04010020Ct'CY OF CUPER't'INO.--
BUILDING DIVISION PLRMIT
OR�INFORMTION &
CONTR`ACTA
?`a.., a.:a�s4 £,F �.. T.SSaNrz4R .✓,.r.',ewgG �ess"F.3 trpsi... n.
BUILDING ADDRMS:
MARK CUNHA' S PAVING
PERMITN0040I0020
ERSNAM1IG:
2491 OTTAWA W71,V
PERMIT MUE DATE
2
PHONE:
SANITARY NO, CONTROL NO.
(408)866-0945
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR 'SDECLARATION
Job Description
I affirm that I am licensed undo provisions of Chapter 9 (commencingsis
p
with Scnion ]akp ul Division 3 Little Duinms and Professions Cnde, and my license is
ionherchy70 Bu
to mu tome and effect.
DEMOLITION
License Class Lie. It
Dat Contractor
ARCHITECT' DECL
ARCHITECTS DECLARATION
Aic
_
FINN E®
IundcrstanJ my plans is occond,RATION
e� i�g
MAR 1 6 2004
Licensed pmfessirnal
OWNER BUILDER DECLARATION
1 hereby alum 1 exempt from lbe Contractor's License Law for the
if turn. (Section 703 Business and Professions Code: Any city nrcounty
rn I
which
which reyuires a pennil Ir eonslrucl, nllet improve, demolish, or repair any structure
construct.
prior to its issuance. den requires the applicant for such Permit to Glc a signed statement
Nat he is licensed pursuanuo the provisioner of Ne Common's License law(Chapter 9
Sq. FL Floor Area anon
(commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he is exempt thcmfmm and co, basis for the alleged exemption. Any violation of
$7600
Section 7031.5 by airy applicant for a permit subjects the appliCMLto a civil penally of
APN Number
Occupancy Type
P Y YP
not mom Nan fin hundred dollars (SSW).
❑ 1, M owner of the propcny, or my employees with wages as their role compenution,
will do the work, and Ne structure is not mendcdser offered for sale (Sec. 7044, Business3
5918013 Re Inspections
and ProbesCode: The CoThe Contractor's Lt.. Law does not apply in an owner of
wired
q ns P
propeny who builds or improves thereon. and whodoessueh work himsdforthmugh his
-
own employees. provided that such improvements arc not intended or offered fmuk. If.
however, be Wilding or improvement is sold within one yeu of completion. tit owner -
builder will ban Ot burden of proving that he did not Wild or improve for purpose of
_
sled.
1, as owner of the property, am exclusively contracting with licensed convectors to
constuct Ne pmjecl (Sec. 7044, Business and Profusions Code:) The Convector's Li.
.
cense Law dors not apply t an owner of property who Wilds or improves Merton, and
who contracts for such projects with a comminetm(e) licansed pursuant o the Contractors
License law.
❑1 undor5 c. .B&PCfm this.
Data
gK C NSATIDN DE ATION
I hereby affum under Penalty of perjury one of Bt following declarations:
❑ I bare and will maintain a CeniGmm of Consent o ¢cif--insum for workers Compcn-
fuumn, u provided for by Section 3700 of the labor Code, for the penformorea of in.
work for which this permit is Issued.
❑ I ban and will maintain Worker's Compensation Insurance, of mquimd by Section
3900 of the labor Code, for the performance of Ne work for which this permit is issued.
My Worker's Compensation Insurance canter and Policy number art:
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(nb seninn reed not necomplomd irthe Permitis forane hundred dollars ($100)
in less.)
I cenify Nat in the perfumance or the work for which this Permit is ismod. I shall not
employ any Person in any manner so as m become subject o the Workers' Compensation
Laws of California. Data
Applicam
NOTICE TO APPLICANT: If, after making this CenIML0 of EacmPtion, you should
become subject to Ne Workers Compevnlon provisions of Ne Lahr Code, you most
roMwith comply with such Prmisions of this Permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 hereby alGnm that there is a construction lending agency for the perftumancc of
the work for which this permit is issued (See. 30n, Civ. C.)
Lattices Name
Lender's Address
1 moral Nat 1 bare read his application and sot Nat Jx above information is
comen. 1 agree to comply with all city and county ordinances and serle laws relating to
Wilding construction, and hereby authorise halmsentiowes of his city to enter upon the
shove -mentioned p rperty for impaction purpoma.
(WO) agree to rave. indemnify and keep harmless the City of Cori against
liabilitiea.judgmcnu, coats and expenses which may in any way accrue against mid City
in co conte of the muting of this permit.
XTLI ANTU R NO AND WILL COMPLY WITH ALL NON -POINT
Issued by: Dale
UR R A ON
Re -roofs
Type of Roof
�- �- d
gn5mrc h HA ARDOUSMATERIALS DISCLOSURE mi Dat
Will aPPPPll our future building occupant store or handle ha/Mous material
as defined by the Cotentin Municipal Cede, Chapter 9.12, and the HOILh and Safety
e. sn y. 25532(a)?
❑Yes �Nn
All roofs shall be inspected prior to an roofing material being
P P Y g g installed.
If a roof is installed without first obtaining an inspection, I agree to remove
Will the. Iicant or future building occupant use equipment or devices which
s p
conoPP
hvardnus air contaminants as Jcfncd by Nc Bay Area Air Quality Management
a Air Quality
all new materials for inspection.
Dig
Disvin?
[3 yes no
I have avl Ne bvmdous materials caloom enc under Chapter 6.95 of the patter.
nia Health & Safety Codo, Sections 25505.25533 and 25534.1 undersuM Nat if Jr building
does WI e y arc a moan" N my mspomihility m notily tit occupml of the
mgnim mel Prior i ceof Cay roreatnlot, sty.
Signature of Applicant Date
< �J
All roof coverings to be Class "B" or better
Ow Frir.
n Dat
opZ,
�F t]
tt W
Y�6
t
Ot
chC
ym�
_Z<
a
crrY or coP�a'rtNo'
,
T
PERM
nA�
.'
BUILDING DIVISION
,.CONaTRtiC"TN14"QRMA*N
BUILDING ADDRESS:
MARK CUNHA'S�PAVING
PERMITN904010020
OWNER'S NAME:
T. A DT
2491 OTTAWA TA7\V
PERMIT ISSUE DATE
004
SANITARY NO.CONTROL NO.
4 8GINEER:
BUILDING PE0.MRINPO
BLDG ELECT PLUMB MECH
7ARCHMCf/ENGINCER:
LICENSED CONTRACTOR'S DECLARATIONIObD
Cr 10D
ffirm this I am lime under provisions of Chapter mmmcnse
Bu nd
is p of Oivisiun 3 of Ute➢usincxs and Professios CnM, and my IiecnSs isin
rras
DEMOLITION
Lic.0
Data Contractor
ARCHITECTS DECLARATION
��
I understandmyplans shall be used as public records
/
Licensed Professional
OWNER -GUILDER DECLARATION
1 M1omom arum that I nm cacmpt from the Contractor's Low Or the
//�
e: Any
I following reason. (Secdun ]ill L5. Buincss and Profcainnx Code: Any city m county
V
which requires a pemtit to cmnsuuct, aper, improve. demolish, or repair any structure
? prior to its issuance. also mymics the applicant forsuch permit to File aligned statement
I
Sq. Ft. Floor Arca
Valuation
hat past islicensed pursuant nthepro.isionsofdoContractor:Uan.Law(Chapter9
(commencing with Section 7") of Division 3 of the Busious and Professions Code) or
-
$7600
. that he is evem,I tbdrefrom and the h mix for the alleged exemption. Any violation of
APN-Number
Occupancy Type
Section 7031.5 by any a pplicantsfor .pe.it subjects the applicant m a civil penally of
not more than five hundred dollars ISM).
❑ I, u owner of she property, or my employees with wages u their sole compewlion,
ns
Re uired Inspections
will do the work, and the suunam i5 not intended or offered par sale (Sce.]04a, Business
and Profeaboro Cade: The Contractors License Law docs not apply to an Owner of
q P
property who builds orimoroves nhercon, and who doeasuch work himsalf or through his
own employees, provided that such improvements are not intended or offered for safe. If.
how ver. Ute building or improvement is sold within one year or completion, the owncr-
builder will have the burden of proving that he did not build of improve for purpose of
. .
.Is.).
h as Owner of the property, am exclusively contracting with licensed contractors to
,[3
conssmet the project (Sec. 7047, Business and Professions Cade:) The Contractors Li
cane Taw docs not apply to an owner of property who Wi ids or improve domino, and
who contracts Lor such projects with a contra on(a) licensed pursuant so the Convacme.
License Law.
1 fent under See. . B & P C for this reason
Ow er ` Date
/ K C NSAI10\ ATION
�EC
1 bereby anion under penepy of perjury ..—of the following declarations:
have and will maintain a Certificate of Consent to self -insure ror Workers Compen-
.tion, .provided for by Section 37M of the lahor Cade, for the performanm or the
'
work for which this permit is isowd.
C3 I have and will maintain Worker's Compensation Insurance, or required by Section
37W of the Labor Code, for the performance of the work for which this permin is issued.
My Workdls Compensation Insurance canner and Policy number arc:
Cartier. Policy No.:
CERTIFICATE OF EX EM MON MOM WORKERS'
COMPENSATION INSURANCE
Ofiisseelion need nm W bompleted if the permit is foranc hummed dollos (SIM)
car leu)
1 eetify that in the performance of the work for which his permit is issued. I shall not
employ any person in any manner an as to become subject a me Workers'COMIXOT okm
Laws of C.1iforri.. Date
_
Applicant
N'JnCE TO APPLICANT: If, after making this Ceniream of Eeemption, you should
become subject to the Worker's Compeesation previsions of the Labor Code, you must
ronhwith comply with such provisions or this permit shall be, deemed revoked.
D
CONSTRUCTION LENDING AGENCY
I henhy union that there is a conswction lending agency for the performance or
> the work for which this permit is issued (Sec. 3 7. Civ. C.)
Lender's Name
—
Und is Addmsa
I eenify that 1 have read this application and suit that the above information is
bonding I agree no comply with all city and cauay and atatc laws relating m
ourvatcex
WilditgeatswNao,ert hereby authon ativesof Niscity reenter upon the
Furrows.
above for inspection ca.
(We) ,ma I.ed an but,
aw,
y (Wb) agree to cove, indemnify end kith harmless the City of Cupenagainst
cca which may in any way theme against mix City
n Iiabili0a,judgments. costs and expnx
y into me coming car this
sm
€tow. permit.
LI ANT U ER ND AND WILL COMPLY WITH ALL NON -POINT
Issued by: Dale
UR R ATION
Re-roofs
Type of Roof
r '—' /'
—gnatum `j''ach"HA ARDOUS MATERIALS DISCLOSURE Date
Willthbapplic t ser future building Occupant store or handle havardou.material
as Mined by the Cupenino Municipal, Code, Chapter 9.12, and the Health and Safety
Code. Section 25532(4)?
El Yes IG�NV
All roofs shall be inspected prior to any roofing material being installed.
If a roof is installed without firs[ obtaining an inspection, I agree to remove
Will the applicant or future building Occupant use aquipment car devices which
tit hamrdnus air contaminants st defined by the Bay Area Air Quality Management
all new materials for inspection.
strics7
❑Yes no
I have read the hanobo s materials ro oiremenu unMr Chapter 6.95 of the Califon
nix Health& Safely Cmlc. Seedms 25505, 25533 and 25534.1 milarstand that if the building
docs opt cult y ass . ¢n.nt the44, ' my ropomihility m nobly tic aeOr., of the
a
mquim ts "IPnon� Oar Comrbamaf0c pwtcy.
Signature of Applicant Date
` �� '�
All roof coverings to be Class "B" or better
Ow r.aat�rir. t Date
0
F-
L --j LJ
Cin OF
CUPERTINO
CITY OF CUPERTINO
DEMO 20
PERMIT APPLICATION FORM
APN # �? —
O
BUILIDNG
Date: G
Building Address:
p
Owner's Name:
Seismic Commercial
BUILIDNG
Phone #: �l�rpB��S 797
Contractor:7
7
BSEISMICRE
License #:
Contact:
�zE
Pne
h #:
�BJA�/- 7�'7zl-
Applicant/Contractor:
Plan Check Fee
BUILIDNG
rByildijg Permit Info:
B d Elect
Mec
Job Description:
esidential:
5N
Commercial:
q.Ft. Floor Area:
$/Sq.Ft.:
old
Architect/Engineer:
Valuation
Type of Construction:
Occupancy rou :
Fee TD
Fee necrrintinn
Fre (rnnn
BPERMFEE
Bldg Permit Fees
BUILIDNG
BSEISMICOM
Seismic Commercial
BUILIDNG
BSEISMICRE
Seismic Residential
BUILIDNG
BPLANCHK
Plan Check Fee
BUILIDNG
BUSLIC
Business License
BUILIDNG
N Z O i
O O o <
Z O c m
Z O
o -1 z T
i < _
A m C) (n
i 7 i
> titia ,`AN
3ga ao d o� H
X o6a
E 5 �c
s>
n
Cn
a m
zz
0 K I
0
T
1►
a
L- — - -- -S ----
M om = 126.09' o =•
C R I fid
! I Cpl Qi CL'3 CT 6.i C7 .T x
C�
uDo8��2'�mmu
i
i E
SES_.^'
�
>
wa
a
° �S
eg
P
��•
p�p
E' � •_
� �
33
9; �
D
'
ap. >•
G 9
C
m
r
O
O
S
O
EoRpg
0
O
„(
n
r
i
D
Z
-Ni
rC
N
o
r
m
O
m
O
N
D
6
�
z
Z
<
o
0
0
m
M
m9A
m
o
m
�
F"�9 I�
p� ��
•
8
oN,Do a:
i
z
m
0
m
D
n
aE
o
y
A
0
D
r
-m
,n
m-4
m
m
m
O
x
O
0
n; _t^°a
Sam':
c-
rn
?
E
°t
u
x
Ll
D
..
m
p
m
A
D
__°
F'Er
3 3R
o
D
D
°
1
F m E+
3 c o
p
V
Co
°c
o
Cn
a m
zz
0 K I
0
T
1►
a
L- — - -- -S ----
M om = 126.09' o =•
C R I fid
! I Cpl Qi CL'3 CT 6.i C7 .T x
C�
uDo8��2'�mmu
i
i E
F
p
g
€
eg
P
p�p
E' � •_
� �
33
9; �
D
'
ap. >•
G 9
C
m
r
O
O
S
O
EoRpg
0
O
„(
n
r
i
D
Z
-Ni
rC
N
v
r
m
O
m
O
N
D
6
�
z
Z
<
o
0
0
m
M
m9A
m
o
m
�
F"�9 I�
p� ��
•
8
i
z
m
0
m
D
n
aE
y
A
0
D
r
-m
,n
m-4
m
m
m
O
x
O
0
m
c-
rn
����g�
E
°t
u
x
Ll
D
..
m
p
m
A
D
w
w
O
3 3R
D
D
°
1
p
V
Co
°c
o
e
gg
m
A
Gn
(A
OR
N
Cn
a m
zz
0 K I
0
T
1►
a
L- — - -- -S ----
M om = 126.09' o =•
C R I fid
! I Cpl Qi CL'3 CT 6.i C7 .T x
C�
uDo8��2'�mmu
i
W fA 00 OA O d) dl N ff) W N_ ff! ffl
1 1 --4 1 .-=1 1 1 rq � •-zl
W N+OmRb V O ow N+
R�I vmTV m m 'm rn m T W
mmj0zPac0Mmom
mvAO- �z -R C <O
+aio�Rs�°sz-�i-visa
s rIc Viz- vs
n>> 0 D O 00 w i z s 0
=rztnpM, zaco z
X 9
zZ =30 OOM .�z F z
(»nppF
r � • v M
�v�m
=�z>
z U) I-
7.
7LAWICHOWELTON IDENCE SITE &ROOF PLANELTON WAY
INO, CALIFORNIA P.O. Boa 2292.1
Sacramento, CA.96322
(9161 462-5660
F]
•
n
Z
2
i E
F
p
p�p
E' � •_
� �
33
9; �
4y
�
'
ap. >•
G 9
G
fC �
~
$
'a
•
W fA 00 OA O d) dl N ff) W N_ ff! ffl
1 1 --4 1 .-=1 1 1 rq � •-zl
W N+OmRb V O ow N+
R�I vmTV m m 'm rn m T W
mmj0zPac0Mmom
mvAO- �z -R C <O
+aio�Rs�°sz-�i-visa
s rIc Viz- vs
n>> 0 D O 00 w i z s 0
=rztnpM, zaco z
X 9
zZ =30 OOM .�z F z
(»nppF
r � • v M
�v�m
=�z>
z U) I-
7.
7LAWICHOWELTON IDENCE SITE &ROOF PLANELTON WAY
INO, CALIFORNIA P.O. Boa 2292.1
Sacramento, CA.96322
(9161 462-5660
F]
•
n
Z
2
S •1 ,
RECORDING REQUESTED BY
'CHICAGO TITLE COMPANY
AND V✓HEN RECORDED MAIL TO
(Frankie K. Law and Su Y. Law
10559 Felton Way
Cupertino, California 95014
•
DOCUMENT: 173�II7+5+11+27If�IIFees 13.00
Pages 3 III��IIII�III����I�II��I�I��II�IIIIIA�II�I11���A Taxes 726.00
Copies
AMT PAID 739 00
BRENDA DAVIS RDE n 001
L SANTA CLARA COUNTY RECORDER 9/25/2003
Recorded at the request of 1:51 PM
J Chicago Title
Escrow No. 964475 - LY
order No- 964435 SPACE ABOVE THIS UNE FOR RECORDER'S USE
Am 5iaa -, -013---
THE UNDERSIGNED GRANTOR(S) DECLARE(S) ,
DOCUMENTARY TRANSFER TAXIS $726.0 -County DECLARANT:'e-
❑ unincorporetcdarea I] rityor Cupertino
Q computed on the full value of the interest or property conveyed, or is
❑ computed on the fuN valuc less lhevalue of liens orcnmmbmnces remaining at time of sale, and JAN 2 9
FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledged, ?004
Mostafa Ouraie a married man as his sole and separate property
hereby GRANT(S) to
Su Yong Law and Frankie Kan Yin Law husband and wife as community property with right
of survivorship as to an undivided 90% interest and Felicia Y. Chow an unmarried woman
as to an undivded:10% interest all as tenants in common.
® the following described real property in the City of Cupertino
County of SANTA CLARA , State of California:
LEGAL DESCRIPTION ATTACHED HERETO AND MADE A PART HEREOF BY REFERENCE
(
Dated September 22, 2003
STATEOF CALIFORNIA
COUNTYOF Santa Clara ) SS.
On - - before me, Mostafa Ou
o Notary Public In end for Bald County and Stade, personallyappearrad
Mostafa Ouraie
personally known to me (or
eNdeAce) to be the person(s) whose name(S) Is/m9'subscribed td the
within Instrument and acknowledged to me that he/shejihey executed the
eame in hie/ha;AWIr authorized capacltylies), and that by his/hef/tfrelr
signature(s) on the Instrument the person(s), or the entity upon behalf of
which the pawn (a) acted, executed the Instrument.
LORI BASILEa
COMM. N0.1339756�
mr m ' �' a NOTARY PUBLIC-CAUFORMArI
a i.: SANTACIARAC0IRAY �
S p COMM. EXPIRES FEB. g, 2003 t1
Lslsms �� uamaaaocaras:¢anmomscma�macm3
WITNESS my hand and official seal. ��7f
5eF
o Notary ` Date 1. mmissi n pees FIXi NOTARY BEALL OR STAMP
MNL TAX STS TO PARTY SHOWN ON FOLLOWING LINE IF NO PARTY SO SHOWN, MAIL AS DIRECTED ABOVE
name as
Name Street Address Dry, State & Zip
ao, -05/30107
Page 1
Escrow No. 964435 -LY
LEGAL DESCRIPTION EXHIBIT
All that certain Real Property in the City of Cupertino, County of Santa Clara, State
of California, described as follows:
! All of Lot 20, as shown upon that certain map entitled, "Tract No. 420 Pelton Park
Subdivision Unit No. 1", which map was filed for Record in the Office of the Recorder
of the County of Santa Clara, State of California, on April 1, 1947 in Book 13 of
Maps, at Page 12.
otEo�c�aalce/eaa
0
i
40
0
Su Yong Law and Frankie Kan Yin Law hereby accept the interest conveyed to them
as Community Property with Right of Survivorship.
Dated: / 0-3
x
Su Yong L Lgrankie Kan YJ 6plw
E
0
0
0
S7:°:rE GF CAI-IFORNiA i
Cuunry cfs.mta Cara
f, I7RiN'D,t G.'vis, Clnk-Rccordrr of Qte
eCnoduco!y�, C::, n!m P by -.lily L 'E
oe"
etilkd
fll,ofu�c riynnr s
N'ff 1<F,SS myhead anC O_ ; Scal t.`tis
,( dayof__-1L/1///OAA �-?il/ •
TONI AYALA-E3Fr'i<ANT =:.,: - ...�'_
CITY Of
�CUPEkTINO
• ..
•
•
DEMOLITION REQUEST
Addresses of all interested parties:
Bank of America
Attn: Mortgage Customer Service
P. 0. Box 35140
Louisville, KY 40232-5140
Reference: Loan number (if applicable) 6898189086
Dear Sir or Madam:
•
City Hall
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: (408) 777-3228
FAX: (408) 777-3333
BUILDING DEPARTMENT
Please be advised that the owners at 10559 Felton Way, Cupertino, CA 95014
Cupertino, CA 95014, Assessors Parcel number 359-18-013 are requesting
demolition of their house/building.
Please notify us within 15 days if you have any objections.
Our address is: City of Cupertino
Building Dept.
10300 Torre Avenue
Cupertino CA 95014
If you have any questions, please call me at (408) 777-3228.
Sincerely,
Susan Winslow
Administrative Clerk, Building Department
Printed on recycled Paper
COMPLIANCE &
BAYAREA ENFORCEMENT
�QALtYY DIVISION
D[ S T ., c T
'9gulation 11, Rule 2
Acknowledgement of
Notification and
Payment of Fees
1/26/2004
Mark Cunha's Paving Job No: IX893
15100 Montebello Road
Cupertino, CA 95014 Invoice No: OSW37
The Bay Area Air Quality Management District (BAAQMD) acknowledges receipt of your payment and
Your Asbestos Removal or Demolition Plandescribed as: Demolition
Site address 10559 Felson Way
C
Cupertino, CA 95014
' .iAN 2 9 2004vL1
Start Date February 5, 2004 1` -
Completion Date March 30, 2004
Removal amounts of friable ACM 0 linear feet Q square feet Q cubic feet
Should it become necessary to revise this plan, please do so in the spaces provided below and irmnediately
copy the District by fax or by mail.
REGULATION 11-2 REVISION BAAQMD J# 1X893
.KEV1J1UN # START DATF,
1 / /
2
3
4
5
f :()MPT .RTTnN n ATF
NOTE" This form is not intended as a verification ofeither the completeness ofyour original notification
or of its compliance with Bh1AQMD Regulation 11-2- Ifyou have any questions about this
acknowledgment, please call our off(ce at (415) 749-4762.
n. S
id wdss:80 ve03 �-3 •upf 9370898807: 'ON XHd UHNnJ Aatlw: woad
11
0
0
Z -CON Specialty Services, Inc.
Asbestos & Lead Abatement Contractor
CERTIFICATE OF WORK COMPLETION
DATE:
SUBMITTING TO
JOB LOCATION:
WORK PERFORMED:
January 15, 2004
Frankie & Su Law
10559 Felton Way
Cupertino, CA. 95014
JAN 9 2004
Removed existing asbestos containing flooring material located in the kitchen and bathroom.
All work performed according to EPA and OSHA regulations. Fully certified and protected work
force. Completely contained work area. Wet removal methods used. Complete detail of all
abated areas. All waste transported to an approved landfill.
•
SignatmrF
Title
1.1
1645 Old Bayshore Road San Jose, CA. 95112
Phone; 406-451.9512 Fax; 408-451-9514
Contractor License No. 803805
11
..•
Pacific Gas and
Electric
Company
City of Cupertino —" _l Vi
10300 Torre Ave. JAN 2 9 2004
Cupertino, Ca 95014
To Whom It May Concern:
Subject: Removal of Gas and/or Electric Facilities
0
10900 North Blaney Avenue
Cupertino, CA 95014
The gas and electric facilities have been removed and/or a andoned at
10S.S F6L-Tt) n-) W1.1 GU pea-mia -on a •021
If you have any further questions, please contact me at (408) 725-2024.
Sincerely,
Service Planning
SANTA CLARA COUNTY • P L"A C°
v
VECTOR CONTROL DISTRICT
.976-L'enzen Ave. 5
San Jose, CA 95126
Technician
10792-5010
1-800-675-1155
Technician's #
www.scevector.org
RODENT HOME(YARD
INSPECTION
SR# `� Address:
' JAN
Owner O Tenant O Previous
RM
9 2004
ATTRACTANTS FOUND: O Pet food/birdseed O Fruit O Nuts O Citrus O Uncovered garbage cans O Insects(snail &
slugs) O Vegetable garden Harborage
O Other
ENTRY & ACCESS POINTS TO BUILDLINGS NEEDING REPAIR: O Vent screens, attic & foundation Holes in roof VL,,�
O Pet doors O Open doors & windows O Chimney O Fences O Trees O Patio cover O Crawl space opening
O Unfinished construction O Pipes, cables &wiring entering walls &
O Over -lapping roof lines � Other (}r�.c _nj (7 L
O Under/around garage doors(s)
ANIMAL DAMAGE TO: O Lawns O Gardens O Flower beds O gR,00f O Vent screens O Foundations O Sidewalks
O Heating ducts O Insulation O Wiring O Plumbing (Other P—T i (-
THE FOLLOWING IS NEEDED FOR YOUR PROPERTY
® TO MINIMIZE OR ELIMINATE RODENT PROBLEMS
O Weather stripping around garage and house doors O Remove any trash accumulation
1
O Keep sheds tightly closed O Seal where pipes/wires enter building
O Keep crawl space covers in good condition and secured O Spark arrester needed on chimney
O Seal all ope._ n_ings where roof -lines overlap O Replace and/or reinforce all vent screens
O Harvest all ripe fruits, citrus and nuts from trees and off ground O Ivy or other plants thinned and/or removed
O Keep all garbage cans covered and secured O Keep all doors and window closed after sunset
O KeeDiall pet doors closed and secured O Take all pet food and containers inside by sunset
0 4�t back all trees, bushes and shrubs approx. 24-36 inches from roof
O Store all firewood approx. 18" above the ground and 12" away from any structure
u r Ll S"? _FUW5- - c r. 2 - A771 c-
PROPERTY OWNERITENAT PLEASE NOTE: Aker all entrances are sealed shut, any rodents left inside the structure
should be trapped with a snap trap. Traps should be baited with oatmeal, walnut meat, or peanut butter
40
CAUTION: Do not use any rat poisons inside structures
THE ABOVE CONDITIONS HAVE BEEN FULLY EXPLAINED TO ME
SIGNATURE (Owner/tenant):Y' ! G ~%�/�i6 ., DATE:
�-
&5653REV 6/02Cot/T.¢oL ),t/t%.2, ,
c` OA/ X 77ftclle�:) /o'af-cs .
Supplemental Page For Service Request # 46906
Completed an inspection at 10559 Felton Way in the city of Cupertino and
discovered evidence of rodents in the residence attic and some areas in the
garage .Upon further inspection in the garage I discovered large amounts of
droppings and evidane on rodent nesting. Following recommendations were
made:
1 to continue trapping in the garage for a period of three weeks and to repair
some of the entrances found to discourage rodents from entering the garage.
2. recommended to concerned owner to hire a pest control agency to trap or
bait for rodents for the same amount of time in the attic.
In the mean time I set several traps and discussed several more options with
owner. I also recommended to owner to clean up the back yard to further
deter the harbourage of rodents. We set a re -inspection date of Jan 5'i' 2004>
Re -inspection completed on 1/5/04 and did not find any evidence of rodents
on the traps or the bait being taken. Owner mentioned that he had sealed all
the openings and entrances to the attic. At time Santa Clara County Vector
Control District will clear this residence for demolition
40