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Home My WebLink AboutB-2016-1266CITY OF CUPERTINO ]BUILDING PERMIT BUILDING ADDRESS: 20400 STEVENS CREEK BLVD CUPERTINO, CA 95014 (369 01028) CONTRACTOR: (GIDEL & KOCAL PEI MUT NO: B-2016-1266 CONSTRUCTION CO INC) CAMPBELL, CA 95008 OWNER'S NAME. CUPERTINO CITY CENTER BUILDINGS D E ISSUED: 01/27/2016 OWNER'S PHONE: 408-873-0121 PHONE NO: 408-370-0280 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class 13 Uo. #40 0 0 Contractor (GIDE L & KOCAL CQNSTRUGTION CO INC ) Date 0 1127/2016 X BLDG _ ELECT _ PLI JMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing --' MECH " RESIDENT X COMMERCIAL with Section'7000) of Division 3 of the Business & Professions Code and that illy license is in full force and effect. .TOB DESCRIPTION: %hereby affirm under penalty of perjury one of the following two declarations: AEMETIS - INSTALL (N) GLASS DOOR IN (E) OPENING 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. v z, I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Val anon: $10000.00 APPI ICANT CERTIFICATION I certify that l have read this application and state that the above APN Number: Oce 1paucy lype: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby 369 01 028 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 PERMIT EXPIRE IF WORK IS NOT STARTED expenses which may accrue against said City in consequence the granting of this permit. Additionally, the applicant understands and will a WITHIN 180 DA S OF PERMIT ISSUANCE OR comply with all non -point source regulations per the Cupertino Municipal 180 DAYS FROM AS INSPECTION. Code, -Section 9.1 f . Issued by: S ANAW Signature Date 0127/2016 Date: 01/2712016 RFROOF& OWNER-BUILDERDECLARA ION I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected pri r to any roofing material being installed. If a roof is following two reasons: installed without first obtaining n inspection, I agree to remove ail new materials for 1. I, as owner of the property, or my employees with wages as their sole inspection, compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044,13usiness & Professions Code) Signature ofApplieam: 2_ 1, as owner of the property, am exclusively contracting with licensed Date: 01/27/2016 Contractors to construct the project (Sco.7044, Business & Professions Code). I hereby affirm under penalty df perjury one of the fallowing Three declarations: ALL ROOF COVER INGS TO BE CLASS "A" OR BETTER s. I have and will maintain a Certificate of Consent to solf-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the HAZARDOL S MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous in aterials requirements under Chapter 6.95 of the 2. 1 have and will maintain Worker's Compensation Insurance, as provided for California Health & Safety Code, Sections 25505, 25533, and 25534. I will by Section 3700 of the Labor Codo, for the performance of the work for which maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the this permit is issued. Health & Safe Code Sect t3' + n 25532 a should I store or handle hazardous ( ) 3. I certify that in the performance of the work for which this permit is issued, I material. Additionally, should I use equipment or devices which emit hazardous obeli not employ any person in any manner so as to become subject to the air contaminants as defined b the Bay Area Air Quality Management District I Worker's Compensation laws of California, If, after making this certificate of will maintain compliance with the Health &Safety the Cupertino o Municipal Code, Chapter 9.12 and ode, Sections 25505, 25533, and 25534. 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 Owner or authorized agent: be deemed revoked, Date: 01/27/2016 APPLICANT CE RTIFICATI CONS CTION LENDING AGENCY I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit 11 s Issued (Sec. 3097, Civ C.) relating to building construction, and hereby authorize representatives of this city Lender's blame to enter upon the above mentioned property for Inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant ARC TECT' DECLARATION understands and will comply with all non -point source regulations per the I understand my plans shall be used as public records. Cupertino Municipal Code, Section 9.18. Licensed Signature Date 01/2712016 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISIC N 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 7773228 - FAX (408) 777-3333 - building(EDGU t'rYinG.or CUPERTINO M 1-1 AnTNTTTn-Kt MX &T -TPP ATIM I TT FIR Fw%m i nrrERR C) ORIGINAL PERMIT PROJECT ADDRESS 20400 STEVENS CREEK BLVD 9700 APN 9 369-01-028 WNERNAMF PRom5TIIrFjsREALtsTATErRouF PHONE 108.873-0121 114JAIL, Nva" ' @P' E'J' X STREET ADDRESS CITY. STATF—UFAX P CUPERTINO, CA 95014 20400STEW-M CRI:FKBLVD 4130 CONrACPHONE -MAIL P NAME 408-370,9280 LRANIEWAGII)ILKOCALCON1 LILIAN RAMEY STREET ADDRESS 574 DIVISION STREET CITY.STATE, ZIP CANIPBELLCA93008 = FAX _J 0 OWNER 13 OWNER-BUILT)ER 11 OWNEMAGENT Ltd CONTRACTOR 0 courRAcToR AGENT11 ARCHUM "t ENENGINEERDEVELOPER ElT NA T CONTRACIORNANIE LANCE(EDEL LICENSE NUMBER LICEN&PT PI, Bus. TAC 9 28790 403050 B COMPANY NAME, L.-NIMIL, t,OMEL@GIDEIXf)(.-AL,.COM FAX 01 [)EL & KOCAL CONSTRUCTION, INC STREET ADDRESS 574C.,NqSjON S-IREET CITY'STATE'ZIP CAUPBELL, CA 95008 PHONE 409-37"280 ARCI-HTECT/ENGINEFR NAME LICENSE NUMBERBUS. LIC COMPANY NAME F -MAIL TAX STREET ADOREss Cfl'Y, STATE, ZIP PHONE DESCRIPTION OF WORK INSTALL A GLASS DOCRATTENANT 1.0131M SUITE 700 L 71-5TImr, ME -PROPOSED USE #8TORMS TYPE OCC. SQTT, VALUATION USE OFFICE B AREA DEN1.0 AREA. TOTAL, NET AREA 5() AREA Stf 0 0 BATHROOM REMODELARM KITCHENKITCHEN REWOUELAREA OTHER RFMODELAREA PORCH AREA DEC A jGT,*,LDECKj'PORCkI AREA GARAGE AREA; DETACII 0 ATTACH 70WELLI'mouNns: BEING AWED? 0 NO ADDITION? ONO PRE -APPLICATION [1YES IT YES, PROVIDE COPY Or IS THE w.DC AN 4-, I.TOTo1,VALUATION; PI.AN'NINGAPDL # ONO PLANNING APPROVAL LETUP, FICHLERTIPME? laniffiepr6perty owner or authorized agent aCt 0 perty Owner's behalf, Ihavereadthis By my signature below, I certify to each ofthe-followilulg.: wifiL all applii;able local information I have provided is correct. I have read [he Description Of Work ammmud v ae'Lu" cc to comply application and the to 1- construetiol). Inan_— roprusentatives ofC'Uperfiuo t t az�,,eijentjjjed pjvZrty For inspection purposes. ordinances and state laws relating Signatureof Applicant/Agent: Dale: SUPPLEMENTAL INFORMATION REQUIRED Now SFD or lylultifamily dwellings: Apply for demolition for -Q �TjstjngbuiIdjjag(s). DernolitionpormitisrecuiTedprioTtoisstianCeofbUildi-ng -E - permit for new building.------ Bldgs: Provide a completed Hazardo us Materials Disclosure A VAIW,21 Commercial cc Torm. Wary Hazardous Materials are being used as Part Of this PrOi t - Copy of.planning Approval Lotter orMeatingy with Planning prior to submittal of Building Permit applicition. . . . . . . Bidg,4pp_20.11.doo revised 06121111