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12050079CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20085 STEVENS CREEK BLVD CONTRACTOR: NOVO CONSTRU : 12050079 OWNER'S NAME: I & D CUPERTINO LLC 4025 BOHANNON DR DATE ISSUED: 0627/2012 OWNER'S PHONE: 4088622477 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 ❑ LICENSED CONTRACTOR'S DECLARATION r r BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class B Lic. # iq ( OZZ Contractor ki V0 CC/l +f%4,t_Jip/1 Date -L 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 I 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. 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 permit is issued. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1, as owner of the property, or my employees with wages as their sole compensation, wil I 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 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. 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 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 1 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. MECH r RESIDENTIAL r COMMERCIAL i JOB DESCRIPTION: APPLE- COMM.T.I 14,129 SQ FT- TO INCLUDE EXTERIOR ACCESS, UPGRADES M,E,P'S 8n2012-REV# I -REVISE LAYOUT OF OFFICE 210 AND OTHER CHANGES TO FINISH, LIGHTING, MECHANICAL AND ELECTRICAL LAYOUTS-8/7/2012 REV#I ISS'D Sq. Ft Floor Area: I Valuation: $1665000 APN Number: 31623025.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: ��.�n/ 7,?� Date: e�'7•l,P RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Ow Dale: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of vwrk's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's A ARCHITECT'S DECLARATION Signature Date I 1 understand my plans shall be used as public records. CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20085 STEVENS CREEK BLVD OWNER'S NAME: J & D CUPERTINO LLC OWNER'S PHONE: 4088622477 ❑ LICENSED CONTRACTOR'S DECLARATION License Class ff Lie. N 79 ► o 22� Contractor NO%/O Caw $��. iodate 6 ga- 1 hereby affirm that 1 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: 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. 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 permit is issued. APPLICANT CERTIFICATION 1 certify that 1 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature (u/ Date a 2I / 2--- ❑ OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: 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) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three 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. 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 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 become subject to the Worker's Compensation provisions of the Labor Code,1 must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 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 with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. CONTRACTOR: NOVO CONSTRUCTION PERMIT NO: 12050079 4025 BOHANNON DR DATE ISSUED: 06/27/2012 MENLO PARK, CA 94025 PHONE NO: (650)701-1500 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r MECH r RESIDENTIAL r COMMERCIAL r JOB DESCRIPTION: APPLE- COMM.T.1 14,129 SQ FT- TO INCLUDE EXTERIOR ACCESS, UPGRADES M,E,P'S Sq. Ft Floor Area: I Valuation: $1650000 APN Number: 31623025.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: ,��N /I 7-Date: 6 '�71a RE -ROOFS: All roofs shall be inspected prior to any roofing material berg installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should 1 use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Ov t e thorized agent: 77llXX Date: S Z CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of Hork's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date Licensed , CITY OF CUPERTINO IMI FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20085 Stevens Creek Blvd DATE: 08/07/2012 REVIEWED BY: Sean APN: BP#: 'VALUATION: $15,000 zPERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION 1 B TI PERMIT TYPE: WORK Revision #1: Revise la out of office 210 and other changes to finish lighting,mechanical and electrical SCOPE layouts. OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 MECH, HOURLY O Yes O No PLUMB, HOURLY Q Yes Q No ELEC, HOURLY O Yes Q No tl,.. 1,, I -Van Chi c/: Phmlh. Plun (_hccd !:Ic< Plan ( hcck 7hrrh. I'rrinir / r Monh. Pe, rnit Frc. 0,:.. !'• , _.:r Fe, Li 4ii; I. /,/r. h•c: Pluu,b. hsp. hi,• 1;1:•;.. Insp. l•,•c NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District, eta). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 Ej. 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (j) Reg. Q 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 (:nn,truc tiorr Tars. 9cGninistruti� e 1''c c: 0 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential Building or Structure 0 0 l i,n (4 Docrunewatiorr Fees. Stronp- Motion Fee: IBSEISWCO $3.15 1 # $799.00 Revisions IREVCoMTT Tenant Improvement Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $4.15 $799.00 TOTAL FEE: $803.15 Revised: 07/01 /2012 - CITY OF CUPERTINO FmC FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 20085 stvns srk blvd. DATE: 05/07/2012 REVIEWED BY: bob s. APN: BP#: *VALUATION: 1$1,650,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: PENTAMATION 1B TI PERMIT TYPE: WORK offices ace includes exterior access. upgrades, M E Ps. [!Lg0Mrn SCOPE OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.E PC FEES PC FEE ID BP FEES BP FEE ID B (Tenant Improvements) II-B,III-B,IV,V-B 14,129 $2,671.08 IBTIPLNCK $7,417.10 IBTIINSP TOTALS: 14,129 $2,671.08 $7,417.10 MECH, HOURLY © Yes 0 No PLUMB, HOURLY 0 Yes O No ELEC, HOURLY 0 Yes Q No Al"c/r Pu,n,. i cv. r�.:1 F"C' 0/1'.'. 1 1•1,.: ,. l,, 1. f c" Plumb. /u.y,. fit". f,h'r. h/v 1. C' NOTE: This estimate does not include fees due to other Departments (Le. 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 F.. 711111) FEE QTY/FEE MISC ITEMS Plan Check Fee: $2,671.08 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: $7,417.10 Suppl. Insp. FeelD Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Co i,/1I(clion K Ix. ll lllnii11.5Irall vc I' e c: 0 Work Without Permit? 0 Yes 0 No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential Building or Structure 0 0 "/,n rl (/rr l+r;;,•u!rurru; l i c'�. Strong Motion Fee: 1BSEISMICO $346.50 Select an Administrative Item BldgStds Commission Fee: IBCBSC $66.00 SUBTOTALS: J10,500.681 $0.00 TOTAL FEE: r $10,500.68 Revised: 04/01 /2012