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14060205CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10201 TORRE AVE
CONTRACTOR: DPR CONSTRUCTION, A
PERMIT NO: 14060205
GENERAL
OWNER'S NAME: I & G DIRECT REAL ESTATE 21 LP
1450 VETERANS BLVD
DATE ISSUED: 08/05/2014
OWNER'S PRONE: 6505924033
REDWOOD CITY, CA 94063
PHONE NO: (650)474-1450
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
LAB 26- COMM. T.I TO IST AND 2ND FLOOR (3375 SQ
r�
License Class 1 .J Lic. #
FT).
i
Contractor �ii(�� ���j I�i7U�r31� Date
I 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.
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
Sq. Ft Floor Area:
Valuation: $150000
performance of the work for which this permit is issued.
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
APN Number: 36941005.00
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 YS 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 M LAST CALLED INSPE PON.
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
Issued by: Date:
with all n- int source regulations per the Cupertino Municipal Code, Section
218.
k_�V
RE -ROOFS:
Signature4.fDate /
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, 1 agree to remove all new materials for
inspection.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
I 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
I, 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)
1, 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. 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 b the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance wi a Cupertino Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, S ctio s 25505, N533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: a 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
Compensation laws of California. If, after making this certificate of exemption, 1
CONSTRUCTION LEN'DIN'G 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
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
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10201 TORRE AVE
CONTRACTOR: DPR CONSTRUCTION, A
PERMIT NO: 14060205
GENERAL
OWNER'S NAME: t & G DIRECT REAL ESTATE 21 LP
1450 VETERANS BLVD
DATE ISSUED: 08/05/2014
OWNER'S PHONE: 6505924033
REDWOOD CITY, CA 94063
PHONE NO: (650)474-1450
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL 0
License Class J of Lic. �� %�'7
LAB 26 -COMM. T.I TO 1ST AND 2ND FLOOR (3375 SQ
FT).
Contractor$_ r L�t Date l0 / /
8/28/2014 -REVISION #I- REVISE IST & 2ND FLOOR
I hereby affirm that I am licensed under the provisions of Chapter 9
PARTITION LA�'OU AND INSTALL EQUIPMENT FOR
(commencing with Section 7000) of Division 3 of the Business & Professions
MACH O ND LAB- ISST 10/14/2014
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
Sq. Ft Floor Area:
Valuation: $150000
performance of the work for which this permit is issued.
1 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
APN Number: 36941005.00
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 1 AYS OF P RMIT 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 OM LAST CALLED INSPECTIO .
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
Issued by: Date: f
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
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.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
[ 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 [he structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
1, 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. 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(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should 1 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, Sections 25505, 25533, and 25534.
Q
Owner or authorized agent: Date: l `i J
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
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
APPLICANT CERTIFICA"TION
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 ail non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
ia
ADDRESS: 10201 TORRE AVE
DATE: 0912612014
REVIEWED BY: MELISSA
APN: 369 41 005
BP#: 14060205
*VALUATION: Iso
}PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY Commercial Building
USE:
Suppl. PC Fee: (F) Reg. Q OT
PENTAMATION
PERMIT TYPE:
WORK
9/26/14 - REV # 2 -ADD ADDITIONAL OUTLET RECEPTACLES AT VARIOUS LOCATIONS &
SCOPE
REMOVE (E) LIGHTING FIXTURES
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These Pees are based on the preliminary information available and are only an estimate- Contact the Dept for addn 7 info.
FEE ITEMS (Fee Resolulion 11-053 Eff 711%73)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Id
Suppl. PC Fee: (F) Reg. Q OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
<?iruslr�litic F." r,.
0
Work Without Permit? 0 Yes No
$0.000
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
O
i
lrwvl F(Y.5
Strong Motion Fee:
$0.00
1 #
$859.00
Revisions
/REVCO:WTI I Tenant Improvement
Bldg Stds Commission Fee:
$0.00
SUBTOTALS:
$0.00
$859.00
TOTAL FSE,
$859.00
Revised: 08/20/2014
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10201 TORRE AVE
CONTRACTOR: DPR CONSTRUCTION, A
PERMIT NO: 14060205
GENERAL
OWNER'S NAME: l & G DIRECT REAL ESTATE 21 LP
1450 VETERANS BLVD
DATE ISSUED: 08/05/2014
OWNER'S P14ON'E: 6505924033
REDWOOD CITY, CA 94063
PHONE NO: (650)474-1450
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL F]
License Class____ Lic. N
9/26/14 - REV N 2 - ADD ADDITIONAL OUTLET RECEPTACLES AT
Contractor DPlee6l, DateVARIOUS
LOCATIONS & REMOVE (E) LIGHTING FIXTURES- ISSD
10/14/2014
1 hereby affirm that I am licensed under the provisions of Cha er 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 the following declarations:
Ihave and will maintain a certificate of consent too Wo self -insure for Wor �YYV//
�-—
ON
Compensation, as provided for by Section 3700 of the Labor Code, fo
Sq. Ft Floor Area:
Valuation: $150000
performance of the work for which this permit is issued.
1 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
APN Number: 36941005.00
Occupant}' Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRE ORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 YS OF ERMIT 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 FRO CALLED 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
/ Z,
granting of this permit. Additionally, the applicant understands and will comply
Issued by: Date:
with all non -point source regulations per the Cupertino Municipal Code, Section
RE -ROOFS:
9.18.
/
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.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
I 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
t, 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)
1. 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. 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(a) should 1 store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should 1 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
the Health & Safety Code, Sections 25505, W5533,4nd 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Dater'��///
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
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
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 constriction, 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 die
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 DIVISIO
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildingna,cupertino.org
❑ NEW CONSTRUCTION d ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT 4-WO(DOWS
PROJECT .ADDRESS 0
7.0 1.�-0r00e
APN d 36� (�/ r 005
OWN NAME r Q PHONE
E-MAIL
ton
STREET ADDRESS
02.01 To•r0. Ave--*_
CITY, ATE, ZIP Q �bl
taper+?%o CA -1 4
FAX
CONTACT NAOL,�•
P ON n
E-MAIL
IAIDIK -°nez..
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONT ACTOR NAME
'E
LICENSE NU E
�`�
LIC 'S T PE
J fD
BUS. LIC b
t e robr:t,
gvo
COMPANY NAME
t Cr o�'1t�Cri ri4
E -? JAIL
Mt+ r44 -e. Z' GI Cor -el E C.ir. c.
FAX
STREET R SS
`' eta o�230, } S#r4A+
CI TATE, ZIP
- aL C�d�� A q sora
PHO
09"886 .--?Wd
ARCHITECT/ENGMIEER NAME
LICENSE NUMBER
BUS. LIC N
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK / J � .
dd : &- qd � + in L J d w eer 44 j/1<Zi �i •�� % � Gc�C�'i a hS.
EXISTING USE
PROPOSED USE / CONSTR
TYPE
11 STORIES
a-Ef E1�6
USE
TYPE
OCC,
SQ.FT.
VALUATION (S)
EXISTG NEW FLOOR
DEMO
TOTAL
AREA AREA
AREA
NET ARL -A
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA TOTAL DECK/PORCH AREA
DETACH
GARAGE AREA: DETACH
'E
❑ ATTACH
IS A SECOND UNrr ❑ YES
SECOND STORY [:]YES
777��
BEING ADDED? ❑NO
ADDITION.'
FRE-APPLICATION ❑YES IF YES, PROVIDE COPY OF
IS THE BLDG AN
RECEIV Y: TOTAL VALUA N:
PLANNING APPL R ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME?
By my signature below, I certify to each of the following: I am the property owner or arize o e property owner's behalf. I have ad this
application and the information I have provided is correct. I have read the Descriptio or and verifFlflis accurate. I agree to comply with all applicable local
ordinances and state laws relating"b 'Iding construction. I auth5paSrepreSentatives of Cupertino to enter the above -identified property for inspection purposes,
Signature of Applicant/Agent: Date: Q / Z t A f'4
SUPPLEMENTAL INFORMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
❑ OVER -TILE -COUNTER
❑ BUILDING PLAN REVIEW
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.
❑ EXPRE'SS
❑ PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
TANDARD
El PUBLICWORKS
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
❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL ITEALTH
BldgApp_201 1. doe revised 06/21/11
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISIONUZ
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTlNO (408) 777-3228 • FAX (408) 777-3333 • building aDcupertino.orq
❑ NEW CONSTRUCTION ❑ ADDITION Eff ALTERATION / T1 ❑ REVISION / DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS 1 D 2 Q ! I V gf p bJQtV'F 7W
" � f, APN d 21 jl_ � 1H UUS
t
OWNERNAME WLJ0 pM orrr R� F—SSTP4
PHONE 6 5Q, Q 4' 033
El -MAIL
STREETADDRESS 26FO j WIN VV41Pb WAY CITY, STATE ZIP SA -N MTA-r&o ' r` FAX
�9ArH �
CONTACT NAME SN47'1 DESK PA -NDS PHONE 6 50, (V,215.41
V,2 5 'G'1 V �@ i
S� n rioraro
STREET ADDRESS G'LY'D� E SVi Zf�
�5
CITY, STATE, ZIP M JHN1 VI j CA 0i 3
F.AX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT 'ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME IMJ;,t VNJSM
LICENSE NUNIBER -7
LICENSETYPE
BUS, LIC
COMPANY NAME t)FK 11 � U�O tNC
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP r,/ L
fj7`1 Cf J�
PHONE
ARCHITECTIENGINEER NAME A L JQ Rival
LICENSE NUMBER
BUS. LIC H
COMPANY NAME rNT (� �!� + r 'u�� 1)4C
Ih
E-MAIL
FAX
STREET ADDRESS O 0 .SA -M SoM E2 STS g �1 r—Lk
CITY, STATE, ZIP SAN -P / ( 5ZO , CA
PHONE
rr r
DESCRIPTION OF WORK
jNGLVD(N(5 Ste, R_C Tt YF_ p_F fGlo L177oN , Pit-R7"ardN l.�GTK141 LS I l-IIJL+�' F/N f SK
Pf,a1 LIF*� STY .
EXI.STJNG USEpp��
E)UG14CSS 0
PROPOSED USE CONST TYPE
Ej(,ISI/1iSS 11 A
?STORIES
a
USE
TYPE
OCC. SQ.FT.
VALUATION (S)
EXISTG r}p
AREA 84�33.5
NEW FLOOR
AREA
DEMO
AREA
TOTAL
NET AREA
3.31 S
BATHROOMKITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
y
❑ ATTACH
-%-ES
LING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY
....
rPRE-APPLICATIONT
BEING ADDED? []NO
ADDITION?^ []NO
❑ YES IF YES, PROVIDE COPY of
IS THE BLDG AN ❑ YES
G : >
- TOT,�L /.ALUATION:
NG APPL b ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME!,' ❑ NO
.. fi
1 rD Q Q
By my signature below, I certify to each of the fol lowing: I am the property owner or authorized agentact on the property om is behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify Itis -accurate. I agree to mply with all applicable local
ordinances and state laws relating to buildi con trUctlOn I authorize representatives Of Cupertino to enter the above©ntlprro f r inspection purposes.
3
Signature of Applicant/Agent: ' Date: (f0
SUPPLEMENTAL INFORMA ION REQUIRED
PLA.NCHECKTYPE
ROUTLNcsLEP
[, ovER-Txr<covxTER
❑ BUILDING PLAN REV7sw
New SFD or Multifamily dNvellines: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
[ F. I ..r.as
❑ PLANNING PLANREVIEN
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
s1 STANDA11a)
❑ uBi to «�oRxs
_
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 tor
❑
.
submittal of Building Permit application.
��ajnt`
.
SAiI1AR\ cEwER;>isTRICT
;-J' ENVIRONMENTAL HEALTH
B1dgApp 2011.doc revised 06/21/11
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
r
ig'
SS: 10201 TORRE AVE
FAN
DATE: 06/30/2014
REVIEWED BY: MENDEZ
PC FEE ID
BP FEES
BP#:
VALUATION: $150,000
YPERMIT TYPE: Building PermitPLAN
CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
IBTIPLNCK
PENTAMATION 1 B TI
PERMIT TYPE: A
WORK
COMM. T.I TO 1 ST AIVD 2ND FLOOR 3375 SQFT
SCOPE
$0.00
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.L
PC FEES
PC FEE ID
BP FEES
BP FEE ID
B (Tenant Improvements)
II-B,III-B,IV,V-B
3,375
$2,322.04
IBTIPLNCK
$2,855.36
1BTIINSP
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,855.36
Suppl. Insp. Fee:Q Reg. 0 OT
F0.0
hrs
$0.00
PME Unit Fee:
$0.00
TOTALS:
3,375
$2,322.04
$0.00
$2,855.36
MECH, HOURLY ()Yes E) No
PLUMB, HOURLY 0 Yes 0 No
ELEC, HOURLY 0 Yes 0 No
QTY/FEE
E3_L_
it C
F-71
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn 7 info.
FEE ITEMS (Fee Resolution 11-053 Eff' 7il'13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,322.04
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. 0 OT0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$2,855.36
Suppl. Insp. Fee:Q Reg. 0 OT
F0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Conslrl'ction
ialttif�r,ir;�ti.,., i•r
G
Work Without Permit? 0 Yes 0 No
$0.00
Advanced Plarmin Fee:
$0.00
Select a Non -Residential
Building or Structure
E)
0
A
Strong Motion Fee:
1BSEISMIC0
$31.50
Select an Administrative Item
1
Bldg Stds Commission Fee: IBCBSC
$6.001
SUBTOTALS:
$5,214.90
$0.00
TOTAL FEE:
$5,214.90
Revised: 04/01/2014
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildinq aacupertino.orq w&)W5'
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI t'F REVISION / DEFERRED ORIGINAL PERMIT t1
PROJECT ADDRESS Q�/ l Are—
' C. �(Y e
APN N
OWNERNAME 6 P jn �, j�28q
`J (�
E-MAIL
STREET ADDRESS ,
CITY, STATE, ZIP
FAX
CONTACT NAME ��
PHONE 7v�
E -MAI
STREET ADDRESS
CITY: STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNB.R AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME ^M
LICENSE NUMBER
LICENSETYPE
BUS. LIC k�
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC N
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE)
DESCRIPTION OF WORK ��y,�j� I�J-"- O'�/l �'�/ •- / 1.(/l7(7
�� t �LU�/CC�nll f rB��I 7QJ j Ie141
EXISTING USE
PROPOSED USE CONSTR.
TYPE
0STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
ATTACH
4 DWELLING UNITS:
IS A SECOND UNIT [3 YES
SECOND STORY ❑ YES
BEING ADDED? C]NO
ADDITION? ❑ NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
.RbWVgp BY.; '"`s a -$.a'••
OTq��]�VALUATION:
PLANNING APPL R ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the grope is beh If. I have read this
application and the information I have provided is corr ct. 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 t ui di constru n. I authorize representatives of Cupertino to enter the above -i entified property for inspection purposes.
Signature of Applicant Agent: Date:
SUPPLEMENTAL TNIFOI&RtATION REQUIRED
PLAN CHECK TYPE
ROUTING SLIP
❑ OVER-THE-coUNTER
:TiBU LDING PLAN REVIEW
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.
❑ EXPRESS
❑ PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑ LARGE
❑ FIRE DE P7
Copy of Planning Approval Letter or Meeting with Planning prior to
❑ MAJOR
❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_201l.doc revised 0612////
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
NOTE: This estimate floes not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
Wwrirt. etr_ ). These fees are ha.ced an the nreliminary information ovailahle and are only an estimate_ Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E ' 7/1!13)
ADDRESS: 10201 torre ave
DATE: 08/28/2014
REVIEWED BY: MENDEZ
APN:
BP #:
`VALUATION: 1$50,000
PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
PENTAMATION
PERMIT TYPE: A
WORKrevision
#1- revise 1 & 2nd floor partitions, interior demo e ceiling, finishes..
SCOPE
PME Plan Check:
NOTE: This estimate floes not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
Wwrirt. etr_ ). These fees are ha.ced an the nreliminary information ovailahle and are only an estimate_ Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E ' 7/1!13)
FEE
QTYIFEE
MISC ITEMS
Plan Check Fee:
Ll I--
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
NOTE: This estimate floes not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
Wwrirt. etr_ ). These fees are ha.ced an the nreliminary information ovailahle and are only an estimate_ Contact the Dent for addn'1 info.
FEE ITEMS (Fee Resolution 11-053 E ' 7/1!13)
FEE
QTYIFEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: Q Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee:Q Reg. Q OTO
.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Ur�_1 (1LN.'il')n 1ti_i'.
E)
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
G
A
frn� i 1>rurr�nrttt 1riu�! /�,'s
Strong Motion Fee:
IRSEISMICO
$14.00
F-1-7 #
$859.00
Revisions
IREVCOMTI Tenant Improvement
Bldg* Stds Commission Fee: IRCRSC
$2.00
SUBTOTALS:
$16.00
$859.00
TOTAL FEE: 1
$875.00
Revised: 0812012014
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildino cu ertino.or
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT tt
PROJECT ADDRESS
APN H
2OY
OWNER NAME
PHONE
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP FAX
CONTACT ME NQ
PHONF� �` _ j /
E-MAIL 15 0
STREET ADDRESS
CITY, STATE ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWKER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
--7CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE
BUS. LIC 4
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER
BUS. LIC N
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK
EXISTING USE
PROPOSED USE CONSTR TYPE
I STORIES
USE
TYPE
OCC. SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DEMO TOTAL
AREA
AREA
AREA NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA TOTAL DECKIPORCH AREA=GARAGEREA:
DETACH
ATTACH
DWELLR4G UNRTS:
IS A SECOND UNIT ❑ YES
SECOND STORY YES
BEING ADDED? E] No
ADDITION? E]NO
PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED $Yc= TOTAL j;ALUATION:
PLAN'N7NG APPL k DNO PLANNING APPROVAL LETTER EICHLER HOME? E] NO /
By my signature below, I certify to each of the followingI am the property owner or authorized agent to act onrcperry owner's behalf. I have read,this
application and the information 1 have pr ided is correct. 1 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 b di gcoristftieVn. I authorize representatives of Cupertino to enter the above-Ide tlfied pro erty for inspection purposes
Signature of Applicant/Agent Date:
SUPPLE -NITAL INFORMATION R-QUIRED
PLAN CHECK TYPE
ROUTING SLIP
0 o,'Ea T fR-CoaNTER
L4-"Il1711—DING PJ AN REVIEW
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.
❑ EXPRESS
-❑- PLANNING PLAN RLYILW.-? -
_ Commercial Bldas: Provide a completed Hazardous Materials Disclosure
❑ STANDARD
❑ 'PueitCWORKS
form if any Hazardous Materials are being used as part of this project.
❑.,
IRIRE
LARGE I
DEPT'
_ Copy Of Planning Approval Letter or Meeting with Planning prior to
❑ > IA.JOR
'
❑ SANITARY SEWER I)ISTIt]eT
submittal of Building Permit application.
' ❑,.ENVIRONMENTAL HEALTH -
BldgApp_2011.doc revised 06/21/11
CITY OF CUPERTINO
FM ---,7 FEE ESTIMATOR - BUILDING DIVISION
ig
ADDRESS: 10201 torre ave
FLR AREA
s.f.
DATE: 1212212014
REVIEWED BY: Mendez
BP FEES
APN:
BP#:
II-B,III-B,IV,V-B
"VALUATION: Iso
`PERMIT TYPE: Building Permit
Select a Misc Bldg/Structure
or Element of a Building
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE.
0.0
PENTAMATION 1A TI
PERMIT TYPE:
WORK revision #4- as built set of drawing
for fire approval.
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
PC FEE ID
BP FEES
BP FEE ID
A (Tenant Improvements)
II-B,III-B,IV,V-B
0
$0.00
Select a Misc Bldg/Structure
or Element of a Building
$0.00
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -.0 Reg.
Q OT
0.0
hrs
$0.00
PME Unit Fee:
TOTALS:
0
$0.00
$0.00
MECH, HOURLY 0 Yes (D No
PLUMB, HOURLY Q Yes Q No
ELEC, HOURLY Q Yes Q No
QTY/FEE
MISC ITEMS
Plan Check Fee:
F)Iher l'lurnfl lrn"jLl
$0.00
Select a Misc Bldg/Structure
or Element of a Building
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc.). These fees are based on the preliminary information available and are only an estimate Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Ef. 71
!l!l3)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 0 Reg. 0 OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Fee -.0 Reg.
Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
'011.1"OWC-tiW7 1 CLf.
A(lalillistrative 1"C"c;
0
E)
Work Without Permit? 0 Yes (j) No
$0.00
Advanced Planning, Fee:
$0.00
Select a Non -Residential
Building or Structure
0
A
Strong Motion Fee_
$0.00
1 #
$859.00
Revisions
1REVC0jVT1 Tenant Improvement
Bldg Stds Commission Fee:
$0.00
SUBTOTALS:
$0.00
$859.00
TOTAL FEE:
F $859.00
Revised: 10/01/2014