the Health&Safety Code,Sections 05,2,553}i,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this (f/J�L/� _ Owner or authorized agent: Date: � I3 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 GENERAL PERMIT APPLICATION M E P COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)7773228•FAX(408)7773333•buildina(a)CUDertino.ora `�}�, M 'S C ❑PLUMBING ❑MECHANICAL ELECTRICAL ❑MISCELLANEOUS PROIECI ADDRESS IO �I �,+,bb V N ��... AFNR /35 ! C—()CO OWNER NAME �nqWQ• G, ( IGT p /v E-MAIL S73KEETADDRESS T� �j _ LAO? O? CITY, STATE,ZIP I CONTACT NAME FG PHONEr/'T' Y �E-MA1L STREETADDRESS CITY,STATE,21P FAX ❑ OWNER ❑ OwNEEAR.BUILDER ❑TOWNER AGENT E3TR CONAROR 13 CONTRACTOR AGENT ❑ ARCIETECT 13 ENGINEER EI DEVELOPER 11 TENANT CONTRACTOR NAME d �d Q_1�:� r'{ LICENSENUMBER LICE3nr BUS.LIC% COMPANY NAME Too"N^ 9&6ro E-MAIL ,n ye_ .� �'O /. ..(i 1C�/ ��M FAX STREET ADDRESS „_I�.r� �L.I{� D._.I . _ CTTY.STATE,UL�fJJ�/' HCK�W�IAL�' ' PEONS ARCN)TECT/ENG1N=NAME . +1 U�WLICENSE NUMBER 3�) L133I BUS.DCN COMPANY NAME' E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑sFDra DUPuDc ❑ MULTI.FAMLLY PR0R=1NWBDLAND ❑ YES PROIECr Dt ❑YES ISTHEBIDGAN ❑ YES BUILDING: ❑COMMERCIAL URBANINIERFACE AREA ❑ NO FLOOD ZONE ❑NO E)CHLER HOMET ❑NO DESCRBRION OF WORK .�ic CGri�rld�•N -�uA'i�f TOTALVALUATION: .'Svd RECEIVED BY: By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the m eny owner's behalf I have read this application and the iaformation I hav provided'a correct. 1 have read the Description of Work and verify it is ac=X1 I agree to comply with all applicable local ordinances and state laws relating m din truction. I authorize representatives of Cupertino to enter the abov -id ti iedproperty for inspection p*oses. Signature ofApplicanNAgene Date: L �� PLEI,IENTAL INFORMATION REQUIRED OFFIC&USE ONLY m OVER-THE-COUNTER Y ❑ EXPRESS u ❑ STANDARD U 3 ❑ LARGE ❑ NWOR MEPMucApp_1011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10181 BUBB RD DATE: 01/08/2013 REVIEWED BY: MENDEZ APN: BP#: "VALUATION: $500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building PENTAMATION 10EAP14 USE: PERMIT TYPE: WORK APPLE-TEMP POWER FOR CONSTRUCTION TRAILER SCOPE F ASech.Pian Chrr3 Pimtlh Plait C/terk Elec.Plan Check 0.0 hrs $0.00 ble(h. Permit Peri• Phanb. Perms Fre: Elec.Permit Fee: 1EPERMIT Omer:blech.Inw. Other Plumblrt>p. Other Flee.Insp. OA hrS $45.00 Me(h. hip. Per. Plumb.lisp. Pee; Etat. Lvp. Ice: 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 prefimina information available and are only an estimate. Contact the De t or addn7 info. FEE ITEMS(Fee Resolution 11-053 EA' 711112) FEE QTY/FEE I MISC ITEMS Plan Check Fee: $0.00 1 amps Electrical Suppl. PC Fee: Q Reg. O OT 0.0 hrs $0.00 $45.00 IECT<200 Temporary Power PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.0 Reg. ® OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $45.00 Consvrnrlion "Tux: Administrative Fee: IADMIN $42.00 Q Work Without Permit? © Yes O No $0.00 G Advanced Planning Fee: $0.00 Select a Non-Residential Q Travel Documentation Fee: ITRAVDOC $45.00 Building or Structure Strong Motion Fee: 1BSEISMICO $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 y'ahs5L1BTOTALS' $133.50 $45.00 TOTAL FEE: $178.50 Revised: 10/01/2012 Building Department City Of Cupertino 10300 Torre Avenue Telephone: 408-777-3228 CUPERTINO Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: (d h` vlzj1WPERMIT# OWNER'S NAME: PHONE# GENERAL CONTRACTOR- BUSINESS LICENSE# ADDRESS: CITY/ZIPCODE: *Our municipal code requirO all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL,-OR`FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR"AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE I am not using any subcoptractorse Signature Date Please check applicable°u'b'conttactorsand complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE# Cabinets &Millvdoik:' Cement Finishing' Electrical �e- CIYWV 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