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14010106CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10990 N STELLING RD CONTRACTOR: ELK GROVE BUILDERS PERMIT NO: 14010106 INC OWNER'S NAME: FRANCHISE REALTY INTERSTATE CORPORA 9918 KENT ST STE 1 DATE ISSUED: 01/16/2014 OWNER'S PHONE: 6505757264 ELK GROVE, CA 95624 PHONE NO: (916) 685-1100 JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ LICENSED CONTRACTOR'/`S DECLARATION License Class_ Lic. # '�7 (�=J�Y MCDONALDS- PORTION OF ADDITION OF ADA Contracto(lj 1f'bate , PEDESTRIAN WALKWAY I hereby affirm that I am licensed under the provisions of C apter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 1 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 performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $16000 1 have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32609051.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this 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 180 DAYS AST CALLED INSPECTION. upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, accrue against said City in consequence of the costs, and expenses which may Issued by: Date: granting of this pe Additionally, the applicant understands and will comply with all non-poi so rce regulations per the Cupertino Municipal Code, Section 9.18. r Date RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is Signature installed without first obtaining an inspection, I agree to remove all new materials for inspection. DECLARATION ❑ OWNER-BUILDiR Signature of Applicant: Date: 1 hereby affirm that 1 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) property, rty, am exclusive) contracting with licensed contractors to I, as owner of the roe y g 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. I 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(x) should 1 store or handle hazardous I 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 will maintain compliance with the Cu rtino M icipal Code, Chapter 9.12 and performance of the work for which this permit is issued. I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2 505, 25 , an 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: permit is issued. 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 CONSTRUCTION/ ENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I 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 APPLICANT CERTIFICATION Lender's Address 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 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 MGDrr-/<i t CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION f ,\ 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 U\ (408) 777-3228 • FAX (408) 777-3333 • building(a-)cupertino.org \ F1 NEW CONSTRUCTION ❑ ADDITION 1X I ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10990 N. Stelling Road, Cupertino, CA 95014 APN # 326-09-051 OWNERNAME McDonald's Corporation PHONE 650-575-7264 E-MAIL margaret.trujillo@us.mcd.com STREET ADDRESS 2999 Oak Rd. Suite 900 CITY, STATE, ZIP Walnut Creek, CA 95497 FAX 925-407-2793 CONTACT NAME Stantec Architectural Inc. / Hala Ibrahim PHONE (707) 774-8315 E-MAILhala.ibrahim@stantec.com STREET ADDRESS 1383 N. McDowell Blvd., Suite 250 CITY, STATE, ZIP Petaluma, CA 94945 FAX (707) 765-9908 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT if ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Elk Grove Builders Inc LICENSENUMBER 456304 LICENSE TYPE B BUS. LIC# 34062 COMPANY NAME Elk Grove Builders Inc. E-MAIL kate@elkgrovebuilders.com FAX (916) 785 1168 STREETADDRESS 9918 Kent Street , Suite 1 CITY, STATE, zip Elk Grove, CA 95624 PHONE (916) 685 1100 ARCHITECT/ENGINEER NAME Gary Semling LICENSE NUMBER C-21541 BUS. LIC # 30639 COMPANY NAME Stantec Architecture Inc. E-MAIL hala.ibrahim@stantec.com FAX (707) 765-9908 STREET ADDRESS 1383 N. McDowell Blvd.., Suite 250 CITY, STATE, ZIP Petaluma, CA 94945 PHONE (707) 774-8315 DESCRIPTION OF WORK Portion of Addition of ADA pedestrian walkway on APN 326-09-051 EXISTING USE Retail Center PROPOSED USE CONSTR. Remain TYPE I # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM REMODEL AREA KITCHEN REMODEL AREA OTHER REMODEL AREA PORCH AREA N/A DECK AREA N/A TOTAL DECK/PORCH AREA N/A GARAGE AREA: DETACH N/A ❑ ATTACH # DWELLING UNITS: N/A IS A SECOND UNIT ❑ YES BEING ADDED? []NO SECOND STORY ❑YES ADDITION? ONO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? ® NO RECEIVED BY: TOT L VA U TION: l By my signature below, I certify to each of the following: I am the property owner or authorized agent to ac owner's behalf. I have read this application and the information I have provided is correct. I have read Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to oon. I au ze repres ntatives of Cupertino to enter the above -i entif ed property for inspection purposes. Signature of Applicant/Agent: /�buildi+� - nstructi`� Date: (Z�3 1 3 SUPPLEMENTAL INFORMATION REQUIRED _ 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. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ EXPRESS ❑ STANDARD ❑ LARGE ❑ MAJOR ❑ BUILDING PLAN REVIEW ❑ PLANNING PLAN REVIEW ❑ PUBLIC WORKS ❑ FIRE DEPT ❑ SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doc revised 06/21/11 ��,,,,���,����,,,�,�,,��,, CITY OF CUPERTINO Fw—x-lJl TPI Ti. FCTIMATOR — RITILDING DIVISION LEIADDRESS: 10990 n stelling blvd DATE: 01/16/2014 REVIEWED BY: Mendez Mech. P. APN: BP#: D 010 `VALUATION: $16,000 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building /'himh. b/w. Fee: PENTAMATION PERMIT TYPE: USE: PME Plan Check: $0.00 WORK Mc Donalds- portion of addition of ada pedestrian walkway $0.00 Suppl. Insp. Fee -0 Reg. Q OT SCOPE 1 hrs NOTE: This estimate does not include fees due to other Departments (Ge. Planning, Punuc works, rtre, aamrarynewer U,J,r,cy acnuv, ava;lahle and are anly all estimate. Contact the Dept for addn'l info. ULJlrlc[, CIC: /„CJC CCJ u,c VUJcu v.s s•.c •......»..... ... ... ........... �. �..—_-- ------ are FEE ITEMS (Fee Resolution 11-053 U' 7if 1/13) Xlech. Plan Check !'hush. Plan C'he(,ti Elec. Plan Check Mech. P. Plumh. Permit Fee: Elec. Permit Fee: Other Mech. Insp. ')cher Plumb Insp.ET )cher Elec. Insp. Suppl. PC Fee: Q Reg. Q OT /'himh. b/w. Fee: 0 ( Insp. Fcx NOTE: This estimate does not include fees due to other Departments (Ge. Planning, Punuc works, rtre, aamrarynewer U,J,r,cy acnuv, ava;lahle and are anly all estimate. Contact the Dept for addn'l info. ULJlrlc[, CIC: /„CJC CCJ u,c VUJcu v.s s•.c •......»..... ... ... ........... �. �..—_-- ------ are FEE ITEMS (Fee Resolution 11-053 U' 7if 1/13) FEE QTY/FEE ---- MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: Q Reg. Q OT F-01hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? © Yes Q No $0.00 Suppl. Insp. Fee -0 Reg. Q OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Titr: Administrative Fee: E) Work Without Permit? Yes E) No $0.00 Advanced Planning, Fee: $0.00 Select a Non -Residential Building or Structure 0 A Travel Documentation Fees: Strong Motion Fee: 1BSEISMICo $3.36 2.0 hrs $278.00 Inspections ISTINSP 7 Inspection, Hourly Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $4.36 $278.00 TOTAL FEE: $282.36 Revised: 01/15/2014 July 3, 2014 ELK GROVE BUILDERS, INC. Don L. Edelberg -0- General Contractor's Lic#: 456304 Patricia Garcia Building Department, City of Cupertino 10300 Torre Ave. Cupoertino, CA 95014 408.777.3228 patriciag@cupertino.org Re: Request for Building permit extention @ 10990 N. Stelling Rd. / Building Permit Application # 14010106 Dear Patricia, We will be able to slurry and line stripe until the ADA ramp (PERMIT APP # 14010105) is completed in the same shopping center. Sincerely, v lam' Kate Arroyo Estimator 9918 Kent Street, Ste #1 *Elk Grove, CA 95624 ♦Office (916) 685-1100 Fax (916) 685-1168