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15110047CUPERT[NO CONSTRUCTION PERM11T APPLICATION COMMUNITY DEVELOPIJ'iENT DEPARTh/,ENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - building a.cuoertino,org ❑ NEW CO ,STRUCTION ❑-JDITION ❑ ALTERSTION / TI X I REViSIO. /DEFER CPOR Gi .4 L -� PERT Is I i d4� PROJECTADDRESS f9371 sTEVENS Cftftc BLVD I.APN'' 31 -20-112 01,VNTERNAME MAIN ST (Offl IND I "0"' 4D8 -?i7 --;0M I E-MLAIL STREETADDRESS CITY, STATE, ZIP rA-14 282 SPNP RILL ST;- 241 I W:NU?MA,) 0P %02-S CONTACT NAME � JONRTI'if�N SlU ALJ�XP�r�eRS �TcA✓� PHONE " 40 .446. 2222 E -MAIL JO��j��SIU I �IeX�Ni� SSZEPrkttbuSE . b0M STREETADDRESS n Y-" Y CITY, STATE, ZIP ��Nb)0 95�� FAX 22�2 ❑ OV'I\'ER ❑ 0WT'ER.BUILDER ❑ OV N'ERAGENT ❑ CON R CTOR ❑CONTRACTORAGET T ElARCHITECT❑ ENGINEER ❑ DEVELOPER TNA T CO?vTRACTOR N.'.E AN-j"VNy .lo P 6�vI N LICENSE NUMBER 7 1 o r /�, f- i LI CF' SE T1?E BUS. LIC COMPANYNA-ME MkvIN Buts E""AIL jkN7iiWNY(# MAVINBUILI)W. CZft4 FAX STREET ADDRESS 1.o. box j a 4b j CITY, STATE, ZIP GFA, OS D ` PHO"\E T E�V\ 32�EZR NAME M G D1 MRI kNt P LICENSE NUh,BER C- 3 33 - P) BUS. LIC C01\UA. I.YNAN,E V•SCFtIEME S1uDlo E - M• 0tAP, ,RNTA@ DSGtMMt. GoM FAx 41S. 252- a3�g -- _- STREET ADDRESS 222 a114 ST CITY, STATE, ZIP SRN �Nusbb, Cjk 9410b PHO\� I ai$-252- DSgB DESCRIPTION OF WORK gtVI3 pN fDR V 1M�9$� IT�N1 S U� Mous 'ii�MIS lS II O 0 � .SySIDA $".V D01TV014 fpTII Po1w.((016 5 ---- — ------ EX:STAN'G L'S I 'ROPOSED USE I CONSTR, TYPE I = S -C aS V hGI�N� k-2 ES tPUIyT I''I� IU SE TYPE I OCC. SQ -FT- i V e.LUATION (S) EXISTGrr__ NEN' FLOOR A..REA 1i,, . UA I Il DEMO DEMO AREA TOTAL q� NET AREA I?jj VD$ --- BATHROOM REMODELAREA KITCHEN OTHER s REMODEL AREA (� REMODEL AREA N(1, PORCH AREA DE`CK.kAEA TOTAL DECK'PORC-I AREA, GA.RSGE.A,REA: DETACH 4ff, ❑ ATTACH DWELLING LNTTS: 1S .4 SECOND li. ❑ YES SECOND STORY ❑ 1'ES BELNGADDED'gp�, C5NO kDDMON? 1K NO PKE-.AP?LICATIGN EIYES IF )7S, FP,OVID: COPY OF IS THE BLDG AN : ESz 5CNOO�I TOTAL V.^._C - G'\. PLaI\T'T\GAPPLR ONO PLA?NINGAPPROVALLETTER EICHLERHOME? By my si_nar:re below, I certify to each of the follo-wine: I am the property ot;ner or authoriz _ n to a4 on the property owner's behalf. I have read t' KS application and the information I have provided is correct. I have read the Description of \Mork and ve i f t is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin_e nstroction. I authorize representatives of Cupertino to enter the above .-idied property. for inspection purposes. SiPatureofApplicant/Agent: SLJ7PPLT\- d,rNTA 1 -FOR IATION REQUIREDs ECK Tl--P.E .raw j New SFD or Multi; roily dyvellirgs: Apply for demolition pemmit for - existing building(s). Demolition pelTnit is required prior to issuance of build::- Z COLITER permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ t srA,�DaRD� �� m form if al:y Hazzrdous ?tdaterizls are beiti used as part of this protect. Copy Planning Approval Letter Meeting Planning to _ of or t;-ith prior submittal of Building Permit application. Bldg.:pp_2011.doc revised 06/31/II CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: 15110047 19379 STEVENS CREEK BLVD (316 20 112) MAVIN BUILDERS INC TORRANCE, CA 90505 OWNER'S NAME: MAIN STREET CUPERTINO DATE ISSUED: 04/19/2016 OWNER'S PHONE: 408-777-3081 License Class GENERAL BUILDING CONTRACTOR Lic. #1011125 Contractor MAVIN BUILDERS INC Date 02/28/2018 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. I hereby affirm under penalty of perjury one of the following two declarations: t. 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 PHONE NO: (310) 422-5651 BUILDING PERMIT INFO: —BLDG —ELECT —PLUMB MECH RESIDENTIAL COMMERCIAL JOB DESCRIPTION: ALEXANDER'S STEAKHOUSE - T.I. - (SHOP 4/MAIN STREET) (12,616 SQ FT) WITH (I) MEZZANINE (1,192 SQFT) performance of the work for which this permit is issued. OUTDOOR DINING AREAS (1,016 SQFT). ISSUED 6/21/2016 2. 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 rion-point source regulations per the Cupertiryp Municipal Code, Section 9.18. OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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) 2. 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: t. 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. z. 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. 3. 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 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 6/21/2016 Sq. Ft Floor Area: I Valuation: $2000000.00 APN Number: Occupancy Type: 316 20 112 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: ABBY AYENDE Date: 04/19/2016 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: 6/21/2016 11 A 11 HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(x) 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 I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505 25533, and 25534. Owner or authorized agent: Date: 6/21/2016 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work'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. Licensed Professional CITY OF CUPERTINO BUILDING PERMIT � BUILDING ADDRESS: CONTRACTOR: I PERMIT NO: 15110047 19379 STEVENS CREEK BLVD (316 20 112) MAVIN BUILDERS INC TORRANCE, CA 90505 OWNER'S NAME: MAIN STREET AGGREGATOR I DATE ISSUED: 04/19/2016 I OWNER'S PHONE: I I PHONE NO: (310) 422-5651 License Class B Lic. #1011125 Contractor MAVIN BUILDERS INC Date 02/28/2018 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. I hereby affirm under penalty of perjury one of the following two declarations: t. 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. f� 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 Cup rtino Municipal Code, Section 9.18. Signature Date �/�Cj/�� OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) 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: 1. 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. 2. 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. 3. 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 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 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH _ RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: ALEXANDER'S STEAKHOUSE - T.I. - (SHOP 4/MAIN STREET) (12,616 SQ FT) WITH (N) MEZZANINE (1,192 SQ FT). Sq. Ft Floor Area: I Valuation: $2000000.00 APN Number: Occupancy Type: 316 20 112 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Phuona Devries RR -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: TO BE CLASS "A" OR HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I 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 I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION understand my plans shall be used as public records. Licensed Professiona CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org ❑ NRW CONSTRt ICTiON ❑ ADDITION 1 CLTERATION / Ti ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS I 33ol Sium n Crea, a d APN # 31 r OWNERNAME ( O E�y �� E-MAIL � STREET ADDRESS S IT LI 101 E; FpX, CONTAC NAMEPHON�i E-MAIL J()y+hanS\LkL STREET ADDRESS, ` CJ Cr, STATE, I I ,V /Z- �+; t❑/1 FAX04�e ❑ OWNER 11OWNER-BUILDER❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ARCHIT�EEC-T ❑ ENGINEER ❑ DEVELOPER TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE RCHITECT/E GINEER NAME LICENSE NUMBER C - BUS. LIC # COMPANY NAME IL ^ FAX STREET ADDRESS N n CITY,STATE ZIP,l^ lJ PHONECA l �� (J DESCRIPTION OF WORK D� Dd lem ow rew v:-�Glur woY �b Vnao i Y1e t ) Y}eUo fi MS I,v . m b w rn EXISTING USE /�Yl V � r ' PROPOSED NSE CONS _I re I YR. TYPE _ # STORIES ' USE TYPE OCC. SQ FT VALUATION ($) EXISTG AREA ce I NEW/FLO R AREA' 1 q ;L.- DEMO AREA TOTAL NET AREA 13, b(t VV BATHROOMKITCHEN REMODEL AREA MIA 1 ' REMODEL AREA A OTHER � 1 / REMODEL AREA n/ \j PORC AREA POP ECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DE�TACH A NIA NJ 1A N A ❑ ATTACH #DWELLIN UNITS: I ISASECOND NIT ❑YES SECON6 STORY []YES BEING ADDED? I&NO ADDITION? JaNO PRE-APPLI ATION []YES IF YES, PROVIDE COPY OF PLANNING APPL # []NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? PLNO RE VED $y: TOTAL VVAALUATION: 10- By my signature below, I certify to each of the following: I a c property owner or authorized agent to act on the property owner's behalf have read this application and the information I have provided is Vrrect. I v rea the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building c ru io resentatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicanUAgent: \ Date: Ot Av0V. zo ( S SUPPLEMENT N RMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-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. ❑ EXPRESS ❑ PLANNING PLAN REVIEW —Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ElSTANDARD ❑ PUBLIC WORKS 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 HEALTH BldgApp_201 1. doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION 19' ADDRESS: 19379 Stevens Creek Blvd DATE: 11/09/2015 REVIEWED BY: Sean PC FEE ID APN: BP#: *VALUATION: $2,000,000 *PERMIT TYPE: Building Permit 13,808 PLAN CHECK TYPE: Tenant Improvement PRIMARY Commercial Building USE: $5,994.01 1ATIINSP PENTAMATION 1A TI PERMIT TYPE: WORK Tenant Improvement(Shop 4 for Alexander's Steakhouse 12616 sq ft); construct a mezzanine 1192 SCOPE sq ft). OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA (s.f. PC FEES PC FEE ID BP FEES BP FEE ID A (Tenant Improvements) II-B,111-B,IV,V-B 13,808 $3,036.42 IATIPLNCK $5,994.01 1ATIINSP 1-11ec. Ins/;. 1 e2: PME Plan Check: $0.00 Permit Fee: $5,994.01 Suppl. Insp. Fee:Q Reg. Q OTJ 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 TOTALS: 13,808 $3,036.42 ; "onsiruclion Tai: $5,994.01 MECH, HOURLY ® Yes (E) No PLUMB, HOURLY Q Yes (F) No ELEC, HOURLY ® Yes Q No MISC ITEMS Plan ("heelk, Tech, l'rrrr,rr i c.. �„ri:. _ Firs Select a Misc Bldg/Structure or Element of a Building rer ljr±t?d111fsr. . F-1 IilliteY I'.'iee. 111sl). ,lfech. Irsn. hr:=: rnfJ. _bi.gl , Fee: 1-11ec. Ins/;. 1 e2: 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 preliminar information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Ef' 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $3,036.42 Select a Misc Bldg/Structure or Element of a Building Suppl. PC Fee: (F) Reg. OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $5,994.01 Suppl. Insp. Fee:Q Reg. Q OTJ 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ; "onsiruclion Tai: Tee. G Work Without Permit? ® Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building or Structure G i Strong Motion Fee: IBSEISMICO $560.00 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $80.00 SUBTOTALS: $9,670.43 $0.00 TOTAL FEE: $9,670.43 Revised: 10/01/2015 Jt STATEMENT OF SPECIAL INSPECTIONS, 2013 CBC COsWUNITY DEVELOPMENT DEPARTMENT • BUILDING DMSION \ ALBERT SALVADOR, P.E., C.B.O.. BUILDING OFFICIAL2 \\\ 103W TORRE AVENUE • CUPERTINO, CA 950143255 CUPTJlTINO (438)777.32213• FAX (409)T/73=-buI1dinafilamerltno.oM �� ! � >' �i CAPH ADDRESS 1 %� I j 511 p p SPS QVAW SAND HILI PROPERTY COMPANY _„ _ Cttraador, ANyJYjQAQJL�(R1A�f%i QVun+F.RS __ Addrtb PO 80�. .11 10469 „-•.�•-----^------"""""'."'".. OWTQW10S.E..Gd._.---wm�as$]4 Add, = 10123 N, %VOLFF f,�j_Q9PSLs,�._.__._._....._ Cj.,,Sj_CUP TIN_CA—mpA&U_-. _PhAL777-3081 App, JONATHAN_,'MALEXANDFR'¢ CTEAKH01jSF _ ( jp Q ----•-••^•--""'^' Adder jW.,.MJ.II°9,•�••-- Ctjo eA11. .. &M-21 p ane �6 62t+ 10330 N. WOLFE ROAD N 41p5t CU?ERTINQ�CA92 QLL..,..._Pho4he�!:. 4_6-2222 PROJECTMCRiPs10►r., ��a.r tM Mfrqq Tis'STATEb1EtfTOFSPECtALINSFEC7tON5'bsubmt(PdntutfRrnealotiharegtmotner+tsaiCBCSedions1744and17 T'6 Aunt 4 Sbucamed s13er arsdused by permission from tha Structu�l Esm neer Assocrat on mm of NorttCalLfon {SEAONC) a i ai$pegal f X15 Aisq meted w3ti t� (9.lM $ thg -IST OF SPECIAL 1NSPEC1103 AGENCIES (page 2). A 8tit of tasting agencies and other Wdal Inspectors Cunt Y11 be tat3ined to cgridUd the tests and inspections for ttLh Prole- [�'sct�EnuL� S>£ $2f �U�l fNS.p btr(P�@ 3 - 6} ThgSSl ii E2 of SyrSW IC 9 ire SDec1a (rsspec6ons, and tests required. SpecW Inspedrns w',9 mfar to the approved piam and spedficali= for detailed special irspedron n;q%Le ts. Any additional tests and impectiom by the apPr�d plans and specifications ShRo also be psriormed. Special btspecdom and Teshng w0 be pedarmed In acrardanc8 with tha aDDwvved PI3ns and speci6ratioM this statenent Se170S. Section 17W, 1706,1707, and 170& Interim mportsw@ be w2rumed to the Sta-ding Official and the FMVIste2d Dest9 Professional of Respornsbte Charga ht accordants wtlh CSC Seton 1704.12- A 704.12A Final Report of Special I nspectiOm doaanar`&Q rcqulred Special Irepectorm testke9 and owrecmn of any d tsacpandes ff� irspecx an &*%9 be subrn tied prior to issuanoa of a Certifica>g of Use and Oaupancy {Sectlon 1704,12} The Fu1s1 �tdrEd�i ns- Carecbon of dbae9arraes noted In Vmpedtoas. Th8 P5d1t t fatQ9niz�S i of t�i9�nt31 tp940•abons. Ovrnretam ar�dWO pay i nAlerr es3 th s P ° , In partial Special ir>spe�ars zs requi eed to CBC Sectim 1704.1. Tarir;Tts §sSsnt? riltiti Bte dt9 m gt! SfittG OfGdalwi6 . - Ra+revr loci app Un§ 4 fira6asi✓ ofl)ia Speak! W�b1niQ perform the ptspeaiom Morew special man activifts on the Job sm to assess the! ft sPecw Inspectors are quaHfled and aro duties as cased far 6t this State nt of Special Ir4"e 15m �%svtmd u revolts Perfcm mspecbon3 as required by the local bmldurg code 011 Scanned by CamScanner Z.:3— inLuPrclionFarm ?011 doem*ed09l06r12 ED LIST OF SPECIAL INSPECTION AGENCIES APPROVAL OF SPECIAL INSPECTORS: Epcp sflecial=pechan agency. teSttng fgtzlily. a&d spe" inSpector.shail tm recognized by the �uildI Cdfidalpriol to performing any duties. $pe al Inspedo XP listed an thin fM must t!10 pre.-4PTQM ann FPWO aA fuRertina's ap MYPI zPP*) Ins9—f4- C a G4t- Special inspectors shall carry approved identification when performing the functions of a special inspector. Identification cards shall follow the criteria set by the California Council of Testing and Inspection Agencies. Pio personnel changes §hall be mage wit TA first o5tairiuta ttte apprpval of theRsiildttQf3ftrdal. unauthmb:ed personnel changes may resuft in a'Stop lllkirk Order' and-p�}a permit revoca�ori. %bti pie a proved byte y o� G`apertirio. refer to the WIC1AL hiridouti Please allow two weeks to complete the application process. T... L.n_..1..� ......M M.•1 __ --A -Z-1 f..e..o. ti o.wr.r:na fh�f _;11 F_ rsa4alnori M lxirrH%tr4 h,ctn nnrf in¢nPnHnn on this orniect EXPERTISE FIRM d INSPECT(* INFOtdYATION' 1. Special Inspectian (ermept far FFrm__..- __...__... _ ........_._.._._....._.._._.__. Addr _. ...;....__.__. .._._.._..___... — r.— �_...._. 9�1>} pry_. _ ____.._.__ ___.__ _ _,.._.-_--•_---Scala.___._._ Tereptione....-.._...-_-_----.--._----- --- .Pas.__._..____._............_. ..EmaA......._..........M..._ _..._._.._......... & Ma"ITQ%tru Funl._................................... __...._.. glttic___..--_ ......__.._—_ ............_ .. _...__...._ Cibr. » ...... __.. ....._.. _.._... ....._ ._ ...__..... _ _. ._—_----.._X1➢— Telephmre__..._.-.__..__._ .Fax.................... __...__---...EmaIl........ .----_...__-.._ HC4fw........_..._........-..._.._n_... ___ ... .. ..-...._» City....... ......... __.................. .. __......_.........._........... ....... _............. State ............ ...... zip .................. Teleph.............._..._..._...... Fzm........ ..._-.._-..._......... _.... Em3A__... ........ ....--------- ------------- -_._ 4• Ath 1?{rn .»..._ __—__._..w.._..... —_...._._1idQ;--_----------•--._.. (fly._._..............v...._...-•--••---•-----_.._........_.___.._......__.........._ Stam ..._..._..._.._.._Zrp .___.....__ Telepltane_- ...... ........ Email ..._..............___..__..... __ ....... All agencies speatied on ttrfs torrtt must De pna-approves arm its" on um i r,ir ur r upmwry clpFiarrcr, �� rr,.a ,,, ...., cFrawr•. Gi°o111RrMFM" rSerzton i7ItS.3.d1 Dwalp2lon of sesmlo-forco res7s9iig system NW dWVated seismic systems SU6)eei to special Umpeziiom as per Section 1705.3: The ardent of the system Is defined In mote Beta➢ In the oonstrmllori doarments. Wscriptlari c f main system and deslBnatadWhA r0sistin9 camp MTts WAW to Spada! Insp d— in accowarice vdM Sectlan 1705.4.2: The extent of the matn wind-forc&-resLgft system and wind rests M compments is defined In mora detaa in the o=tnrdfon doam-s_ Spe=bLTec ionForm 1012.doc rrvired 09AW11 SCHEDULE OF SPECIAL INSPECTION PRO.IECTDESCR1PTiON: Natation Used in Table: Column headers: C Indicates continuous inspection is required. P Indicates periodic inspections are required. The notes andlor contract documents should clarify. Box entries: X Is placed In the appropriate column to denote either'C' continuous or "P' periodic Inspections. Denotes an activity that Is either a one-time activity or one whose frequency is defined In some other marlrlei'. , Additional detail regarding inspections and tests are provided in the project specifications or notes on the drawings. VMFICATION AND INSPECTION p REFERENCED TBC RACE STANDARD INSPECTION OF FABRICATORS 1. ❑ Inspect fabricator's fabrication and quality ocrttrol — — 1704.3 procedures. 1INSPSCTfON OP STEL 1. Material verificatton of high-strength trolls, nuts and washers. B iderltrfitticlrt marking to scltlfarm 4o A£TM stds RISC 360, specified in the approved construction documents. — X Section and applicablee A ASTM material standards .6 Inspect fabricator's fabrication and quality control X — procedures. 2_ In on of himstrength bolting: ❑ Snug -tight joints.— X ❑ Pretensioned and slip -critical joints using tum -of -nut with matchmarking, twist -off holtardirect tension — X indicatbr methods of installation. Section M2.5 1704.3.3 ❑ Pretensioned and slip -critical joints using tum -of -nut without matchmarldng or calibrated wrench methods X = of installation. 3. Material verification of structural steel and cold -formed steel deck. 0 For structural steel, identification markings to conform — X AISC 360, 1 to AISC 380. Section M2.5 ❑ For other steel, identification markings to conform to Applicable ASTM ASTM standards specified in the approved —' X material sfandards construction documents. ❑ Manufacturer's certified test reports- — X SpeeraGupecrionForm 2012.doc revised 091W12 VERIFICATION AND INSPECTION C P REFERENCED STANPAEa_ I [BC LREERENCE "4Material verification of weld filler materials: ❑ Identlflcation marking to conform to AWS specification in the approved rens victim domMlents. — J( AISC 360, 'Section A3.5 and applicable AWS AS documents — 13 Mateuraciurees cg f of gMioigrWe mqu&ad. — X I— — 5. Inspection of welding: a. Structural steel and cold -formed steel decic ❑ Complete and partial joint penetration groove welds. X — AWS D1.1 1704.3.1 ❑ Muttlpass fillet welds. X 11 Single -pass Single -pass fillet welds > 5116' X --- ❑ Plug and slot welds. X -- SingTe-PbtsBrol Wi qTs <= 51f6' — X ❑ Floor and roof deck welds. - X AWS D1.3 b, Relnfomng steal; ❑ Verification of weldability of reinforcing steel arbor than ASTM A 708. _ X AWS DIA ACI 318: Section 3.5.2 — O Relr&a ng steel resistlng flexural and axlai forces In intermediate and special moment frames, and boundary elements of special structural walls of cenafAe and shear reirrfen merrf X — ❑ Shear reinforcernent. X — ❑ mer reinforcing steel. — X 6. inspection of steel frame Joints details for compliance: ❑ Details such as bracing and stiffening. — X — 1704.3.2 ❑ Member locations. — X ❑ Application of joint details at each connection. — X VERIFICATION AND INSPECTION C P REFERENCED IBC STAND E-- INSPECTION OF WELDING 1. ❑ Welded studs when used for structural diaphragms. — IX — 1704.3 Welding of celd-formed steel framing members. — X Welding of stairs and railing systems. — X ��3[0� SpeclabnspectlonFonn 1012.doe revised 09/06/11 t 11 VERIFICATION AND INSPECTION C P REFERENCED STANDARD IBC REFERENCE INSPECTION OF CONCRETE 1. Y Inspection of reinforcing steel, ' _ XACI 318:3-5,7.1-7.7 1913.4 2. ❑ Inspection of reinforcing steel welding in accordance with Table 1704.3 Item 5b. — _ AWS D1.4 ACI 318: 3.5.2 — 3. ❑ Inspection of bolts to be Installed in concrete prior to and during placement of concrete where allowable loads have been increased or where strength design is used. X — ACI 318:8.1.31 21.2.8 1911.5, 1912.1 4. PC Inspection of anchors installed in hardened concrete. — X ACA 318: 19121 5. ❑ Verifying use of required design mix. — X ACI 310: 1904.2.2,19132, 1913.3 6. ❑ At 6me fresh concrete is sampled to fabricate specimens for strength tests, perfprrll slump Ind air content tests and determine the temperature of the concrete. — ASTM C 172 A8rM 'C �1 ACl 318: 5.8, 5.8 7, 19 Inspedfon of conoWe 11 es. ,15.in 1813A 1911T 1913.8 8_ CI Inspection for maintenance of specified curing temperature and technittue8. X ACI 318: 5.11-5.13 1913.9 9. Inspection of prestse,sed concrete: ❑ Application of prestressing forces. X — ACI 318:18.20 ❑ Grouting of bonded prestressing tendons in the selsmtc force -resisting system. X — ACI 318:18.18.4 1-0.13 Erection of precast -concrete members. -.s X ACI 3t8: Ch. 16 . . 11. ❑ Verification of in4du concrete strength, prior to stressing of tendons in posttensioned concrete and prior to removal of shores_ and forms from beams arid structural slabs. — X ACI 318:6.2 — 12. ❑ Inspect formwork for shape, location, and dimensions of ttm concrete member being formed. W X ACI 318: 8.8.1 13. Bohr Installed in Existing Masonry or Concrete ❑ Direct tension testing of existing anchors. — X See ICC ES Reports farm special inspection requirements for proprietary products ❑ Direct tension testing of new bolts. — X �( Torque testing of new bolts. — X ❑ Prequalificabon test for bolts and other types of anchors. — X 14,0 Other. SpecialnspectinnForm_2012.doc revised 09/06/12 TESTING ENGINEERS, INC. 2811 Teagarden St. 510-835-3142 San Leandro, CA 94577 800-660-3142 PROJECT # 62797 PROJECT: 19379 Stevens Creek Blvd. Alexander's Steakhouse Cupertino, CA Permit # 15110047 DATE 3/10/16 HOURS 4 INSPECTOR B. Tonkovich FIL� 510-834-3777 fax San Leandro • San Jose • Martinez INSPECTION REPORT Week Ending: 3/11/16 TYPE OF INSPECTION: Epoxied Anchors PLACE OF INSPECTION: Jobsite Reported to Anthony Joaquin of Mavin Builders at the jobsite as requested. Inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and the injection of Simpson Set XP epoxy (exp. 12/17). Witnessed the proper insertion of six (6) 5/8" diameter Allthread anchors, for HDU4 holddowns, embedded 10" minimum; and ten (10) 5/8" diameter Allthread anchors, embedded 10" minimum, at 18t floor between lines E and H from 1 to 2. The preceding work was, to the best of my knowledge, in compliance with approved plans and specifications, including revisions by engineer and Drawing S6, Detail 4, dated 11/20/15. Inspection Division Manager 1cc: Mavin Builders, Inc. / A. Joaquin Mavin Builders, Inc. / J. Tran Enertia Designs / J. Chen, S. E. D Scheme Architects City of Cupertino / Bldg. Inspection Dept. RECEIVED APR 2 5 201F The results presented in this report relate only to the item(s) tested/inspected and can be reproduced only in its entirety unless written permission from TO is obtained. Page 1 of 1 4/19/2016 PERMITS Y'Miscellaneous Completed fire pit, fountain, between shops 2-3, and gateway sign. Permits _............................._.......... .__.............._....____..__.. _. _......__...__............___..__......._.... Final Planning Inspection 'RIOR TO FINAL OCCUPANCY) A Planning Division inspection is required to verify exterior iaterials/finishes, trees, landscaping, site work, and any other miscellaneous planning -related items. ............ _..... - ____- _... ._...... __....... .... .._ .... ............_...... ._. .... \P'Other NO INSPECTIONS(COURTESY INSPECTIONS) UNTIL PERMIT ISSUED -PER GARY STREAM-VFD4/18/16 View Edit Process Steps Fees Inspections Map it Notes .... ..... . PROPERTY INFORMATIC) Properties: Primary: 19379 STEVENS CREEK BLVD (316 20 112) Issued Permit #: 15110047 Permit App #: 15110047 Issue Date: Expiration Date: Permit Type: 1A TI Project Valuation: 2000000.00 Status: In Review Submittal Date: 11/09/2015 Last Inspection: 04/19/2016 Permit Subcases: Easements: i No configured subcases. Scope of Work: ALEXANDER'S STEAKHOUSE - T.I. - (SHOP 4/MAIN STREET) (12,616 SQ FT) WITH (N) MEZZANINE (1,192 SQ FT). DEF#1 - INSTALL ODOR ABATEMENT SYSTEM; 3 -OUTDOOR DINING'` yy Zoning: Land Use: Specific Plan Area: Lot Area: Lot Type: Light Air Easements: Fire Severity Zone: Flood Hazard Zone: Seismic Zone: Liquefaction Area: Landslide Area: Water Service Area: http:/Aanduse.cuperfi no.org/xajaxGridt ndex.php?section=perm its&page=edit view&section_id=195290 i Type: 1A TI I Start Date: 11/09/2015 Status: In Review i Item: 1ATIINSP Amount: $5,994.01 Fee Assessed By: Legacy Item: 1ATIPLNCK Amount: $3,036.42 Fee Assessed By: Legacy Item: IBCBSC Amount: $80.00 Fee Assessed By: Legacy Item: IBSEISMICO Amount: $560.00 Fee Assessed By: Legacy Item: Administrative Fee Amount: $286.00 Fee Assessed By: Patricia Garcia Total Amount: $11,672.43 Amount Paid: $9,956.43 Amount Due: $1,716.00 Show all 11 Fee Charges j�a] ❑ Applicant MAIN STREET CUPERTINO iAGGREGATOR 2882 SAND HILL RD STE 241 MENLO PARK, CA 94025 Email: mrohde@vallcoshoppingmall.com 0 El El Contractors (1) 01 Date Exp: Status: Active i Contractor #: State License #: Contractor Type: ❑ ❑ ❑ E [316 20 112] i 19379 STEVENS CREEK BLVD CUPERTINO, CA 95014 Water Service Area: CALIFORNIA WATER SERVICE Sanitary District: CUPERTINO SANITARY DISTRICT School District (Unified): Land Use: Com/Off/Res Seismic Zone: Valley Floor, Liquefaction - Inundation Lot Area: 477788 Concrete: Past Public Works Projects: 52525.13, type: COMMERCIAL TI, created by JOANNE on 2015-05-16 Specific Plan Area: Heart of the City Flood Hazard Zone: 0.2 PCT ANNUAL CHANCE FLOOD HAZARD 1 Storm Drain Fee Payment: Fee Rate: 1320, Fee Rate Derived From: Acre, Amount Paid: 22491.00, Fee Rate: j 1100, Fee Rate Derived From: Acre, Amount Paid: 21201.00 i 1/4 STATE OFA CALIFORNIA PLUMBING r'Fr-NRr:I-PI R -f11 -F (RPvmP.rl 12/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-PLB-01-E Plumbing Page 1 of S Project Name: ALEXANDER'S STEAKHOUSE Enforcement Agency: CITY OFCUPERTINO Permit Number 15110047 Project Address: 19379 Stevens Creek Blvd City. Cupertino Zip Code: 95014 A. GENERAL INFORMATION DATE OF PERMIT: 04/19/2016 BUILDING TYPE: Type II B (Sprinklered) PHASE OF CONSTRUCTION: Final If more than one person has responsibility for building construction, each person shall prepare and sign an Installation Certificate document applicable to the portion of construction for which they are responsible, alternatively, the person with chief responsibility for construction shall prepare and sign the installation Certificate document(s) for the entire construction. B. SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy efficiency measures for the scope of responsibility for this Installation Date: 06/29/2016 Certificate. In the table below identify all applicable construction documents that specify the features, materials, components, manufactured devices, or system performance diagnostic results required for the scope of responsibility for this Installation Certificate (continued). Applicable Sheets or Pages, Tables, Date Approved by Document Title or Description Schedules, etc. Enforcement Agency Plumbing Plans P0.0, P0.1, P1.0, P1.1, P1.2, P1.3, P1.4 04/08/16 1«- J CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 STATE O� CALIFORNIA PLUMBING CEC-NRCI-PLB-01-E (Revised 12/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-PLB-01-E Plumbing Page 2 of 5 Project Name: ALEXANDER'S STEAKHOUSE Enforcement Agency: CITY OF CUPERTINO Permit Number: 15110047 Project Address: 19379 Stevens Creek Blvd City_ Cupertino zip code: 95014 C. MANDATORY REQUIREMENTS FOR ALL CENTRAL DOMESTIC HOT WATER RECIRCULATION SYSTEMS On systems that have a total capacity greater than 167,000 Btu/hr, outlets that require higher than service water temperatures 01 as listed in the ASHRAE Handbook have separate remote heaters, heat exchangers, or boosters to supply the outlet with the higher temperature. (Section 110.3 (c)1) 02 Systems with circulating pumps or with electrical heat trace systems shall be capable of automatically turning off the system. (Section 110.3(c)2). 03 For public lavatories, the control system shall limit the outlet temperature to 110 degrees Fahrenheit. (Section 110.3(c)3). Unfired storage tanks are insulated with an external R-12 or combination of R-16 internal and external Insulation. Alternatively, 04 the heat loss of the tank surface based on an 80 degrees Fahrenheit water -air temperature difference shall be less than 6.5 Btu per hour per square foot. (Section 110.3(c)4). All sections of the recirculation loop, and the first five feet of all branches off the loop are insulated, to the thicknesses required by Table 120.3A, except for the following: (RA4.4.1) • Piping installed in interior or exterior walls that is surrounded on all sides by at least linch of insulation. • Piping installed in attics with a minimum of 4 inches (10 cm) of attic insulation on top 05 Piping that penetrates framing members shall not be required to have pipe insulation for the distance of the framing penetration. Metal piping that penetrates metal framing shall use grommets, plugs, wrapping or other insulating material to assure that no contact is made with the metal framing. Insulation shall butt securely against all framing members. • Insulation is not required on the cold water line when it is used as the return Hot water pipes that are buried below grade are installed in a water proof and non -crushable casing or sleeve that allows for 06 installation, removal, and replacement of the enclosed pipe and insulation. (RA4.4.1) Insulation outside conditioned space is protected from damage, including that due to sunlight, moisture, equipment 07 maintenance, and wind. (RA4.4.1) 08 Pipe insulation fits tightly to the pipe. (RA4.4.1) 09 On insulated sections of pipe, no piping is visible due to insulation voids, and all elbows and tees are fully insulated.. (RA4.4.1) The recirculation pump is mounted on a vertical section of the return line, OR an automatic air release valve is installed on a 10 riser at least 12 inches in length, on the inlet side of the recirculation pump, no more than 4 feet from the pump. (Section 110.3(c)5A). 11 A check valve is located between the recirculation pump and the water heater. (Section 110.3(c)5B). A hose bibb is installed between the pump and the water heating equipment with an isolation valve between the hose bibb and 12 the water heating equipment. (Section 110.3(c)SC). 13 Isolation valves are installed on both sides of the pump. One of the isolation valves may be the same isolation valve as in item 12 above. (Section 110.3(c)SD). The cold water supply piping and the recirculation loop piping is not connected to the hot water storage tank drain port. 14 (Section 110.3(c)5E). A check valve is installed on the cold water supply line between the hot water system and the next closest tee on the cold 15 water supply. (Section 110.3(c)5F). The hot water distribution system piping from the water heater(s) to the fixtures and appliances takes the most direct path. (RA 16 4.4.7.1) Installation and operation instructions that provide details of the operation of the pump and controls are available at the 17 jobsite for inspection. (RA 4.4.7.1) 18 More than one circulation loop may be installed. Each loop shall have its own pump and controls. (RA4.4.8, RA 4.4.9, RA 4.4.10) The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 STATE OP CALIFORNIA PLUMBING CEC-NRCI-PLB-01-E (Revised 12/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-PLB-01-E Plumbing Page 3 of 5 Project Name: ALEXAN DE R'S STEAKH OUSE Enforcement Agency: CITY OF CUPERTINO Permit Number 15110047 Project Add,.,,: 19379 Stevens Creek Blvd City: Cupertino Zip Code: 95014 D. MANDATORY MEASURES FOR ALL SINGLE DWELLING HOT WATER DISTRIBUTION SYSTEMS 01 Equipment shall meet the applicable requirements of the Appliance Efficiency Regulations (Section 110.3 b 1). 02 Unfired Storage Tanks are insulated with an external R-12 or combination of R-16 internal and external Insulation. (Section 110.3(c)4). The following pipes are insulated, to the thicknesses required by Table 120.3A, except for those sections of pipe that are subject to one of the exceptions below: (RA4.4.1) • The first 5 feet (1.5 meters) of hot and cold water pipes from the storage tank. • All piping with a nominal diameter of 3/4 inch (19 millimeter) or larger. • All piping associated with a domestic hot water recirculation system regardless of the pipe diameter, except when cold water return is used in a demand system. • Piping from the heating source to storage tank or between tanks. • Piping buried below grade. 03 All hot water pipes from the heating source to the kitchen fixtures. The following sections of pipe do not have to be insulated: (RA4.4.1) • Piping installed in interior or exterior walls that is surrounded on all sides by at least 1 inch of insulation. • Piping installed in attics with a minimum of 4 inches (10 cm) of attic insulation on top • Piping that penetrates framing members shall not be required to have pipe insulation for the distance of the framing penetration. Metal piping that penetrates metal framing shall use grommets, plugs, wrapping or other insulating material to assure that no contact is made with the metal framing. Insulation shall butt securely against all framing members. 04 Piping buried below grade must be installed in a water proof and non -crushable casing or sleeve that allows for installation, removal, and replacement of the enclosed pipe and insulation. (Section 150.0(j)) 05 All elbows and tees shall be fully insulated. (RA4.4.1) 06 Where insulation is required, no piping shall be visible due to insulation voids, and all insulation shall fit tightly to the pipe. (RA4.4.1) For Gas or Propane Water Heaters: Ensure the following are installed (Section 150.0(n)) 1. A 120V electrical receptacle is within 3 feet from the water heater and accessible with no obstructions 07 2. A Category III or IV vent, or a Type B vent with straight pipe between outside and water heater 3. A condensate drain no more than 2 inches higher than the base on water heater for natural draining 4. A gas supply line with capacity of at least 200,000 Btu/Hr The responsible person's signature on this compliance document affirms that all applicable requirements in this table have been met. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 STATE OF CALIFORNIA PLUMBING CEC-NRCI-PLB-01-E (Revised 12/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-PLB-01-E Plumbing Page 4 of 5 ProjectName: ALEXANDER'S STEAKHOUSE Enforcement Agency: CITY OF CUPERTINO Permit Number: 15110047 ProjectAddre- 19379 Stevens Creek Blvd City. Cupertino Zip Code. 95014 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: M. Anthony Joaquin Documentation Author Signature: Company: Mavin Builders, Inc. Signature Date: 06/29/2016 Address: PO Box 1365 CEA/ HERS Certification Identification (if applicable): city/state/zip:Hermosa Beach, CA 90254 Phone: 310-873-3325 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to !Pe building owner at occupancy. Responsible Builder/Installer M. Anthony Joaquin Responsible Builder/Install _ Name: Signature: Company Name (Installing Subcontractor or General Contractor or Builder/Owner): Mavin Builders, Inc. Position with Compantle): GC Address: PO Box 1365 CSLB License: 1011125 city/state/zip:Hermosa Beach, CA 90254 Phone: 310-873-3325 Date Signed: 06/29/2016 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 STATE OF CALIFORNIA PLUMBING CEC-NRCI-PLB-01-E (Revised 12/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-PLB-01-E Plumbing Page 5 of 5 Project Name: ALEXANDER'S STEAKHOUSE Enforcement Agency: CITY OFCUPERTINO Permit Number: 15110047 Project Address: 19379 Stevens Creek Blvd City Cupertino zip code: 95014 Instructions for NRCI-PLB-01-E Section A. GENERAL INFORMATION 01. Enter the date on the building permit. 02. Enter the appropriate building type from the pull down list. 03. Enter the appropriate phase of construction from the pull down list Section B. SCOPE OF RESPONSIBILITY 01. Enter the date the enforcement agency approved the certificate of compliance (NRCC-MCH-XX) that used as the basis of the specifications used to demonstrate compliance. 02. Enter the construction document that specifies the installed feature, material, component, manufactured device or system performance diagnostic results required for compliance as specified on the certificate of compliance. 03. As needed, this row shall be filled according to the instructions for row B.02 04. As needed, this row shall be filled according to the instructions for row 13.02 05. As needed, this row shall be filled according to the instructions for row B.02 Note: more rows shall be added when needed Section C. MANDATORY REQUIREMENTS FOR ALL CENTRAL DOMESTIC HOT WATER RECIRCULATION SYSTEMS - For central systems only. Ensure all mandatory requirements are met. Section D. D. MANDATORY MEASURES FOR ALL SINGLE DWELLING HOT WATER DISTRIBUTION SYSTEMS For single dwelling systems only. Ensure all mandatory requirements are met. CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 STATE OF CALIFORNIA MECHANICAL �t_ RAI JIMPKIIA FNFRr V Rl)MMIRSInN -e vCERTIFICATE OF INSTALLATION NRCI-MCH-01-E Mechanical (Page 1 of 2) Project Name: Alexander's Steakhouse l• Enforcement Agency Ci of Cupertino Permit Number Project Address: 19379 Stevens Creek Blvd. C'": Cupertino hp Code. 9 014 A. GENERAL INFORMATION DATE OF BUILDING PERMIT In the table below identify all applicable construction documents that specify the features, materials, components, manufactured devices, or system performance diagnostic results required for the scope of responsibility for this Installation Certificate. BUILDING TYPE Applicable Sheets or Pages, Tables, Schedules, etc. PHASE OF CONSTRUCTION Mechanical Plans if more than one person has responsibility for building construction, each person shall prepare and sign an Installation Certificate document applicable to the portion of construction for which they are responsible; alternatively, the person with chief responsibility for construction shall prepare and sign the Installation Certificate document(s) for the entire construction. B. SCOPE OF RESPONSIBILITY Date of approval by the enforcement agency of the Certificate of Compliance that provides the specifications for this Installation Certificate. In the table below identify all applicable construction documents that specify the features, materials, components, manufactured devices, or system performance diagnostic results required for the scope of responsibility for this Installation Certificate. Document Title or Description Applicable Sheets or Pages, Tables, Schedules, etc. Date Approved By the Enforcement Agency Mechanical Plans Ml, M2, M3 4 ; CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA MECHANICAL rcr_aari_aecu_n1_c tRe.A—i nKrltt CALIFORNIA FNFRGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-MCH-01-E Mechanical (Page 2 of 2) Project Na— Alexander's Steakhouse Enforcement Ap— Cityof Cupertino Permit Number. Project Address: 19379 Stevens Creek Blvd. `nt`CupertinoZip code: 95014 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Installation documentation' accurate Documentation Author Name: Documenta ' n A hor signature: Mark Trillo Documentation Author Company Name: Date Signed: Trillo Mechanical /All Address: CEA/ HERS Certification Identification (if applicable): Box 1330 City/State/Zip: Hollister, CA 95024 Phone. 831-636-7825 RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Installation is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code in the applicable classification to accept responsibility for the system design, construction, or installation of features, materials, components, or manufactured devices for the scope of work identified on this Certificate of Installation and attest to the declarations in this statement (responsible builder/installer), otherwise I am an authorized representative of the responsible builder/installer. 3. The constructed or installed features, materials, components or manufactured devices (the installation) identified on this Certificate of Installation conforms to all applicable codes and regulations, and the installation conforms to the requirements given on the plans and specifications approved by the enforcement agency. 4. 1 reviewed a copy of the Certificate of Compliance approved by the enforcement agency that identifies the specific requirements for the scope of construction or installation identified on this Certificate of Installation, and 1 have ensured that the requirements that apply to the construction or installation have been met. 5. 1 will ensure that a completed signed copy of this Certificate of Installation shall be ed, or made available . the building permit(s) issued for the building, and made available to the enforcement age or all applicable i ns. I understand that a completed signed copy of this Certificate of Installation is requir be' u ocu ation the builder provides to the building owner at occupancy. Responsible Builder/Installer Name: Re uil nstaller Signa Mark Trillo Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) Position with Comp ny Trillo MechanicalPr Idem Address: P.O. Box 1330 000 0 CSLB License: 8 0088 1 0 city/state/zip: Hollister, CA 95024 Phone 831-636-7825 Date Signed: 6/28/16 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance May 2015 STATE OF CALIFORNIA ELECTRICAL POWER DISTRIBUTION r]FC-NRCI-FI C -n1 -F !Revised 19/151 CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-ELC-01-E Electrical Power Distribution Page 1 of 2 Project Na me: ALEXANDER'S STEAKHOUSE Enforcement Agency: CITY OF CUPERTINO Permit Number: 15110047 Project Address: 19379 Stevens Creek Blvd °ty: Cupertino zip code: 95014 GENERAL INFORMATION DATE OF BUILDING PERMIT: 04/19/2016 PERMIT NUMBER: 15110047 BUILDING TYPE: ✓❑ Nonresidential E] High -Rise Residential (common area) ❑ Hotel/Motel (Common Area) PHASE OF CONSTRUCTION: E] New Construction ❑ Addition ❑ Alteration SCOPE OF RESPONSIBILITY Enter the date of approval by enforcement agency of the Certificate of Compliance that provides the specifications for the energy efficiency measures for the scope of responsibility for this Installation Date: 06/29/2016 Certificate. In the table below identify all applicable construction documents that specify the requirements for the scope of responsibility reported by this Installation Certificate (continued). Document Title or Description Applicable Sheets or Pages, Tables, Date Approved by Schedules, etc. Enforcement Agency Electrical Plans to io EU. Lu Co. L) 60.1 L, 617.13 04/08/16 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 STATE OF CALIFORNIA ELECTRICAL POWER DISTRIBUTION CEC-NRCI-ELC-01-E (Revised 12/15) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF INSTALLATION NRCI-ELC-01-E Electrical Power Distribution Page 2 of 2 Project Name: ALEXANDER'SSTEAKHOUSE Enforcement Agency: CITY OF CUPERTINO Permit Number: 15110047 Project Address: 19379 Stevens Creek Blvd City: Cupertino Z1p Coda: 95014 DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. 1 certify that this Certificate of Compliance documentation is accurate and complete. Documentation Author Name: M. Anthony Joaquin Documentation Author Signature: Company: Mavin Builders, Inc. Signature Date: 06/29/2016 Address: PO Box 1365 CEA/ HERS Certification Identification (if applicable): City/State/Zip:Hermosa Beach, CA 90254 Phone:310-873-3325 RESPONSIBLE PERSON'S DECLARATION STATEMENT 1 certify the following under penalty of perjury, under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. 1 am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance (responsible designer). 3. The energy features and performance specifications, materials, components, and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24, Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the information provided on other applicable compliance documents, worksheets, calculations, plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. 1 will ensure that a completed signed copy of this Certificate of Compliance shall be made available with the building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I understand that a completed signed copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: M. Anthony Joaquin Responsible Design ' nat , Company: M. Anthony Joaquin Date Signe . 06 9/2016 Address: PO Box 1365 License: 1011125 city/state/zip:Hermosa Beach, CA 90254 11one:310-873-3325 CA Building Energy Efficiency Standards - 2013 Nonresidential Compliance December 2015 F I L "- TESTING ENGINEERS, INC. 2811 Teagarden St. 510-835-3142 510-834-3777 fax San Leandro, CA 94577 800-660-3142 San Leandro • San Jose • Martinez INSPECTION REPORT Week Ending: 2/26/16 PROJECT # 62797 PROJECT: 19379 Stevens Creek Blvd. Alexander's Steakhouse Cupertino, CA DATE Permit # 15110047 2/26/16 HOURS 4 INSPECTOR B. Tonkovich Reported to Steve of Fine Steel Products at the shop as requested. TYPE OF INSPECTION: Visual Welding PLACE OF INSPECTION: Fine Steel Products (shop) Collected certified mill test reports and verified against material heat numbers. Checked welder qualification papers (Francisco Hernandez, ID # 3657). Checked WPSs and verified welding parameters. Verified proper electrode storage. Verified proper preheat. Visually inspected fit -up. Performed continuous visual inspection of the in -progress welding performed by one qualified welder using the FCAW process with E71T-9 wire electrode. Weldments consist of 1/4" fillet welds joining W12 x 45 to 1/4" plate for wide flange beams at mezzanine; W10 x 22 to 3/8" plate for wide flange beams at mezzanine; and two (2) HSS 5" x 5" x 1/4" to 3/4" base plate for columns at mezzanine on lines 1 and 1.8 (complete). The preceding work was, to the best of my knowledge, in compliance with approved plans and specifications, including revisions by engineer and Drawings SK -1, SK -2 and SK -3. —(7�Reviewed by: Davi Ins 'ppe�y-, Special pectilaii�i�� 1cc: Mavin Builders, Inc. / A. Joaquin MAR 1 2016 Mavin Builders, Inc. / J. Tran Enertia Designs / J. Chen, S.E. D Scheme Architects BY City of Cupertino / Bldg. Inspection Dept. The results presented in this report relate only to the item(s) tested/inspected and can be reproduced only in its entirety unless written permission from TO is obtained. Page 1 of 1 TESTING ENGINEERS, INC. ad l(12 2811 Teagarden St. 510 835-3142 510 8/ San Leandro, CA 94577 800-660-3142 PROJECT # 62797 PROJECT: 19379 Stevens Creek Blvd. Alexander's Steakhouse Cupertino, CA DATE HOURS Permit # 15110047 2/29/16 INSPECTOR A. Gundersen San Leandro • San Jose • Martinez INSPECTION REPORT Week Ending: 3/4/16 TYPE OF INSPECTION: Visual Welding / Epoxied Anchors PLACE OF INSPECTION: Jobsite Reported to Hector of Fine Steel Products at the jobsite as requested. Checked welder qualification papers (Cesar Gallager, ID # 2932). Checked WPSs and verified welding parameters. Verified proper electrode storage. Verified proper preheat. Visually inspected fit -up. Performed periodic visual inspection of the in - progress welding performed by one qualified welder using the FCAW process with E71T-8 wire electrode. Weldments consist of 1/4" single pass fillet welds joining new 3/8" shear tab to existing wide flange column for new 10 x 22 beam on lines 1 and 2 at C and D; and new HSS 5" x 5" column to new W12 x 45 beam. The preceding work was, to the best of my knowledge, in compliance with approved plans and specifications, including revisions by engineer and Drawings SKS1, dated 2/17/16 and S6, Details 4 and 10, dated 11/9/15. Reported to Mavin Builders at the jobsite as requested. Inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and the injection of Simpson Set XP epoxy (exp. 6/17). Witnessed the proper insertion of ninety (90),1/8" diameter Allthread anchors, for HDU 4 holddowns,16" in length, embedded 10" between lines 1 and 3 from C to H at track foundation; and four (4) 5/8" diameter Allthread anchors, 16" in length, embedded 10" at new HSS 5" x 5" column base plate on line 1 at C. The preceding work was, to the best of my knowledge, in compliance with approved plans and specifications, including revisions by engineer and Drawings SKS1, dated 2/17/16 and S.6, Detail 4, dated 11 g/ Reviewed b . 1cc: Mavin Builders, Inc. / A. Joaquin David Chippero Mavin Builders, Inc. / J. Tran Special Inspection Division Manager Enertia Designs / J. Chen, S. E. D Scheme Architects City of Cupertino / Bldg. Inspection Dept. The results presented in this report relate only to the item(s) tested/ inspected and can be reproduced only in its entirety unless written permission from TEI is obtained. Page 1 of 1