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CITY OF CUPERTINO
BUILDING DIVISION PER
BUILDING ADDRESS-
C.
OWNE*RRAW��
PHONPONY WONG -`0�M-yZP-2 0 0 7 CONTROL Q.
ARCHITE,CT/ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
e
C) LICFENSED CONTRACTOWS DECLARATION ■
P I hereby affirm that I arn licensed under provisions of Chapter 9(commencin.- Job Descl'iption
WU With SeCLion 700M of Division 3 of the Busincss and Pro1 'ns Code...'and my license is
D'4 a- in full form and erfmt �4.11111114
En 77 1
1)Z License C1 Lie.# DEMOLITION OF A 1 STORY SFD
Date Comrwtor
XRCHnECrS DECLARATION v
e. I understan rmnyy plans shall he used as public records
Licensed Profcssional
D U)
_< OWNER-BUILDER DECLARATION
n.-J
:X I bercby affirm that I am exempt from the Coniractoils License Law for the
0 followin:re on.(Section 7031.5.Business and Proficssions Code:Any city or county
which uires a i t to--.,nsLmcl,alter,im prove.demcells,or repair any structure
the applicant Cor such perm i I to rile a signed sLalemen I
he provisions or the Contractor's Licensc Law(Chap tc-r 9 Sq.Ft.Floor Area Valuation
)of Division 3 of the Business and Professions Code)or
d the basis for Lbe alleged exempflom Any violation of ——--------------------------- to
k• tfor a permit subjects the applicant,to a civil penalty of APN Nuffbef Occupancy lype
not more $500).
as oemployees with wages as theirsole compensation,
iH do 32-526022—
w -1 c
Ch,111 not intended or offered fors (Sec.7044,Business Required Inspections
&nd Profe Loi's Lice=Law does not apply to an owner of
property con,and who does such work himself or through his
ownz I rnprovements are not intended or offered for salr-If,
hip zl t is sold within one year of complefion,the owner-
builder w in that he did not build orimprove.for purpose of
sale.).
[:]1.as owner of Lhe property,am exclusively contracting with licensed contactors to
construct the p roj (Sec.70".Business and Professions Code:)The Contractor's Li-
cense Law does not apply to an o of property who builds or' v ereon,and
who contracts for such pmjects with a con uaciv r(s)licensed pursuant to the Contractor's
Lice nm Law.
E)I am exempt and Sec, B&P C for this remon
Owner Date
WORKER'S COMPENSATION D LARATION
I h=by affim under penalty of pedury one of the following declarations:
I ha Ye and will rn ainud n a Cerificate of Conscnt to self-insure for Woftes Compen-
sation,as provided for by Section 3700 of the or Code,for the performance of the
work for which this permit is issuccL
EI I havc and will maintain Wo Compensation Insurance,as mquired by Section
3700 of the or Co e,for the pciformance of the work for whiit is issued.
My Worker's Co sation Insurance carrier and Policy numbcr am,
CaTTiemq.. Policy No.:
'Ift-RTIPICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
CMis section need ricAbe ca pieced if the permit is for one hundrod dollars($100)
or Ics&)
I cznify that in the performance of the work for which this permit is imued,I shall not
c.mploy any person in any manncr so as to become subjec i to the Workrxe Ccnsadon
Laws of California.Date
Apptic ant.
NOTICE TO APPLJCANT.If,after making ft Cenificate of Exemption,you should
become subject to the Workees Compensation provisions of the or Code,you must
Z forthwiLh comply with such TwovWons or this permit sha))be deemed revoked.
0
CONSTRUCTION LENDING AGENCY
V)
11-4 1 hereby affirm that there is a constrwtinn lending agency for the performance of
> Lhe work for which tWs permit Is iss'ued(Sec.3097,Civ,C.)
0 Lender"s Name
z Lender's Address
0 1 certify that I have read this application and state that the above information is
1-4 corrccL I agree to comply with all city and county onancts ands laws relating to
building cons coon,and hereby authorim reprewntatives of this city to enter upon the
U
oho ve-mcnLioncd property for inspection purposes.
(We)agme to sam indemnify and keep harmless the City of Cupertino against
i i abi I i ties,judgments.costs and expenses which m ay in any way accrue against said City
Awk-
Z in consequence of the granting of this permit.
-4 APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS. 9f
Re-roofs
Ii t! nntractor D_
Signature of Ampop-1 C
�
HA ARDOUS MATERIALS DISCLOSURE Type of Roof
Will the appli i or fu tm building occupant store or handle hazardous material
a.s defined by the Cupertinoi al Codc,Chapter 9.12,and the Health and Set
es y
Code,Section 25532(a)? All roofs shall be inspected prior to any ng material being installed.
[:]yMzo roofi
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
emit hazardous air contaminants as dcrined by the Bay A=Air Quality Management all new materials for inspection,
District?
[3 Yes
I have rzad the ha7ardous materials requirements under Chapter 6.95 of the Califor-
nia Health&Safety Code,Seclions 25505,25533 and 25534.1 understand dw if Lhe building
does not currently have a mnant.that it is my rc-sponsibility to notify the occupant of the
circ encs which met ma"o issuance of a CerUficasc of pancyb
Signature of Applicant Date
Owner or authori7tage it All roof coverings to be Class"B"or better
CITY OF CUPERTINO
DEMO
Cv 11 No PERMIT APPLICATION FORM p1p30l1tP
APN # 2_� Date: 3 - 22 07
2
Building Address'. � � �r r � �� �� �v ��r�p .
Owner's Name: ONCPh neA I
�v C �
, 73�Z
Contractor: License
Contact: Phone#:
� � L �U b�m 0 3 Co-L
Applicant/Contractor: G ��
B ,gilding Permit Info:
idg) (gle 4!lupjb ("e
'J-o%_Description 7%'\ A- SFF t
D Residential: Commercial:
Sq.Ft. Floor Area: $/Sq.Ft.: 4 (L
Architect/Engineer: Valuation. � r D
-
Type of Construction: Occupancy Group:
Qty. if
App Licabl; Fee 11D Fee Description Fee Grou
BPERMFEE Bldg Perrm't Fees BUILIDNG
BSEISMICOM Seismic Commercial BUIEL]IDNG
BSEISMICRE Seismic Residential BUELIIDNG
BPLANCHK Plan Check Fee BUELIDNG
7k
BUSLIC Business License BUIEL]IDNG
Pm-D la, sit, 3laalo�
Adilk
CITY OF CUPERTINO
3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: kiersaw
COPY
Sec: Twp: Rng: Sub: Blk: Lot :
APN 06664664 : 37526022
DATE ISSUED. . . . . . . 03/22/2007
RECEIPT 4. . . . . . . . BS000000755
REFERENCE ID 4 . . . -0 07030176
SITE ADDRESS . . . . . 18661 STARRETT CT
SUBDIVISION . . . . . .
CITY . . . . . . . . . . . . . CUPERTINO
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : TONY WONG
ADDRESS . . . . . . . . . . : 12354 PRICILLA LN
CITY/STATE/ZIP . . . : LOS ALTOS HILLS, CA 94022
RECEIVED FROM . . . . : RECEIPT INTERFACE
CONTRACTOR . . . . . . . : TBD - TO BE DETERMINED LIC 00096
COMPANY . . . . . . . . . . : TBD - TO BE DETERMINED
ADDRESS . . . . . . . . . . :
CITY/STATE/ZIP . . .
TELEPHONE . . . . . . . .
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
BPERMFEE VALUATION 51000 . 00 115 .56 0 . 00 115.56 0 . 00
BPLANCHK PERMIT FEE 115 .56 154 .21 0 . 00 154 .21 0 . 00
BSEISMICRE VALUATION 51000 . 00 0 . 50 0 . 00 0 .50 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 270 .27 0 . 00 270 .27 0 .00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 270 .27 1279
---------------
TOTAL RECEIPT 270 .27
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
704 DEMO
AWL
Building Department
■
10300 Torre Avenue
Cupertino,CA 95014
Telephone(408) 777-3228
Fax(408) 777-3333
CUPE TINO
PROCEDURE FOR DEMOLITION PERMITS
BEFORE DEMOLITION PERMITS CAN BE ISSUED,THE FOLLOWING STEPS MUST
BE COMPLETED:
SIGNATURE/DATE:
R
1. P.G.&E. must be contacted AS EARLY AS POSSIBLE prior to demolition to schedule
the abandonment. Contact P.G.&E.at(408) 725-3325. A letter from P.G.&E.shall be
provided to the City.,stating that all gas and electric has been disconnected. (This step
can be time-consurru*ng,so 'it 'is important to be 'in the process immediately)
911
-nership of property,open
2.Provide a current preliminary title report,which shows ow
deeds of trust,any hens,and a legal description. All taxes must be current and paid
in full. Any hens(This excludes mortgages),must be taken care of. This report is to
be issued within thirty(30) days prior to issuance of the demolition permit.
low 5 working days for review..
3. ill out the Demolition Request Form with the names and addresses of any lending
titutions,banks,lease holders,partnerships,lines of equity, or any other persons
having entitlement to the property. We will send the form(s) advising 'Interested
parties that therelis a request for demolition,and they have 15 working days to
respond to our office if they object to the demolition.
4. A plot plan will be required showing any trees(10 inches in diameter at 3 feet above
grade on the subject property,and what means wiH be taken to protect same. Three
copies of this plan are required for review by the Planning Department. These need
to be subim"tted at the time of permit application,to the Building Department.
6. Provide a letter of inspection,tests,and abatement of any Hazardous Materials. Letter
to be initiated by person(s)certffied in asbestos and/or hazardous material
examination.
7. Check to see if the building is�onsidered an historical landmark. Obtain clearance
---------------------......... clearance from the Community Development Planning Department. Allow io working days.
8. Provide a letter of clearance of all vermin from a licensed pest control contractor.
9. Important: Prior to the issuance of the demolition permit,the applicant must call the
'habitable dweRing"
Public Works Department at(408)777-3104 and arrange a'
inspection.
10.Debris bin and Recycling sheet: read,sign and date. The sheet will remain in the
project's building permit file for the duration of the project.
11.Prior to issuance of the demolition permit, the Fire Department must review the
plans for fire suppression/alarm systems that shall remain in service or be modified
during demolition or that shall be replaced with the new construction.
Printed on Recycled Paper
• Community Development
10300 Torre Avenue
Cupertino CA 9501
Telephone(408) 777-3228
Fax(408)777-3333
I Ar%
LuPEkTINU
r
Buildin g Department
JOBB ADDRESS.- PERMIT # /���71/ 1 f L
G
�P�`I��
L.�
WNERPHONE #
--6- -'S NAME: ��\j '07
q -M S(Ptk6E— X/
3 6 2
GENERAL CONTRACTOR: FAX # v �' 3— 1�
I am not using any subcontractors: �— 3�=�
Si tyre Date
Please check applicabie subcontractors and com lete the followm* g information,:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &NUlwork
Cement Fl*nlshing
Electrical
Excavation
Fencing
Flooring: Carpeting
/ Wood
Linoleumoleum
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock F_
Tile
Owner/Contractor Signature Date
City of Cupertino
Permim07030176 Plancheck# 1
Project HOUSE DEMO FmIleDate 3/22/07
Address 18661 STARRET CT
Owner WONG
Description
Plan Check Status (attach comments and return to Building with plan set)
Plan
Dept check# Date Due Date staff Comment Date Approval?
Building 1 3/22/07 4/5/07 1:10 ,
Planning 1 3/22/07 4/5/07
Assessor 1 3/22/07 4/5/07
Additional Plan Check Fee ❑ Hours
Planning Fees
Housing Mitigation Fee Amount
Heart of the City Specific Plan Fee Amount
w y
March 23, 2007
To Whom. It May Concern:
The property at 18661 Starret Court, Cupertino, Cal"fornia,95014, was
IN today for any infestation of rodents. No active infestation was
found.
Mike Stadmiller, Field Representative !vs
w
City of Cupertino
Public
10300 Torre ■
Cuperfino CA 95014
(408)777-3354
Deoris .uins
Debris from a project in Cupertino can be collectea ana cusposed or in• • • either.
1. a losAJtos Garbage
ll
4020
OR
• !
d by
and hauled by a vehicle
rcontractor,
owned and registered to that contractor(contractor should be prepared to prove ownership), OR
•
• !
but no bin
The Los Altos Garbage Company is the only debri"s bin service provider
franchised
• in
Bins
leasingcompaines
• •
Cupertino.
Please check all that •
apply,
0 1 will use a Los Altos Garbage Company bin
El I will use a b in and truck owned by the general contractor or the demolition contractor.
+ r ■
truck,ll use.a
vafe
and not drop a ■
Recyclable Materials .
10
• 0 If V In • In •
Recyclable materials may be collected in private debris b
ins or containers leased
from ANY company, as long as the •
als are both:
separated by type of maten"al • containers,
RECEIVED
t
■ are not contaminated by garbage. 7,
material.Separated recyclable mateneals are matefials that are separated M* to vidual containers, each
containing just one type of recyclable
Typical examples o)#' rec7Ctabk"nftteAa1&-
concrete,include.- metal, wood, concrete, steel-reinforced
asphalt, tree trimr,rings, white goods,
� dirt.
ultimately
• Separated recyclables must
landfill.recycled or otherwise reused, and not disposed of'in a
Contractor should be prepared to provide the name and phone number of any recycling comparnes bem' g
used on the A list of local recycling compames.can be found
■
project. ■ • + •
•••••• • ••••• •••••••••••••••••••• ••••••••••• ••• ••• ••••••••• •••••• ••••• •• ••••• ••
-7
Signaturee
•
Date.ILZCName (pn*nted).@
•
•
Phone, 4:&P
I~
address.Pr Ject
01
This form to remain in the project"s building pem-dt file for the durafion of the project.
Revised 1/03
m R-21-2007 05 : T-604 P 002/00 F Grow,
18-38 % 'OERO REAL ESTATS 408-000-0000
ASBESTEST, INC
— — -------------
I&M D*11 Avenue,Suite C.CompbIT14 C -RW(408)374-3362 Fox(409)374-720
TONY WONG Liarch 20t 2007
10285 SEARDON DR.
CUPERTINO, CA 96014 Job No.Ao31815-07
ATTENTION: TONY WONG
PROJECT: 18801 STARRET CT
CUPERTINO,CA
AS13ESTOS IDENTIFICATION BY
Non-Fibrous
Fibrous Agmstos Other Fibrous MaWals or
1 SOUTH WEST BEDROOM NONE OETECTED OnGANIC FIBERS, BINDER, 97%
SHEETROCKI JOINT 3%
COMPOUND COMPOSITE
2 NORTH SATH FLOORING NONE DETECTED F113ERGLA-S, BINDER,60%
ORGANIC FIBERS,
50%
3 SOUTH 13ATH FLOOR NONE DETECTED NONE SAND,BINDER,
TILE 10D%
4 NORTH HALL NONE DETECTED FIBERGLAS, BINDERs 95%
SHEETROCK/JOINT ORGANIC FIBERS,
COMPOUND COMPOSITE 6%
6 NORTH BEDROOMS NONE DETECTED NONE SAND,BINDER,
BROWN FLOOR TILE 100%
6 ROOFING,TOP LAYER NONE DETECTED ORGANIC FIBERS, BINDER, 50%
50%
7 ROOFING, BOTTOM NONE DETECTED ORGANIC FIBERS, SINDER, 10%
LAYER 90%
ials
This test report nWates only bo the Name tested. The materwere examinw!by polafized fight
mlemscapy Ing to EnvironMont&I asbestos percenWges
were esfimatsd based on comperism to test san*o provided by the EPA. Samples will be swred for six
months and then pro"rty disposed unless prior arrangriments have been made.
RespectfuNy submittedf
ASSESTEST, INCORPORATED RECEIVED
law-ff
Robert M. Kumagal
Microscopist BY
iii
CAC 92-0841
TF
r#i ., -
f)J f/J i M.. �,�■
f f ® 08 4087253342 PGE-SVS-PLANNING PAGE r.!
7•
41abs and
COMPaBy
I
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City of Cupertino
103 00 Torre Avenue
Cupertino,
Ca 95014r
15
mlACILITTES
MA IMP
f
L-.. ilities bave beenre-moved .
f _. r
"Ou anv ftirthek queslion5, pl,eas%=, contact me at (408)725.3-
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