12080141CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10200 S DE ANZA BLVD
CONTRACTOR: VULCAN CONSTRUCTION
PERMIT NO: 12080141
INC
OWNER'S NAME: SEAGATE TECHNOLOGY LLC
346 MATHEW ST
DATE ISSUED: 09/20/2012
OWNER'S PHONE: 4086581602
SANTA CLARA, CA 95050
PHONE NO: (408) 499-6039
❑ LICENSED CONTRACTOR'S DECLARATION
F F_ PLUMB r
License Class ' Lic.11 G/ Z
BUILDING PERMIT INFO: BLDG ELECT
MECH RESIDENTIAL COMMERCIAL
Contractor V (.CC L°.4--J ate ZD (%/
I hereby affirm that I am licensed under the provisions of Chapter 9
JOB DESCRIPTION: SEAGATE - CONSTRUCTION OF (2) ISLANDS WITH NEW
(commencing with Section 7000) of Division 3 of the Business & Professions
PARKING ACCESS CONTROL SYSTEMS AT ENTRANCES TO
Code and that my license is in full force and effect.UNDER
GROUND PARKING.
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
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
Sq. Ft Floor Area:
Valuation: $15000
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APN Number: 36901035.00
Occupancy Type:
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
PERMIT EXPIRES IF WORK IS NOT STARTED
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally, the applicant understands and will comply
180 DAYS FROM LAST CALLED INSPECTION.
with all non -point source regulatirns per the Cupertino Municipal Code, Section
9.18.
Issued by: I%r!� Date: � l�
Signature Date
❑ OWNER -BUILDER DECLARATION
RE -ROOFS:
1 hereby affirm that 1 am exempt from the Contractor's License Law for one of
All roofs shall be inspected prior to any roofing material being installed. If a roof is
the following two reasons:
installed without first obtaining an inspection, I agree to remove all new materials for
I, as owner of the property, or my employees with wages as their sole compensation,
inspection.
will do the work, and the structure is not intended or offered for sale (Sec.7044,
Business & Professions Code)
Signature of Applicant: Date:
1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec.7044, Business & Professions Code).
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1 hereby affirm under penalty of perjury one of the following three
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
1 have read the hazardous materials requirements under Chapter 6.95 of the
performance of the work for which this permit is issued.
California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain
I have and will maintain Worker's Compensation Insurance, as provided for by
compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &
Section 3700 of the Labor Code, for the performance of the work for which this
Safety Code, Section 25532(a) should I store or handle hazardous material.
Additionally, should 1 use equipment or devices which emit hazardous air
permit is issued.
contaminants as defined by the Bay Area Air Quality Management District I will
I certify that in the performance of the work for which this permit is issued, I shall
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
not employ any person in any manner so as to become subject to the Worker's
Health & Safety Code, Sections 25505, 25533, and 255 4.
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
Owner or r' agent:
forthwith comply with such provisions or this permit shall be deemed revoked.
Date: (z�
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
I hereby affirm that there is a construction lending agency for the performance of wrk's
correct. I agree to comply with all city and county ordinances and state laws relating
for which this permit is issued (Sec. 3097, Civ C.)
to building construction, and hereby authorize representatives of this city to enter
Lender's Name
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
Lender's Address
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
ARCHITECT'S DECLARATION
9.18.
1 understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10200 S DE ANZA BLVD CONTRACTOR: VULCAN CONSTRUCTION PERMIT NO: 12080141
INC
OWNER'S NAME: SEAGATE TECHNOLOGY LLC 1346 MATHEW ST I DATE ISSUED: 09/20/2012 I
OWNER'S PHONE: 4086581602 1 SANTA CLARA, CA 95050 I PHONE NO: (408) 499-6039 1
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Lic. #
Contractor AJ Date�Z6
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
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.
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. dditionally, the applicant understands and will comply
with all non -point ur r ulations per the Cupertino Municipal Code, Section
9.18.
Signature Date
❑ 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:
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.
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, 1 must
forthwith comply with such provisions or this permit shall be deemed revoked.
APPLICANT CERTIFICATION
I certify that 1 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.
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r-
MECH r— RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: SEAGATE - CONSTRUCTION OF (2) ISLANDS WITH NEW
PARKING ACCESS CONTROL SYSTEMS AT ENTRANCES TO
UNDER GROUND PARKING.
10/26/12 DEFERRED #1 REMOVE AND REPLACE EXISTING PARKING SIGN FOR
GARAGE -ISSUED 10/26/12
Sq. Ft Floor Area: I Valuation: $15000
APN Number: 36901035.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: i. Date: /v
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 al I new materials for
inspection.
Signature of Applicant:
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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 & Sammy (lode, Sections 25505, 25533, and 25534.
DateMa I;?—
CONSTRUCTION LENDING AGENCY
1 her6by 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.
Signature Date
Licensed Professional
CITY OF CUPERTINO
Fm_� FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 1020 eAnze Blvd
DATE: 10/26/2012
REVIEWED BY: Sean
APN:
BP#: 12080141
*VALUATION: 1$35,000
*PERMIT TYPE: Building Permit
PLAN CHECK TYPE:
PRIMARY
USE: Sign
PENTAMATION
10EAP5
PERMIT TYPE: 19
WORK
Deferred Submittal #1: Remove and replace illuminated garage entrV wall sign.
SCOPE
SIGN TYPE
FEE ID
QTY
SIGN FEE
Wall Sign, Electric
1SIGNWELEC
1
$266
TOTALS:
$266.00
Xfecb. Plan Check
Plumh, Plan Check f
# Branch Circuits 1 $45.00
Z,:tc . Permit Fee:
Plumb, Permit Fcc:
1ESIGN Elec. Permit Fee: IEPERMIT
Oilier tech. Insp.
Other Plumb insp.Li I
Other Elea Insp. 0.0 $45.00
.11cch. Insp. Fee:
I Phanb. blsp. Fee.
Elec. Insp. Fec:
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District etc). These tees are based on the Dreliminary information available and are only an estimate Contact the Dent for addn'1 into.
FEE ITEMS (Fee Resolution 11-053 E . 711112)
FEE
QTY/FEE
MISC ITEMS
Plant Check Fee:
Suppl. PC Fee: Q Reg. Q OTT0.0
1
hrs
$0.00
P/umbJwlech./Flee:
Permit Fee:
$266.00
Suppl. Insp. Fee:Q Reg. Q OT
0.0
hrs
$0.00
PME Unit Fee:
$45.00
PME Permit Fee:
$45.00
Construction 1aY:
Administrative Fee:
Work Without Permit? 0 Yes (j) No
$0.00
Sign Master Plan: 0 Yes (F) No
$0.00
Travel Documentation Fee: ITRAVDOC
$45.00
Strong Motion Fee: IBSEISMICO
$7.35
Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC
$2.00
'SUBTOTALS:
$410.35
$0.00 TOTAL FINE:
$410.35
Revised: 10/01 /2012