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12110090CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19399 STEVENS CREEK BLVD OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR OWNER'S PHONE: 6509650700 LICENSED CONTRACTOR'S DECLARATION License Class Lic. # °fie Contractor VLa Date } " 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: t. 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 saw 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-poi source re latiorv,,Ver the Cupertino Municipal Code, Section 9.18. t Signature Date 13 OWNER - BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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. 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). CONTRACTOR: SOUTH BAY CONSTRUCTION, INC 1711 DELL AVE CAMPBELL, CA 95008 PERMIT NO: 12110090 I DATE ISSUED: 05/28/2014 PHONE NO: (408)379 -5500 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL Q MAIN STREET- SHOP #5- CONSTRUCTION OF A NEW ONE STORY RETIAL BUILDING SHELL 4,080 SQ FT REV # 1 - ADD ROOF WALK PADS TO PLANS (RFI 504), RELOCATE ROOF TOP EQUIPMENT (RFI 478), CHANGE DOOR TYPE /COLOR (RFI 53 1) - ISSUED 10/1/15 Sq. Ft Floor Area: I Valuation: $0 APN Number: 31620109.19399 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR ED INSPECTION. 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 & I hereby affirm under penalty of perjury one of the following three declarations: Safety Code, Section 25532(a) should I store or handle hazardous material. t. I have and will maintain a Certificate of Consent to self - insure for Worker's Additionally, should I use equipment or devices which emit hazardous air Compensation, as provided for by Section 3700 of the Labor Code, for the contaminants as defined by the Bay Area Air Quality Management District I will performance of the work for which this permit is issued, maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 2. I have and will maintain Worker's Compensation Insurance, as provided for by Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this er or ai l�orize agent permit is issued. ? Date: 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 CONSTRUCTION LENDING AGENCY 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 I hereby affnm 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 ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO ❑ NEW CONSTRTICTlnt, - u Ai, I r KA I IUN / I I IJ REVISION / DEFERRED ORIGINAL PERMIT #12110090 & TE, PROJECTADDRESS Shops 5 19399 Stevens Creek Blvd b r7 /5 1 /S 3 APN# l�.V ( V o OWNERNAMEMain Street Cupertino Aggregator LLC PHONE (650) 344 -1500 E -MAIL STREETADDRESS 2882 Sand Hill Rd Suite 241 CITY, STATE, ZIP Manlo Park, CA 94025 FAX CONTACT NAME Paul Hansen PHONE (408) 44 -2121 E -MAIL STREETADDRESS 28.820 Sand Hill Rd Suite 241 CITY, STATE, ZIP Menlo Park, CA 94025 FAX ❑ OWNER ❑ OWNER- BUILDER ❑ OWNER AGENT El CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME Mark Avila LICENSENUMBER B336974 LICENSE TYPE BUS. LIC# COMPANYNAME South Bay Construction E -MAIL mavila @sbci.com FAX (408)379 -3256 PHONE (408)379 -5500 STREET ADDRESS 1711 Dell Ave CITY,STATE',ZIP Campbell, CA 95008 ARCHITECT /ENGINEER NAME Ken Rodrigues LICENSE NUMBER C12, 818 BUS. LIC# COMPANYNAMEKenn.eth Rodrigues & Partners, INC E -MAIL kenr @krparchi.tects.com FAX (650) 960 -0707 STREETADDRESS445 N Whismari Suite 200 CITY,STATE,ZIP Mountain View, CA 94043 PHONE (650)965 -0700 DESCRIPTION OF WORK 1.) Add walking pads to roof- mounted equipment, sheet A4.6 - RFI ##504 2.) Move roof mounted equipment, sheets A4.6, A6.8, & S2.1 -S5 - RFI #478 3.) Change door on west elevation from wood -clad to metal & add paint color P12- Pebble Rock, Sheet A5.10 - RFI ##531 EXISTING USE - PROPOSED USE CONSTR. TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA DEMO TOTAL - - AREA NET AREA BATHROOM KITCHEN OTHER - REMODELAREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY YES BEING ADDED? ❑NO ADDITION? ❑NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # []NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES. EICHLER HOME? ❑ NO IVED TOTAL VALUATION: By my signature below, I certify to each of the following: I am the property er or authorize en ct t behalf. I have read this application and the information I have ovided is corr ct. I have read the Descn agree to comply wI licabie local ordinances and state laws relating to b 1 ng Inic t _ uth representatives n o ent e apove-illentified property for inspection pu es. Signature of Applicant/Agent: O Date: ZZI SUPPLEMENTAL INFORMATION REQUIRED PLANC CK TV PE ROUTING SKIP New SFD or Multifamily dwellings: Apply for demolition permit for �_ 0VER- THE- CQUMR CT BUILDIN6PLAN"VIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. EGRESS Pi ANNINGPLAJXREVTEW . _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Cl' ST NflA .. "- '. CI :rUBUC,WORWS form if any Hazardous Materials are being used as part of this project. ❑` LARGE - C4 FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to M" _ submittal of Building Permit application. fi p sANrrAR)tsEiNmDISMCT Cl ,I NVWONMENTALMALT$ . BldgApp_2011.doc revised 06121111 • = LLLJ GaLL.rcutG uae'l rful uZCxuue fees aue ro orner veparmwnts (Le. -planning, public Works, Fire, sanitary Sewer District, School %)Z.CiPZ!'i_ O /!") Tbnco fooe nr•n AnonA n fAn ,.D: a:, v_z�_ _ - - -- - -- - - -- - ------ - - ---- FEE ITEMS f)Eee Resolution 11 -053 E 711113) UH' Y OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION w.rw w. .. QTY /FEE ADDRESS: 19399 STEVENS CREEK BLVD DATE: 08/2812015 REVIEWED BY: MELISSA APN: 31620109.19339 BP #: 12110084 *VALUATION: $0 -PE TYPE: Building Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY Commercial Building Civil / Religious activities PENTAMATION in BQ zone? Yes � No PERMIT TYPE: 1 GENCOM WORK REV # 1 - ADD ROOF WALK PADS TO PLANS RFI 504 RELOCATE ROOF TOP EQUIPMENT RFI SCOPE 478), CHANGE DOOR TYPE /COLOR (RFI 531) 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee :1@ Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAW $0.00 tt �5YY Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non- Residential Building or Structure �= r ;�vcl.I.?r�t:ttrlrz�Ercfttott 1 c�c�:s: Strong Motion Fee: $0.00 Select an Administrative Item Bldg S Commission Fee: $0.00 S17BTt TALS = $0.00 $429.00 Z TOTAL�ER ; ", $429.00 • = LLLJ GaLL.rcutG uae'l rful uZCxuue fees aue ro orner veparmwnts (Le. -planning, public Works, Fire, sanitary Sewer District, School %)Z.CiPZ!'i_ O /!") Tbnco fooe nr•n AnonA n fAn ,.D: a:, v_z�_ _ - - -- - -- - - -- - ------ - - ---- FEE ITEMS f)Eee Resolution 11 -053 E 711113) - -- --- -----....r w.wrrwvr.. FEE w.rw w. .. QTY /FEE V•cr w•L a.v LLVLLLLL. VVLLLILGb LLLL LG L VI ILLLLLLL L WL V. MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes IS No $0.00 3 hours Plan Check, Hourly $429.00 ISTPLNCK Suppl. PC Fee: (E) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee :1@ Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAW $0.00 tt �5YY Work Without Permit? 0 Yes (E) No $0.00 Advanced Planning Fee: $0.00 Select a Non- Residential Building or Structure �= r ;�vcl.I.?r�t:ttrlrz�Ercfttott 1 c�c�:s: Strong Motion Fee: $0.00 Select an Administrative Item Bldg S Commission Fee: $0.00 S17BTt TALS = $0.00 $429.00 Z TOTAL�ER ; ", $429.00 Revised: 07/02/2015 r- CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19399 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERMIT NO: 12110090 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 1711 DELL AVE DATE ISSUED: 05/28/2014 OWNER'S PHONE: 6509650700 CAMPBELL, CA 95008 PHONE NO: (408)379 -5500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL El COMMERCIAL _3_3 6 ��_�/ L. MAIN STREET- SHOP #5- CONSTRUCTION OF A NEW ONE License Class Lie. # T STORY RETIAL BUILDING SHELL 4,080 SQ FT Contractor �� Z l jam, DEFERRED #2- CONSTRUCT TRASH ENCLOSURE - �.��- Date ISSUED 7/21/15 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 Sq. Ft Floor Area: Valuation: $0 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 APN Number: 31620109.19399 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 WITFIIN 18 ERMIT 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 save indemnify and keep harmless the City of Cupertino against liabilities, judgments, 18 S ALLED INSPEC ION costs, and expenses which may accrue against said City in consequence of the �' f granting of this permit. Additionally, the applicant understands and will comply su Date: with all non -point so regulations per the Cupertino Municipal Code, Section 9.18. / Z I RE- ROOFS: Signature Date 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 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 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 by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupzrtiipo Municipal Code, Chapter 9.12 and 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 the Health & Safety Code, Sections 505, 5533, and 25534. 1 61 � 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 l 11 6- CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION I 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 CUPERTINO (408) 777 -3228 • FAX (408) 777 -3333 • buildin cu ertino.or ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REV I ON / DEFERRED ORIGINAL PERMIT # { fzdu; :a;t tmS APN # L O E E -MAIL STREET ADDRESS CITY, STATE, ZIP FAX CONTACT NAME PHO I v &—S �� „[l uL d STREET ADDRESS CITY, STATE, ZIP FAX OWNER ❑ OWNER - BUDDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT C01,1TRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NA ffi(qw " (, !�J �I co Wx STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK f' EXISTING USE PROPOSED USE CO 'ST E It STORIES .. USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑ DETACH ❑ ATTACH R DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATIO El YES IF PLAN INGAPPLN ❑NO PL YANNINGAPPROVAL OLETTER IS P. EICHLERHON E? 0 pS V UA IQN� WINE By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have re d this application and the information I halp provided is corre . have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relati ' d c n o n. z representatives of Cupertino to enter the alcove- identifed p� for inspection purposes. Signature of ApplicanUAgent: Date: SUPPLEMENTAL INFOPMATIOf/REQUIRED � =r' a _ New SFD or Multifamily dwellings: Apply for demolition permit for ' CQ OVER THE C1211I�TER air ' BiTIIb1G�17IRE \'IEw °' existing building(s). Demolition permit is required prior to issuance of building f -��, N a '�� permit for new building. Ex1PESS �' ”` / IP eI.i�i�GPLANRSytw ,s �" WU n t _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure �= �r'BilG,wbR )] sr� n K form if any Hazardous Materials are being used as part of this project. w.�x5`a.. x' i" fC ' u ti's �"� "zrlw Rf 3 r _ Co of Planning Approval Letter or Meeting with Planning prior to PY � PP b 5 P Qryb7ATpR ' X s submittal of Building Permit application., e4sSANITARXSEERISiSTRICT . `?rte = .�u��:t.:�L.,- 1�;,�`_.'�.•�., <.�rr:��.._' -�- ,, Q $11b?IROI��11EN�TALHEAITAa w.r_ -,. BldgApp_2011.doc remised 06121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION lialADDRESS: 19399 scb P F f � �'Yda, �. ✓ 9 ; 4; Xi.X,r ..h �, kb �r,� � .✓ K DATE: 01/29/2015 REVIEWED BY: Mendez APN: BP #: f 'VALUATION: $40,000 'PERMIT TYPE: Building Permit x r � C.3P ir.'t tYr.f. , c'li• tf ?ri• PLAN CHECK TYPE: New Construction PRIMARY USE: Commercial Building : L('.L'Fi. IPCSJJ. I "Yt. Civil / Religious activities in BQ zone? Q Yes (E) No PENTAMATION PERMIT TYPE: 1 GENCO WORK DEFERRED #- TRASH ENCLOSURE 0,0 SCOPE $0.00 PME Unit Fee: "s � �' ._ r '� x ✓�r s Y 4 3 S ✓y �F 4 .!-�� T � S f A ,� Yy��,+'.✓� i Yz (i„T, •'?.i`r_. ✓ �. � . i1F,�':'.�' P F f � �'Yda, �. ✓ 9 ; 4; Xi.X,r ..h �, kb �r,� � .✓ K �,. F� r` �, r .�- .Y_�.i � .\ .rly ✓. r.. kled" "'. Mal'. � %f.'Ch` �jitf�t ±S. tfsifXi< � f}Ef'J i:L£tL ;. �°iff }i f d(G' ?£. 'L: :} 1- .. "ee f3GtLi::... FFimi. F26.,: flenvi, F C.: x r � C.3P ir.'t tYr.f. , c'li• tf ?ri• OtheOther F ho— 5 IYZS'J ?. ?�%�"ier E" ' <. 1} ti}}. : L('.L'Fi. IPCSJJ. I "Yt. MUM .'.;'i >. I`f.'e. De... NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School niclr•irf atr_ )_ Thaco foot nro hncad nn tho nralirninnry infnrntnAnn availahle and are anhf an estimate. Contact the Dent for addn'I info. FEE ITEMS (Fee Resolution 11 -053 E . 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Deferred Submittal $572.00 IDEFSUBM Suppl. PC Fee: (j) Reg. 0 OT f 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:(D Reg. 0 OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: 1BCONSTAXC $0.00 Ad}91inis'tralive Fee: Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential G Building or Structure 0 ./ Favel D£3canientation F'e.'e'S': Strong Motion Fee: IBSEISMICO $11.20 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $2.00 F ' STJBTOTALa $13.20 $572.00 s r TOIL FEE $585.20 Revised: 01/06/2015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19399 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERMIT NO: 12110090 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 1711 DELL AVE DATE ISSUED: 05/28/2014 OWNER'S PHONE: 6509650700 CAMPBELL, CA 95008 PHONE NO: (408)379 -5500 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL MAIN STREET- SHOP #5- CONSTRUCTION OF A NEW ONE License Class n�; P Lic. 4 STORY RETIAL BUILDING SHELL 4,080 SQ FT Contractor ' D\7 � QNS� Date ,DEFERRED #1- INSTALL (2) ALUMINUM SUNSHADE AWNINGS - ISSUED 11/17/14 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 Sq. Ft Floor Area: Valuation: $0 performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 31620109.19399 Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 18 "AYS EMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save 18 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the Date: 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. RE- ROOFS: Signature Date `4 n' 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 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 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(a) 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 I 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 25505 25..5 3, an 2 34. \; 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 CONSTRUCTION LENDING AGENCY 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 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. 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(dcupertino.org CUPERTINO I ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI REVISION / DEFERRED ORIGINAL PERMIT # o PROJECT ADDRI l GPq.` APN # OWNER NAME PHONE,,W �Z'.'n1 E-MAIL Py� - , 9TH S -hQ p L_ �1'O Llr oN. NiN(�F�i �JJpp �V\j "�aV J_11, STREET ADDRESS p.�� j� CITY, STATE, ZIP ft t �{1 C" FAX `7 1 r \ VWVL� CONTACT NAME PHONE ID ? E -MAIL ► Q /) STREET ADDRESS ij / 13 ' 1 ,yam �iJ s�S) t� ll`D�. i 1 CITY, STATE, ZIP n�� A � Cr4c) Ad1lt FAX OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ,CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME C.W— 1� Co�s�- LICENSE NUMBER fL, (� LICENSE TYPE BUS LIC # rl (Pr' 5 l E- MAIL�V ✓ 1LJ(�+(` lJ�%�` �rt� C.. FAX l COMPANY NAL9E� � C CITY, STATE, ZIP �� PHONE' I �� STREET ADDRESS '\ (� f� V LICENSE NUMBER BUS. LIC # ARCHITECT /ENGINEER NAME A� �' ` � p, A `�� COMP E -MAiI v/�J FAX ANY NAME , PHONE yf STREET ADDRESS /�, A `, g CITY, STATE, ZIP • �� , �` , /yam 5 DESCRIPTION OFWORhC 1 ► �r �. — A n`�� ®q �, \A 1S Q� �� EXISTG 7KEM FLOOR DEMO TOTAL AREA A AR EA NET AREA BATHROOM I KrrCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA USE I TYPE I OCC. I SQ.FT. I VALUATION ($) 0 ATTACH # DWELLING LNITS IS A SECOND UNI'1 LJ BEING ADDED? ONO u " ADDITION? ONO i PRE - APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: TOTAL VALUATION: ONO PLANNING APPL ONO PLANNING APPROVAL LETTER EICIILERHOME? / By my signature below, I certify to each of the following: I am the property owner or authorized o ct on the property o ner's behalf. l have read this it is agr ee to comply with all applicable local application and the information I have provided is correct. I have read the Description of Work and verify accurate. of Cupertino to enter the above-identified roperty for inspection purposes. ordinances and slate laws relati to building co t ction. I au to ze epresentatives ,(_iii - Date: , Signature of ApplicanUAgent: v SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECKTYPE ROUTING SLIP R- THE•COUNTER D ING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building fOFXPRESS q�f PLANNING PLAN REVIEW permit for nct� building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD ❑ PUBLICWORKS _ form if am Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ copy ()f Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal Ol Building Permit application. ❑ ENVIRONMENTAL HEALTH Blcdg4pp_2011.doc revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION ADDRESS DATE: 10/28/2014 REVIEWED BY: Mendez APN: BP #: / ` VALUATION: 1$42,706 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE: Commercial Building Other i'::wc. PENTAMATION PERMIT TYPE: 1GENC0 i WORK sho 5 install 2 aluminum sunshade awnings SCOPE PME Plan Check: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, tire, Sanitary Fewer District, achoot n ;err: r ors 1 TI.— Fooc nre hnced on the nrelLminnr) infarrnatinn availahle and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Ef• 7, %1/13) W -ec N. : "fajy Ch k QTY/FEE MISC ITEMS _t {'c:ll. i'(.' %1F17CFee. • "3!ililt1). 1'1;.'i? a (.'.ft.'C t lrht ?(�:iE'{:71. tY;.l'r3 ir)i" ,t.'7' ��. +.tiF'S �s ..r`i� r3 Other i'::wc. Suppl. PC Fee: (j) Reg. Q OT 0.0 I . Insp. NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, tire, Sanitary Fewer District, achoot n ;err: r ors 1 TI.— Fooc nre hnced on the nrelLminnr) infarrnatinn availahle and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Ef• 7, %1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 I -T I # 390 Awning / Canopy (Support'd by Bldg) 1A�1• Awning _ Suppl. PC Fee: (j) Reg. Q OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee-.(j) Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Work Without Permit? 0 Yes E) No $0.00 Advanced .Planning .Fee: $0.00 Select a Non - Residential Building or Structure G 0 d t• F(;; ?.:�11., =t1!:il;rrt�,,tcalrc >rr 1�=.: °t:. Strong Motion Fee: IBSEISMICO $11.96 47ZXP 0 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC $2.00 SUBTOTALS: $13.96 TOTAL FEE: 3� . Revised: 07/10/2014 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19399 STEVENS CREEK BLVD CONTRACTOR: SOUTH BAY PERMIT NO: 12110090 CONSTRUCTION, INC OWNER'S NAME: MAIN STREET CUPERTINO AGGREGATOR LL 1711 DELL AVE DATE ISSUED: 05/28/2014 OWNER'S PHONE: 6509650700 CAMPBELL, CA 95008 PHONE NO: (408)379 -5500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ License MAIN STREET- SHOP #5- CONSTRUCTION OF A NEW ONE Class Lic. # STORY RETIAL BUILDING SHELL 4,080 SQ FT Contractor`. pate ts 7r� �r—i: I hereby affirm that I am licensA 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 Sq. Ft Floor Area: Valuation: $0 performance of the work for which this permit is issued. �Jiave 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. APN Number: 31620109.19399 Occupancy Type: I 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 8I1 DAYS OF PERMIT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS R ® M LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the c L� granting of this permit. Additionally, the applicant understands and will comply Issued by: Date:�a with all non -point source regulations per the Cupertino Municipal Code, Section r �� 9.18. RE- ROOFS: gnatu Date 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 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 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 & Safeiy Code, Section 25532(a) 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 I 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 25505,2255333,1A d 25534, Section 3700 of the Labor Code, for the performance of the work for which this 6� ' Owner or ut orized age Date:,«3 permit is issued. _ .: - I— QVJ 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 • CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333- bui [din a(Qcugertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION /TI ❑ REVISION / DEFERRED ORIGINAL PERMIT n PROJECT ADDRESS APN 9 ONWERNAME 66 E&- bcs r lJ 1PHOZPS-b -3 +4' ) ,SD2 E -MAIL STREET ADDRESS ,sKi CITY, ST Z FAX 2.03 P,• vjoc)J snares �L-�, Zov cel�wo( C c CA q41005 , 3L{ • D(RSa CONTACT NAME , PHONE h QOM ��rlt'�e�'S �l(� IL en c r z LP570- -O�0v r1r2Kr rCht4 --&(5 STREETADDRESS A4 l� W h6rYKLn R/ s�c 4e- 2� CITY, STATE, ZIP own��h Vie'N -A (3140 FAX S0- 9W - Q19 ❑ OWNER ❑ OWNER - BUILDER ❑ ORT'ERAGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME 76c) LICENSE NUMBER LICENSE TYPE BUS. LIC COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTIENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE, DESCRIPTION OF WORK (�i. nn '^ �� hU S q �� S 4-4- I � l t� CJ i�lS VIC -I�(an a -Ylev\1 one i IcyIn She -d EXISTING USE PROPOSED USE CONSTR TYPE 4 STORIES 1 USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECIUPORCH AREA GARAGE AREA: DETACH ❑ ATTACH RDWELLINGUNrrS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEINGADDED? ❑NO ADDITION? E)NO PRE - APPLICATION ❑ YES IF YES, PROVIDE COPY OF I PLANNING APPL 0 ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? []NO ;RECEIVED $Z'x"�r 1" i, � ��` `� s _ �.ty TOTAL VALUATION' - -s s -��,�4 �"c2 - �,v�rn�� 7�' ,� �•-. ar..xa.SFk•T By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I h v provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating b - ']ding con`s ion I authorize representatives of Cupertino to enter the above identi ed property for inspection purposes. Signature of Applicant/Agent: �• e!?� `,� -vim° - Date: SUPPLEMENTAL INFORI\4ATION kEQUIRED pp I New SFD or Multifamily dwellings: A PP ] for demolition permit for o a'' � O �\` 'EzR THE COLATEx B UILDIRGPI�4At R�rE'Vi M94". < c "B". existing building(s). Demolition permit is required prior to issuance of building sa x x a permit for new building. xK a ❑Ess 5� APT AAliIhGPLAT2EVIEW� s _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure :❑ sT DARD Q PUBL,ICWORI.s r "r form if any Hazardous Materials are being used as part of this project.v�xcE sg�� s '"� 4'S}' ,aTk.'l =� �te�. i ilk. '1 _Copy of Planning Approval Letter or Meeting with Planning prior to ?fi. HLAJO�t A avE i.e•^'L'd^�*r^M. 54�IT YsE\iERDISTRICTS.- submittal of Building Permita application. PP r z x �. i;�- :�x;�r:;- •t..�`�...,k:-* r»,..x �x....a: "� ..:Ei>;VIR0Nb1ENTAL HE;:0.L,TH B1dg,4pp 2011.doc revised 06121111 a At !, MAIN. 11,11 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 ^ buildingna•cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / Tl 9 REVISION /DEFERRED ORIGINAL PERMIT# I V Q b PROIECT ADDRI /l0,%'i •C� C� Tzm *3� /�� APN d OWNERNAME � O� pZ� V?1 PHONE s�•��' E\1AIL � � ` STREET ADDRESS a^"C' ✓ ' % %M�r �r 7(��W CITY, STATE, ZIP /�j-�•V �i M ,f FAX CONTACT NAME `? ` PHONE 7, • Z17 E -MAIt pv pp I/y.. ^ @ S� �� • t�/\F!AX3�/V� STREET ADDRES.° ,� ( CITY, STATE, ZIP n�, ^ `�r� L��f� �` V�uJ ` 9OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT ,CONTRACTOR ❑ CONTRACTOR AGENT ❑l ARCHITECT 11 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACrORNANIE & 0_ /y am c,,,�,) `A LICENSENUMBER tal„(��j LICENSE TYPE BUSLIC# vlr`n�L� �/ _•/ COMPANY NAMF./� E- MAILc� se M FAX STREETADDRf:SS try,\ �w� tk-XL CITY, STATE, ZIPA., �� PHONE/_ ARCHITECT /ENGINEERNAME ` LICENSE NUMBER BUS. LIC# FAX COMPANY NA \IG E- MAII • STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF \ \'ORK A w \m EXISTING USE PROPOSED USE CONSTR TYPE # STORIES 1 USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DE1110 TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: rJ DETACH []ATTACH I H DWELLING U IS ASECOND UNIT C] YES SECONDSTORY ❑YES BEING ADDED? []NO ADDITION? ❑NO PRE - .APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVEDBY: TOTAL VALUATION; PLANNING APPL : []NO PLANNING APPROVAL LETTER EICHLER HOME? []NO �^7 L! By my signature below, I certity to each of the following: I am the property owner or authorized a roper o net's behalf I have read this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. agree to comply with all applicable local ordinances and state laws relatiN to building co t action. I aut of Cupertino to enter the above- identifiedd property for inspection purposes. ]Uepresentatives Signature of Applicant/AgenL �d Date: 1 0 f �1� SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER -TILE- COUNTER BUILDING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for ne\\ building. ❑ EXPRESS PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD ❑ PUBLIC WORKS form if anv Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIREDEPT _ Copy of Planning Approval Letter or Meeting With Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT Submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH 3(dgApp_201 l.doc revised 0612111/ M VJ (CffT Y OF cCUIFIERTENG FEE IEMMATOR — BUI LDENG BMSEGN .. ADDRESS: 19399 scb )[DATE: 01/29/2015 REVIEWED BY: Mendez ,: APN: BP #: ` *VALUATION: 1$40,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: New Construction PRIMARY Commercial Building Civil /Religious activities o PENTAMATION 1GENCOM USE E) in BQ zone, 0 Yes No PERMIT TYPE: WORK DEFERRED #- TRASH ENCLOSURE SCOPE NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are horsed on the nreliminary information available and are only an estimate. Contact the Dent for add►t'1 info. FEE ITEMS (Fee Resolution 11 -053 E . 711113) 11cci "a. lllfw C? rk 13bfnib, Man, Cjlt<•k F >iec. T'hw ("'h Perini•' l=ee: P'ban!" rlt r•rnit Fee: l lec. 'e of lii Fee: ter.,Veelt, Asp. C [herPlwnh lT8)'(.�. 0 zherElec. It ip, LA v1C'i: /t. h1v "). Ft " ".` Pl wnb, fn,. P. Tee; i'.iec. lass J. l.',,e: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are horsed on the nreliminary information available and are only an estimate. Contact the Dent for add►t'1 info. FEE ITEMS (Fee Resolution 11 -053 E . 711113) FEE QTY/IFIEIE MISC ITEMS Plan Check Fee: $0.00 0 # Deferred Submittal $572.00 I DEFSUBM Suppl. PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee: Reg. () OT 0,0 lirs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: IBCONSTAXC $0.00 AtInzi isTralive 11ee: 0 G Work Without Permit? 0 Yes C) No $0.00 Advanced Planning Fee. $0.00 Select a Non - Residential 0 Building or Structure 0 A t'ta�tc>t 11t>c:,arric:nt!aTitlTi Firers; Strong Motion Fee: IBSEISMICO $11.20 Select an Administrative Item B1diz Stds Commission Fee: IBCBSC $2.00 SUIE$TOTAI.S: $13.20 $572.00 TOT , >F>E>E' $585.20 Revised: 01/06/2015 1Buiilduuag IDepai -tent City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014 -3255 Tel.ephone: 408- 777 -3228 Fax: 408- 777 -3333 CONTRACTOR SUBCONTRACTOR LEST JOB ADDRESS: 19399 Stevens Creek Blvd - Shop 5 PERMIT # 12110090 OWNER'S NAME: Sand Hill Management PHONE # GENERAL CONTRACTOR: South Bay Construction BUSINESS LICENSE #5655 ADDRESS: 1711 Dell Ave CITY /ZIPCODE:Campbell, CA 95008 *Our municipal code requires alll buAnesses working in the city to have a City of Cupertino business license. NO 2UIILIDI[NC FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE, GENERAL CONTRACTOR OR ANID ALL SUBCONTRACTORS CRS HAVE OBTAINED A CI'T'Y OF CtT.P E.RTINO BUS.a,Mi SS LICENSE. 11 am not using any subcontractors: Signature Please check app ➢icaNe subcontractors anal comp11ete the following information: .Date co SUBCONTRACTOR OR 1BUS1fN ESS NAI�TIE BUSINESS LICENSE # Cabinets & Millwork X Cement Finishing Techcon 23513 X Electrical Redwood Electric Group 21108 X Excavation Doyle's _ 35611 Fencing Flooring / Carpeting Linoleum / Wood X Glass / Glazing Classic Glass 25840 X X Heating Insulation The Trillo Company Central California Insulation 29816 557 Landscaping X Lathing Con Cal Plastering 33021 X Masonry Pacific Bay Masonry 25509 X Painting / Wallpaper �» G &G Painting 34391 Paving X Plastering Con Cal Plastering 33021 X Plumbing Fresno Plumbing & Heating 32000 X Roofing Statewide Roofing 23509 Septic Tank X Sheet Metal The Trillo Company 29816 X Sheet Rock South Bay Interiors 25499 Tile Owner / Contractors Signature 5/12/15 Date c �141JPC�(�7T1�7® J CONTRACTOR / SUBCONTRACTOR LEST Building (Department City Of Cupertino 10300 Tone Avenue Cupertino, CA 95014 -3255 Telephone: 408- 777 -3228 Fax: 408- 777 -3333 JOB ADDRESS: 19379 Stevens Creek Blvd - Shop 4 PERMIT #12110081? OWNER'S NAMF.,:Sand Hill Management PHONE # GENERAL CON TRACTOR: Bay Construction .BUSINESS LICENSE #5655 ADDRESS: 1711 Dell Ave CITY /ZI.PCODE:Campbell, CA 95008 -Our unaaunicipall code requires ail➢ businesses working in the city to have a City of Cupertino business license. YO MI LDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE Cg3ENZRAL CONTRACTOR AND AIL.II., SUBCONTRACTORS HAVE OBTAINED A CITY OF CU PIERTINO 3USINIESS LICENSE. LT am not using any subcontractors. Signature Please check aapplicablle 5ubcontracton-s and conaaplete the following information; Date V SUBCONTRACTOR BUSIN ESS NAME BUSINESS LICENSE # L Cabinets & Millwork X Cement Finishing Techcon 23513 X Electrical Redwood Electric Group 21108 X .Excavation Doyle's 35611 Fencing 1 Flooring / Carpeting Linoleum / Wood X Glass / Glazing Classic Glass 25840 X Heating The Trillo Company 29816 X Insulation Central California Insulation 557 Landscaping _ —` i X :Lathing Cen Cal Plastering 33021 X Masonry American Tile & Brick Veneer 35158 X Painting / Wallpaper G &G Painting 34391 Paving X Plastering Cen Cal Plastering 33021 X X Plumbing Roofing Fresno Plumbing & Heating —` Statewide Roofing 32000 23509 Septic Tank X Sheet Metal. The Trillo Company 29816 X Sheet Rock South Bay Interiors 25499 JI Tile Owner / Contractor Signature 5/12/15 Date