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14030087CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20807 STEVENS CREEK BLVD STE 100 CONTRACTOR: SILICON X PERMIT NO: 14030087 CONSTRUCTION INC OWNER'S NAME: STEVENS CREEK RETAIL ASSOCIATES LLC 2051 JUNCTION AVE DATE ISSUED: 07/22/2014 OWNER'S PHONE: 4084180099 SAN JOSE, CA 95131 PHONE NO: (408) 418-0099 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E]COMMERCIAL ❑ �� c�- PANERA BREAD - SITE IMPROVEMENTS, INCLUDING License Class Lic. # ACCESSIBLE PATH, TRUNCATED DOMES, STRIPING & ; �� o,✓S " Z�� t y SIGNAGE TO CONNECT PARKING TO ADJACENT Contracto r ttiwcn �IIate PARCEL 1 hereby affirm that I am licensed under 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. 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 Sq. Ft Floor Area: Valuation: $25000 er#ormance of the work for which this permit is issued. ave 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 APN Number: 32632051.100 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 DAYS FROM L, ED 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 Date: with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. y3 iLf RE -ROOFS: Signature `�� Date 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. ❑ OW. UILDER DECLARATION Signature of Applicant: Date: 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, as owner of the property, or my employees with wages as their sole compensation, 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 California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should 1 store or handle hazardous 1 have and will maintain a Certificate of Consent to self -insure for Worker's 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 1 have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agen : permit is issued. I certify that 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 Worker's Compensation laws of California. If, after making this certificate of exemption, 1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, l 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. 1 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION O� 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingQcupertino.Org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION /'1'1 ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECTADDRESS 20807 Stevens Creek i3lvd. ANN# 326-32-051 OWNERNAME Stevens Creek Retail Associates LLC E-MAIL HON Ym) ys3-3-6 36 1 PH')--'0m) AV STREETADDRESS / iCJS ��,�s { daeZf9,STATE, ZIP v� II qy�a Aa CONTACT NAME Tony Gonzalez, SjliconX Construction PHONE (408) 418-0099 E-:vtAIL tony@siliconxconstructlon.com STREE-T ADDRESS 2051 Junction Ave., Suite 100 CITY,STATE, zip, San Jose, CA 95131 —J FAX (408) 453-5636 ❑ OWhiR ❑ OR'NER-BUILDER ❑ OWNE•RAGENT ® CONTRACTOR ❑ CONTRACTOR AGENT 13 ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME Tony Gonzalez LICENSENUNIBER LICENSETYPE EUS. LIC# COMPANYNAME SiliconX Construction E-MAn, tong@siliconxconstruction.com FAx (408) 453-5636 STRF.ETADDRESS 2051 Junction Ave., Suite 100 CITY,STATE,ZIP San Jose, CA 95131 PHONE (408) 418-0099 ARCHITECTilINGINEERNAME Cedric Craig LICENSENUMBBR C-15490 DUS.LIC# COMPANYNAMF FCGA architecture EMAIL ric@fcgainc.com FAx (925) 820-5858 STRL'ETADDRESS 301 Hartz Ave., Suite 213 CITY,STATE,zIp Danville, CA 94526 PHONF (925) 820-7585 x103 DESCRIPTIONOFWORK Panera Bread - Site improvements, including accessible path, curb ramp, curbs, paving, pavement markings, underground transformer, landscaping and irrigation. EXISTINGUSE PROPOSEDUSE CONSTRTSPE #STORIES Restaurant N/A N/A I USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA N/A DEMO AREA TOTAL NETAREA N/A Restaurant N/A N/A N/A $25,000 BATHROOM IQTCHEN OTHER REMODEL AREA REMODEL AREA REMODELAREA PORCEAREA DECKAREA TOTALDEMPORCH AREA GARAGiiAREA: ❑DETACH I I 11 ❑ ATTACH #DWELLtNGUNTTS: ISASECOND VNTr ❑YES SECONDSTORY El YES BEINGADDED? NO ADDITION? []NO PRE -APPLICATION ®ITS IF YES, PROVIDE COPY OF ISTHEBLDGAN []YES TOTAL VALUATION: PLANNINUAPPL# EI PLAA'NINGAPPROVAL LETTER EICHLERROMET ❑74� - $25,000 By my signature below, I certify to each of the followhng: I am the property oNwler or authorized agent to act on the property o«uer's behalf. I have read this application and the information I have Dray.1d0dIs correct. i have read the Description of Work and verify it is accurate. I agree to comply wilh all applicable local ident/ifi/ed/property inspection ordinances and state lawsrel uilding cofistruction. I tftilorize representatives ofCupertino to enter the above r purposes. Date: Signature of Applicant/Agent: SUPPLEMF,PTAL INFORMATION nQUIREDpl A tC.HECi{TSPE ` " sROIfrINGSLIP ❑ otiERTilEcotJnTEn {D DIJILDINGPL1,NREVIE{t -: New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0 EXPRESS _ C011lmercial Bldgs: Provide a completes! Hazardous Materials Disclosure ❑ STANDARD ❑ pUDL1C:N1 ORh5. � form if any Hazardous Materials are being used as part Of this project. ❑ LARGE l FIRE DEPT _ Copy of Planning Approval Letter or Meeting Nvith Planning prior to ❑ vtAaoRl SANETARI SES\ER DtSFIiIC( submittal of Building Permit application. . ' ❑ E,V%IIRONXiEN'T 1L HEALTH Bldgrlpp_2011.doc revised 06121/11 FM__7 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i e. Planning, Public Works, Fire, Sanitary Sewer District, School Dicirirtt etc-)- Thoco feoc are haced an the nreliminary infnrmatinn availahle and are only an estimate_ rantart the Dent for addn'l info_ FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) ADDRESS: 20807 STEVENS CREEK BLVD DATE: 03/14/2014 REVIEWED BY: MELISSA MISC ITEMS APN: 326 32 051 BP#: / � "VALUATION: 1$25,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Addition/ Repair PRIMARY Commercial Building USE: 0.0 PENTAMATION 1GENCOM PERMIT TYPE: WORK PANERA BREAD - SITE IMPROVEMENTS INCLUDING ACCESSIBLE PATH TRUNCATED SCOPE DOMES, STRIPING & SIGNAGE NOTE: This estimate does not include fees due to other Departments (i e. Planning, Public Works, Fire, Sanitary Sewer District, School Dicirirtt etc-)- Thoco feoc are haced an the nreliminary infnrmatinn availahle and are only an estimate_ rantart the Dent for addn'l info_ FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (D No $0.00 0 hours Plan Check, Hourly $417.00 1STPLNCK Suppl. PC Fee: (F) Reg. () OT 0.0 I hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? (),Yes Q No $0.00 Suppl. Insp. Fee:Q Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 G Work Without Permit? Yes (F) No $0.00 Advanced Planning Fee: $0.00 hours Inspections $139.00 1 STINSP Inspection, Hourly 0 Strong Motion Fee: 1BSEISMICo $5.25 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS: $6.25 $556.00 TOTAL FEE: $562.25 Revised: 01/15/2014 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 0 JOB ADDRESS: 61,1> PERMIT # -Z-Z/ — G OWNER'S NAME: SSS e+-! fiT50C, PHONE # Oe— I - f3 3 GENERAL CONTRACTOR: Tk-,-�BUSINESS LICENSE # ADDRESS:Q_r/ �fiii A,.t-s CITY/ZIPCODE: 57.j-. S/3 *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 OwnerACont ctor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical V/ Excavation Q,- lq- ` 5�2 Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping c 5 E Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile OwnerACont ctor Signature Date FOGA 1. ui 11 WON O IBM 414i", WIN ONION WON ------- — ------ M. runnimmanch ..... ...... 0. ..... Hill 1 M! wammuman ME— M. SHOPS usng 6 ..... I ilil"M RESTAURANT DEMISING ........ . . U.—L! 1. 1 - * "MM!; ... Ing ---------- ---- ------ .......... .. . .... .... u Mir -MOR. ---- 17--- SAI fil I A 10 14