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09080116 - DEF3CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19800 VALLCO PKWY CONTRACTOR: LAYTON PERMIT NO: 09080116 CONSTRUCTION OWNER'S NAME: CUPERTINO PROPERTY DEVELOPMENT 9090 S SANDY PKWY DATE ISSUED: 08/14/2012 rNRHONE: 4083431088 SANDY, UT 84070 PHONE NO: (949) 429-6740 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL E] sROSE BOWL -MIXED USE RESIDENTIAL/RETAIL 476,016 Lic. # % SQFT-INCLUDES 204 APARTMENTS, COMMON AREAS - t a I am censed under the pLrovisions of Chapter 9L/16R(383,913 with Section 7000) of Division 3 of the Business & Professiions oeanthat my license is in full force and effect. 2/8/2013 - DEFERRED 0 NEW ELEVATOR CONSTRUCTION, 7 ELEVATOR CABS & HOISTWAYS RANGING FROM 2 TO 7 STORIES- ISSD 6/12/2014 I hereby affirm under penalty of perjury one of the following two declarations: I have and will maintain a certificate of consent to self-in*.1e,lb leer's Compensation, as provided for by Section 3700 of the L e, fo;for performance of the work for which this permit is is Sq. Ft Floor Area: I have and will maintain Worker's Compensati6ip) gurance, as prov' by Valuation: $46000000 Section 3700 of the Labor Code, for the performance ofAt i 0 or which this permit is issued. �� APN Number: 31620037.38CONDOS Occupancy Type: 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 PERMIT EXPIRES IF WORK IS NOT STARTED to building construction, and hereby authorize representatives of this city to enter WITH -IN 18� DAYS OF P IT ISSUANCE OR upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FR ` 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 — granting of this permit. Additionally, the applicant understands and will comply Issued by: Date: CO- /0/ - with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. Signature Date 2 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. OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will declarations: maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the I have and will maintain a Certificate of Consent to self -insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous 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 Cup ti Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2535Z5 25533„and 25534. Section 3700 of the Labor Code, for the performance of the work for which this y// permit is issued. Owner or authorized agent: Date: 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 1 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 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, 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE ^ CUPERTINO, CA 95014-3255 V (408) 777-3228 ^ FAX (408) 777-3333 = bUlldlnq(a7CUgertirl0 ora LJ ADDITION UALTERATION/TI �i REVISION /DEFERRED ORIGINAL PERMIT # 09080116 PRc,n:c rADDRIss 19800 Vallco Parkway Cupertino, _ CA 95014 APN # ow,r:It NAME Cupertino Property Development 1 LLC p PHONE 408-343-1088 E-MAIL STREET ADDRESS 19620 Stevens Creek Blvd. echan@kcrdevelopment.com AREA TOTAL AREA NET AREA Suite 200 CITY, STATE,ZIP Cupertino, CA 95014 FAX 408-343-1089 CONTACT NAME Douglas Schmoldt BATHROOM KITCHEN REMODEL AREAREMODEL AREA STREET ADDRESS 19800 Vallco Parkway PHONE 702-664-5617 E-MAILdschmoldt@laylonconstruction.com CITY, STATE, ZIP Cupertino, CA 95014 FAX 408-777-8639 ❑ OWNER❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR CONTRACTOR NAME Trent Lafrentz ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT LICENSE DECK AREA NUMBER ds 1 791 66 LICENSE TY BUS. LIC # 9f V �21/Cl COMPANY NAME KONE Inc. 1 E-MAIL trent.lafrentz@kone.com FAX 510-351-5341 STREET ADDRESS 15021 1/Vicks Blvd. CITY, STATE, ZIP San Leandro, Cdr 94577 PHONE ❑ ATTACH 510-760-5448 ARCHITECT/ENGINEERNAME Michael Stanton # DWELLING UNITS: IS SECOND UNIT ❑YES SECOND STORY OYES BEING ADDED? LICENSE NUMBER COMPANY NAME Stanton Architecture BUS. LIC # ONO ADDITION? ONO E-MAIL mstanton@stantonarchltecture.com FAX 415-865-9608 STREET ADDRESS 555 De Haro St. Suite 300 PRE -APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER RECEIVED BY: CITY, STATE, ZIP San Francisco, CA 94107 PHONE 415-865-9600 DESCRIPTION OF WORK New elevator construction. A total of (7) elevators cabs and hoistways ranging from 2 to 7 stories tall. i r rn # STORIES EXISTG NEW FLOOR DEMO AREA 7 USE TYPE OCC. SQ.FT. VALUATION ($) AREA TOTAL AREA NET AREA BATHROOM KITCHEN REMODEL AREAREMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS SECOND UNIT ❑YES SECOND STORY OYES BEING ADDED? ONO ADDITION? ONO PRE -APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER RECEIVED BY: EICHLER HOME? ❑ NO TOTAL VALUATION: By my signature below. I certify to each Of the following: 1 wn the property owner or authorized agent to act on the property owner's behalf. application and the information 1 have pry?vided is I have correctrl {iavf. re��ad-the Description of Work ordinances and state laws relating to btlfldinglc} ntiu ucti6jl•, (aP'thyfi�c read this and verifyitis accurate. I agree to comply with all applicable local representatives Of Cupertino toe er the above -identified Signature of Applicant/Agent: property for inspection purposes. k Date: 2/8/13 SUPPLEMENTALINFORMATION REQUIRED f New SFD or Mttltifamilyfdwellings: Apply for demolition permit for PLAN CHECK TYPE ROUTING SLIP existing building(s). Demolition permit is required prior to issuance of building El OVER -THE COUNTERBUILDING PLAN REVIEW pelmit for new building. ❑ EXPRESS _ Commercial Bldgs: Provide a completed Hazardous PLANNING PLAN REVIEW Materials Disclosure form if any Hazardous Materials being ❑ STANDARD El PUBLIC WORKS are used as part of this project. _ CO of Planning PY g Approval Letter or Meeting ❑ LARGE FIRE DEPT With Planning prior to submittal of Building Permit application. ❑ MAJOR /// ❑ SANITARY SEWER DISTRICT ❑ _ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11