10090013CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19376 STEVENS CREEK BLVD
CONTRACTOR:- PERMIT NO: 10090013
OWNER'S NAME: BANK OF AMERICA
_ �1 �� wl (
DATE ISSUED: 11/03/2010
e R'S PHONE: 5105084786
PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION
ELECT 7 PLUMB �
License Class Lic. # + 6,
BUILDING PERMIT INFO: BLDG
MECH RESIDENTIAL COMMERCIAL r
Contractor
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: T.I DISABLED ACCESS UPGRADE, PARKING STALLS,
(commencing with Section 7000) of Division 3 of the Business & Professions
PATH
OF TRAVEL AND BANK ACCESSORIES
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.
Sq. Ft Floor Area:
Valuation: $15000
APPLICANT CERTIFICATION
APN Number: 37501018.19376
Occupancy Type:
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,
PERMIT EXPIRES IF WORK IS NOT STARTED
costs, and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally, the applicant understands and will comply
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non- sourc regulatio a Cupertino Municipal Code, Section
180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date l `� «
Issued
❑ OWNER-BUlb4R DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
RE -ROOFS:
the following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
I, as owner of the property, or my employees with wages as their sole compensation,
installed without first obtaining an inspection, I agree to remove all new materials for
will do the work, and the structure is not intended or offered for sale (Sec.7044,
inspection.
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
Signature of Applicant: Date:
constmct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self -insure for Worker's
HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Section 3700 of the Labor Code, for the performance of the work for which this
Safety Code, Section 25532(a) should I store or handle hazardous material.
permit is issued.
Additionally, should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued, I shall
contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Compensation laws of California. If, after making this certificate of exemption, I
LHVJW& Safety Code, c on 5505, 25533, and 25534.
become subject to the Worker's Compensation provisions of the Labor Code, I mus
Ow r r ho ' ed gent: t 2
forthwith comply with such provisions or this permit shall be deemed revoked.
Date:
APPLICANT CERTIFICATION
�ONSTRUCTIQNLEN�DINGGENCY
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
I hereby affirm that there is a construction lending agency for the performance of work's
to building construction, and hereby authorize representatives of this city to enter
for which this permit is issued (Sec. 3097, Civ C.)
upon the above mentioned property for inspection purposes. (We) agree to save
Lender's Name
i tify and keep harmless the City of Cupertino against liabilities, judgments,
, and expenses which may accrue against said City in consequence of the
Lender's Address
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
I CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 19875 STEVENS CREEK BLVD
OWNER'S NAME: CINDY CHENG
OWNER'S PHONE: 4089212814
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. # %
Contractor (: Yd Yt >o [bk.5 t 11/4! -Pate
1 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:
1 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.
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/WL4
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
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 (/ 12vk)
d
❑ OWNER -BUILDER DECLARATION
1 hereby affirm that 1 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)
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
1 hereby affirm under penalty of perjury one of the following three
declarations:
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.
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.
1 certify that in the performance of the work for which this permit is issued, 1 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, 1
become subject to the Worker's Compensation provisions of the Labor Code, 1 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. l 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
CONTRACTOR: PERMIT NO: 10080078
DATE ISSUED: 11/23/2010
PHONE NO:
BUILDING PERMIT J[NFO: BLDG ELECT r PLUMB r
MECH r RESIDENTIAL 7 COMMERCIAL r -
JOB DESCRIPTION: IDDIE ACADEMY- T.I.REMOVE ALL EXISTING INTERIOR
CONSTRUCTION -NEW INRIOR WALLS,
MECH/ELEC/PLMBING, ADD FRONT & REAR DOOR -NO
Sq. Ft Floor Area: I Valuation: $550000
APN Number: 31621031.00 1 Occupancy Type:
PERMIT EX RES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued 'L= Date:
RE -ROOFS:
All roofs shall be inspectedprior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, 1 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 Cupe�tino Municipal Code, Chapter 9.12 and the Health &
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should I usejequipment or devices which emit hazardous air
contaminants as defined hy 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.
Owner or thou' d agent:
Date:
CONSTRUCTION LENDING AGENCY
1 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
understand my plans shall be used as public records.
Licensed Professional
CITY OF CUPERTINO
ISI FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS:
FLR AREA
s.f.
DATE:
REVIEWED BY:
BP FEES
APN:
BP#:
*VALUATION: 0
*PERMIT TYPE: Building Permit
$0.00
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
Plulnh. hlsp. Fee:
TOTAL
FLOOR 41M 4.
PENTAMATION 16 TI
PERMIT TYPE:
WORK
$0.00
SCOPE
Permit Fee:
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
II-B,III-B,MV-B
0
$0.00
Oilier Elec. Insp. 17F—L
$0.00
Plulnh. hlsp. Fee:
Elco. Insp. Fee.
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee10 Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
0
$0.00
Consnzrction Tris
$0.00
MECH, HOURLY 0 Yes 0 No
PLUMB, HOURLY 0 Yes 01 No
ELEC, HOURLY 0 Yes 0 No
,L1c-cll. Plan Check
Ph(mb. Plan Check FT
Dec. Plan Check
l'�tecll. Permit Fee:
P111MI). Permit Fce.
Ele.c. Pe17mr Fee.
Other Afech. Insp.
01he' Plumb Imp,Lj
Oilier Elec. Insp. 17F—L
Alech. hmp. Fee.
Plulnh. hlsp. Fee:
Elco. Insp. Fee.
NOTE: These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn'1 info.
FEE ITEMS (Fee Resohilion 09-051 E . 7/I/I0)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee10 Reg. 0 OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Consnzrction Tris
Acoustical Fee: 0 Yes 0 No
$0.00
0
0
Work Without Permit? 0 Yes 0 No
$0.00
Plannin Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
Tavel Documentation 7=ces:
Strong Motion Fee: IBSEISAECO
$1.65
7437hrs
$504.00,
Standard Hourly Rate
,
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$2.65
$504.00
TOTAL FEE:
5
Revised: 9101/2010