13080109CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20488 STEVENS CREEK BLVD STE 2040
CONTRACTOR: ALL APPLIED PERMIT NO: 13080109
CONSTRUCTION INC
OWNER'S NAME: STEVENS CREEK COMMERCIAL, LLC
433 LINDA AVE STE I DATE ISSUED: 04/30/2014
OWNER'S PHONE: 4086661688
PIEDMONT, CA 94611 PHONE NO: (510)847-5283
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
MEZEN JAPANESE RAMEN NOODLE RESTAURANT -
License Class Lic. # 83s CRs
COMM. T.I
<< q ce� Date
Contractor T� On
TO INCLUDE NEW INTERIOR PARTITIONS, FIXTURES,
M,E,P S 1450 SQ FT
1 hereby affirm that I am licensed under the provisions of Chapter
(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: $145000
performance of the work for which this permit is issued.
t 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: 36953207.2040
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
180 DAYS FRO D 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
granting of this permit. Additionally, the a licant understands and will co
a by: Date: _l
with all non-point source regulations t e Cupertino Municipal Code, Se ion
9.18.
Q /
�3�
-ROOFS:
Signature Date I r
All roofs shall be inspecte or 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 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. 1 will
1 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 I use equipment or devices which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Qltality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino pat Code, Chapter 9.12 and
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
the Health & Safety Code, Sections 25505, 53 rid 25534.
6y
Owner or authorized agent: Datr.
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 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
FROM :ALL RPPLIEDCONSTRUCTION FAX NO. :5106559988 Dec. 16 2014 07:45PM P1
1
V
l
BUILDING PERMIT EXPIRATION NOTICE
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION I, v �l
ALBERT SALVADOR, P.E., C,8.0„ BUILDING OFFICIAL rS /
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPlEStIVQNO (408) 777.3228 • FAX (408) 777-7606 • build IngCO)cuoertino.org
Scl)teinber 16, 2014 i
ALL APPLiED CONSTRUCTION TNC -7f r '� trveVJ
433 LTNUA AV!E STE 1. /
l"117nMONT CA, 04611 , (� /L f
S11BJCCT: BUiLDIi'NG PEM11T.1FXPIRATION NOTICE
Sii.e Address ; 20488 STEVENS CRE EK BLVD STF 2040
Building Permit Application #: 13080109 `
Txpiration Dute:.10/27/.2014
This notification Icticr is issued as a reminder that the construction pdrmit for d..te following project will expire on
the date shown above unless further nclion it; taken by yon.
Pcr Seetio4 105,5 of the California Huilding Code, ... "everypermll rstnec•d shall becorne invalid unless the work on
!hc site aulhen iced by 5'uchpernait is' cr�n:rnenced wi(hin 180 days ciJk•r i/.c issuance, or frhe work awhorized nu /he I t~
tl �
sire by such pound is suspended or abandoned for a period o/ 180 detyx rafter the finer, the work is commenced, " J
The following options aro available to keep your building pernul active:
A. if consu ucti.on for your project is ongoing, an inspection must lie requested prior to the rxuiration dute of (ltc
porn»t to verify work is continuing and the project is not abandoned.
B. A request in writing to extend yow• building permit nmy he submitted prior to the expiration date of the permit.
Valid reaeons shall be cited for the delays on your construction Schedule with a;ustiflablc cause demonstrated to the
Building 011iuial. The extension, if granted, will be fora period of not more than 180 days. A processitlg !co will be
due upon submittal of the request. Extension rcilrtests shall be hand delivered to the building department or e-mailed
to Pat!•icia u'cu crkip.)
if no action is taken prior to the expiration date of the building permit. the building penni.t will expire. Once a permit
expires till fees paid to date will be relinquished, new fees will be required to reactivate the expired permit and the
project wit l be subject to toritpliance with all now Building Code standards and loco] ordinances in effect at the time
the, permit is reactivated. For projects that require plan review, additional plan review fees and.new plans and
documents will be required to lie submiacd for review to atI new code standards and inch ordinances,
Discretionary Plnmiing approvals are subject to expiration if the building permit expires. Please refer to the Planning
Deharltnent to determine if a new planning review process is required. 4 Code Er farcement action may result if
partial construction ofa building i.r left abandoned um1 rhe rile is deemed unsafe.
If your records show that the permit inspection card was signed and released (finaled) by one of our building
k specion-, please notity us at your earliest convenience at (408) 777.3228. We will update our records and rinse
your pemiii and we apologize for any inconvenience this letter may have caused.
Sincerely,
Patricia. Garcia
408.777.3228,Patricia !t)puacrtino.grg
131-lilding 1)eparbncnt, City of. Cupertino
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION p d
10300 TORRE AVENUE o CUPERTINO, CA 95014-3255 ,3 0 0
(408) 777-3228 o FAX (408) 777-3333 ^ buildinq(@cupertino.org
❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT #
PROJECT DDRESS
�®
OWNERNA�.l�
o�o �J
E-MAILf�,B/�
STREET ADDRESS
CITY, STATE, ZIP
FAX
CO ACT NAME
n
PHONE ���,
E-MAIL
S
��� a
STREET ADDRE
CRY, STATE, ZIP
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
ARCHITECT/ENG EERNAME
LICENSE NUMBER
BUS. LIC#
COMPANY NAME
E-MAIL
FAX
LHC- G
auck3nq Qc,zYrt
STREET ADDRE S
Avenue_
C STATE,ZIP
PHONE
3 3 r
DESCRIPTION OF WORK
0 r,, Al Ye Sfau I'ui YL t t
EXISTING USE
PROPOSED USE CONSTR.
TYPE
# STORIES
YD UV� 5
..//--
R staar ."t
V a,
4
USE
TYPE
OCC.
SQ.FFTT.
VALUATIONEXfST($}
G
rig
AREAIL
NEW FLOOR
AREA
D EMO
AREA
TOTAL
NET AREA
j4�
�J _
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECKAREA
TOTAL DECKIPORCH AREA
GARAGE AREA: DETACH
❑ ATTACH
#DWELLING UNITS:
ISASECOND UNIT ❑YES
SECONDSTORY ❑YES
BEING ADDED? ONO
ADDITION? ONO
PRE -APPLICATION OYES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECEIV Yq A
TOTAL VALUATION:
PLANNING ADPL# gNO PLANNING APPROVAL LETTER
EICHLERHOME? ONO
-I�?
By my signature below, I certify to each of the following: 1 am the property owner or authorized age to act on the property owner's behalf. I have read this
application and the information I have provided 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 relati g building c nstruction. authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
10 1I
Date: �4
Signature of Applicant/Agent: Cn�t�l�/ /
SUPPLEMENTAL INFORM [ N REQUIRED
PLAN -CHECK TYPE ROUTING SLIP
p
SFD or Multifamily dwellings: Apply for demolition permit for
—New
existing building(s). Demolition permit is required prior to issuance of building
OVER-THE-6UNTER BUILDING PLAN REVIEW
_
permit for new building.
❑ EXPRESS *E?'–PLANNING PLAN REVIEW
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure,
s ANDARD azs-
_
form if any Hazardous Materials are being used as part of this project.
❑ 'LARGt;
E EPT
_ Copy of Planning Approval Letter or Meeting With Planning prior to
❑
submittal of Building Permit application.r�,�,�.
MAJOR' sANI sEWERDisTwcr
a ENVIRONMENTAL HEALTR
BldgApp_201 Ldoc revised 06/21/11
FM-,7
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
OCCUPANCY TYPE:
ADDRESS: 20488 SCB
FLR AREA
s.f.
DATE: 0811412013
REVIEWED BY: Mendez
BP FEES
APN:
BP#:
II-B,111-B,IV,V-B
`VALUATION: 1$145,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Tenant Improvement
PRIMARY Commercial Building
USE:
IBTIINSP
Elec. Insp, Frye:
PENTAMATION 1B TI
PERMIT TYPE: A,
WORK mew- comm. t.i to include new interior partitions, fixtures M E P's 1450 sq ft
SCOPE
OCCUPANCY TYPE:
TYPE OF
CONSTR.
FLR AREA
s.f.
PC FEES
IPC FEE ID
BP FEES
BP FEE IID
B (Tenant Improvements)
II-B,111-B,IV,V-B
1,450
$2,097.32
IBTIPLNCK
$1,367.44
IBTIINSP
Elec. Insp, Frye:
PME Plan Check:
$0.00
Permit Fee:
$1,367.44
Suppl. Insp. Fee.S Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
TOTALS:
1,450
$2,097.32
1
1 $1,367.44
J
MECH, HOURLY 0 Yes (D No
PLUMB, HOURLY 0 Yes Q No
ELEC, HOURLY Q Yes Q No
jVvch. Plan CheckF-F
Plumb. Plan Check
Elec. Plan Check
FL1eclt. Perrnil Fee..'
Plumb. Permit Fee:
Dec. Permit Fee:
Other Uech. Insp.
Other Plumb Insp.
Ocher Elcc. Insp.
1�eeh. Insp. lee:
Phmab. hap. Fee:
Elec. Insp, Frye:
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 Dent for addn'l info.
FEE ITEMS (Fee Resolution 11-053 Elf. 711112)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$2,097.32
Select a Misc Bldg/Structure
or Element of a Building
Suppl. PC Fee: 0 Reg. ® OT
0.0
hrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$1,367.44
Suppl. Insp. Fee.S Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
Construction Tax:
Adin.inis trative .Fee:
0
Work Without Permit? ® Yes (F) No
$0.00
Advanced Planning Fee:
$0.00
Select a Non -Residential
Building or Structure
Travel Documentation Fees:
Strong Motion Fee: IBSEISMICO
$30.45
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$6.00
SUBTOTALS:
$3,501.21
$0.00
TOTAL FEE:
1 $3,501.21
Revised: 0-7/61/2013
CUPERTONO
TOR ILffS7
Bu llding Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
Fax: 408-777-3333
JOB ADDRESS: 2p4gy StIvetA.5 PERMIT # � V a vi
OWNER'S NAME: i k&e PHONE #
GENERAL CONTRACTOR: 1l - BUSINESS LICENSE #
ADDRESS: 4 33 L ` ,� j CITY/ZIPCODE: % i , 94-C
*Our municipal code requires all businesses working in the city to have a City of Cupertino business Incense.
NO BUILDING FINAL OR FINAL OCCUPANCY MSPIECTMN(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPIERTIINO
BUSINESS LICENSE.
1< am no using any subcontractors:
Signature
P➢ease check appllncable subcontractors and compllete the ffollllowung nnfformation:
Date
c�
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
��= ff
Owner Contractor Signature-
-f
ignature
-f /I'DZ) f /I
Date