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