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14080068 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19200 STEVENS CREEK BLVD CONTRACTOR:GIDEL AND KOCAL PERMIT NO: 14080068 OWNER'S NAME: CYPRESS BUILDING ASSOC ET AL 574 DIVISION ST DATE ISSUED:08/11/2014 OWNER'S PHONE: 6504248383 CAMPBELL,CA 95008 PHONE NO:(408)370-0287 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ryJAMF SUITE 130-T.I. TO RECONFIGURE OFFICE AREA License Class_ Lic.# gC-S05D INCLUDING M.E.P.'S, DEMISING WALLS&ABOVE T-BAR Conte• Contractor LOL� ,*AnMJ Co, Date 0 1 I N 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. 1 hereby affirm under penalty of perjury one of the following two declarations: 1 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:$141918 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 APN Number:37506005.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.1 agree to comply with all city and county ordinances and state laws relating WITHIN 18 OF PE T 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 VI L ALLED 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 6th granting of this permit. Additionally,the applicant understands and will com ue y: Date: with all non-point source regulations per the Cupertino Municipal Code,Sec ion 9.18. RE-ROOFS: Signature �. Date 11 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. F1OWNER-BU R 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 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). 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will 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 1 have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sectio 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Owner or authorized agen Date: I certify that in the performance of the work for which this permit is issued,1 shall 0 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,1 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 I 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the 1 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 b� CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333• buildindCa p cu ertino.ora CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION 0 ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS APN# 375-06-005 19200 Stevens Creek,#130, Cupertino CA 95014 OwNERNAMECypress Properties pert es fSOe. PHONE 650-424-8383 E-MAILtim@cypressproperties.com STREET ADDRESS CITY, STATE ZIP FAX 2191 E. Bayshore Rd. #220 Palo Alto, CA 94303 650-424-8226 CONTACT NAME Lilian Ramey PHONE 408-370-0280 E-MAIL lramey@gidelkocal.co STREETADDRESS 574 Division Street CITY,STATE, zip Campbe11, CA 95008 FAx 408-370-0335 f ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT IR CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Dave Baird LICENSE NUMBER,03050 LICENSE TYPE BUS.LIC#2 8 7 9 0 coMPA Gide & Kocal Construction, Inc. EMIL 4dbaird@gidelkocal.comB FAX 408-370-0335 STREET ADDRESS 574 Division Street CITY,STATE,ZIP Campbell, CA 95008 PHONE408-370-0280 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# James Crawford C 17641 COMPANY NAME E-MAIL- FAX 1 James Crawford Architect Jgm,eS @ jbc.0LrehiaeCA. 408-993-1978 STREET ADDRESS CITY.STATE,ZIP PHONE 4 North Second Street Suite 580 San Jose, CA 95113 408-993-2252 DESCRIPTION OF WORK Non structural demolition, including suspended ceiling. New interior walls, doors, suspended ceiling, lighting. Distribution of existing HVAC. New Finishes. Modification of fire sprinklers. Modification to the power and communication. New interior casework, relocate plumbing. EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES Office Office III B 2 USE TYPE OCC. SQ.FT. VALUATIONS) EXISTG 2771 NEW FLOOR DEMO TOTAL Off1Ce III B B 2771 AREA AREA n/a AREA 2771 NET AREA 2771 BATHROOM KITCHEN OTHER REMODEL AREA n/a REMODEL AREA n/a REMODEL AREA 2 7 71 PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ODETACH n/a n/a n/a n/a ❑ATTACH 4-DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES n/a BEING ADDED? aNO ADDITION? QNO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES TOTAL VALUATION: PLANNINGAPPL# ®NO PLADININGAPPROVAL LETTER EICHLERHOME? [a NO $141,917.62 By my signature below,I certify n he NIM or authorized agent to act on the property owner's behalf. I have read this application and the informatio have prorea the Des ription ofWork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relat g to buildoriz res tatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL ATIONREQUIRED PLANGHECKTYPE ROUTING SLIP' New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER © BUILDING PLAN REV JEW 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 ❑ EIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. El MAJOR © SANITARY SEWERDTSTRICT; ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doe revised 06121111 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 19200 STEVENS CREEK BLVD# DATE: 08/11/2014 REVIEWED BY: MELISSA APN: 375 06 005 BP °VALUATION: 1$141,918 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY PENTAMATION USE: Commercial Building PERMIT TYPE: 1 B T� WORK �JAIKV/IF SUITE 130 -T.I. TO RECONFIGURE OFFICE AREA INCLUDING M.E.P.'S DEMISING WALLS SCOPE ABOVE T-BAR OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. B (Tenant Improvements) II-B,111-B,IV,V-B 2,771 $2,348.98 IBTIPLNCK $2,453.03 IBTIINSP TOTALS: 2,771 $2,348.98 $2,453.03 MECH,HOURLY 0 Yes (F) No PLUMB,HOURLY 0 Yes Q No ELEC,HOURLY Q Yes Q No NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees are based on the preliminar information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolietion 11-053 E 1' 7,LI3) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,348.98 Select a Misc Bldg/Structure Suppl. PC Fee: (j) Reg. Q OT FO.0 hrs $0.00 or Element of a Building PME Plan Check: $0.00 Permit Fee: $2,453.03 Suppl. Insp. Feer Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 F-1 0 Work Without Permit? 0 Yes (j) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential 0 Building or Structure i Strom, Motion Fee: 1BSEISMICO $39.74 Select an Administrative Item Bldg Stds Commission Fee: /BCBSC $6.00 SUBTOTALS: $4,847.75 $0.00 TOTAL FEE: 1 $4,847.75 Revised: 07110/2014 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 'C12()3 nc PERMIT# OWNER'S NAME: PHONE# o� GENERAL CONTRACTOR: Cl p BUSINESS LICENSE# ADDRESS: S CITY/ZIPCODE: q�00's *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 Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Co actor Signature Date