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06050044 5a CITY OF CUPERTINO CuP of PERMIT APPLICATION FORM APN# �1 + P -�-10 & 0 Date: 5 `4- O� AA 10i Building Address: ' UYIPI�VM 111A Mailing Address (if different from building address): WC, 5;T,6\1 � 6y- & LeoL 6 Owner's Name: Phone#: 64LI&O"liq fizz-h 510-) ,3 -f�Z 46 Contractor: License#: TZ iz) Contac : Phone: Cupertino Business License#: N 1 N f I +i G`� Fax: Building Permit Info: 14ew C,p uM{aXiA SeAce IP4srAommT Bldg Elect X Plumb Mech Job Description: Residential ❑ Commercial Sq.Ft.Floor Area: !�•© 7 q.R.: - Cost of Project: ��/S D D®� Occupancy Group: �� A � 3 �1 i TT Type of Construction: Please check this box if the project is a Ful- A I N ERZ--T--> second-story addition: ❑ Project Size: Standard Large ❑ Major ❑ Quantity Fee ID Fee Description Fee Group BAPPLOTHER Other Appliances MECHANICAL _ BBOILERI Boiler<= 100,000 Btu MECHANICAL BBOILER2 Boiler> 100K to 500K Btu MECHANICAL BBOILER3 Boiler>500K to 1M Btu MECHANICAL BBOILER4 Boiler> 1M to 1.75 M Btu MECHANICAL BBOILER5 Boiler> 1.75M Btu MECHANICAL BCONSTAX Construction Tax BUILDING BCONSTAX Ind/Off/Comm/Quasi BUILDING BCONSTAXBQ Con. Tax for BQ Zone BUILDING BCONSTAXH Hotel and Motel BUILDING BCONSTAXR Constax--Resi/Mobile BUILDING / BELEC1000 Elec 600V<= 1000A ELECTRICAL BELEC1001 Elec 600V> 1000A ELECTRICAL BELEC200 Elec Svcs 600V<=200A ELECTRICAL BENERGY Energy BUILDING BENERGYADD Energy Add Multi BUILDING BINVESTIGA Investigation fee BUILDING 1 of3 i f ° = CITY OF CUPERTlNG CUPEI TING PERMIT APPLICATION FORM Quantity Fee ED Fee Description Fee Group BIMCELL Miscellaneous Fee BUILDING BMITIGATC Comm. Housing Mit. Fee BUILDING BNUCOM M New Comm Electric ELECTRICAL _.r BNUCONUV M New Comm Mechanical MECHANICAL,,, BNUCOMMP New Comm Plumb PLUMBING BOVERTME Inspection Overtime BUILDING BPBACKFLOW Atmospheric Vacuum . PLUMBING BPCESSPOOL Cesspool PLUMBING BPERMFEE Bldg Permit Fees BUILDING BPFIXTURE Pblg Fixture PLUMBING BPGA.S Gas Piping System Fee PLUMBING BPINTERCEP Ind Waste Interceptor PLUMBING BPLANCHK Plan Check Fee BUILDING BPLANCKADD Plan Check Add Multi BUILDING BPLANCKREP Plan Check Repeat Fee BUILDING- BPREPIPE Re i e Of Fixtures PLUMBING BPSEWAGE Sewage Disposal PLUMBING, BPSEWER Sewers PLUMBING , ` BPSPRI K Lawn S rinkler/Backflo PLUMBING- BPSTORM Storm/Rain Water PLUMBING BPTRAP Kitchen Trap PLUMBING 32- BPVENT Alt of Drain &Vent 'PLUMBING BPWATER Install/Alter Water Pie PLUMBING 2 BPWHEATER Water Heater/Vent PLUMBING BPWSVCS Main Water Service PLUMBING BREINSPECT Reins ection Fee BUILDING ,re ' BREMACOVER A/C Unit> 10,000 din MECHANICAL BREMAMHAN AIC Units<= 10,000 cfrn MECHANICAL BREMAPPLI Appliance Install MECHANICAL BREMBUS WAY Remodel Busways ELECTRICAL 2o[ BREMFIXT Lighting Fixtures ELECTRICAL BREMFURN Relocation of Furnace MECHANICAL BREMFURNOV Relo Fumace> l OK btu MECHANICAL 2 BREMHEAT Heater Installation MECHANICAL BREMMHOOD Installation of Hood MECHANICAL BREMMISC Misc Apparatus ELECTRICAL BREMINrRAPP Rem Non-Res Appliance ELECTRICAL BREMPOLE Pole/Platform Fixture ELECTRICAL 2-5 BREMPOWER Power DevicelA aratus ELECTRICAL 55 BREMRECEPT Rc tl, Switch & Outlets ELECTRICAL BREMRELOCA Relocation of Hood MECHANICAL BREMREPALT Repair/Alter Heating MECHANICAL BREMRESAPP Remodel Res Appliance ELECTRICAL 2 of 3 r Y.= xATY OF CUPERTINO CITY Or PERMIT APPLICATION FORM euP �No - - ' Quanti Fee ID Fee Description Fee Grou BREMSIGNAD Rmdl Signs Add Branch ELECTRICAL BREMSIGNS Remodel Signs, Marquee ELECTRICAL BREM=ATR Theatrical Lighting Fix ELECTRICAL BREMVENFAN Vent Fan Single Duct MECHANICAL BREMVENSYS Ventilation Systems MECHANICAL BSCBLVD Scb Specific Plan BUILDING BSEISMICOM Seismic Commercial BUILDING BSEISMICRE Seismic Fee Res BUILDING BSPECLA,L Special Inspection BUILDING BS)VW Swimming Pool BUILDING BTEMP Temporary Power ELECTRICAL BTEMPPERM Temporary BIdg Permit BUILDING BTEMPSVCS Temp Dist Svcs ELECTRICAL BUSLIC Business License BUILDING ELECTRIC Electrical sq foot ELECTRICAL ! EPERNffrFEE Elec Permit Issuance ELECTRICAL MPERMFEE Mechanicals . foot MECHANICAL MPERIVIITFEE Mech Permit Issuance MMCE[AMCAL PPERNIITFEE Plumbing Permit Issue PLUMBING PPLBG Plumbing Fee sq foot PLUMBING 0 PLLONGRNGC Planning LR Commel Multi-Fam PLANNING PLLONGRNGR Planning Long Range Residential PLANNING =' ZADDCHCT Address Chane BUILDING• - •J N r 3 of 3 Community Development ' 10300 Torre Avenue `YN Cupertino CA 95014 Telephone(408) 777-3228 CIV Of Fax(408) 777-3333 CUPEKrINO Building Department JOB ADDRESS: PE # Dl 2 3 N c�o c �� d o .Sa z7 Y OWNER'S NAME: C~VWXUA PizZA PHONE # GENERAL CONTRACTOR: -;OO FAX# 1 am not using any subcontractors: TO AA, y Zoo6 Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating h -sulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date y�, CITY OF CU')ERTINO BUILDING DIVISION P�j'RT � - BUILDING ADDRESS: CALIF0RNIA PIZZA KITCHEN PERMIT N°-0 6 05 0'044 1962.1 STEVENS CREEK BLVD OWNERS NAME: PERMIT ISSUE DA7E CALIFORNIA PIZZA KITCHEN 19621 STEVENS CREEK BLVD 10 26 2006 PHONE: SANITARY NO, CONTROL NO. ARCHITECI'IENGIN£ER: BUILDING PERMIT INFO ' BLDG ELECT PLUMS MECH E-1 a o 0 o p LICENSED CONTRACTOR'S DECLARATION Job DeSCRpt10R U f= 1 hereby affirm that 1 am licensed under provisions of Chapter 9(commencing ' 2z� infull crceande or rsion3OftiheHusincssandProfossiansCadt,andmylicen5eis NEW COMMERCIAL SPACE/RESTAURANT in full fame and effect j z License Class Lic.# ,7 :FoDatc /a'—�x'so �c Contractor rCLIFORNIA PIZZA KITCHEN. ARCHITECTS DECLARATION yr j 5.7' Z C jj rCj X Q I understand my plans shall be used as public recnrds �Q. L,y Licensed Professional a„[ OWNER-BUILDER DECLARATION e N I hcrchy affirm that i am exempt from the Contractor's License Law for the L o O following mason.(Section 74171.5,Business and Professions Cade:Any city or county (z which requires a permit Eo construct alter,improve,demolish,or repair any structure z eprior to its issuance,also requires the applicant forsuch permiltn file asigned statement that he is licensed pursuant to the provisions of the Contractor's license Law(Chapter 9 Sq.Fit.Floor Area ValdEf71@ 0 0 0 (commencing with Secdon70W)ofDivision 3nftheBusincssnndPrOfcssionsCode)or y °9 that he is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of }p-+N{00 N ber Occupancy Type not more than five hundred dollars(8500). 3 G V3 . 00 ❑1,as owner of the property,or my employees with wages as their sole eompensaden, will do flinwork,and the suucture is not intended or offemil for sala(Sec.7044,Business Required cations and Professions Code:The Cortuactor's License Law does not apply to an owner of Ll p property who builds or improves thereon.and who does such work himself or through his own employees,provided that such improvements aft not intended oroffered for sale,if, however;The building or improvement is sold within one year of completion,the owner. builder will have the burden Of proving that he did not build or improve for purpose of sale,)• ❑l as owner of the property,am exclusively contracting with licensed contractors ED Construct the project(Sec.7044,Business and Professions Code:)The Contractor's Li- cense Law dors not apply to an owner of property who builds or improves thereon,and who contracts for such projects with a contractors)lieeased pursuant to the Contractor's License Law. ❑lam eaemptunder Sec. B&P C for this mason Owner Date WORKER'S COMPENSA71ON DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑I hate and will maintain a Ccruificatc or Consent to self-insumfor WorkcesCompen- Satien,as provided for by Section 3700 of the Labor Code,ror the performance of the work for which this permit is issued. ❑I have and will maintain Worker's Compensation Insurance,as required by Section 37W orthe Labor Code,far the performance of the work Carwhich chis permit rs issued. My Worker's Comgedsatian In once canter and Pelicya Carrier. ]icy No.;•'7 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE CThis section need not be completed if 011e permit is for one hundred dollars($1()0) or less.) I Certify L%at in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Workcrs'Compensation Laws or California.Elate Applicant NOTICE TO APPLICANT:If.aper making this Ccniti.,i of Exemption,you should became subject m the Worker's Compensation provisions of the Lahcr Code,you most Q forthwith comply with such provisions or this permit shall bc deemed revoked. CONSTRUCTION LENDING AGENCY [—[a I hcrchy affirm that there is a constmclinn lending agency for the performanc2 of ai On work Car which this permit is isnucd(Scc.3047,Civ.C) Lr]A Lender's Name Z Lender's Address U 0 I certify that 1 have read this application and state that Ella above infOnmadon is Lt, �^' correct I agree to comply with all city and county Ordinances and state laws relating to O building consuuctien,and hereby aulhorire mprrscnlativcs Of this city to enter upnn the above-mentioned property far inspection purposes. F �Wc)agree to save,indemnify and keep harmlrss the City of Cupertino against, w--[to liabilid s,' dgments,costs andec�p nseswhichmay inanyway accrue agains[saidCity (},Z Inco venae OfthegrarLdng'C spermit. r �y b-' APP (4T UNDERSTAN- ND WILL COMPLY WITH ALL HON-PO Issued by: Date so IGV .�rlolvs. Re-roofs Sig tore fApplicanUConlractar ❑le HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will the applicant er future building Occupant store or handle hazardous material as defined by the Cuperlino�cipal Cock,Chapter 9.12,and the Health and Safety Cede,ElYen25532(a)? All roofs shall be inspected prior to any roofing material being installed. El Yes // No Will the applicant dr future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove MR h7dous air contaminants as defined by the Bay Amit Air Qnality Management all new materials for inspection. District? t ❑ Yesu Ikvctend the hamrdu sED to Ern iremcatsunderChaprerG.95oftheCalifor- Din Health&SafetyCode,Scctions 25505,255 .d2l5534.f undcrsmnd thatif the building deer t c nlfy hath a henartC the[' is msponsibilfty[o notify the peau t of _ requi cn s wn`ch must be met pr x w't o is G{ifica�c of Occu an eY.fi�` �Up y b Signature of Applicant Date All roof coverings to be Class "B" or better Owner or authorind agent Dat City of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 CITY OF TeIephone: (408)777-3228 1 ti CU P E I N O FAX: (408)777-3333 �� BUILDING DEPARTMENT OFFICIAL NOTIFICATION OF NEW ADDRESS ASSIGNMENT TO: All Agencies FROM: City of Cupertino DATE: November 09,2006 RE: Address assignment Please note the following address assignment. Parcel 316-20-082(Vallco) is adding two new restaurants. The new addresses are 19621 (California Pizza Kitchen) and 19623 (Islands Fine Burger &Drinks)Stevens Creek Blvd.,Cupertino,CA 95014. Please update your records accordingly. The new address will take effect thirty days from the date of this letter. If you have any questions, please call me at (408) 777-3246. Sincerely, Susan Winslow Administrative clerk Printed on Recycled Paper ed N r xal N 5� E2CO-4 + M m "' O x'1 � a d � +• F,; -� �� fl m o m d ]CPI)i c in Wbd} I � a �' -IAV nVINVI n W I a a� ti nl m h� J g � •� a ^lG �� n In �a\ .•��PaNrL,77 SMI F'g�a: Q' 4 �a m ~ - V _ Z b FJ xl �A Qi ciW m BL'av ... . w J r .Z J +� N .I SfL011 r7 O: ' Z u • ------ lCLI l m n d' rr a.•rr .� ,�[ 9 ri • w ra � .s • .'J "[ �a' '� r��" .•six � en•ra e.,n �� YL7ri£ avow "-� 33-IOM .N N O W- Mal - I F£Fal tt'Li2 y • xx rsv ` 0 cn LS ile LLA a n� Dari 9 c n a� w cu. te ur aU Wa `�+1 e^d• yy`a1 � �aF Y �� e•- !.` f \ C'l I MN W W 8't q R p N 11 I C /"1 aIQ 1 I 99 C9� l-`[,,s'i oi, enea: ... .._ aa•=w .�7 W _ OW ii o � N ��d e• N n m� m � a 9i as e5 U 6 py fj it '� C1'[IS[ 9 oeY O N `S 3AV w—IVIHOd 'N :,t v `� sem\` N JUL-17-2006 10:00 STDR ARCHITECTS INC. 714 444 3160 P.09/12 FROM :Fancher Development Services FAX NO. :7142582401 Jul. 17 2006 09:56AM P9 07/1112008 12:06 FAX 408 77'7 2200 CITY CUPERTINO IM 007/091 ReToinin8 curb 11 necessor/ >�!�ramp tQ be Musa 6"kETRxN7iN6G'uAB YP'NEtieS3AItY with glut r 'AA - 5' -I� 6„ 6°GVRg 12" SPC77GN A r AA r A BORDER,CiP,00VeS {~NOTE. IF SIDEWALK 25 LE55 THAN 5', FULf,W10TH QF 51"hFWALK SHALL 6, as UEPAE�;aEa. A 76 GRTr R sPncdc RAMP A - W MONOLITHIC SIDEWALK � t F-- qT,DISI. J;ASE LSI I 1�°�ORi}EiR&A5 IMWALIF WAWJZMG sUOFact $"cUag 9 ' M1TAL;1N5ftTrvaa.erNAVMA1t . . ■. , I 2'aUTTEP �' •: �,.� r HfC romp to be °�' fler�h with Rutter 7 Sly' 8.339E 3ECriON f3-B 13 RAMP R - DETACHED 51DEWALK OR 10' MONOLITHIC STDEWAL9 NM TRAMP TO BE MDUMUM 4°P,C.C,ON 3°CLASS 2. W26ATE PASS WM I4FAVY BAOCIM FZNTSI4 T'RANSV&SE To AXT5 OF AAMP. z. CURB RAMPS TO 92 PLACED MCN=THiCAW WITH CUP&,GUTTER A SMEWALK 3. "0 RAMPS SMALL HAVE bM(7TAAl e WARNTN&$f.1RFACE THATEmmb.S'rHE RXL WlbTH Arab 5 FEEt DEPTH OF THE M&RAMP.13ETECTA OLE WARN174 SUAFAa SHALL CONFORM TO THE(DETAILS ON THIS PLAN USE METAL.INSERT PANEL YELLOW,BY NAVIPLATE 02 ern APPROVED EQUAL. INETALL PER MANUFACTURERS SPECIFICATSDhl, 4. THE ED6E OF INF DETWAOLE WARNR40 SURFACE NEARE5T THE STREET 5HALL BE BETWEEN 6"AND all FROM Tf4E GUTTER FL(7W1.IN2 5. CURB RAMP INSTALLA17ON$WILL COMPLY W$TH CALTRANS STAND RO PLAN ASEA,IF YIELD CON]ITTONS L p2o.„ HANDICAP RAMP DETAIL'S y CITY OF G'IUPSRT Q ]YEx `' ' , .�; ,- ?a STA Gift'Engineer ARD DETAU ' `��:�"'�'