14070040CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10355 N DE ANZA BLVD
CONTRACTOR: CUPERTINO ELECTRIC
PERMIT NO: 14070040
INC
OWNER'S NAME: VIDOVICH-CUPERTINO LIMITED PARTNERS
1132 N 7TH ST
DATE ISSUED: 08/08/2014
OWNER'S PHONE: 4084460700
SAN JOSE, CA 95112
PHONE NO: (408)991-1000
❑ LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
INSTALLATION OF (4) EV CHARGING STATTIONS
n
License Class C 1 0 Lic. # [i1 T
CREATING
Contractor l �GeL� Date g -g -
(7) STANDARD EV STALLS AND 1 ACCESSIBLE EV STALL
.udAti�t�p
(9) TOTAL
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:
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: $85000
performance of the work for which this permit is issued.
1 have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance of the work for which this
APN Number: 32633113.00
Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT E W.QRK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WITHIN 18 DAYS OF PE IT ISSUAN EOR
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 F OM LAST LLED INSPE I N.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which ay accrue against said City in consequence of the
Issued by: Date:
granting of this permit. itionally, the applicant understands and will comply
With all non- oint s c egulations per the Cupertino Municipal Code, Section
9.18.
Signatur Date 166-/
-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.
❑ OWNER -BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
I, as owner of the property, am exclusively contracting with licensed contractors to
HAZARDOUS MATERIALS DISCLOSURE
construct the project (Sec.7044, Business & Professions Code).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
declarations:
Health & Safety Code, Section 25532(a) should I store or handle hazardous
I have and will maintain a Certificate of Consent to self -insure for Worker's
material. Additionally, should I use equip ent 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 a Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with a Cupe no Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, I o 25 5 5 3, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date: ((((////
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
CONSTRUCTION LENDING AGENCY
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
I hereby affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked.
work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
APPLICANT CERTIFICATION
Lender's Address
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
CITY OF CUPERTINO
I/f 1 FEE ESTIMATOR - BUILDING DIVISION
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
hhtri't of, 1 Thom foot aro hacod nn tho nroliminary infnrmatinn availahle and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution II-053Lf/' '. 1,13)
ADDRESS: 10355 N DE ANZA BLVD
DATE: 07/10/2014
REVIEWED BY: SEAN
11ech_ Permit For
APN:
BP#:
VALUATION: 1$85,000
,PERMIT TYPE: Building Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY Commercial Building
USE:
I I)b, ,h h1sp. Fec
PENTAMATION SOLAR -COMM
PERMIT TYPE:
WORK
INSTALLATION OF 4 EV CHARGING STATIONS CREATING 7 STANDARD EV STALLS AND 1
SCOPE
ACCESSIBLE EV STALL(91rOTAL).
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
hhtri't of, 1 Thom foot aro hacod nn tho nroliminary infnrmatinn availahle and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution II-053Lf/' '. 1,13)
tlech. Plan Check
Plumb. Plan Check
lac. Plan Check
11ech_ Permit For
Plumb. Permit h -,
Elec. Permit f
Other l,fech. Imp.E17--
Other Plumb Insp.E17-
).,herF.lec. Irish.Ll I
kl;" "7 l� i . ", f ee:
I I)b, ,h h1sp. Fec
_ rI>?' "c
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School
hhtri't of, 1 Thom foot aro hacod nn tho nroliminary infnrmatinn availahle and are only an estimate. Contact the Dent for addn'l info.
FEE ITEMS (Fee Resolution II-053Lf/' '. 1,13)
FEE
QTY/FEE
MISC ITEMS
Plan Check Fee:
$0.00
L—±—J #
$436.00
Alternative Energy System
ICHRGSTA7 EV Charging Station
Suppl. PC Fee: Q Reg. 0 OT
0.Q
rhrs
$0.00
PME Plan Check:
$0.00
Permit Fee:
$0.00
Suppl. Insp. Feels Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$0.00
PME Permit Fee:
$0.00
E 'onstrucfion TtLv:
1rbnini.vtrufhle fee:
0
Work Without Permit? 0 Yes (F) No
$0.00
Advanced. Plannint, Feer
$0.00
Select a Non -Residential
Building or Structure
0
0
i
Treat e11)ctcun�etatatirrtt l°ccs:
�O
Strong Motion Fee: IBSEISMICO
85
Select an Administrative Item
o
Bldg Stds Commission Fee: IBCBSC
$4.00
SUBTOTALS:
$21.85
$436.00
TOTAL FEE:
85
Revised: 07/07/2014
1 -%
e
Cupertino Electric, Inc.
1132 N. 7th Street
San Jose, CA 95112
(408) 808-8016
March 6, 2015
City of Cupertino
10300 Torre Ave.
Cupertino, CA 95014-3255
Attn: Building Dept.
Re: 10355 N. De Anza Blvd.
Bldg. Permit Application 14070040
Building Dept.,
Cupertino Electric respectfully requests a 180 day extension be granted for above
referenced building permit. We have requested Apple provide a date that building
services can be interrupted for completion of our work.
Please contact me should you have any questions.
Sincerely,
Scott Moreau
Project Manger
408-660-6636
Scott—Moreau@cei.com
sm/Ij
cc: Russ Beasley
file:2014jobs\appleda06evchargers\permits\elec\extensionrequest