11060134 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10600 N TANTAU AVE CONTRACTOR:XL CONSTRUCTION PERMIT NO: 11060134
OWNER'S NAME: 10590 TANTAU INVS LLC 851 BUCKEYE CT DATE ISSUED:08/25/2011
OWNER'S PHONE: 4089744876 MILPITAS,CA 95035 PHONE NO:(408)240-6000
❑ LICENSED CONTRACTOR'S DECLARATION r r r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class Lic.8 F F {
MECH RESIDENTIAL COMMERCIAL
Contractor��5y-t, I ate 1
I hereby affirm that 1 am licensed under the provisions of Chapter 9 JOB DESCRIPTION:APPLE-COMMERCIAL TENANT
(commencing with Section 7000)of Division 3 of the Business&Professions IMPROVEMENT(23,529SQFT)
Code and that my license is in full force and effect. EXTERIOR UPGRADES(REMOVAL OF SINGLE DOOR/WINDOW
ASSEMBLY&ADDITION OF NEW DOUBLE DOOR&CIVII.
I hereby affirm under penalty of perjury one of the following two decla
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. Sq.Ft Floor Area: Valuation:$2200000
APPLICANT CERTIFICATION
1 certify that I have read this application and state that the above information is APN Number:31618035.10600 Occupancy Type:
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, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regula'ons per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. 7
Signature eIssue* y: Date.�f �✓
U OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,1 agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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 read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(x)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
1 certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety ode,Sections 25505,25533,and 25534.
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.
*er o auto ed a ent: f
ate: l
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
1 certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating [hereby affirm that there is a construction lending agency for the performance of Hork's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
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. ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
/ o,6 v,13
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTINO (408)777-3228•FAX(408)777-3333•building(ftyperfino.oro
❑NEW CONSTRUCTION ❑ ADDITION 9 ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT k
tJ N J
PROJECT ADDRESS I APN N ` . D 5, 10 (t,00
O NAME` I • PHO O _7U
-4(t
'"f T !"' IA('� C.T'G ISN COYf�
STREET II SS�• •� / O. C[T�, STATE,Z .n 0 A� G,�J FAX
COMA �r� hArc��L P _nG• 4478 D E N, "F��
STREET DVS CITY,STATE,ZIP
1 int — O
❑OWNER ❑ OWNER-BUILDER 9OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CON OR AME, ,I+O LIC SE 0 E E BUS.LIC N
COMP AME H 1 E-MAiL FJq0, 600&
•
s kt.c o �"on C&%51.
OV*n
STRE D SSO I CITY TATE, iP IhO ���I P
ARC GINEER LICENSE NUMB Q�j BUS.LIC 0
_`
COMPA N ME 57'N(�i OS �• FAX
STREET RE SS 00 C STATE,• Cl 4C
50 DE TION OF WORK �J•
t •or►S
S1 �d wr/t ori dSJ�++ C',
-mow.ova '
ddor4' r,,Wl , Cid2 ^ elo 7VAL
k
„I h
EXISTING US PROPOSEDOE CO1�jST1=T5 1 STORIES OFFICE NLY
SI
EXISl'�,%,"�J� 4 A �`7VV 11 P TD R N .FT VALUATION
VALUAA /( .
AREA 51 ` ADEMO TOTAL
REA�I§Z 1 AREA21+` ` NET AREA 0 �� 1 .� � �-`�� x+00
BATHROOM KITCHEN OTHER /
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA:❑ DETACH
❑ ATTACH
9 DWELLING UMTS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? ❑NO ADDITION? ❑NO
PRF-APPLICATION ❑ YES IF YES.PROVIDE COPY OF PLANNER'S NAME: RECEIVEDBY: �• T�.ER VA
PLANNING APPL I ❑ NO PLANNING APPROVAL LETTII J -L
Oft
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to ildi construction. I authorize representatives of Cupertino to enter the abo//ve entifi d property for inspection purposes.
Signature of Applicant/Agent: Date: (O �S ,
SUPPLEMENTALINFORMATIO11 REQUIRED PLAN CHECK TYPE ROUTING SLIP
_New SFD or Multifamily dwellings: Apply for demolition permit for ❑ &��_OVER-THE-COUNTER BUILDING PLAN
REVIEW
existing building(s). Demolition permit is required prior to issuance of building _�
permit for new building. ��TANDAS.
P �//LANNING PLAN REVIEW
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure meg( UBLIC WORKS
form if any Hazardous Materials are being used as part of this project. ❑ LARGE U FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning prior to
submittal of Building Permit application. El MAJOR �TARYSEWERDISTRICT
ENVH2ONMENTAL HEALTH
Bldg,4pp2011.doc revised 03/16/11
b
COURTESY INSPECTION REQUEST FORM
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR,P.E.,C.B.O.,BUILDING OFFICIAL
C U P E RT I N O 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777.3333•building0cupertino.org
SITE BUILDING APPLICATION . DATE SUBMITTED: r�
ADDRESS: 1061 A/ Tan v Ave 106013 . -
APN TI PREPARATION
BUILDING PERMIT M
OWNER'S NAM4. PHONE M by 11UL-$134
AIDIDIf", - et`}o FAX
MAILING AD ES (if different from site address):
(n de
CONTRACg,R: PHONE#'. '1� 7. 0- 3
l�L Gor •d FAX 4 7.40-6001
CONTACT: PHONE#: 408 540--I 100
Ob Mk FAX#: (44 2
LIMITS OF WORK REQUESTED FOR COURTESY INSPECTIONS:
• I request to start construction work in which a buildingpermit has not been lately secured. I have obtained a tenant Improvement
P com P
preparation permitwhlch covers the removal of Interior.non-structural elements within the building. Furthermore,I have submitted a
building permit application and plans for the tenant improvement project and it is currently in the plan review process. I agree to call for
courtesy Inspections for the Limited work as noted on this application. I fully understand that I will be responsible to redo the work
performed under courtesy Inspectlons if the work does not fully comply with the approved set of plans and all State and local rules and
regulations. y �f
Owner.. .Print:? .Date:. ..1 ......� ..
Contractor: ....Print: 34?f�. 2�1�.
INSPECTION RESULTS
INSPECTION TYPE TIME ESULTS INSP. COMMENTS(REASON IF INSPECTION FAILED)
SPE T IN T.
$30 ' FR,4PA116 rDO 20OF «a
I
'RESULTS: P-Pass,F-Fall,C-Cancel,I-Incomplete,N-Not Required,R-To be Rescheduled �
Couriesy1nspForm_2011.doc revised 07112111
COURTESY INSPECTION REQUEST FORM 411
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR,P.E.,C.B.O.,BUILDING OFFICIAL
C U P E RTI N O 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228-FAX(408)777-3333•buildingC&cupertino.org
SITE ADDRESS: (0600 N TUn � Ave, B i 1�6d��P3LICATION#: DATE SUBMITTED:
APN TI PREPARATION
BUILDING PERMIT M
OWNER'S NAM : PHONE M 01 $(aj,-$Z34
P, - 3,\A,, 0 o FAX#:
rMAtILTING AD E (if different from site address):
RAC R: PHONE#: �{0a 2 0-
1
- 43
(_ FAX 4 240-6001
CONTACT: PHONE M 4C"AN
SRO__7 100
0b m ko", FAX 1. -
LIMITS OF WORK REQUESTED FOR COURTESY INSPECT(ONS:
u ;'DUA ?IUmbl lis �C
• I request to start construction work in which a building permit has not been completely secured. I have obtained a tenant improvement
preparation permit which covers the removal of Interior non-structural elements within the building. Furthermore,I have submitted a
building permit application and plans for the tenant improvement project and it Is currently in the plan review process. I agree to call for
courtesy inspections for the limited work as noted on this applicatlon. I fully understand that I will be responsible to redo the work
performed under courtesy inspections if the work does not fully comply with the approved set of plans and all State and local rules and
re ulations. 10 J
L ..Date:......r/
Owner: ....................Pnnt:..... f� .................. ... ............... t ..,�.........
.....
Contractor:. ...............................Print:....,.... ......... .Y .....................Date:..:: 7... ........
INSPECTION RESULTS
INSPECTION TYPE TIME `RESULTS INSP. COMMENTS(REASON IF INSPECTION FAILED)
SPENT INIT.
PJ r% .br,rr )niC le-�j�i- �d+t» 2-1
I,ri )Nc p Go rrlTn- tLDehns ) 0z, >r " I Q3
gal• ' It
RESULTS: P-Pass,F-Fall,C-Cancel,I-Incomplete,N-Not Required,R-To be Rescheduled
Coto•tesylnspForm_2011.doc rev(sed 07/l2lll
,30
•
COURTESY INSPECTION ES 21+1
TE S ON REQU T FORM �\
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O.,BUILDING OFFICIAL
C U P E RT I N O 10300 TORRE AVENUE-CUPERTI NO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildingr&.cuoertino org
SITE ADDRESS: 106m N Tan tA Ave BUILDING 11660134 460'3 KATION#: DATE SUBMITTED:
APN Tl PREPARATION
BUILDING PERMITM
OWNER'S NAM€: PHONE M Oq $(3L—SI34
FAX M
MAILING AD ES (if 4ifferent from site address);
[ LOOP
CONTRAIR: PHONE#: 40% 2 0- 43
]�L GOr iOYL FAX#: 40t Z40-6ocfl
CONTACT: PHONE#: yc78 Selo— 100
O mk FAX#:
LIMITS OF WORK RE UEST FOR COURTESx IN PEC IONS:
Yet �/►5 bcC4 C'_ 4omorrdw 7 ZI (I. Please- Co,nt ,rn
DvITGL� Dj f�r�!-q.
• I request to start construction work in which a building permit has not been completely secured. I have obtained a tenant Improvement
preparation permit which covers the removal of interior non-structural elements within the building. Furthermore,I have submitted a
building permit application and plans for the tenant improvement project and it is currently in the plan review process. I agree to call for
courtesy inspections for the limited work as noted on this application. I fully understand that I will be responsible to redo the work
performed under courtesy Inspections if the work does not fully comply with the approved set of plans and all State and local rules and
regulations.
�L Date:..... .QOI!
Owner...... ... .. PrinC.......®IKI�!........................ ...........
Contractor:. .. : Ov,� �..... ...... ..Dace:... 2.
.............................................Print:...............�....... .......1�..4 ....... .... .. 7 �. ...
INSPECTION RESULTS
INSPECTION TYPE TIME 'RESULTS INSP. COMMENTS(REASON IF INSPECTION FAILED)
SPENT INIT..
Coro° S gyp- Piss p )VOS s,lrro — C)n-AP );Ivll
065-- �wpots
.
i
• 'RESULTS: P-Pass,F-Fail,C-Cancel,I-incomplete,N-Not Required,R-To be Rescheduled
CouriesylnspFa•ut_2011.doc revised 07112,11
• COURTESY INSPECTION REQUEST FORM
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
ALBERT SALVADOR,P.E.,C.B.O.,BUILDING OFFICIAL
CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014.3255
(408)777-3228-FAX(408)777-3333•building ancupertino.org
SITEADDRESS: 106M N Tan N Ave. B UILDING 110(00 I APPLIC)TION#; DATE U /ITTED:
APN TI PREPARATION
BUILDING PERMIT M
OWNER'S NAM : PHONE M dY %(M-Snq
xivie, FAX#:
MAILING AD ES (if Oifferent from site address):
�v� ',naki, Loop
CONTRACTAR: PHONE M 4 2 0- '3
JAL FAX#: 4OSt, 7.40-600t
CONTACT: PHONE#: 40$ SRO- 100
Ob FAX#: (424 •yy
LIMITS OF WORK REQUESTED FOR COURTESY INSPECTIONS:
I request to start construction work In which a building permit has not been completely secured. I have obtained a tenant Improvement
• preparation permit which covers the removal of Intertor.non-structural elements within the building. Furthermore,I have submitted a
building permit application and plans for the tenant improvement project and it is currently in the plan review process. I agree to tail for
courtesy Inspections for the limited work as noted on this application. I fully understand that I will be responsible to redo the work
performed under courtesy Inspections if the work does not fully comply with the approved set of plans and all State and local rules and
r ulations.
Owner...... .. ift Print:.......1.1. .ltrs, ....1..........L .................Date:.....t
......l/.........
Contractor:, .: !:v:..
.. .. ...................................................Print:..,..1.1.�'.r,.h�......... .. .. ... .............Date:. .. .. .....
INSPECTION RESULTS
INSPECTION TYPE TIME 'RESULTS INSP. COMM NTS(REASON IF INSPECTION FAILED)
SPENT [NIT.
of
Wq cc.
*RESULTS: P-Pass,F-Fail,C-Cancel,I-Incomplete,N-Not Required,R-To be Rescheduled
• CourteryhtspForrn_201 Ldoe revised 07/12/11
r l
COURTESY INSPECTION REQUEST FORM
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O.,BUILDING OFFICIAL
C O P E RT I N O 10300 TORR E AVENUE•C UPERTINO,CA 95014-3255
(408)777-3228-FAX(408)777-3333•buildingtiya�cupertino.ong
SITE ADDRESS: 106MN Tan N Ave, B 11LDING 1060 3 CATION#: DAT 71MITTED:
4 11
APN TI PREPARATION
BUILDING PERMIT M
OWNER'S NAM : ^� PHONE M 01 'J"-$Z3y
Nev?- - Ror-l-o FAX M
MAILING AD ES (if dif`ferent from site address):
CONTRAC R: PHONE M 40`b Z40-rwi
L Gor •0Y1- FAXM Ott$ 240-6001
CONTACT: PHONE#: 408 $a0_-7100 Ob FAX M 4 1,
LIMITS OF WWORK _,QUESTED FOR C�1D,URT SY INSPECTIONS:
I request to start construction work in which a building permit has not been completely secured. I have obtained a tenant improvement
preparation permit which covers the removal of interior non-structural elements within the building. Furthermore,l have submitted a
building permit application and plans for the tenant improvement project and it is currently In the plan review process. I agree to call for
courtesy inspections for the limited work as noted on this application. I fully understand that I will be responsible to redo the work
performed under courtesy inspections if the work does not fully comply with the approved set of plans and all State and local rules and
r22ulations.
Owner. ....Print:....
WtI L .Date: l/
Contractor:. ...Print:.... ...... jr. . ..... .....r. ........... ...........
INSPECTION RESULTS
INSPECTION TYPE TIME `RESULTS INSP. COMMENTS(REASON IF INSPECTION FAILED)
SPENT INIT.
O
J�
'RESULTS: P–Pass,F–Fail,C–Cancel,I–Incomplete,N–Not Required,R–To be Rescheduled
CourresylnspForm_201 Ldoc revised 07/12/11
U.S.DEPARTMENT OF HOMELAND SECURITY ELEVATION CERTIFICATE OMB No. 1660-0008
Federal Emergency Management Agency Expires March 31,2012
National Flood Insurance Program Important: Read the instructions on pages 1-9.
SECTION A-PROPERTY INFORMATION For Inst rance.Compa�y:Use:_ . .
Al. Building Owners Name Policy Number
APPLE,INC.
A2. Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Company NALC Number
10600 N.Tantau Ave
City State ZIP Code
Cupertino California 95014
A3. Property Description(Lot and Block Numbers,Tax Parcel Number,Legal Description,etc.)
APN:316-18-035
A4. Building Use(e.g.,Residential,Non-Residential,Addition,Accessory,etc.) Non-Residential
A5. Latitude/Longitude:Lat.37°19'54.40" Long. 122°00'19.40" Horizontal Datum: ❑NAD 1927 Q NAD 1983
A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance.
AT Building Diagram Number IA
A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage:
a) Square footage of crawlspaceor enclosure(s) N/A sq ft a) Square footage of attached garage N/A sq ft
b) No.of permanent flood openings In the crawlspace or b) No.of permanent flood openings in the attached garage
encosure(s)within 1.0 foot above adjacent grade N/A within 1.0 foot above adjacent grade N/A
c) Total net area of flood openings in A8.b N/A sq in c) Total net area of flood openings in A9.b N/A sq in
d) Engineered flood openings? ❑Yes Q No d) Engineered flood openings? ❑Yes Q No
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
B1.NFIP Community Name&Community Number B2.County Name B3.State
City of Cupertino-060339 Santa Clara California
B4.Map/Panel Number B5.Suffix B6.FIRM Index B7.FIRM Panel B8.Flood B9.Base Flood Elevation(s)(Zone
Date Effective/Revised Date Zone(s) AO,use base flood depth)
060339 0209 H May 18,2009 May 18,2009 AO Depth I'
B10. Indicate the source of the Base Flood Elevation(BFE)data or base flood depth entered in Item B9.
❑FIS Profile 0 FIRM ❑Community Determined ❑Other(Describe)
B11. Indicate elevation datum used for BFE in Item B9: ❑NGVD 1929 NAVD 1988 ❑Other(Describe)
B12. Is the building located in a Coastal Barrier Resources System(CBRS)area or Otherwise Protected Area(OPA)? ❑Yes Q No
Designation Date ❑CBRS ❑OPA
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REQUIRED)
Cl. Building elevations are based on: ❑Construction Drawings' ❑ Building Under Construction' Finished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
C2. Elevations-Zones Al-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,ARIA,ARAE,AR/A1-A30,AR/AH,AR/AO. Complete Items C2.a-h
below according to the building diagram specified in Item AT Use the same datum as the BFE.
Benchmark Utilized BM-134 Santa Clara Valley Water District Vertical Datum NAVD 1988,ELEVATION 172.92
Conversion/Comments SCV WD BM 134 adjusted May 4,2010
Check the measurement used.
a) Top of bottom floor(including basement,crawlspace,or enclosure floor) 160.2 feet Q meters(Puerto Rico only)
b) Top of the next higher floor N/A. U feet meters(Puerto Rico only)
c) Bottom of the lowest horizontal structural member(V Zones only) N/A._❑feet ❑meters(Puerto Rico only)
d) Attached garage(top of slab) N/A._❑feet ❑meters(Puerto Rico only)
e) Lowest elevation of machinery or equipment servicing the building N/A. feet feet ❑meters(Puerto Rico only)
(Describe type of equipment and location In Comments)
f) Lowest adjacent(finished)grade next to building(LAG) 159.7 ❑✓ feet ❑meters(Puerto Rico only)
g) Highest adjacent(finished)grade next to building(HAG) 160,3 J21 feet ❑meters(Puerto Rico only)
h) Lowest adjacent grade at lowest elevation of deck or stairs,including N/A_❑feet ❑meters(Puerto Rico only)
structural support
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyor,engineer,or architect authorized by law to certify elevation
information. I certify that the information on this Certificate represents my best efforts to interpret the data available. VAND S
I understand that any false statement may be punishable by fine or Imprisonment under 18 U.S.Code,Section 1001.
Q Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a `V� 44J,9 j `O
licensed land surveyor? ❑r Yes ❑No
Certifiers Name License Number
Ryan M.Amaya LS 8134
Title Company Name
Land Surveyor Kier&Wright Civil Engineers&SurveXors
Address city state ZIP code (P �0.813N
3350 Scott Boulevard,Building 22 Santa Clara California 95054
Signature Date Telephone OFLF
07 1 - «l� (408)727-6665
FEMA Form 81-31,Mar 09 See reverse side for continuation. Replaces all previous editions
IMPORTANT: In these spaces,copy the corresponding Information from Section A For Insurance Company Use:
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number
10600 N.Tantau Ave
City State ZIP Code Company NRIC Number
Cupertino Califomia 95014
SECTION D-SURVEYOR, ENGINEER,OR ARCHITECT CERTIFICATION(CONTINUED)
Copy both sides of this Elevation Certificate for(1)community official,(2)Insurance agent/company,and(3)building owner.
Comments
C2(a)Finished Floor at main entrance.C2(e)no visible machinery serving the building.
C2(f)Ground at the northeast comer of the building.C2(g)Ground at the southeast comer of the building.
Signature � Date j
/lam ,ryfGr� ~/'t���/ ❑ Check here if attachments
SECTI N E-BUILDIN ELEVATION INFORMATION(SURVEY NOT REQUIRED)FOR ZONE AO AND ZONE A(WITHOUT BFE)
For Zones AO and A(without BFE),complete Items E1-E5. If the Certificate Is Intended to support a LOMA or LOMR-F request,complete Sections A,B.
and C. For Items E1-E4,use natural grade,if available. Check the measurement used. In Puerto Rico only,enter meters.
E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent
grade(HAG)and the lowest adjacent grade(LAG).
a)Top of bottom floor(including basement,crawlspace,or enclosure)is _ ❑feet ❑meters ❑above or ❑below the HAG.
b)Top of bottom floor(including basement,crawlspace,or enclosure)Is ❑feet ❑meters ❑above or [-]below the LAG.
E2. For Building Diagrams 6-9 with permanent flood openings provided in Secti Items 8 and/or 9(see pages 8-9 of Instructions),the next higher floor
(elevation C2.b in the diagrams)of the building is _❑feet LJ meters ❑above or H below the HAG.
E3. Attached garage(top of slab)is ❑feet❑meters ❑above or ❑ below the HAG.
E4. Top of platform of machinery and/or equipment servicing the building is _❑feet ❑meters ❑above or ❑below the HAG.
E5. Zone AO only: If no flood depth number is available,is the top of the bottom floor elevated in accordance with the community's floodplain management
ordinance? ❑Yes ❑ No ❑Unknown. The local official must certify this Information In Section G.
SECTION F-PROPERTY OWNER(OR OWNER'S REPRESENTATIVE)CERTIFICAI-ION
The property owner or owner's authorized representative who completes Sections A,B,and E for Zone A(without a FEMA-issued or community-issued BFE)
or Zone AO must sign here. The statements in Sections A,B,and E are correct to the best of my knowledge.
Property Owner's or Owner's Authorized Representative's Name
Address City State ZIP Code
Signature Date Telephone
Comments
❑Check he.if attachments
SECTION G-COMMUNITY INFORMATION(OPTIONAL)
The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A,B,C(or E),
and G of this Elevation Certificate. Complete the applicable item(s)and sign below. Check the measurement used in Items G8 and G9.
G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor,engineer,or architect who
is authorized by law to certify elevation Information. (Indicate the source and date of the elevation data in the Comments area below.)
G2. ❑ A community official completed Section E for a building located in Zone A(without a FEMA-issued or community-Issued BFE)or Zone AO.
G3. ❑ The following Information(Items G4-G9)is provided for community floodplain management purposes.
G4.Permit Number G5. Date Permit Issued G6. Date Certificate Of Compliance/Occupancy Issued
G7. This permit has been issued for. ❑New Construction ❑Substantial Improvement
G8. Elevation of as-built lowest floor(including basement)of the building ❑feet ❑meters(PR) Datum
G9. BFE or(in Zone AO)depth of flooding at the building site ❑feet ❑meters(PR) Datum
G10.Community's design flood elevation ❑feet ❑meters(PR) Datum
Local Official's Name Title
Community Name Telephone
Signature Date
Comments
❑Check her.if attachments
FEMA Form 81-31,Mar 09 Replaces all previous editions
Building Photographs
See Instructions for Item A6.
For Insurance Company Use:
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number
10600 N.Tantau Ave
City State ZIP Code Company NAIC Number
Cupertino Califomia 95014
If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to
the instructions for Item A6. Identify all photographs with: date taken; "Front View"and 'Rear View"; and, if required, 'Right
Side View"and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the
reverse.
East side of the building
North side of the building
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Building Photographs
Continuation Page
For Insuranco company use:
Building Street Address(including Apt.,Unit,Suite,and/or Bldg.No.)or P.O.Route and Box No. Policy Number
10600 N.Tantau Ave
City State ZIP Code C,ompartyNAfi,Number
Cupertino Califomia 95014
If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all
photographs with: date taken; "Front View"and "Rear View";and, if required, "Right Side View"and "Left Side View."
Southeast comer of building.
Ilk
I
I
West side of building.
e
L
Building Department
CITY OF CUPL=RTINO
10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
C U P E RT I N O I ELEPHONE: (408)777-3228 • FAX: (40.')777-3.133
OUTSIDE AGENCY PLAN CHECKING FEES
Date: /
Agency Name: `����
Permit Number:
Project Address:
Plan Check Fees:
1`' &/2,,d plan checks included in initial plan check fee:
$ 3605/ X65% = $ �,3 �.��
3rd plus plan checks:
Number of hrs X $126.00 = $ X 65% _ $
Please attach this form with the number of hours spent on the 31d plus plan checks and
send with the plan check comments or if plans are approved, with the plans & approval
letter.
Please email the plan check comments to:
Suew@cupertino.or and Sylviam@cupertino.or� .
"Please do not give plan check comments directly to the customer. We don't give out
the comments until we have all of them back from each department.
Report Page 1 of 1
City of Cupertino
Parcel-Detail Report /
APN 316 18 035 Percent Improved 33%
Secondary APN Home Owners NaN
Owner 10590 TANTAU INVS LLC Exemption Type
In Care Of RANDALL C SINGLE ESQ.GREENBERG TRAURIG Tax Rate Area 13003
Situs Address 10600 N TANTAU AVE CUPERTINO,CA 95014-0739 Tax Amount $147,401
Mail Address 1900 UNIVERSITY AVE 5TH FLR EAST PALO ALTO CA 94303 Mapgrld G6
Transfer Date Nov 12 2010 Subplat
Document Number 20957361 Zoning P(MP)
Price $12,531,000 Land Use Industrial/Residential
Price Transfer Date 11/12/2010 L% ht Air
Prior Price $12,531,000 Front
Sale Price-Full/Partial FULL Street Side
Use Code 14 Address
Tract And Lot Phon
Census Tract 5081.02 Owner Phone
Assessed Total Value $11,466,200 Tenant Phone 0
Land Value $7,628,856
Improvement Value $3,837,324
Structure Value $
District Data Title Company FIRST AMERICAN TITLE
School District Recorders Map Number
Elementary School CUPERTINO UNION Recorders Page
High School FREMONT UNION Number Of Buildings 1
Assessor Map 316-18,Ddf
Assessor Map Index-I1 316-I l.Ddf
Assessor Map Index-I2 316-I2.Ddf
Assessor Map Index-I3 316-I3.Ddf
Assessor Map Index-I4 1 4 f
Total Rooms 0 Lease Sq Ft 64,680 Year Built 1976 Fire YES
Bedrooms 0 Office Sq Ft 40,328 Effective 1976 1st Floor NaN
Bathrooms 0 Rental SgFt 64,680 Dishwasher 0 2nd Floor NaN
No.Of 1 Lot SgFt 194,278 Tennis Ct 0 3rd Floor NaN
Dining Lot Acres 4.46 Frame Type NONCOMBUST MAT Elevator NO
Family Lot Total Units 2 Wall Height 16
Rec Room 0 Cntrl HEAT ONLY Patio UG/hies
Utility Room Bldg Class 6.0 Porch 0 Water
Fireplace Bldg Shape SQUARE Garage Type 0 Electric
Pool Bldg AVG Garage Gas Service
Sauna Bldg SgFt 64,680 Garage SgFt 0
Useable 194,277
Addition NaN
Planning ProiecYs
File Number DIR-2003-17 I DIR-2003-18 I TR-2003-10 I Z-1966-10 11 Q I U-1977-04 I GPA-1983-02 I U-1984-31 I
Show All
http://gissvr/cupertinointranet/home/XSLTransformer.aspx 6/16/2011