The URL can be used to link to this page

12020050 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 942 SEPTEMBER DR CONTRACTOR:JOHN MOLINA PERMIT NO: 12020050 CONCRETE OWNER'S NAME: ANAND PUNEET AND MANISHA 30 CLAREVIEW AVE DATE ISSUED:02/13/2012 OWNER'S PHONE: 4082030605 SAN JOSE, CA 95127 PHONE NO:(408)729-3642 ❑ LICENSED CONTRACTOR'S DECLARATION 3 ( BUILDING PERMITINFO: BLDG ELECTPLUMB License Class G Lic.# -3 1 9:�rF MECH RESIDENTIAL COMMERCIAL Contractor,—'ZW P1 D"A4 in /c Z I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION: POOL DEMO 496 SQ FT (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. Sq.Ft Floor Area: Valuation:$7000 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 APN Number:36214003.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. 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 Issued by i- Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature_ Date / Z 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 all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: health&Safety Code,Section 25532(x)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should 1 use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for thep erformance of the work for which this permit is issued. Owner or authorized agen / �7�/BL.t Date: 1 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,1 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address I certify that I have read this application and state that the above information is correct. 1 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, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date 9LfZ- CyP�-,�a c�►--�tajy °b P tt• � LOY 2-o3-oko� IFt pPMENT DEPARTMENT COMMUNITYDEQ U BUILDING DIV ON-CUPF�TINO 1 ' specifications Ml1ST be kept at the This set.of plans and sF �^ t make an jo`�r during construction. !t is unlawful o or alterations on same,or to deviateFicial. therotrom,without approval from the Building ; tan and specifications SNAt-t I`lOT ;' - of this p . a��roval of the vi ;ia:°n to ,c;cl:0 Pnrrrzit or to b-'zn N. tate Law. Cit Ordinance or S o`any provisions of anyY BY —) 2- 5c.o P� o� vs oQ k . (�odLI+tc7 i i v M IL CITY OF CUPERTINO F 70 FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 942 september dr. DATE: 02/13/2012 REVIEWED BY: bob s. APN: BP#: VALUATION: 1$7,000 ikl i PERMIT TYPE: Demolition Permit PRIMARY Swimming Pool, Res. PENTAMATION 15FPOOLDEM USE; PERMIT TYPE: WORK sfd swimming pool demo. SCOPE FEE ID FLR AREA s.f. 1DEMOPRES 1 Li NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public{Forks,Fire,Sanitary Sewer District,School District,etc.). These.Les are based on the grelinina inormation available and are onl an estimate. Contact the Det or addn'l in o. FEE ITEMS 1?e. /",,, o= 05 1 FEE QTY/FEE MISC ITEMS Permit Fee: $300.00 SrrFpl. Insp. Fee12) Reg. (Q OT (j 0 hrs $0.00 :L) e $0.00 Seleet an Administrative Item lBcasc $1.00 SUBTOTALS: 1 $301.001 $0.00 TOTAL FEE: $301.00 Revised;9126 CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot : APN . . . . . . . . : 36214003 . 00 DATE ISSUED. . . . . . . : 02/13/2012 RECEIPT # . . . . . . . . . : BS000015993 REFERENCE ID # . . . : 12020050 SITE ADDRESS . . . . . : 942 SEPTEMBER DR SUBDIVISION . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : ANAND PUNEET AND MANISHA ADDRESS . . . . . . . . . . : 942 SEPTEMBER DR CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : JOHN MOLINA CONCRET CONTRACTOR . . . . . . . : JOHN MOLINA LIC # 28594 COMPANY . . . . . . . . . . : JOHN MOLINA CONCRETE ADDRESS . . . . . . . . . . : 30 CLAREVIEW AVE CITY/STATE/ZIP . . . : SAN JOSE, CA 95127 TELEPHONE . . . . . . . . : (408) 729-3642 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 7, 000 . 00 1 . 00 0 . 00 1 . 00 0 . 00 1BSEISMICR VALUATION 7, 000 . 00 0 . 70 0 . 00 0 . 70 0 . 00 1DEMOPRE EACH 1 . 00 300 . 00 0 . 00 300 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 301 . 70 0 . 00 301 . 70 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 301 . 70 3326 --------------- TOTAL RECEIPT 301 . 70 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 704 DEMO Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRACTOR/ SUBCONTRACTOR LIST JOB ADDRESS: 9q2- 50re,%ge&50r,% PERMIT# ZZ G OWNER'S NAME: Atd&00 PHONE# GENERAL CONTRACTOR: c,>jjr"-rg BUSINESS LICENSE# ADDRESS: 30 ,6&J pive sAoi .gQA- I CITY/ZIPCODE: 5&%j 2-? *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. -� I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner/Contractor Signature Date i SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 (408)777-3228-FAX(408)777-3333•buildingCcDcupertino.orq CUPERTINO PROJECT ADDRESS �". ^ APN# O OWNERNAMEPHONE E-MAIL STREET ADDRESS CITY, I FAX 2 N q CONTACT NAME PHONE , E-MAIL _13�6 4W A1444,1444 gels JhAaLfhaf (::OAI .�rK STREET ADDRESS cny,STATE,ZIP FAX a 2'1 ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT 13ARCHnWT 13 ENGINEER ❑ DEVELOPER 13 TENANT rfCONTRACTOR NAME LICENSE 7LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP 9s 1 2 7 PHOlyE,G,$ �qd-�j 2 ARCHn ECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK USE OF SFD or Duplex ❑ Multi-Family TYPE MATERIAL TYPE(CODE) AREA (SQ.FT.) VALUATION($) STRUCTURE: ❑ Commercial POOL POOL/SPA MATERIAL TYPE CODES: SPA V - VINYL-LINED F - FIBERGLASS DEMO E-,V1 `�UU�� G - GUNITE ( / P - PREFABRICATED RECEIVED BY: r TOT ATION: 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 buildin onstruction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Nate: Z /Z SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP _Commercial or Multi-Family Buildings with Public Swimming Pools: y, � Department of Environmental Health approval required. .L! OVVa TII&CCOUNTER SUMMG DEPT C❑ EXPRESS ❑ PLANNING DEPT ❑ STANDARD ❑ PUBLIC WORKS DEPT ❑ LARGE ❑ ENVIRONMENTALHRALTH ❑ MAJOR ❑ SANITARY SEWER DISTRICT SwimPooUpp 2011.doc revised 03/16/11