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15080202
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10815 N WOLFE RD CONTRACTOR: TOENISKOETTER PERMIT NO: 15080202 CONSTRUCTION INC OWNER'S NAME: CUPERTINO VILLAGE LP 1960 THE ALAMEDA STE 20 DATE ISSUED: 12/11/2015 OWNER'S PHONE: 6507467503 SAN JOSE, CA 95126 PHONE NO: (408) 200-3260 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL -D STE 100-TENANT IMPROVEMENT FOR KEYPOIN® License Class Lic. # f 1 CREDIT Contractor Date UNION(2508 SQ FT). I hereby affirm that I am licensedunder 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 p r rmance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $200000 ae and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for this APN Number: 31605056.10815 Occupancy Type: which 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 laws PERMIT EXPIRES IF WORK IS NOT STARTED state 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 indemnify and keep harmless the City of Cupertino liabilities, 180 YS FROM LAST CALLED INSPE T ON. against judgments, costs, and expenses which may accrue against said City in consequence of the granting this Additionally, f` Issued by: t f of permit. the applicant understands and will comply Date: 6 9'�. with all non-point source regulations per the Cupertino Municipal Code, Section 9.18.E C ), '�" RE-ROOFS: Signature � E _ v s t/inr,t 'Date e f 3t 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: I, 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) 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 I hereby affirm under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: 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 Cupertino 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, Section05, 25533, and 25534{" f' '}{ issued.i` Owner or authorized agen t �!�^✓ - ate: ` permit is .. 1 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 Lender's Address 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 Cityof 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 CUPERTINO I ❑ NEW CONSTRI WTInN CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinaCa�cupertino.org 1� I I A TlTlT7Tl1T1]C ii A T 'PT`T e 1 1 _ ---- PROJECT ADDRESS Id�lE) voO -..._�,-••••••••••• u �j (Z6� - SUI IQA avi:ri.�ivivil�DrDlttCCU UKI1J11NHLF11KNIIIV - APN# OWNER NAME llllL` m O N� f �y� PHONE c E-MAIL COMPANY NAME CoS 0 -i45o t� 1EL L IK%C-0rtfMAL) ri STREET ADDRESS 1 5 '516 a ll+— CITY, STATE, ZIP FAX CO S 0 LICENSE NUMBER = Z L E.[ CA 'q 4.61 S 'i 5 Ca CONTACT NAME t L A h � `tet Imo- COMPANY NAME E-MAIL j O AAA M S Cs' %A': " PHONE 4 $ C► etZt- E-MAIL TA I cj C., � i STREET ADDRESS CITY, STATE, ZIP 2 s1- S ' S 6n S,exa ` c S ' �i5t1 PHONE 4 u ' ct cf2Z 5 z 2Z Z JI5G G M STREET' ADDRESS 5 G(� CITY, STATE, ZIP .Si' 5 FAX N ' ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ C-ONTRArTnR AnFNT Dk Anrvrrc— rl to r'1 .. Cl m' CONTRACTORNAME kDt'v�t� LICENSENUMBER LICENS,TYPE BUS. LIC# v. TYPE # STORIES COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT/ENGINEER'TA1� E �» LICENSE NUMBER BUS. LIC# v \ `--•1 �'�IJU G SQ.FT. COMPANY NAME E-MAIL j O AAA M S Cs' %A': " FAX VIA ,yA -T%k Aw YLID 6 i -)GG � i STREET ADDRESS CITY, STATE, ZIP 2 s1- S ' S 6n S,exa ` c S ' �i5t1 PHONE 4 u ' ct cf2Z 5 z DESCRIPTION OF WORK !V! C-t,I LMNT l;or S daft 7 �! 4 Zoe G nl Z- GU l C l,0 - IGI� G 1 I�r EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES Fat! -G Gt2trbp1't L*J l IJIt� $ USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR) DEMO TOTAL 2 �. O O ® AREA 2 o g AREA f j AREA (�' laCl_ a� NET AREA ` BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: DETACH til 06- cN) 0- K ) )f1er ❑ATTACH # DWELLING UNITS:IS A SECOND UNIT []YES SECOND STORY []YES e t [1 BEING ADDED? �Qb ADDITION? �O PRE -APPLICATION gYES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES BELE$Y TOTAL VALUATION: IN PLANNG APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? O /y M ----- CITY OF CUPERTINO FRE F.qTll%4ATn]P —'n1rT111r "WC- 71117-11'eir"XT iADDRESS: 10815 N Wolfe Rd Suite 100 28/2015 m APN: VIEWED BY: Sean *VALUATION: [$200,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY USE. Commercial Building --PERMIT PE ' — P NTAMATION 1��P 1B T1 1�� PERMIT TYPE: WORK - Tenant Improvement for keypoint credit union (2508 sq ft). SCOPE IBTIPLNCK OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA sS.) PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) 11-13,111-13,1VIV-B 2,508 $2,320.06 IBTIPLNCK $2,292.41 IBTIINSP $0.00 Permit Fee: $2,292.41 Suppl. Insp. Fee -E) Reg. C) OT T 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (.7onsh-Liction Tax: T TOTALS: 2,508 $2,320.06 $2,292.41 Akch, Plari Cheek We, � ch. Perl;W Fee: Other Akch, 7nsp. Phu;lb. Nal'i Check I plivnb. Peri -nit Fee: Other Plumb Trap. E/ec. Plan Check Alec Permit Fee.: other 1:7ec. Imp. ,Wech Ins]), Eee: I Phtwb. hisp; Fee: Elec. lnsj.s- Pe: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Distriet.ptn). TJIP.CP fOPR //Yo %/dc0/I nH t/fa nrnlisr�innnr i»fnrsysntinst minilnhln assail nrn n»Iv n» ocfir»nfo /'n»innt Elio Vont fnr ni%%ia �l sHfn FEE ITEMS (Fee Resolution 11-053 Eff 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,320.06 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. 0 OT=0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $2,292.41 Suppl. Insp. Fee -E) Reg. C) OT T 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 (.7onsh-Liction Tax: T Administrative Fee: 0 E) Work Without Permit? 0 Yes E) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G 0 Ti aivl Documentation Fees: Strong Motion Fee: IBSEISMICO $56.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $8.00 WaTbu—V va., I l $4,676.47 $0.00 —IT . . . . . . $4,676 .47 Revised: 07/02/2015 333 N et 1'oi t9 t Nein e {q f L2a IIOXi2LryDJlr TEMPORARY CERTIFICATE OF OCCUPANCY FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 3 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • bbgLIdtino a@cunertino,org n ion �)o APN 0 BP FLOOR AREA DATE: Z/3 A0/4,VALUATION: PROJECT a Uo (560 SITE ADDRESS: DS'I.S� _ f cA V, O© PPROVED WITH CONDITIONS" OWNER'S NAME- ; �^ PHONE #: ' FAX #: ❑ APPROVED I l Gl Z o5Ul " MAILING ADDRESS f different fro site addr ): - c. 5d0Ps CONTRACTOR -PHONE-- FAX ##LV�d�W, xi SJ CONTACT: PHONE #: / FAX M TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION BOP TYPE: ❑ SURETY BOND AMOUNT (1 % VALUATION CODE CHECK ❑CASH BOND OF BOND: 5Kmin-10K m IJL�/ (BLDBONDS] EDITION: TCO EXPIRATION FEL -/$,'>86.00/ r ��(�(1TEMPOCC] DATE (6 MONTHS MAX): I V0 TOTAL FEE: 5 ���✓✓✓ USE TYPE OF CONSTR FLOOR AREA OCC LOAD LEVEL COMMENT ._ _ APPROVED PPROVED WITH CONDITIONS" Si nature:.....,,.......1 41x4-�........... ..... ..... , - L U,4 er: ❑ APPROVED ❑ APPROVED WITH CONDITIONS' Signature: ........ .................... Date:...................... Z o5Ul " OTHER DEPARTMENT / AGENCY APPROVALS: Panning .... Signature: ............................. ......... ............. Date:........................ ❑APPROVED 11 APPROVED WITH CONDITIONS Fire --' Si nature:..,.!.:..... .. ��j .. Date:..G�..2V/ `� .............. -G-APPROVED [I APPROVED WITH CONDITIONS' Public WorKs Date:.. 0.... 3 I� APPROVED PPROVED WITH CONDITIONS" Si nature:.....,,.......1 41x4-�........... ..... ..... er: ❑ APPROVED ❑ APPROVED WITH CONDITIONS' Signature: ........ .................... Date:...................... CONDITIONS OF COMPLETION - Attach a tetter signed by the contractor and owner of the property stating the list of items required to be completed for each Individual Department before final occupancy can be granted. Include approximate completion dates for each item. The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or buildings complete and in compliance with all building codes, ordinances and regulations and ready for inspection prior to the expiration date specified. If this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited and the non-compliance may result enforcement action. oe Owner + I _ Contracto Z /� Signature.:.. I.,-...._.. ............................ Date:........................ Signature:.. .. ...................... Date:......./........... This temporary certificate ensures that all fire protection and life safety systems have been completed, inspected, successfully tested and approved for the specific area of the building specified above to provide a reasonable degree of safety to the occupants from fire and similar emergencies. LL I / r- / BuildingOfficial:.....:. !. ... >--....................Print:....�:.J. ........1.",..1��E .............................Date:. .:3:. :Lk,....... TempOceForm_2013.doc revised 717114 2q l�17C71 � G� sPW f CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a.cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION 19 ALTERATION / TI ❑ REVISION / DEPERRED ORIGINAL PERMIT # PROJECT ADDRESS w I APN # I O 0 PICO 5ut = I O 0 (O'�d OWNERNAMEL` �y 7 Lr PHONE -MAIL G L. C05U 74Ca ® •l-• Ir ELS-�1G11t'1ca1 Act STREET ADDRESS 1 S X76 U 1'r1• G P4 -n --l t = Za I CITY, STATE, ZIP OA N 011--! GA 4 FAX CO `J 0 -j2 C1 0 CONTACT NAMES1 L A C_M�w �� PH 6 3 C y E MAI t' S °� l 4 Z Z 2- J 15C G M MCC STREET ADDRESS 4 ZMD 5 EJ CITY, STATE, ZIPl �'a St. q 51 FAX N 14 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT J<ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECTIENGINEER NAME LICENSE NUMBER BUS. LIC # R1 C 12rf4tnl .. C✓ 17 5 COMPANY NAME E-MAIL J Rv" I!_� S Cs ,T)k m t; S C 4,Lt�w n� e i c �4 _ FAX �°1 STREET ADDRESS CITY, STATE, ZIP "PHONE.4 6 S 4 Z DESCRIPTION OF WORK 1 hilgm on, I ,tet `IL k,4 a C1Y1-^ s "moi C- I LSI j' ¢08 7'� l qI Z0,*GV G J4)2►2 l e LD - I G 1 o I of CP &4D EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES sl Ac-orw Cnevi-f Lit � l J j I USE TYPE OCC. SQ.FT. VALUATION ($) EXI3ATG 25 0 > NEW FLOOR K16�- DRE .NJao- 22 rV NET ARElr O BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE AREA: LJDFTACH iJ/ CNJ i�r- �% 1 {� []ATTACH # DWELLING UNITS: IS A SECOND UNIT [] YES SECOND STORY ❑ YES 1 I (_ W BEINGADDED? 5e ADDITION? VeO PRE -APPLICATION YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVUD )3Y`. TTqTAL VALUATION: PLANNINGAPPL# ❑NO PLANNING APPROVAL LEITER EICHLERHOME? 2410 A -N - Da o00 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 have 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 to authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: e��Z �°J 11 GJ SUPPLEMENTAL FORMATION�REQUIRED, PLAN CHECK TVPK, ".F . � ROOTING SLiP °w❑OVER-TIIE-COUNTLR e New SFD or Multlfamlly dwe111ngS: rmit for _ existing building(s). Demolition permit is required prior to issuance of building ° BUILDING PLAN REVIEW �; " permit for new building. ❑ EXPRESS, PLANNING PLAN RE VIEW ^ _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARD' El PUBLtc WORKS form if any Hazardous Materials are being used as part of this project. LARGE' FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR SANT IA)tY`SCrVER DIsTRici submittal of Building Permit application. ❑ 'ENVIRONMENTALHEALTH' B1dgApp_2011.doc revised 06121111 •Coi, CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: 10815 LTE—L 9-6A p PERMIT # /509 Q2.(J OWNER'S NAME: gr, q P4';',.g CK D)T U M 16'1,1PHONE # 2.00 GENERAL CONTRAC OR:7rq,—:is -d pC—o m jf , BUSINESS LICENSE # '7 3 3 G ADDRESS: E PA S 4,4 ® CITY/ZIPCODE:-5A i) —1S G *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 Please check applicable subcontractors and complete the following information: Date d SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork - - Cement Finishing Electrical Z,.1;e--t e 7 `160 3F i ,-, A S Cr- f r -C7* -C-rio'\j 20/30 Flooring/ Carpeting CO3j k �, �j ? Ef—S 33 Qq 9 Linoleum / Wood CQ Q L ,Q R O f M—S 33:2-'133 Glass / Glazing Cl ass) e_ C- f 4 5 T.I C , --z' 6-'R210 Heating ,I PA c- Vor- OSfk9- I1✓�i��t�AAJ i14L tt� � ►J-743 ®i Insulation L C- I >'j -r—r R10 6F -S Landscaping Lathing Painting / Wallpaper (�(�� �'� �/j ,� C �; �,� 3 p (v Paving Plastering Stix -cd Q Q c Q P LAS T 9,(uJ G- iz (0 1 Z Plumbing FL ohnezic, P1 cal to b` .�o Roofing 1 it �2-CSL`, i _ �. o � ':Z 0-7 3-3 Septic Tank ^' Sheet Metal/ Sheet Rock f, L3 1;z Tilel.C.r—�t���,d�� Date Z CUPERTIINO I TEMPORARY CERTIFICATE OF OCCUPANCY FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 77T-3228 • FAX (408) 777-3333 • building &cunertino.or� APN O BP M ©� CHECK ❑ CASH BOND; DATE:PROJECT Z 5 �f' VALUATION: $ p` SITE ADDRESS: ❑ APPROVED F 2S ` $ 6.00/ O TOTAL FEE: R$6 UTEMPOCCJ OWNER'S NAM Q PHONE MAILING ADDRESS, f d'Iferent iro site add p i—Q a0p' CO,Mo.1k ,% � M FAX#E 7d "' 0 A O t �► r 1�.3 CONTACT: PHONE #: FAX #: TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION ISOYD TYPE: ❑ SURETY BOND AMOUNT (1% VALUATION S IBLDBONDSIED}i170N: CODE CHECK ❑ CASH BOND; OF BOND: 5Kmin-90K COMMENT TCO EXPIRATION �jIsn ❑ APPROVED F 2S ` $ 6.00/ O TOTAL FEE: R$6 UTEMPOCCJ DATE (6 MONTHS MAX): `�16 ❑ APPROVED WITH CONDITIONS - Signature: ............................ Date:...................... USE TYPE OF CONSTR FLOOR AREA OCC LOAD LEVEL COMMENT Public WorKS�fc, Si nature:........... ............ Date :...............:..... ❑ APPROVED PROVED WITH CONDITIONS" ❑ APPROVED ❑ APPROVED WITH CONDITIONS - Signature: ............................ Date:...................... OTHER DEPARTMENT I AGENCY APPROVALS: Planning Signature: ......................................................... Date:........................ ❑ APPROVED 11 APPROVED WITH CONDITIONS` re 5i nature :......... ..... .......... .. Date:..?A / /(� y -APPROVED [3 APPROVED WITH CONDITIONS' Public WorKS�fc, Si nature:........... ............ Date :...............:..... ❑ APPROVED PROVED WITH CONDITIONS" ❑ APPROVED ❑ APPROVED WITH CONDITIONS - Signature: ............................ Date:...................... "CONDITIONS OF COMPLETION - Attach a letter signed by the contractor and owner of the property stating the list of items required to be completed for each Individual Department before final occupancy can be granted. Include approximate completion dates for each Item. The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or buildings complete and In compliance .with all building codes, ordinances and regulations and ready for Inspection prior to the expiration date specified. If this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited and the non-eompiiance may result)kaQ enforcement aeon. Owner �-Contractore,22Z Si nature.. .. Date:.....! �'� .:.. Si nature:.. .. Date: ..' This temporary certificate ensures that all fire protection and life safety systems have been completed, inspected, successfully tested and approved for the spectfic area of the building specified above 'to provide a reasonable degree of safety to the occupants from fire and TempO=Form 2013.doc revised 717114 CALGREEN NON-RESIDENTIAL CHECKLIST —. MANDATORY ITEMS COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build in cu ertir,6.or PURPOSE: The non-residential provisions of the 2013 CalGree Me ' e planning, design and development methods that include environmentally responsible site c i>�r°ri, ilding design, building siting and development to protect, restore and enhance the environme al q ty of the site and respect the integrity of adjacent properties; establishes the means of conservin ater used indoors, outdoors and in wastewater conveyance; outlines means of achieving material conservation and resource efficiency; and outlines means of reducing the quantity of air contaminants. Project Name: Project Address: oint Credit Union 10815 North Wolff Road, Cupertino Ca.4 �0�, A Project Description: Tenant Improvement, from cold shell Instructions: 1. The Owner or the Owner's agent shall employ a licensed professional experienced wiI'the13 California Green Building Standards Codes to verify and assure that all required work described herein is properly planned and implemented in the project. 2. The licensed professional, in collaboration with the owner and the design professional shall initial Column 2 of this checklist, sign and date Section 1 - Design Verification at the end of this checklist and have the checklist printed on the approved plans for the project. 3. Prior to final inspection by the Building Department, the licensed professional shall complete Column 3 and sign and date Section 2 - Implementation Verification at the end of this checklist and submit the completed form to the Building Inspector. Page 1 of 9 CalGreen Non -Res Checklist. doe revised 01/23/14 Column 2 Column 3 MANDATORY FEATURE OR MEASURE Project Verification Requirements CHAPTER• DA • -MEASURES ,kddheral Requirements The project meets all the requirements of Divisions 5.101 through 5.508. 0 ❑ Division 6.1 PLANNING AND DESIGN Planning and Design 'Site Dev'elo'pment 5.106.1 Storm water pollution prevention. For projects of one acre or less, develop a Storm Water Pollution Prevention Plan (SWPPP) that has been designed, specific to its site, conforming to the State Storm water NPDES Construction Permit or local ordinance, whichever is stricter, as is required for ❑ ❑ projects over one acre. The plan should cover prevention of soil loss by storm water run-off and/or wind erosion, of sedimentation and/or of dust/particulate matter air pollution. Page 1 of 9 CalGreen Non -Res Checklist. doe revised 01/23/14 j 5.106.4 Bicycle parking. Comply with Sections 5.106.4.1 and 5.106.4.2; or meet local ordinance, whichever is stricter. ❑ ❑ 5.106.4.1.1 Short -Term bicycle parking. If the qualified project is anticipated to generate visitor traffic, provide permanently anchored bicycle racks within 200 feet of the visitors' entrance, readily visible to passers-by, ❑ ❑ for 5 percent of visitor motorized vehicle parking spaces being added, with a minimum of one two -bike capacity rack. 5.106.4.1.2 Long -Term bicycle parking. For qualified buildings with over ❑ ❑ 10 tenant -occupants, provide secure bicycle parking for 5 percent of tenant vehicle parking spaces being added, with a minimum of one space. 5.106.5.2 Designated parking. Provide designated parking for any combination of low -emitting, fuel-efficient and carpool/van pool vehicles as ❑ ❑ shown in Table 5.106.5.2. 5.106.8 Light pollution reduction. Outdoor lighting systems shall be ❑ ❑ designed and installed to comply with the following: 1. The minimum requirements in the California Energy Code for lighting zones ❑ ❑ 1 — 4 as defined in Chapter 10 of the Califomia Administrative Code; and 2. Backlight, Uplight and Glare (BUG) ratings as defined in IES TM -15-11; and ❑ ❑ 3. Allowable BUG rating not exceeding those shown in Table 5.106.8, or ❑ ❑ Comply with a local ordinance lawfully enacted pursuant to Section 101.7, whichever is more stringent. 5.106.10 Grading and paving. The site shall be planned and developed to keep surface water away from buildings. Construction plans shall indicate how ❑ ❑ site grading or a drainage system will manage all surface water flows. Division 5.2 ENERGY EFFICIENCY . s Performance Requ�remerts n E � P 5.201.1 Scope. The California Energy Commission will continue to adopt ❑ ❑ mandatory building standards. Division 5.3 WATER EFFICIENCY AND CONSERVATION Irjdoor GUater`iJse 5.303.1 Meters. Separate meters shall be installed for the uses described in Sections 503.1.1 and 503.1.2. 5.303.1.1 New building or additions in excess of 50,000 square feet. ❑ ❑ Separate submeters shall be installed as follows: 1. For each individual leased, rented or other tenant space within the ❑ ❑ building projected to consume more than 100 gal/day. 2. Where separate submeters are unfeasible, for water supplied to the following systems: a. Makeup water for cooling towers where flow through is greater ❑ ❑ ,than 500 gpm. b. Makeup water for evaporative coolers greater than 6 gpm. c. Steam and hot-water boilers with energy input > 500,000 Btu/h. Page 2 of 9 CalGreen Non -Res Checklist.doc revised 01/23/14 5.303.1.2 Excess consumption. A separate submeter shall be provided for any tenant within a new building or within an addition that is projected ❑ ❑ to consume > 1,000 gal/day. 5.303.2 Water reduction. Plumbing fixtures shall meet the maximum flow rate values shown in Table 5.303.2.3. Q ❑ Exception: Building that demonstrate 20 -percent overall water use reduction. 5.303.2.1 Areas of addition or alteration. For those occupancies within the authority of the California Building Standards Commission, as specified in Section 103, the provisions of Section 5.303.2 and Section 5.303.3 shall ❑X ❑ apply to new fixtures in additions or areas of alterations to the buildings. 5.303.4 Wastewater reduction. Each building shall reduce by 20 percent wastewater by one of the following methods: 1. The installation of water -conserving fixtures or Q ❑ 2. Utilizing non -potable water systems. ❑ ❑ 5.303.6 Standards for plumbing fixtures and fittings. Plumbing fixtures and fittings shall be installed in accordance with the California Plumbing Code ❑ ❑ (CPC), and shall meet the applicable standards referenced in CPC Table 1401.1 and CalGreen Chapter 6. Outdoor Water Use 5.304.1 Water budget. A water budget shall be developed for landscape El El use. 5.304.2 Outdoor potable water use. For new water service or for addition or alteration requiring upgraded water service for landscaped areas of at least ❑ ❑ 1,000 sq.ft. but not more than 5,000 sq.ft., separate submeters or metering devices shall be installed for outdoor potable water use. 5.304.3 Irrigation design. In new nonresidential construction or building addition or alteration with at least 1,000 but not more than 2,500 sq.ft. of cumulative landscaped area, install irrigation controllers and sensors which ❑ ❑ include the following criteria, and meet manufacturer's recommendations. 5.304.3.1 Irrigation controllers. Automatic irrigation system controllers installed at the time of final inspection shall comply with the following: 1. Controllers shall be weather- or soil moisture -based controllers that automatically adjust irrigation in response to changes in plants' needs as ❑ ❑ weather conditions change. 2. Weather -based controllers without integral rain sensors or communication systems that account for local rainfall shall have a separate wired or wireless rain sensor which connects or communicates ❑ ❑ with the controller(s). Soil moisture -based controllers are not required to have rain sensor input. Weather Resistance and -.Moisture Management ,, . 5.407.1 Weather protection. Provide a weather -resistant exterior wall and foundation envelope as required by California Building Code Section 1403.2 ❑ ❑ and California Energy Code Section 150, manufacturer's installation instructions or local ordinance, whichever is more stringent.' Page 3 of 9 CalGreen Non -Res Checklist. doc revised 01/23/14 5.407.2 Moisture control. Employ moisture control measures by the following methods; 5.407.2.1 Sprinklers. Prevent irrigation spray on structures. ❑ ❑ 5.407.2.2 Entries and openings. Design exterior entries and/or openings ❑ ❑ to prevent water intrusion into buildings. 5.407.2.2.1 Exterior door protection. Primary exterior entries shall be covered to prevent water intrusion by using nonabsorbent floor and ❑ ❑ wall finishes within at least 2 ft around and perpendicular to such openings plus at least one of the following: 1. An installed awning at least 4 ft in depth. 2. The door is protected by a roof overhang at least 4 ft in depth. 3. The door is recessed at least 4 ft. 4. Other methods which provide equivalent protection. 5.407.2.2.2 Flashing. Install flashings integrated with a drainage El Elplane. Construction. WasteReduction, Disposal and,Recycling _• 5.408.1 Construction waste management. Recycle and/or salvage for reuse a minimum of 50 percent of the nonhazardous construction and demolition waste in accordance with Section 5.408.1.1, 5.408.1.2, or 5.408.1.3; or meet a ❑X ❑ local construction and demolition waste management ordinance, whichever is more stringent. 5.408.1.1 Construction waste management plan. Submit plan per this ❑ ❑ section to enforcement authority. 5.408.1.2 Waste management company. Utilize a waste management company that can provide verifiable documentation that the percentage of ❑ ❑ construction and demolition waste material diverted from the landfill complies with CalGreen Section 5.408. 5.408.1.3 Waste stream reduction alternative. The combined weight of new construction disposal that does not exceed two pounds per square ❑ ❑ foot of building area may be deemed to meet the 50 percent minimum requirement as approved by the enforcing agency. 5.408.1.4 Documentation. Provide documentation of the waste ❑X ❑ management plan that meets the requirements listed in Section 5.408.1.1 through 5.408.1.3. 5.408.3 Excavated soil and land clearing debris. 100 percent of trees, stumps, rocks and associated vegetation and soils resulting primarily from land ❑ ❑ clearing shall be reused or recycled. Building Maintenance and Operation. 5.410.1 Recycling by occupants. Provide readily accessible areas that serve the entire building and are identified for the depositing, storage and collection ❑X ❑ of nonhazardous materials for recycling. 5.410.2 Commissioning. For new buildings 10,000 square feet and over, building commissioning for all building systems covered by T24, Part 6, process systems and renewable energy systems shall be included in the ❑ ❑ design and construction processes of the building project. Commissioning requirements shall include items listed in Section 5.410.2. Page 4 of 9 CalGreen Non -Res Checldist.doc revised 01/23/14 5.410.2.1 Owner's Project Requirements (OPR). Documented before the design phase of the project begins the OPR shall include items listed in ❑ ❑ Section 5.410.4. 5.410.2.2 Basis of Design (BOD). A written explanation of how the design of the building systems meets the OPR shall be completed at the design phase of the building project and updated periodically to cover the systems ❑ ❑ listed in Section 5.410.2.2. 5.410.2.3 Commissioning plan. A commissioning plan describing how the project will be commissioned shall be started during the design phase of ❑ ❑ the building project and shall include items listed in Section 5.410.2.3. 5.410.2.4 Functional performance testing. Functional performance testing shall demonstrate the correct installation and operation of each component, system and system -to -system interface in accordance with the ❑ ❑ approved plans and specifications. 5.410.2.5 Documentation and training. A Systems manual and systems operations training are required. ❑ ❑ 5.410.2.5.1 Systems manual. The systems manual shall be delivered to the building owner or representative and facilities operator and shall ❑ ❑ include the items listed in Section 5.410.2.5.1. 5.410.2.5.2 Systems operations training. The training of the appropriate maintenance staff for each equipment type and/or system ❑ ❑ shall include items listed in Section 5.410.2.5.2. 5.410.2.6 Commissioning report. A complete report of commissioning process activities undertaken through the design, construction and ❑ ❑ reporting recommendations for post -construction phases of the building project shall be completed and provided to the owner or representative. 5.410.4 Testing and adjusting. Testing and adjusting of systems shall be required for buildings less than 10,000 square feet or new systems to serve an addition or alteration subject to Section 303.1. 5.410.4.2 Systems. Develop a written plan of procedures for testing and adjusting systems. Systems to be included for testing and adjusting shall include, as applicable to the project, the systems listed in Section ❑X ❑ 5.410.3.2. 5.410.4.3 Procedures. Perform testing and adjusting procedures in accordance with industry best practices and applicable national standards ❑ El each system. 5.410.4.3.1 HVAC balancing. Before a new space -conditioning system serving a building or space is operated for normal use, the system should be balanced in accordance with the procedures defined by ❑X ❑ national standards listed in Section 5.410.3.3.1. 5.410.4.4 Reporting. After completion of testing, adjusting and balancing, provide a, final report of testing signed by the individual responsible for © ❑ performing these services. 5.410.4.5 Operation and maintenance manual. Provide the building owner with detailed operating and maintenance instructions and copies of ❑ ❑ guaranties/warranties for each system prior to final inspection. 5.410.4.5.1 Inspections and reports. Include a copy of all inspection El and reports required by the enforcing agency. Page 5 of 9 CalGreen Non -Res Checklist. doc revised 01/23/14 r . e , q Fireplaces 5.503.1 Install only a direct -vent sealed -combustion gas or sealed wood - burning fireplace or a sealed woodstove and refer to residential requirements ❑ ❑ in the California Energy Code, Title 24, Part 6, Subchapter 7, Section 150. 5.503.1.1 Woodstoves. Woodstoves shall comply with US EPA Phase II emission limits. ❑ ❑ Pollutant•, Control ; 5.504.3 Covering of duct openings and protection of mechanical equipment during construction. At the time of rough installation or during storage on the construction site and until final startup of the heating and cooling equipment, all duct and other related air distribution component ❑X ❑ openings shall be covered with tape, plastic, sheet metal or other methods acceptable to the enforcing agency to reduce the amount of dust or debris which may collect in the system. 5.504.4 Finish material pollutant control. Finish materials shall comply with Sections 5.504.4.1 through 5.504.4.4. 5.504.4.1 Adhesives, sealants, caulks. Adhesives and sealants used on the project shall meet the requirements of the following standards. 1. Adhesives, adhesive bonding primers, adhesive primers, sealants, sealant primers and caulks shall comply with local or regional air pollution control or air quality management district rules where applicable or ❑ ❑ SCAQMD Rule 1168 VOC limits, as shown in Tables 5.504.4.1 and 5.504.4.2. 2. Aerosol adhesives and smaller unit sizes of adhesives and sealant or caulking compounds (in units of product, less packaging, which do not weigh more than one pound and do not consist of more than 16 fluid ounces) shall comply with statewide VOC standards and other ❑X ❑ requirements, including prohibitions on use of certain toxic compounds, of California Code of Regulations, Title 17, commencing with Section 94507. 5.504.4.3 Paints and coatings. Architectural paints and coatings shall comply with Table 5.504.4.3 unless more stringent local limits apply. ❑X ❑ 5.504.4.3.1 Aerosol paints and coatings. Aerosol paints and coatings shall meet the Product -Weighted NIIR Limits for ROC in Section 94522(a)(3) and other requirements, including prohibitions on use of ❑ ❑ certain toxic compounds and ozone depleting substances (CCR, Title 17, Section 94520 et seq). 5.504.4.3.2 Verification. Verification of compliance with this section shall be provided at the request of the enforcing agency. ❑X ❑ 5.504.4.4 Carpet systems. All carpet installed in the building interior shall meet the testing and product requirements of at least one of the standards ❑ ❑ listed in Section 5.504.4.4. 5.504.4.4.1 Carpet cushion. All carpet cushion installed in the building interior shall meet the requirements of the Carpet and Rug Institute ❑ ❑ Green Label program. 5.504.4.4.2 Carpet adhesive. All carpet adhesive shall meet the requirements of Table 5.504.4.1. ❑X ❑ Page 6 of 9 CalGreen Non -Res Checldist.doc revised 01/23/14 5.504.4.5 Composite wood products. Hardwood plywood, particleboard and medium density fiberboard composite wood products used on the interior or exterior of the building shall meet the requirements for © ❑ formaldehyde as specified in Table 5.504.4.5. 5.504.4.5.3 Documentation. Verification of compliance with this section ❑ ❑ shall be provided as requested by the enforcing agency. Documentation shall include at least one of the following standards listed in Section 5.504.5.3. 5.504.4.6 Resilient flooring systems. For 80 percent of floor area receiving resilient flooring, installed resilient flooring shall meet at least one ❑ ❑ of the following standards listed in Section 5.504.4.6. 5.504.5.3 Filters. In mechanically ventilated buildings, provide regularly occupied areas of the building with air filtration media for outside and © ❑ return air prior to occupancy that provides at least a MERV of 8. 5.504.7 Environmental tobacco smoke (ETS) control. Prohibit smoking within 25 feet of building entries, outdoor air intakes and operable windows where outdoor areas are provided for smoking and in buildings; or as enforced ❑ ❑ by ordinances, regulations or policies of any city, county, city and county, California Community College, campus of the California State University or campus of the University of California, whichever are more stringent. indoor Moisture and Radon Control . 5.505.1 Indoor moisture control. Buildings shall meet or exceed the provisions of California Building Code, CCR, Title 24, Part 2, Sections 1203, © ❑ and Chapter 14.1. Air Quality and Exhaust _. 5.506.1 Outside air delivery. For mechanically or naturally ventilated spaces in buildings, meet the minimum requirements of Section 121 of the California ❑ ❑ Energy Code, CCR, Title 24, Part 6 and Chapter 4 of CCR, Title 8 or the applicable local code, whichever is more stringent.' 5.506.2 Carbon dioxide (CO2) monitoring. For buildings equipped with demand control ventilation, CO2 sensors and ventilation controls shall be ❑ ❑ specified and installed in accordance with the requirements of the latest edition of the California Energy Code, CCR, Title 24, Part 6, Section 121(c).' Environmerital Comfort 5.507.4 Acoustical control. Employ building assemblies and components ❑X ❑ with STC values determined in accordance with ASTM E 90 and ASTM E 413. 5.507.4.1 Exterior noise transmission. Wall and floor -ceiling assemblies making up the building envelope shall have an STC of at least 50 and exterior windows shall have a minimum STC of 30 for any of the building 0 ❑ locations listed in Items 1 through 3 in Section 5.507.5.1. 5.507.4.2 Interior sound. Wall and floor -ceiling assemblies separating tenant spaces and tenant spaces and public places shall have an STC of ❑ ❑ at least 40. Page 7 of 9 CalGreen Non -Res Checklist.doc revised 01/23/14 0utdoor,�►�r �tual�t�� �� a � �s � F�� � ��,f 55 .t � 'ter `b � : P z3 "s .nr «^" ' _ '•`$ .�,. z� ����� � . 5.508.1 Ozone depletion and greenhouse gas reductions. Installations of HVAC, refrigeration and fire suppression equipment shall comply with Sections 5.508.1.1 and 5.508.1.2. 5.508.1.1 Chlorofluorocarbons (CFCs). Install HVAC and refrigeration equipment that does not contain CFCs. 5.508.1.2 Halons. Install fire suppression equipment that does not contain Halons. ❑ Page 8 of 9 CalGreen Non -Res Checklist.doc revised 01/23/14 CALGREEN SIGNATURE DECLARATIONS Project Name: Keypoint Credit Union Project Address: 10815 North Wolff Road, Cupertino Ca. Project Description: Tenant Improvement, from cold shell SECTION 1 —DESIGN VERIFICATION Complete all lines of Section 1 — 'Design Verification" and submit the completed checklist (Columns 1 and 2) with the plans and building permit application to the Building Department The owner and design professional responsible for compliance with CalGreen Standards have revised the plans and certify that the items checked above are hereby incorporated into the project plans and will be implemented into the project in accordance with the requirements set tort4 in the 2013 California Green Building Standards Code as adopted by the City of Cupertino j 1 10/08/2015 .... Date Larry ScofFdd VP. Gorpof e Services Owners Name (Please Print) 10/08/2015 Design Professional's Signature Date James Crawford Architect Design Professional's Name (Please Print) 11/12/2015 Signature of License Professional responsible for CalGreen compliance Date Leticia SooHoo, AIA,Leed AP+ 10/08/2015 Name of License Professional responsible for CalGreen compliance (Please Print) Phone Leiicia@soohoociily.com Email Address for License Professional responsible for CalGreen compliance SECTION 2 — IMPLEMENTATION VERIFICATION Complete, sign and submit the competed checklist, including column 3, together with all original signatures on Section 2 to the Building Department prior to Building Department final inspection. I have inspected the work and have received sufficient documentation to verify and certify that the project identified above was constructed in accordance with this Green Building Checklist and in accordance with the requirements of the 2013 California Green Building Standards Code as adopted by the City of Cupertino. Signature of License Professional responsible for CalGreen compliance Date Leticia SooHoo 10/06/2015 Name of License Professional responsible for CalGreen compliance (Please Print) Phone Leticia@Soohoocity.com Email Address for License Professional responsible for CalGrecompliancemm� Psige 9 vl 9 r:idGrevrn \bu-Res ( 71"eklisr,doc rwised 0/ 23,14 NONRESiDENTIA'L, VOLUNT,#RYWEAS4JRES, ! TABLE A5 S01 NONRESIDENTIAL BUILDINGS. Graen' B.Uilding' Standirds.Ciade pr,"otos>rdi?erformanrre'Apr�iach Na1o:,Th1s,Mbi& rs;PnibndarJ oniv es:an r 1d in"i%lusrrnitiar�alin nanrestlYerltinf:2r r struettrra �ATEGOt?Y ENYIFiQNfujENT4. PERF.O>3<AANCE:GOAL TII_fi 2 A11 � i`�ttntliuul: i`9�ixttlnCca[y iY1rX t .tU ottii� Fartavlsisnls. � � Mvi ali dlhdrrili Ision Pluiuling;atuhf).cs[};n; r�� � �[Xcsl�at]td�l'ls�lt'h,in� tetr Fucl Efflcl Ctlt Vah !cies - 104'0 (11'_1Cal-:ll,s`jlaecti ._. ... n� . - I _JY,S]lylL}tcl� SPIC,6 I (:let:.lrjr'V811tC1L';Cl1ar�i_ii /�[7T'QC:-i:�4401`.fOt:[1'Sj7:1CC.`.1 ' � /�PIarC�X`..�rii:[j(IQtif( 5():1CCS Cott! Roor--Jb,Rciht& Hcut, Roo NSlopa<.2 12SRl7, kland L 1.cutitct�tf l �a ? i SCtI I G 1<04I Slnpc,--212 SR1 S2 �l�ncrl' .7dd14i611n f lccti\+ frc11i1,blvision", 3 ukhti6nal )~icdl, iN. l_ A5.I �_ frntn.]�ivtt[oitt\5a Elle 1-gy`F fliCiency } nar y P�rftaritl}mcc a=u Outdoorlh hihl (ao\vcr011ulour�llo 'I atrCCtalll�lvtfilce 6,1116whow, clf Pao (1`rillti�Ytl ICi; lkuppti�abtts scilarrl,�ater,-11i:1ttS1�," ds�s( rn: 57tf1 ll�inittlusn i�iu'r wu tit Ci;[cfic+n,cerOrl$� 1fa��lCtn�lc 4cltru��terr=hc�un� +} jtent +\tthjpI jmtatt) cil tr lvtit 5 fraction�ofU..IS IJ t(apheitblc t.l,lyalin-Im1Clt�iita[ LrGi1� cwlnply L41CGr�ldcntiail;iiulaar FC tjipli�nllls, ult'lalq luttotit�aninrens conipl� vtilih,l=�ltllntihl indci�r 1I,;it[n ro ulrerh—tS f~ degv; laud zt J ry c)r jI(Ji cif �.' 1rY ajtraUhtCtinit[� rid r[Ila [t1 Wtll.l EmoiellCy jn(JoorAVutc..r U%4`. lf2's�n'uitY_Iil & nw, Conservation li 4hun re it tt 'llicnls. 1~net y F3ud t tl' qr Se dr,- 1°ffirt G r`illanlltel;ha.n� a(Ilx�v iru -iDr'.c.savings ( _ C)utd4lor=W uer.0 t f llltto 4 yce4xii G1?ru clt I Tci _ aitnes Clive Ittitds,,����ir�a Nrn ul q cY cd Marc, or:ETo liillev Chald�tdsi-i c.inun 1'viddulon.fl8-lrcaive li,additionut Electives tt '[\'i�ibn ASSA 110, C3 _ frclilii 5u[ti[c1Ci S:b Nlf�teristl C'onscrvalt(gn antd Resnircc I rliriedcy Gtiilti(ri[ctian ,��'uslc'P.vilu[ tient At lc ttit 65% r I I'Ctii it At icact ()Y3?, rc<luctig) Cies ls7d Gct'nlent lukilixo ret3elecl':Axintent n,joiLdak for,.Utilizc;r�!cycWd .. .,. ... .- . -r�.. _�_ I U aIa nr traC'tl !11$C4rtati quit. canicllt inntcrials Rii,; r Lh,,�+ l+f lntml. tllalcl t7l,t.�aSt' � ''I ,.^,L1tll:Uratl,lt•C1e.Il,Vr• lrnnl I)Iv_rstnal AJ,':.- `=: iitfdlllllltjtl'�I.eL'C14,�`S .f CDIri.F"}.tYdStCta ASA. _ F'�nl°II'Unt118tltnt•�ltit� c��l.t1\y.-�rl��'F�4SlflCflt�l''l(1t+C[n�' �1�Q4:� ot'•IloStr�•ritcCt's VUC.Ii[i[itx :'�tlt�'-�'fd4�-'l`h�rril[ilailsulntic+[i�' i�'o[lipj3 wi.Cll"SftJ� limilr 1flOfi'n'Slf'1�1t1Rt7n�4tS v()� (It1t1tC.� .1nstnII no ndc16drorm IldcivAje` insulation tttll� et�rrt�lirlvith V Dt`-ligifti I..addiflonal'Elective I nadiiionaall C ec(ivcs rr8'ril'L71t<'iclp`tl,lCJ�S' ! 1.1'(}111 Dlolsitia AS.S Added measures shall be 1 Addithmni'Mcilsi"NS f1011t+VC4 i1vK41 4 ili !past 3 l Iddlticlnal C14clIYC orics ._ -3 ;tddlt.ti lltt;k: i'•iCCtNk' A a te `rotlil 1feu ut.es l_Ll._ nusiitm_ i _ m 14 IF24 L l:acc()licafi, Allb'vunce iiuiyal . jicmlll,lei! in'13cY ? rtit;tip let'5.jicIry nt.aijici ilty.(atigau+i l7l)ririity 2.:Solurlv;,[,cr ticntiug yvti14 t..n. ngilircllipm,(or,,n4a4i(g c4n}slntetad RSuati mlg iy lltr iC5 �{7�.`I:1 L GXcetitic�ils:, , d 1�1711Sti1t�i \\LIt1.[I t1 ttnr'11�WJ5 Si!'G,14'"* 1v[ttl.r lira°tlr:rt4 altA:1'Mliilnliltt[`b+) �J� tri:riEt1S t}[�fnthf I�CIC[IL'S: ' tt; i3ulte1lnbtis+vhUrc t,l`4,a14.r.ill;itl b�lf,CNCI1kUlllic;`C'1L[II+1'ilSllTilfk'[1117LCn11+UiIl &i3l+iraCfic Ca[I11{L1t1 fCi7i-tt1t111.7tit1q lt.(131. i7larrii[C4Y!i Y$'. iiir rt4i1C'YC+�2CliljrinSt�l`+4111)1[711. tlt[ctlrt t4hclr ltrllt�,rrttrilni°�hstit+uavitltautfil114rlc.SPaYdin' 'frarst'calis4`+9ckFunhlt rues! tittlrc:rc,¢fetchry};clJl6mitiorittdbinlchn ki ll [1UEtilt'lncluJrcilnth. i ti�ir� luistudoti:ul' i�haf}itrlrs filar Acwgii 3.1Uc�.gle: i+atasni4 itrcniilRti.i+u will Sec A5`.�t04J hilt Chi .ccxl iniry l%4aFuf2aitulci7 fCh(yrra4npJn� nlenaurcr,ftnni'15ivi4l4aa ft.4: j ..� i 21113 GAGI�pFiNIA!GFIEEM SUiLbINC�`SIANi]AFtaS,GCSDH ,rutr:�;''a�y1,61�i�aiEasrrrar: 133 ` ret:ue I N6.14R"ES'664Ti4L V-OL'UNTARy,,MEA§�VF(Ep, 134 !-a$ -,"CORE_ 9 NONRESIDENTIAL' V61;UNTAFlY. h,lEASqRES SECTION -AS,601, 'NONAiEtj'DEkTIA1L, -'.bC*bbOA-WdfgglyA'i�p.,-L,i,C4T.iO�'C, HECKL. 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Inalud tha lt4trt3 lssted iaccttna a, t lil a 1 Sc 31U.2.S,�'Sy*,tenuaperntialkstrstimn};.^(l`tJr1:"[trc>}Y.uri`fast'ltcriningilfkhlPilC7pt`oprtptuttittin(t,n"tnve.�sn"ttF.'16r; � !I each egnillrticnt t+pe atttllur s rant tit�IAhly dcvinizti andhtd! inc luttc�ill tris 11 niMl,itl Stitjen i 1IIL2«5,2. SA Ill 'r fi Conlin ititiisiE,� report'![ J A,repAtti nlctsingtiaKirininp, pmc .tt iVlht s ltrsdert tl� it-tltetstrgii tlic,duign � niid t:[ itcinl4ticii:phicsr'.y ttt`dtc. litilitian� Pr�latit t,h dt ttc ecntplctecLs,ad prutsidatl-ter I}ie�atvnt.rgt-riccplittivL. Cx7 (aarJrinxatl j, 'i�i'2, �� :!llirYi zotsilnp�CF�rl�r 9!21,3.�Al;IF;Qf�NW?CF�EEIiIRUIGi71�1G�ST"AtdQARI]S:CODE utu. MRS, pl&�T)f A TOOAPOS�,�O �Ilvp` 143, N641 6ENT1AL V.OWNTARY•MEaSURES: :`(�e�trt�iittcrd� u 1A4, ,aiaii�'1 �aExti��rt�d,�t�r. '2013;CgL1F�WN1�1�+GREEt�gUILC71f�lG-��`�,ND,Af3f�5;GQDt .NONRESlDEN.Tl.AL.VQL.UNTANY. MEASuriEs tittfib N,,M-. 6 U2 -46-iR'ESi'D'E"N,I-IAL-OCCLIPAN6�IE!S;;4iP'L;'fd'4tf6N CHEid1(bsT9--nnntintlprf 4 .fiibailhudd) 2013,CALlRN14,GPEEN:BUILDINC-'STANDAROS"Cb]JE autY;r.zoissupcirr:�erfT, 1'45 FO OLUE MANDATORY 'Tideii- ZBse. '.For, 1017 2.Ito mjjnwlcfInj,,-rcq 16� 1�8�p c w- Iicaitles:201 U StAfldarAX1clho&for I he 201 IA 0:1 i roni'i h �(twdflis) C- .111rudk P'L fcijrmap) cc t �'D ala i ;ise: nc 41. Nrnducla ccairw(I kW04;4.1.'2 , ihilts.. "lee 1"111S{.'}, Ito. El crimsion finti i, l 7, ori ils:1 Itlasc I ell 'Ili)ll;sllitli,l)cipfolitciJ, C3 110t lailds 111�,4(lhe pbli [no - be.u. X5;504i-,; �,d"*ri'lo-tiii-C,4,11p-Otluin 11 ls;�Kiniiruizc a nd,control.poijuiant, entry. inio'In -1.3 0 117611-rceall" p! coll iSttY�tin items b dir'd"n' g It 3 jji!;4, c016ii 1[ .. '2— 1� .. ..iilcil exhutm 411111"wfkt isofiitc]illirn 66i iilli6ii","I�j z6-111.1"ii torl ; n M:144."i It vsJolai"fiall ' '' airCiltrtt#nnn lil(cN 1�a I I fit i:,A:Ajn , i , inclfid6d tip, lite bjwrafliilllmd the 20 0 Colypilldo: fiitelgy, Owfi? kcrlu3rh41,jeA rii"rint3fnctrinfr lnilicntirY A4. nir 5 0 4'350, 1 V to kid reg ularjy occijpJ1Cd�t"x,;,Uf!,l 11C ,(':N' 'tit -,6 J t 15;504Ji rournedi'liotimNasirc4lltc my 1?i'c�Iiibitrd by , - 1. ind cojiillty,� 011�* c q n3inls f tho!'bi U4 -'-,I siaw 04" - - - - - - - - - - - - - ' lim- 0 yf.r= end-cl 'El pidlo, 'Willi; flie rq4ilii .fiibailhudd) 2013,CALlRN14,GPEEN:BUILDINC-'STANDAROS"Cb]JE autY;r.zoissupcirr:�erfT, 1'45 FO OLUE MEASMM :46N H-6i6dN-T",14L-VOLUNT A RYMEASURES ttbtWA I S.602 'NONRESIDENTIAL ,O.C.'C,UPAN6"S"A""P'OL'["'G4A'�'TiON!"CHt,O'KLI'STg!=cohtinued'.1, lite '' lik -coun'ty' 1017. 11, cwdblliwing mo-wattvsin mandifoRyAhtdo - d ',,ry fl, .� 't>>Iltuyt mm'isoirvi -.it I c'em I r qm lvrutluR I edcJ�ck� , *pr ill , rQ'Illillip'll.- te) the usvr: I pji,ay;ibt1Lpn!O'omply(v 29'13',Q4�IF,PR.NIA,PgAEM-f3UlLD,lNq-'..',S,T,ANDA,nD$.C,O,E)'E A47 :13t;U, V&UkAW &OAT601 ping,11 ills - tisi,illnlf 111t) A xvil 11ARIDER lcss thiff fj„r:i i!i! 4 to l t tl9 cii;nitl4n lt4Ll81aelnta• rin"r.11ock I Silo] T'radfus "'i Lnii�k,l s U, [v: oill y per All illed, w1wre'spatw1i mliatiolis I aui ll. , I lic Val. ,t vXofi . o ws- 4. I'llplure ifigesiti(II IwIlAst; Ld f I ol'�il Oflik 61 A Ic i pm"11're deftClioil. �A.prcsstru, gauge, tfeviaes�ailhe'?n5fuitrciuzitlrarutill�-iif' ilve ttilat to rndit to tt-dis x 1pthtr Grtii cl1 a zkczf thii re rvhjv(L ijen4illted ror. 6 .50!, fefl,igelmiji vli- r I �tP! 1 5'p 1 otind, s 1 0 1 .- ;S�:if`clltw. 11.4drsitzrim fn; it,:&p place, o INCO on: A hhu tire --Atli -.,ha 11 t; sucli cractlution and cimt&lg: nitrogen and iip'&Oj�rlatc- to 300 NA: prmstire A,'! aso o: I) s% be evacuilwd arwrpms llr�, lestiog 1ralictile to'- ch! I.TirAi-aCull iii P Iiiienjits), im'illulm Ruh] lf'of.,5110 yactillm dqwa 90 1101 -andhold'hod. lite '' lik -coun'ty' 1017. 11, cwdblliwing mo-wattvsin mandifoRyAhtdo - d ',,ry fl, .� 't>>Iltuyt mm'isoirvi -.it I c'em I r qm lvrutluR I edcJ�ck� , *pr ill , rQ'Illillip'll.- te) the usvr: I pji,ay;ibt1Lpn!O'omply(v 29'13',Q4�IF,PR.NIA,PgAEM-f3UlLD,lNq-'..',S,T,ANDA,nD$.C,O,E)'E A47 :13t;U, cy4? - Ive�a.—N�� a TEMPORARY CERTIFICATE OF OCCUPANCY FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O.,.BUILDING OFFICIAL 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 0 CUPERTI 10 (408) 777-3228 • FAX (408) 777-3333 • bulldingQcueenino org kdWN I W vOV TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION ' K71) E: QSURETYBOND AMOUNT (9%VALUA710N CODE CHECK ❑ CASH BOND OF BOND: 5Kmin-10K $ -51M) (BLDBONOSj EDITION: TCO EXPIRATION . r DATE (6 MONTHS MAX): g krb FE $28602 O TOTAL FEE: $ S J\ [t TEMPOCC] USE - TYPE OF CONSTR 0 BP I" LEVEL DATG c3 20� PR JECT VALUATION: $ SIT SITE ADDRESS: OP/,S�N J "�* QC.3 ❑ APPROVED OWNER'S NAM 'ty.r. �Ip PHONE M' �f)(�7 11 APPROVED WITH CONDITIONS" _ Signature; .......................,...,......,...,......,....,... to FAX#: S® MAILING ADDRESS f d fferentfro site addrM. C t2QP1 grzsj CO TRACTO : (..�-. PHONE#:,r FAX#: CONTACT: PHONE #: FAX #: TEMPORARY CERTIFICATE OF OCCUPANCY INFORMATION ' K71) E: QSURETYBOND AMOUNT (9%VALUA710N CODE CHECK ❑ CASH BOND OF BOND: 5Kmin-10K $ -51M) (BLDBONOSj EDITION: TCO EXPIRATION . r DATE (6 MONTHS MAX): g krb FE $28602 O TOTAL FEE: $ S J\ [t TEMPOCC] USE - TYPE OF CONSTR FLOOR AREA OCC LOAD LEVEL COMMENT %1-APPROVED ❑ APPROVED WITH CONDITIONS° u n SI naturo:....k....... .. .......... ............Data:.. . :' :. ❑ APPROVED .APPROVED WITH CONDITIONS" � utner: ..•' ❑ APPROVED 11 APPROVED WITH CONDITIONS" _ Signature; .......................,...,......,...,......,....,... ZSvs^ e?wl� nre-y' Aik, grzsj OTHER DEPARTMENT I AGENCY APPROVALS: -Planning-- :..................................................... ftnature: .... Date:...............,........ ❑ APPROVED ❑ APPROVED WITH CONDITIONS" Fire Si s at r� %1-APPROVED ❑ APPROVED WITH CONDITIONS° u n SI naturo:....k....... .. .......... ............Data:.. . :' :. ❑ APPROVED .APPROVED WITH CONDITIONS" � utner: ..•' ❑ APPROVED 11 APPROVED WITH CONDITIONS" _ Signature; .......................,...,......,...,......,....,... Date:...................... "CONDITIONS OF COMPLETION -Attach a letter signed by the contractor and owner of the property stating the list of items required to be completed for each individual Department before final occupancy can be granted. Include approximate completion dates for each Item. The undersigned covenant and agree as a condition to the approval of the above request for temporary occupancy to have the building or buildings complete and in compliance with all building codes, ordinances and regulations and ready for Inspection prior to the expiration date specified. if this Temporary Certificate of Occupancy expires, the total amount of the bond may be forfeited and the non-complianoe mayresult enforcement action. Owner ¢ f -1`_ Contracto z Sinnaiure... ... ............................ Date:..,..................W... Signature:.. Date:......./....l ensures that all fire protection and life safety systems have been completed, Inspected, successfully tested and area of the building specified above to provide a reasonable degree of safety to the occupants from fire and Temp0vvFarm_2013,doc rev/sed 7/7/14 E ! mivt77c Rw6. 11f� -1(7vl�i/� PERMIT FEE RECEIPT Case # 15080202 Date Printed: 02/24/2016 CUPERTINO CITY OF CUPERTINO - FEES RECEIPT Case Number: 15080202 Permit No: 15080202 Project Valuation: 200000.00 Date Submitted: 08/28/2015 Permit Type: 1B TI Address/APN: 10815 N WOLFE RD CUPERTINO CA 95014 Receipt#: 201713 (316 05 056) Scope of Work: STE 100 -TENANT IMPROVEMENT FOR KEYPOINT CREDIT UNION(2508 SQ FT). Company Name: CUPERTINO VILLAGE LP Full Name: Company Name: CUPERTINO VILLAGE LP Full Name: STE 100 NEW HIDE Temporary Occupancy TCO GOOD TILL 3/24/2016 Building - Bond TCO GOOD TILL 3/24/2016 Primary Phone: (650) 746-7507 Primary Phone: (650) 746-7507 NY 11042 $286.00 Temporary Occupancy 02/24/2016 KEYPOINT CREDIT UNION Credit Card $286.00 Building - Bond 02/24/2016 KEYPOINT CREDIT UNION Check $5,000.00 FEE TOTAL $5,286.00 AMOUNT PAID $5,286.00 BALANCE DUE $0.00 02/2412016-4:12:36 PM -Generated by: paulos