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10110098CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 20010 STEVENS CREEK BLVD -`VNER'S NAME: HEINZ JONG . ^ER'S PHONE: 8009353056 LICENSED CONTRACTOR'S DECLARATION License Class Lic. # � Contractor Date 1 hereby affirm tha 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. I have and will maintain Worker's Compensation Insurance, as provided or by Section 3700 of the Labor Code, for the performance of the work for w ich permit is issued. APPLICANT CERTIFICATION 1 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 expe hich may accrue against said City in consequence of the granting of is permi Additionally, the applicant understands and will comply with all no point sou a regular ns pe a Cupertino Municipal Code, Section 9.18. /% Sip -nature Date A,4 OWNER -BUILDER DECLARATION I hereby affirm that 1 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 1 certify that I have read this application and state that the above information is correct. 1 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 anon the above mentioned property for inspection purposes. (We) agree to save mnif'y and keep harmless the City of Cupertino against liabilities, judgments, ,s, and expenses which may accrue against said City in consequence of the grunting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Si Date CONTRACTOR: MG/SOMA PERMIT NO: 101 10098 CONSULTING INC 2535 W WINTON AVE STE 4G DATE ISSUED: 03/09/2011 HAYWARD, CA 94545 PHONE NO: (510) 781-0500 r r r BUILDING PERMIT INFO: BLDG ELECT PLUMB F_ r r MECII RESIDENTIAL COMMERCIAL. JOB DESCRIPTION: VILLAGE FELAFELS- COMM'L 1-1 MINOR TENANT IMPROVEMENT WORK(900SQ)'REPLACING KITCHEN HOOD SYSTEM & FIRE SUPPRESSION SYSTEM.ACCESSIBILITY Sq. Ft Floor Area: I Valuation: $50000 I AFN Number: 36903005.00 I Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued b Date: _3_/ , -� 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. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(x) should I store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as definedthe ay Area Air Quality Management District I will maintain compliance' th the upertino Municipal Code, Chapter 9.12 and the Health & Safety Code,(Sectioni 25505, 25533, and 25534. Owner or authorized agent: Dater CONSTRUCTION LENDING AGENCY 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 Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 20010 STEVENS CREEK BLVD OWNER'S NAME: HEINZ JONG +ER'S PHONE: 8009353056 ❑ LICENSED CONTRACTOR'S DECLLARATION License Class Lic. # 7�� U Contractor Date li I hereby affirm that I am licen ed under the provisions of Ch pter 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: 1. 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. 2. 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 1 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 expe es w 'ch may accrue agains aid City in consequence of the granting of thi permit. dditiona y, the plicant understands and will comply with all non -point ource reg lation the upertino Municipal Code, Section 9.18. Signature Date , LO// L OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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) 2. 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. 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. 2. 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. 3. 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 in-' ify and keep harmless the City of Cupertino against liabilities, judgments, cc ad 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 CONTRACTOR: MG/SOMA CONSULTING PERMIT NO: 10110098 INC 2535 W WINTON AVE STE 4G DATE ISSUED: 03/09/2011 HAYWARD, CA 94545 PHONE NO: (510) 781-0500 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ VILLAGE FELAFELS- COMM'L TI MINOR TENANT IMPROVEMENT WORK(900SQ);REPLACING KITCHEN HOOD SYSTEM & FIRE SUPPRESSION SYSTEM.ACCESSIBILITY REVISION #I -PARKING PLAN ISSUED 5/27/11 Sq. Ft Floor Area: I Valuation: $50000 APN Number: 36903005.00 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: 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. Ad ' ' ally, should I use equipment or devices which emit hazardous air c ntami ants as defined by the Bay Area Air Quality Management District I will Lealth ain ompliance with he Cupertino Municipal Code, Chapter 9.12 and the & afety C coons 25505, 25533, and 25534. r zed agent: Date: 2-,-/1 CONSTRUCTION LENDIN AGENCY 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 Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20010 STEVENS CREEI{ BLVD CONTRACTOR: MG/SOMA PERMIT NO: 10110098 CONSULTING INC OWNER'S NAME: HEINZ JONG 2535 W WINTON AVE STE 40 DATE ISSUED: 03/09/2011 O)VNER'S PHONE: 8009353056 HAYWARD, CA 94545 PHONE NO: (510) 781-0500 ❑ LICENSED CONTRACTOR'S DECLARATION � F BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class = Lic.# % �" F F_ D4ECH RESIDENTIAL COMMERCIAL Contractor Date � // I hereby affirm tha am licensed under the provisions of Chapter 9 JOB DESCRIPTION: VILLAGE FELAFELS- COMM'L TI MINOR TENANT (commencing with Section 7000) of Division 3 of the Business & Professions REPLACING KITCHEN HOOD IMPROVEMENT SUPPRESSION SYSTEM &FIRE SUPPRESSION SYSTEM.ACCESSIBILITY 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 Ft Floor Area: Valuation: $50000 performance of the work for which this permit is issued.Sq. I have and will maintain Worker's Compensation Insurance, as provide*by,/' Section 3700 of the Labor Code, for the performance of the work for wA permit is issued. N Number: 36903005.00 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. 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 WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expe s vhich may accrue against said City in consequence of the Issued b Date:' granting of is permi Additionally, the applicant understands and will comply -. with all no point sou a regulat2ns pe the Cupertino Municipal Code, Section 9.18. Signature L RE -ROOFS: Date 'l 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 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) 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(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 the ay Area Air Quality Management District I performance of the work for which this permit is issued. ; will maintain compliance th the upertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code,( 'Sectionj 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this 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, 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 CITY OF CUPERTINO BUILDING PERMITr`" "x w_`o BUILDING ADDRESS: 20010 STEVENS CREEK BLVDI CONTRACTOR: MG/SOMA CONSULTING PERMIT'NO: 10110098 OWNER'S NAME: HEINZ JONG 12535 W WINTON AVE STE 4G I DATE ISSUED: 03/09/2011 OWNER'S PHONE: 8009353056 I HAYWARD, CA 94545 PHONE NO: (510) 781-0500 LICENSED CONTRACTOR'S DECLARATION License Class-A.—Il Lic. # a /( if—?*—) Contractor ru Date K--2 / I I hereby affirru;�tl} t 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 -point source regulations per the Cupertino Municipal Code, Section 9.18. 34, Signature 31 Date F ❑ 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. Date BUILDING PERMIT INFO: BLDG F ELECT PLUMB r MECH RESIDENTIAL__. COMMERCIAL `F JOB DESCRIPTION: VILLAGE FELAFELS- COMM'L TI MINOR TENANT IMPROVEMENT WORK(900SQ);REPLACING KITCHEN HOOD SYSTEM & FIRE SUPPRESSION SYSTEM.ACCESSIBILITY 6/21/2011-REV#2 - REVISE PATH OF TRAVEL, OCCUPANCY, CLASS, EXITS - 6/21/2011 REV#2ISS'D Sq. Ft Floor Area: I Valuation: $50000 APN Number: 36903005.00 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: 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 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 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 Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owne r author' ed ag nt /` c f� r", Date: 6 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of N4ork'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 TY OF LIZ CUPERTINO CITY OF CUPERTINO TENANT IMPROVEMENT PERMIT APPLICATION FORM APN # Building Address: Mailing Address (if different from building address): Tenant (If tenant please provide a letter from the building owner approving the tenant improvement.) Building Owner10/ Are Hazardous Materials being used as part of this project? Yes ❑ No Tenant/Building Owne 's Name: Phone #: 4 Contractor: Phone #: -.. w, /. J Fax #: Cupertino Business Lic nse: State Contractor License #: Contact: /%Clsv Ait/�✓ Phone #: d' ��' Fax #: c�(�' YS1 Z L Z 6 Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated areas): If 2,500 sq. ft. or less, compliance with the Landscape Water -Efficiency Checklist is required. If more than 2,500 sq. ft., a complete Landscape Project Submittal is required. Compliance Method: ❑ Plant Tye ❑ Water Budget Job Description (be specific): Tenant Improvement Includes Re -Roof: Yes ❑ No If yes, number of squares Tenant Improvement Includes Structural Yes ❑ No Type of Construction (Usage Class): Occupancy Type: 1-A, 1-B ❑ WMIV-A ❑ II/III B, -HT, V -B Ej/ Valuation/e/t o, ._o Project Size: Express ❑ Standard V Large ❑ Major ❑ Green Building: Please complete Leed for commercial interiors checklist & attach it to the application or if applicable, include in plans & sheet index C___1)_ . LEED Points Achieved *** For Office Use Only*** Over The Counter ❑ Revised 05/18/10 /Vb CUPS-RTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building cupertino.org U NEW CONSTRUCTION U ADDITION LJ ALTERATION / TI L3- —REVISION / DEFERRED ORIGINAL PERMIT # �(✓ %�L�i� l PROJECT ADDRESS /d t -RA/ APN# -amdJ'o OWNER MANE 7/F l PHONE E-MAIJ, STREET ADDRESS �1� J ��' 'P aQ I s ZA CITY, STATE, ZIP IA �'ra C.-, FAX CONTACT NAME Al�d PHONE O bESCRIP'[70N STREET ADDRESS 44/O v �%y� n®SL� /OWWNE(ERAGENT `-❑l ^ CITY, STATE, ZIP / / 0.�a, Q�/ 7❑ FAX ❑ OWNER ❑ OWNER -BUILDER ❑ CONTRACTOR ❑ CONTRACrORIAGGGENTT El ARCHITECT ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME a,/ LICENSE R LICENSE TYPE BUS. LIC # COMP ANY NAME f, EMAII `w+Y 6. Fes. STREET ADDRESS 9�9� /�/� /..../ O CITY, STATE, ZIP ^ y PHONE r/ ARCHITECT/ENGIIJEERLAAME •�40VZ /{' LICENSE NUMBER � o/ 12, BUS. LICC #/ COMPANY NAME /y�n"%j EMAIL �t FAX /r 7 - STREET STREET ADDRESS /Q ^ /w / CITY, STATE, ZIP J� C r HONE DESCRIPTION OF WORK %� . _ _ / /0 J, l` EXISTINGU )POSED USE CONSIR #ST _, r_ OFFICEIJSEONLY,--- ":OCC. '_ TYPE bESCRIP'[70N _:Sh Fr_ -' YALUAT[ON EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM KITCHEN OTHER -_ - - •, € =-� -- - , ' PORCH AREA i DECK AREA I TOTAL DECK/PORCH AREA I GARAGE AREA: ❑ DETACH A DWELLING UNDS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YESBEING ADDED? ❑ NO ADDITION? ❑ NO - PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNER'S NAME: RECEiyxDgy TOTAL V' i1TIGN PLANNING APDL A ❑ NO PLANNING APP LEITER ✓ �, -c- _ L+'J moi, By my signature below, I certify to ea of th follow' g: I he property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I hav provide is c ect. I ave read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to uilding c n ction. authorize representatives of Cupertino to enter the above y-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED _ 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. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp_201 Ldoc revised 03/16/11 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO CA 95014-3255 h ' x j (408) 777-3228 • FAX (408) 777-3333 • building(Qcupertino orq L NEW CONSTRUCTION L ADDITION L ALTERATION / TI L REVISION / DEFERRED ORIGINAL PERMIT # % PROJECT ADDRESS I APN # COMPANYNAME 11�'e E -SII" ��sTo';) W FAX STREET ADDRESS& -Z— /, ��7 CITY, STATE, ZIP �� PHONE + � ARCHITECT/ENGINEERNAMET'0W6:S7 LICENSE NUMBER ®y /� 2 9e HUS. LIC # COMPANYNAME /�7rn\J CE ,.,ZZ E-MAII c® FAX STREET ADDRESS CITY, STATE, ZIPa PHONE C DESCRIPTION OF WORK / / ` �� / /^ Cx�rC T ' PROPOSED TJOE7 I CONSTR. TYPE I # EXISTG NEW FLOOR OWNERNAME /ma9 p PHONE E-bfAIL STREET ADDRESS �® S7 CITY, STATE, ZIP C -If / �ro / AREA FAX CONTACT NAME m2'. /41 ^ A [?.7F*�/!' PHONE �f� / /jJ b 77 E-MAIL STREET ADDRESS VO p WT C ^ �l l� C.i r K�� CITY, STATE, ZIP CK��z7i� C J o/ f>z � f` FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHrrECT ❑ ENGITIEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # REMODEL AREA REMODEL AREA COMPANYNAME 11�'e E -SII" ��sTo';) W FAX STREET ADDRESS& -Z— /, ��7 CITY, STATE, ZIP �� PHONE + � ARCHITECT/ENGINEERNAMET'0W6:S7 LICENSE NUMBER ®y /� 2 9e HUS. LIC # COMPANYNAME /�7rn\J CE ,.,ZZ E-MAII c® FAX STREET ADDRESS CITY, STATE, ZIPa PHONE C DESCRIPTION OF WORK / / ` �� / /^ Cx�rC T ' PROPOSED TJOE7 I CONSTR. TYPE I # EXISTG NEW FLOOR DEMO TOTAL ^, AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCHAREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH'- ❑ ATTACH SUPPLEMENTAL INFORMATION REQUIRED 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. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp 2011. doe revised 03/16/11 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: SUBCONTRACTOR PERMIT # BUSINESS LICENSE # OWNER'S NAME: Cabinets & Millwork PHONE #o GENERAL CONTRACTOR: Cement Finishing BUSINESS LICENSE # ADDRESS: d` d-�J— WZ GrrL �o,� , / CITY/ZIPCODE: `/ btJ ' C, -It Vj` Our municipal code requires 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 subcontractors: Signature Date Please check applicable subcontractors and complete the following information: Irl✓ U ►� caner / Contractor Signature Date SUBCONTRACTOR BUSINESS 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 R c Tile Irl✓ U ►� caner / Contractor Signature Date Department of Environmental Health 1555 Berger Drive, Suite 300 San _lose, California 951 1 2-271 6 (408) 918-3400 \vw\v.E1-1info.org May 23, 2011 Soma Consulting Attention: Musto Gunan 2535 West Winton Avenue Hayward, CA 94545 Dear Mr. Gunan: PROJECT NUMBER: SR0836325 PROJECT NAME: VILLAGE FALAFEL PROJECT ADDRESS: 20010 STEVENS CREEK 0L CUPERTINO Drawings for the above project have been reviewed and approved by this department. This approval shall expire by limitation and will become null and void if the construction, reconstruction, alteration, or other work authorized by this approval is not commenced within 180 days from the date of approval. Please notify this office when construction begins. Please retain one copy of the approved drawings on the job site. A FOO® FACILITY CONSTRUCTION CAR® has been attached to the job copy and must be posted with the other building permits. Present at least two (2) copies of the drawings to your local building official for the required permit application and approval. Any change to the drawings as a result of reviews by Other jurisdictions must be brought to the attention of this department as soon as possible to avoid construction delays. Please be advised that you are responsible to contact this office to arrange for a construction inspection before rough plumbing signoff, installation of equipment, and again upon completion of the project. Absolutely no food storage or food preparation will be allowed onsite until the department issues a Permit to Operate. This permit will be issued upon the successful conclusion of our final construction inspection. You willalso be asked to submit a performance test of the mechanical exhaust system, if one is present, and verification of garbage collection before the issuance of the Permit to Operate. This food establishment will be required to have either the owner or an employee successfully pass an approved and accredited food safety certification examination. This certification must be obtained within sixty (60) days after your Permit to Operate is obtained. Contact this department for more information. If you have any further questions or would like to call for an inspection appointment, please contact the Department at (408) 918-3400, between 8:00 a.m. and 5:00 p.m., Monday through Friday, very truly yours, Kerry Ann Hamilton, REHS Senior Environmental Health Specialist Plan Review and Construction Unit cc: City of Cupertino Building Department Board Of Supervisors: A/like Wasserman, George Shirakawa, Dave Cortese, Ken Yeager, Liz Kniss County Executive: Jeffrey V. Smith 8001 May 23, 2011 Soma Consulting Attention: Musto Gunan 2535 West Winton Avenue Hayward, CA 94545 Dear Mr. Gunan: PROJECT NUMBER: PROJECT NAME: PROJECT ADDRESS: SR0836325 VILLAGE FALAFEL 20010 STEVENS CREEK BL CUPERTINO Drawings for the above project have been reviewed and approved by this department. This approval shall expire by limitation and will become null and void if the construction, reconstruction, alteration, or other work authorized by this approval is not commenced within 180 days from the date of approval. Please notify this office when construction begins. Please retain one copy of the approved drawings on the job site. A FOO® FAC%LITY CONSrRUCr7ON CAR® has been attached to the job copy and must be posted with the other building permits. Present at least two (2) copies of the drawings to your local building official for the required permit application and approval. Any change to the drawings as a result of reviews by other jurisdictions must be brought to the attention of this department as soon as possible to avoid construction delays. Please be advised that you are responsible to contact this office to arrange for a construction inspection before rough plumbing signoff, installation of equipment, and again upon completion of the project. Absolutely no food storage or food preparation will be allowed onsite until the department issues a Permit to Operate. This permit will be issued upon the successful conclusion of our final construction inspection. You will also be asked to submit a performance test of the mechanical exhaust system, if one is present, and verification of garbage collection before the issuance of the Permit to Operate. This food establishment will be required to have either the owner or an employee successfully pass an approved and accredited food safety certification examination. This certification must be obtained within sixty (60) days after your Permit to Operate is obtained. Contact this department for more information. If you have any further questions or would like to call for an inspection appointment, please contact the Department at (408) 918-3400, between 8:00 a.m. and 5:00 p.m., Monday through Friday. Ve truly yours, /JA - Kerry Ann Hamilton, RENS Senior Environmental Health Specialist Plan Review and Construction Unit cc: City of Cupertino Building Department Board of Supervisors: Nlike \Nasserman, George Shirakawa, Dave Cortese, Ken Yeager, Liz Kniss County ExeCUtive: Jeffrey V. Smith M 8001 CUPERTINO March 08, 2011 PLAN REVIEW EXPIRATION NOTICE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildina(a)-cupertino.orq HEINZ JONG 20010 STEVENS CREEK BLVD CUPERTINO CA, 95014 SUBJECT: PLAN REVIEW EXPIRATION NOTICE Site Address: 20010 STEVENS CREEK BLVD Building Permit Application #: 10110098 Expiration Date: 5/16/2011 Asa courtesy, the Building Department makes every effort prior to the expiration of a construction permit application to notify the applicant of the impending expiration. _ Per the California Building Code Section 105.3.2, ... "an application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been pursued in good faith or a permit has been issued" This notification letter is issued as a reminder that the construction permit application for the specified project will expire on the date shown unless the following action is taken: A. A building permit application is approved and the building permit is paid for and issued prior to the expiration date specified; or B. A request for an extension is submitted in writing with a justifiable cause demonstrated to the Building Official prior to the expiration date of the application. The extension, if granted, will be for a period of not more than 90 days. An extension will NOT be granted if the code or any other pertinent laws or ordinances have been amended subsequent to the date of application unless the construction plans comply with the 2010 California Codes and any new local regulations that came into effect from the date of the original application. If any new regulations became effective after the submittal date of the original application, additional plan review (and associated fees) will be required to verify compliance with these new regulations. Extension requests shall be hand delivered to the building department or e- mailed to suew@cupertino.org. The plans will become null and void after the expiration date if a building permit is not secured or an extension is not granted. You will have 10 business days pick up your documents or they will be recycled. The permit application will then be voided in the Permit System and all documents pertaining to the permit application will be recycled. Sincerely, Susan Winslow, Administrative Clerk City of Cupertino PlanReviewFxpirationNotice.doc revised 12/06/10 CUPERTINO March 08, 2011 PLAN REVIEW EXPIRATION NOTICE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • building cupertino.org MG/SOMA CONSULTING INC 2535 W WINTON AVE STE 4G HAYWARD, CA 94545 SUBJECT: PLAN REVIEW EXPIRATION NOTICE Site Address: 20010 STEVENS CREEK BLVD Building Permit Application #: 10110098 Expiration Date: 5/16/2011 As a courtesy, the Building Department. makes every effort prior to the expiration of a construction permit application to notify the applicant of the impending expiration. Per the California Building Code Section 105.3.2, ... "an application for a permit for any proposed work shall be deemed to have been abandoned 180 days after the date of filing, unless such application has been pursued in good faith or a permit has been issued" This notification letter is issued as a reminder that the construction permit application for the specified project will expire on the date shown unless the following action is taken: A. A building permit application is approved and the building permit is paid for and issued prior to the expiration date specified; or B. A request for an extension is submitted in writing with a justifiable cause demonstrated to the Building Official prior to the expiration date of the application. The extension, if granted, will be for a period of not more than 90 days. An extension will NOT be granted if the code or any other pertinent laws or ordinances have been amended subsequent to the date of application unless the construction plans comply with the 2010 California Codes and any new local regulations that came into effect from the date of the original application. If any new regulations became effective after the submittal date of the original application, additional plan review (and associated fees) will be required to verify compliance with these new regulations. Extension requests shall be hand delivered to the building department or e- mailed to suew@cupertino.org. The plans will become null and void after the expiration date if a. building permit is not secured or an extension is not granted. You will have 10 business days pick up your documents or they will be recycled. The permit application will then be voided in the Permit System and all documents pertaining to the permit application will be recycled. Sincerely, Susan Winslow, Administrative Clerk City of Cupertino P1anReviewExpirationNotice.doc revised 12/06/10 DISTRICT MANAGER -ENGINEER MARK THOMAS & COMPANY, INC. RICHARD K. TANAKA DISTRICT COUNSEL ATKINSON • FARASYN, LLP. HAROLD S. TOPPEL December 9, 2010 City of Cupertino Building Department 10300 Torre Ave. Cupertino, CA 95014-3202 s j v � �o �sr'4B1 IS H ED 1�h 20833 STEVENS CREEK BOULEVARD, SUITE 104 CUPERTINO, CALIFORNIA 95014.2154 (408) 253.7071 PHONE • (408) 253-5173 FAX www.cupertinosanitarydistrict.com BOARD OF DIRECTORS WILLIAM A. BOSWORTH JOHN M. GATTO STEVE C. ANDREWS WENDELL H. KERR, JR. CHRISTOPHER C. LEE File: CSD — MOP Building Dept. — Cupertino Approf i� � Permits Subject: Tenant Improvement —Submittal No. 1- APPROVED Name: Village Felafel Address: 20010 Stevens Creels Blvd. APN: 369-03-005 Permit No. 10110098 The Cupertino Sanitary District has reviewed the plans for the subject project: ■ Sanitary sewer is available and the existing building is connected to sanitary sewer, see conditions/requirements listed below. The following Conditions/Requirements are made: • Pretreatment facilities to be inspected by the City of Cupertino and the District for the total loading for Interceptor serving subject restaurant. Interceptor to be inspected for serviceability and certified for size when empty and clean. (O.C. 6221) • Closed-circuit video of the existing/new property line cleanout, point of connection and District lateral is required prior to clearance for City of Cupertino Final Inspection. Owner to call District at least 48 hours prior to video inspection to schedule a District Inspector. District to provide Building Department with written notification upon completion of inspection. (O. C. 5104) SUPPLYING SANITARY SEWERAGE SERVICES FOR: CITY OF CUPERTINO, PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE, LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS Subject: Tenant Improvement —Submittal No. 1- APPROVED Name: Village Felafel Address: 20010 Stevens Creek Blvd. APN: 369-03-005 Permit No. 10110098 Property Owner shall maintain a log of grease trap cleaning, and or copies of grease interceptor pumping cleaning and maintenance, on site for at least three (3) years and made available for inspection and/or copies furnished to the District upon request. (O. C. 6221) • Property Owner shall establish routine cleaning of a grease trap or interceptor. (O.C. 6221) a) Grease traps must be cleaned monthly or more frequently if needed to meet the discharge limit of 150 ppm of grease, oils and/or fats. b) Grease Interceptors must be pumped out every three months, or more frequently if needed to meet the discharge limit of 150 ppm of grease, oils and/or fats. Sanitary sewer emergency operation plan and pumping plan for grease interceptor shall be submitted to the District by the Owner. (O. C. 6203) Storm water from surface or roof drains, other general surface runoff water shall not be discharged to the sanitary sewer. All conditions, requirements and recommendations are to be completed at the (owner/developer)'s expense. Yours very truly, MARK THOMAS & COMPANY, INC. District Manager -Engineer , for Richard K. Tanaka If you have any questions or need additional information, please call Nichol Bowersox at 408- 253-7071. S:AWORDS\CUSD\LETTERS\BUILDING DEPT LETTERS\TENANT IMPROVEMENTS (RESTAURANTS ONLY)ARestaurants 2010\10110098 Village Felafels 20010 Stevens Creek Blvd Sub I APPROVED 12-09-2010.doc SUPPLYING SANITARY SEWERAGE SERVICES FOR: CITY OF CUPERTINO, PORTIONS OF THE CITIES OF SARATOGA, SUNNYVALE, LOS ALTOS AND SURROUNDING UNINCORPORATED AREAS Mr. Richard Tenaka Cupertino Sanitary District .20833 Stevens Creek Blvd., Suite 104 Cupertino, CA 95014 Subject: Plans submitted show the following sources of wastewater: Wok Range Dishwasher Garbage Grinder _ Pot Sink(s) No. Seating Capacity: REQUIIZEM ENTS: RECEIVED OUPERTINO k Floor Drains No. '2— Floor Sinks No. k' Mop Sink (EMF) _ Other Clarifier 25C Pound grease trap Gallon grease interceptor Gallon per minute power operated grease removal device No requirement This unit is to be plumbed to accept the wastewater flow from the items checked below: Wok Range Dishwasher Garbage Grinder Pot Sink(s) No. t COMMCNTS: Floor Drains No. Floor Sinks No. Mop Sink (EMF) Other V s'e r / Sincerely, Envi onmental Inspector/E-ngineer� 17 cc: Plan check Unit, County Health Dept. CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION imADDRESS: 20010 stvns crk blvd. DATE: 11/15/2010 REVIEWED BY: PC FEE ID APN: BP#: *VALUATION: 1$50,000 ,PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: TOT.1L FL,OC>h .d Ie Eft: PENTAMATION 1B TI PERMIT TYPE: WORK minor t.i. commercial restaurant non structural include mech. elect. plumb. SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.L PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,111-B,IV,V-B 900 $1,883.96 IBTIPLNCK $883.06 IBTIINSP Elec. Insp, F( -,e: PME Plan Check: $0.00 Permit Fee: $883.06 Suppl. Insp. Fee. -G Reg. 0 OT 1 0.0 j hrs $0.00 PME Unit Feer $0.00 PME Permit Fee: TOTALS: 900 $1,883.96 1 $883.06 MECH, HOURLY 0 Yes G No PLUMB, HOURLY ® Yes Q No ELEC, HOURLY ® Yes (F) No A,fer(h. Plan Chrclr Plrrmh. Plu1r Check E/ec. Plan Cheep rlfecli. Pcrnlit Fee: land). Per snit Fee: Elec. Permit Fere: Other Jt/ech, 71�sP, Other Pltrmh 177sp.E7 O/her Elec. Insp, jl'kch, Insp, Fee: Phnnh. hiy. Fee: Elec. Insp, F( -,e: NOTE: These fees are based on the Drefindliary Information QVOIIOhJP and Orn ntfly On vetimOta C'nntnrt thv T) t Mr nddn 11;"fn FEE ITEMS ("Fee Resohttion 09-051 Ef'. 7/1/10 FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,883.96 Select a Misc Bldg/Structure or Element of a Building 'A Suppl. PC Fee: Reg. ®OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $883.06 Suppl. Insp. Fee. -G Reg. 0 OT 1 0.0 j hrs $0.00 PME Unit Feer $0.00 PME Permit Fee: $0.00 ConstruNion Tax Acoustical Fee: 0 Yes (D No $0.00 G Work Without Permit? Yes E) No $0.00 Plamiin&Fee: PLLONGRNGC $0.00 Select a Non -Residential Building or Structure G i Trmvl Dociiiiienlution Fees: Strong Motion Fee: IBSEISMICO $10.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 SUBTOTALS:;: $2,779.52 $0.00 TOTAL FEE: 1 $2,779.52 Revised: 11/08/2010 Assessors Parcel Number: Name of business. 1111-L146L— Project address. Contact person. S Phone. Fax.Y� Current use of space.37/–$4e i Proposed use. Building construction type. Occupancy Group(s) Occupancy Load. Square footage of remodeled area. &Q Is the building equipped with: Fire sprinkles? YN; Fire alarm system? Y Number of floors in the building? On what floor(s) is work being done?_ Brief description of work. n-0— 7� 9Y�- Lt/ L cc S/sem 7� GZi ?z,,,a&5 Code editions: 2008 CBC- N)2008 CFC N)2008 CMC N)/ 2008 CPC'- N)2008 NECN) otZEz7�t� Effective 1/1/08 Are there any chemicals/hazardous materials to be stored at site? Y.;0 If above answer is yes, provide a list of mate quantities. x If job is involves food servic ;rovi3 gxtW�lan sets for Health Department review. Commercial Plan Review Process Work BookPage -10- revised 1/1/08