The URL can be used to link to this page

08120085 CITY OFCUPERTINO BUILDING DIVISION PERMIT CONTRACTOR INFORMATION BUILDING ADDRESS: PERMIT NO. 1454 POPPY WAY BAY AREA HAULIN & BOBCAT 08120085 ' OWNER'S NAME: SERV PERMIT ISSUE DATE NE: A CONTROL NO. (408) 592-9755 ARCHITECT/ENGINEER: BUILDING PERMIT INTO BLDG ELECT PLUMB MECH it" LICENSED CONTRACTOR'S DECLARATION Job Description a 1 hareby affirm that 1 am licensed under provisions of Clupler 9(am rces,.all <� with Section 70(10)of Division 3 ofthe Business and Professions Code.and my licenses i. infall facemdcffea SWIMMING POOL REMOVAL(520SQ) a z License Class Lk.0 F Dau Contractor ARCHITECTS DECLARATION wU I undersand my plans Nall he used as public reenrds sy Licensed Professional a c OWNER-BUILDER DECLARATION <E I hereby affirm Nat I am exempt from the Contractor's License Law for to COO following mason.(Sccuon 7031.3,Business and Profcssinus Calc:Any city or county which require a permit to consnamL altar.improve,demolsh,or repair any structure a z prior m its issuance.also requires the applicant for such Permit to Ole a signed statement ppxp that heislicensed pursuant tothe provisions,ofthe Commoner's License Law fChapter9 Sq.Ft.Floor Area Valuation yi- (commencing with Section 7000)of Division 3 of the B uslness and Professions Cock)or 5000 '52 Nat he Is exempt therefrom and fthems(or the alleged exemption.Any violation of Section 7031.5 by any applicant fa a permit subjects the applica L to a civil penalty of APN Number Occupancy Type not mom than live hundred dollars(500). 36610086 . 00 ❑I,ss soar of Us ptopeny,a mY wplayce with wage ss Ne'v sole comperoatimn, will da the wmk,and emanation,s not intended or offered for sale(Sec.7094,Business and Professions Cade:The ConuismrS License Law don nae apply to an owner of Required Inspections property who Wilds or improves themon,and who dos such work himsel f or through his own employes.provided that wen improvements am not intended oro@reA for sale.IL however,the building or improvement is sold within arc year of completion,the owner- builder will have the burden of proving that he did not build or improve for purpose or sale.). I,u owner of site property,am eadcovely contracting wit liansed commonness m utwet the pmajea(Sec.7099.Business and Professions Code:)Tlm Contractor's Li- , cove Taw data not apply to an owner of propcnY who builds or improve daemon,and, who contracts for such projects with a contracmr(s)licensed pursuant to tita Co rtraaofs License law. ❑I xmesemptunderSc .B&PCfa Nisreason omme, i i Data W ARB 7 ' MP ON DECLARATION I hereby anion under ,prsWty of perjury oncof the following declantio� haw and will maintain s Cmsitisu of Convent enself-insure for Warke(s Compen- oa,as provided fa by Section 3700 of the Lebo Code,fa the performance of the work for which this permit s issued. ❑1 have and will maintain Worke/s Compensation Insurance,az tegmred by Section 3700 offt Tabs Code,for ac perforans of the work fa which this permit u sscd. ' My Workces Compensation Ins rano carim and Policy number art: Carrier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE Obs station need not he completed if the permit Is Tsar hundred dollars($I00) or less) 1 anify that in the pximmamc.of the work for which this permit is issued,l shall not employ anypersoa in my mon u m become subject m the Workers'Compcusatlon Laws of califpmia.DDrim Applicant `ll ' NOTICE TO APPLICANTS 'aftcY711aflag this Cenificau of Exemption,you should become subject in the Woh6fa Compeusation provisions of the Labor Cade,you most .�z forthwith comply with such provisions or this permit shall he domed mated. Z O CONSTRUCTION LENDING AGENCY [-i 1 hereby&Mme that them as construction lending agency for the performance of lYi the work fur which this permit s issod(Sts.3097,Co.C.) Q Lcndets Name =,z fender's Addams V Q 1 caufy Nat 1 have red this application and sou that the show informed.s gg. E corntt 1&gram comply with 91 chy and cowry oNinanas and sou laws mlaung m .� SVbuilding Convection,and hereby audaorim reprxnudim of this city to emor upon site C27 above-mentioned property fa inspection purposes (We)ague to ave.indemnify and kap homeless the City of Cupertino agsiet liabiliue,judgmcnts,casts and expenses which may in any way accoc against had City U z in coaequeno of the gruung of thispermit. / — "" APPLICANT UNDER ILL COMPLY WITH ALL NON-POINT Issued by: Date SOURCERE U TION I�%r" o� '/ / Re-roofs Sigwurtof Appli HAZARDOUS MATERIALS DISCLOSURE s Type of Roof Will the applicant m Tatum building aceuput store 2,and t c Health material az defined by the Cupertino Municipal Code,Chapter 9.12,roti the HcaIN and Safety Cale,Section 25532(a)7 All roofs shall be inspected prior to any roofing material being installed. C]Y. )ZfNo Will the applicant or forum building oceupant me equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove the xdmus air contaminants ss defined by the Bay Area Air Quality Management all new materials for inspection. rict7 ❑Yes ZNa 1 haw mail me hica acus menerialsn,quivments under Chaptar 6.95 ofthe Cadres. nix Health&Sxfcty Code,Secuaus M505,25533 and 35534.1 undersand then if the Wilding dura not currently hoc a ren..,the it is my n,apousintity in odfy me occupant of in. "ainumcncs whichhe met oar to issuance of a CCNficata of cup®cy. Signature of Applicant Date (y res e& rte oat ,td ager Dam- All roof coverings to be Class'%a."or better CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36610086 . 00 DATE ISSUED. . . . . . . : 12/10/2008 RECEIPT #. . . . . . . . . : BS000006801 REFERENCE ID # . . . : 08120085 SITE ADDRESS . . . . . : 1454 POPPY WAY SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : DEBBIE CHEN ADDRESS . . . . . . . . . . : 1454 POPPY WAY CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-5336 RECEIVED FROM . . . . : DEBBIE Y CHEN CONTRACTOR . . . . . . . : ROBERT ARRIGHI LIC # 24175 COMPANY . . . . . . . . . . : BAY AREA HAULING & BOBCAT SERV ADDRESS . . . . . . . . . . : P 0 BOX 36143 CITY/STATE/ZIP . . . : SAN JOSE, CA 95158 TELEPHONE . . . . . . . . : (408) 592-9755 • FEE IDUNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL 1BSEISMICR VALUATION 5, 000 . 00 0 . 50 0 . 00 0 . 50 0 . 00 1DEMOPRE SQUARE FEET 520 . 00 490 . 00 0 . 00 490 . 00 0 . 00 TOTAL PERMIT 490 . 50 0 . 00 490 . 50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ------------------ CREDIT CARD 490 . 50 MC --------------- TOTAL RECEIPT 490 . 50 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ------------------- 704 DEMO • Community Development 10300 Torre Avenue ii7 Cupertino CA 95014 y Telephone(408)777-3228 CITY OF Fax(408)777-3333 q6UPEkTINO Building De artment JOB ADDR SS: PERMIT # 01f I a 0v 0C5 OWNER'SN j PHONE # k- 3563 -386 GENERAL CONTRACTOR:.. rYi i FAX# I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following ' ormation: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile • er/Contractor Signature Date r Ulla CITY OF CUPERTINO DEMO COF •CUPERTINO PERMIT APPLICATION FORM APN# 3b & / 0 o�`o/ . 00 Date: Building Address: )45-4 FOMIC k C)5161 (k Mailing Address (if diffirbrit from building address): Owner's Name: Phone: D-e�b6_e- CA eq LOW- 3g3 -3Z6 Contractor: Robei t A{ ri9�r' ( 3C ,�� Phone : t48-723 osP/ Fax: Contractor License #: &q 3q 3 D Cupertino Business License #: 27-4 1 Contact: Phone: Fax: Residential [ Sq Footage S2o Commercial ❑ Sq Footage Job Description: ft) M,0A0V t Valuation: Project Size: Express ['_Standard ❑ Large ❑ Major ❑ Please complete relevant portions of the Green Building Checklist & attach it to the application or if applicable, include on the plan set & the sheet index. Quantity Fee ID Fee Description Fee Group Permit Type 1DEMORES Demo-Residential B 1SFDWL-DEM 1DEMOPRES Pool Demo Residential B 1SFPOOL-DEM 1BSEISMICRE Seismic Residential B Revised 6/16/08 CITY OF CUPERTINO IMS D f DEMO CUPERTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group Permit Type 1DEMOCOM Demo-Commercial B 1COMML-DEM 1DEMOPCOM Pool Demo Commercial B 1CPOOL-DEM IBSEISMICOM Seismic Commercial B 1BUSLIC Business License B • Revised 6/16/08