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B-2018-0890 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0890 20400 STEVENS CREEK BLVD STE 250 CUPERTINO,CA 95014-2296(369 01 028) PACIFIC RIDGE BUILDERS INC SANTA CLARA,CA 95054 OWNER'S NAME:CUPERTINO CITY CENTER BUILDINGS DATE ISSUED:06/05/2018 OWNER'S PHONE: PHONE NO:( LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#940761 Contractor PACIFIC RIDGE BUILDERS INC Data 01/31/2020 X BLDG ELECT_PLUMB hereby affirm that 1 am licensed under the provisions ofChapter 9(commencing _MECH_RESIDENTIAL X COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: SPECULATIVE SUITE-T.1.(6,676 SF)DEMO OF EXISTING I hereby affirm under penalty of perjury one ofthe following two declarations: PARTITIONS AND FINISHES; BUILD CONFERENCES AND BREAK i, I have and will maintain a certificate of consent to self-insure for Worker's ROOM Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 ofthe Lubin Code,for the performance ofthe work for which this permit is issued Sq.Ft Floor Area: Valuation:$270000.00 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 APN Number: Occupancy Type: and stale laws relating to building construction,and hereby authorize 36901 028 A(Tenant Improvements),13(Tenant Improvements) 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 PERMIT EXPIRES IF WORI{IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Si in 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature - Date 06-05-2018 Issued by:Kim Dunbar Date:06/05/2018 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lor for one of the - RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is r. 1,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) z I,as owner ofthe property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:06-05-2018 I hereby affirm under penalty of perjury one of the following three deehtrations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. 1 have and will maintain a Certificate of Conscnt to self-insure for Worker's Compensation,as provided for by Section 3700 ofthe Labor Cade,for the performance ofthe work for which this permit is issued, HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534.1 will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should 1 store or handle hnzardous shall not employ any person in any manner so as to become subject to tlrc 'material.Additionally,should I use equipment m-devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California.If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Clmpter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must Forthwith comply with such provisions or this permit shall be deemed revoked Owner or authorized ager APPLICANT CERTIFICATION Date:06-05-2018 1 certify that I have read this application and state that the above information Is ONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there Is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for Inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARNMON Code,Section 9.16. 1 understand my plans shall be used as public records. SignatureLicensed Data 06-05-2018 Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2018-0890 20400 STEVENS CREEK BLVD STE 250 CUPERTINO,CA 95014-2296(369 01 028) PACIFIC RIDGE BUILDERS INC SANTA CLARA,CA 95054 OWNER'S NAME:CUPERTINO CITY CENTER BUILDINGS DATE ISSUED:06/05/2018 OWNER'S PHONE: PHONE NO:( LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lie.#940761 Contractor PACIFIC RIDGE BUILDERS INC Date 0113112020 Y BLDG_ELECT_PLUMB I hereby affirm that I am licensed under the provisions of Chnpter 9(commencing —MECH_RESIDENTIAL x COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license Is in tall force and effect. - JOB DESCRIPTION: SPECULATIVE SUITE-T.I.(6,676 SF)DEMO OF EXISTING I hereby affirm under penalty,of perjury one of the following two dechusulmon PARTITIONS AND FINISHES;BUILD CONFERENCES AND BREAK n. I have and will maintain a certiftente of consent to self-f na re for Worker's ROOM Compensation,as provided for by Section 3700 of the Labor Code,for the REV#1-DEMO T-BAR CEILING AND INSTALL OPEN CEILING performance of the work for which this permit is issued. DUCT WORK,PENDANT LIGHTING IN ROOMS 201.,204 AND 208- -I have and will maintain Worker's Compensation Insurance,as provided fur by ISSUED 08/21/2018 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Pt Floor Ares: Vulnation:$270000.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 36901 028 A(Tenant Improvemcnts),B(Tenant Improvements) 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature 0 812 1/2 01 8 Issued by:Kim Dunbar Date:06/05/2018 OW -B ILDER DECLARATION ATI I hereby affirm that I am exempt from the Conti-actor's License Law for one of theRE-ROOFS• following two reasons: All mops shall bo inspeowd prior to any roofing material being installed.if e roof is t. 1,as owner of the property,or my employees with wages as their sole installed without first obtaining as inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec,7044,Business&Profcudous Corte) z, 1,as owner of the property am exclusively contracting with licensed Signature ofApplicanu contractors to construct the project(Sec.7044,Business&Professions Code). Date:08/21/2018 I hereby affirm tinder penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER r. 1 have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Cade,for the performance of the work for which this permit is issued, HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance,as provided for by I lurve read the hazardous matmisls requirements under Chapter 6.95 of live Section 3700 of the Labor Cade,far the performance of the weak for which this California Health&Safety Code,Sections 25505,25533,and 25534.1 will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(n)should 1 store or handle hnzardmrs shall not employ any person in any manner so as to become subject to the material.Additionally,should I use equipment or devices which emit hazardous air contsminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California.If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Scott an 05,25533,sad 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revolted. Owner or authorized agent: APPLICANT CERTIFICATION Data:08121!2018 I certify that I have read this application and state that the above information is TROCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for Inspection purposes. (We)agree Lender's Name to save Indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCRITECT'S DECLARA'T'ION Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date 08/21/2018 Licensed Professional CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2018-0890 20400 STEVENS CREEK BLVD STE 250 CUPERTINO, CA 95014-2296 (369 01 028) PACIFIC RIDGE BUILDERS INC SANTA CLARA, CA 95054 OWNER'S NAME: Cupertino City Center Buildings DATE ISSUED: 06/05/2018 OWNER'S PHONE: PHONE NO: (408) 627-4765 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #940761 Contractor PACIFIC RIDGE BUILDERS INC Date 01/31/2020 X BLDG _ ELECT _ PLUMB MECH _ RESIDENTIAL X COMMERCIAL 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. JOB DESCRIPTION: SPECULATIVE SUITE - T. I. ( 6,676 SF) DEMO OF EXISTING I hereby affirm under penalty of perjury one of the following two declarations: PARTITIONS AND FINISHES; BUILD CONFERENCES AND BREAK 1. I have and will maintain a certificate of consent to self-insure for Worker's ROOM Compensation, as provided for by Section 3700 of the Labor Code, for the REV # 1 - DEMO T BAR CEILING AND INSTALL OPEN CEILING :ys performance of the work for which this permit is issued. DUCT WORK, PENDANT LIGHTING IN ROOMS 201, 204 AND 208 - 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by ISSUED 08/21/2018 Section 3700 of the Labor Code, for the performance of the work for which this REV # 2 - ADDING CONFERENCE ROOMS, OFFICES, ENGINEERING permit is issued. WORKROOM, COFFEE AREA, RECEPTION, IPF ROOM - ISSUED APPLICANT CERTIFICATION 11/14/18 1 certify that I have read this application and state that the above Sq. Ft Floor Area: Valuation: $270000.00 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 APN Number: Occupancy Type: inspection purposes. (We) agree to save indemnify and keep harmless the . 369 01 028 A (Tenant Improvements),B (Tenant Improvements) 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 r t e Cu ertino Municipal Code, Section 9.18. PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR Signature Date 11/14/2018 180 DAYS FROM LAST CALLED INSPECTION. E LDER'DECLARATION Issued by: Kim Dunbar I herebyaffirm that I am exempt from the Contractor's License Law for one of the Date: 06/05/2018 following two reasons: 1. I, as owner of the property, or my employees with wages as their sole RE-ROOFS: compensation, will do the work, and the structure is not intended or offered for All roofs shall be inspected prior to any roofing material being installed. If a roof is sale (Sec.7044, Business & Professions Code) installed without first obtaining an inspection, I agree to remove all new materials for 2. I, as owner of the property, am exclusively contracting with licensed inspection. contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations:' Signature of Applicant: 1. I have and will maintain a Certificate of Consent to self-insure for Worker's Date: 11/14/2018 Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE permit is issued. I have read the,hazardous materials requirements under Chapter 6.95 of the s. I certify that in the performance of the work for which this permit is issued, I California Health & Safety Code, Sections 25505, 25533, and 25534. I will shall not employ any person in any manner so as to become subject to the maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Worker's Compensation laws of California. If, after making this certificate of Health & Safety Code, Section 25532(a) should I store or handle hazardous exemption, I become subject to the Worker's Compensation provisions of the material. Additionally, should I use equipment or devices which emit hazardous Labor Code, I must forthwith comply with such provisions or this permit shall air contaminants as defined by the Bay Area Air Quality Management District I be deemed revoked. will maintain compliance with the Cupertino MuniciX533, l Code, Chapter 9.12 and the Health & Safety Code, 25534. APPLICANT CERTIFICATION I certify that I have read this application and'state that the above information is Owner or authorized agent: correct..) agree to comply with all city and county ordinances and state laws Date: 11/14/2018 relating to building construction, and hereby authorize representatives of this city CO STRUGf(0N LENDINGAGENCY to enter upon the above mentioned property for inspection purposes. (We) agree I hereby affirm that there is a gnstruction lending agency for the performance to save indemnify and keep harmless the City of Cupertino against liabilities, works, judgments, costs, and expenses which may accrue against said City in of for which this permit is issued (Sec. 3097, Civ C.) consequence of the granting of this permit. Additionally, the applicant understands Lender's Name and will comply with all non-point source regulations per the Cupertino Municipal Lender's Address Code, Section 9.18. ARCHITECT'S DECLARATION Signature Date 11/14/2018 1 understand my plans shall be used as public records.