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12050142 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1520 ASTER CT CONTRACTOR:CAI-WEST LANDSCAPE PERM IT NO: 12050142 DEMOLITION OWNER'S NADIE: KUO HWANG 21103 BRUSH RD DATE ISSUED:05/18/2012 OWNER'S PHONE: 4084067621 LOS GATOS,CA 95033 PHONE NO:(408)375-2809 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL.0 COIIIMF,RCIAL License Class elz eZ7 Lic.4 Jr 7 Z.<3 REMOVE EXISTING IN GROUND POOL 350 SQ Flr Contractor ewg6 t'5-f f�IfrCi'Y�!l�ate —'��'l Z I hereby affirm that l am licensed under the provisions of Chapter9 (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: 1 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 whichthis permit is issued. Sq.F1 Floor Area: Valuation:$8000 1 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:36616044.00 Occupancy Type: pennit is issued. APPLICANT CERTIFICATION I certify that 1 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 ISO 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 � /✓ �TG� .J •�O ��� granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations perCupertino Municipal Code,Section 9.18. KI RF.-ROOFS: Signature _ -Dale-N=�- 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 I hereby affirm that 1 em exempt from the Contractor's License Lew for one of Signature of Applicant: Date: the fallowing two reasons: ALL ROOF COVER INGS 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) 1,as owner or the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). 1 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(a)should I store or handle hazardous 1 have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I 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 whichthis 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,Section 5505,2553 an 534. Section 3700 of the Labor Code,for the performance of the work for which this [ `(?"( permit is issued. Owner or authorized agent: Dale: I certify that in the performance of the work for which this permit is issued,I shall not employ any person many manner so as to become subject to the Worker's Compensation laws ofCalifomin- If,alter making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,1 must 1 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.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, ARCHITECT'S DECLARATION costs,and expenses which may acerae 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 Dale CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: SylviaM COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 36616044 .00 DATE ISSUED. . . . . . . : 05/18/2012 RECEIPT #. . . . . . . . . : BS000016852 REFERENCE ID # . . . : 12050142 SITE ADDRESS . . . . . : 1520 ASTER CT SUBDIVISION . ... . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : KUO HWANG ADDRESS . . . . . . . . . . : 1520 ASTER CT CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : J. WADDINGTON CONTRACTOR . . . . . . . : JOHN WADDINGTON LIC # 23440 COMPANY . . . . . . . . . . : CALWEST LANDSCAPE DEMOLITION ADDRESS . . . . . . . . . . : 21103 BRUSH RD CITY/STATE/ZIP . . . : LOS GATOS, CA 95033 TELEPHONE . . . . . . . . : (408) 375-2809 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- -------- -- ---- -------- -- 1BCBSC VALUATION 8, 000. 00 1.00 0 . 00 1 .00 0 .00 1BSEISMICR VALUATION 8, 000. 00 0. 80 0 . 00 0 .80 0. 00 1DEMOPRE EACH 1. 00 300..00 0 .00 300. 00 0.00 TOTAL PERMIT 301. 80 0.00 301 .80 0.00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- ----- -- CHECK 301.80 chk --------------- TOTAL RECEIPT 301. 80 VOICE ID DESCRIPTION VOICE ID DESCRIPTION ---------------------------- ------------------------ 704 DEMO SWIMMINGPOOL LSPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUIPERTINO (408)777-3228 • FAX(408)777-3333•buildinafG8cuoertino.org I A561442- PROJECT ADDRESS I ,s-z o it-t,/� s 4C/ '[gF V2/ ai AFN 4 I /� OWNER NAME PHONE E-MAII.�/ I`CVD J,(olv - 7�z1 STREET ADDRESS. ZL7 CRY.STATE,Z@ S lU I FAX �- CONTACT NAME "NOL4 3`? _7[.� MAR M.STAELT ADDRESS U S SPA Z v / c� ✓c FAX ❑OWNER ❑ OW -BUILDER ❑ OWNEt AOINT ❑ CONTRACTOR ❑COMRACTORAGEM' ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR �� A LICENSE NUN® LICENSE C f2 C 11.LIC aZ Y�IU COMP NAME `bJ� ZI E-MA - / FAX ,, ln� ilkSC; v N STREET ADDRESS .STATE, PONE z 3 C2 GTA Sa33 0 3 SS-29 ARCHITECVFNGINEER NAME LICENSE NUNMER BUS.LIC B COMPANY NAME E-MAIL FAX STREET ADDRESS CITY.STATE.ZIP PHONE DESCRIPTION OF WORK NO USE OF 1�. SFD or Duplex ❑ Multi-Family TYPE MATERIAL TYPE(CODE) AREA (SQ.FTJ E6VALUATION(S) - STRUCTURE: /❑ Commercial POOL 3 O 000D POOIISPA MATERIAL TYPE CODES: SPA V - VINYL-LINED F - FIBERGLASS DEMO G - GUNI E _ r.a!rwv �r�yc .�- P - PREFABRICATED C pRy{EyCE+�6V�HYK Vis", r ON TOT V1ll.UAT10`Nll, • '-- ry4 4Lr'�-L 3 4 YE lT .Sa CJIX�a By my signature below,I certify to each of the following: I em the property owner or authoriad agent to act on the property owner's behalf. I have read this application and the informadon I have provided is correct I have read the Description of Work and verify it is accurate. I agree to comply with all applicable Racal ordinances and state laws relating to b din nsDUcdan. I>autho en of Cup no to enter the shove-idtndfied pTOperty far mspecdon purposes. Signature of ApplicanJAgcn[ 'f%• LC/ Dates J/-_u// Z- SUPPLEMENTAL INFORMATION.REQUIREDV IL -,�s.:Q :;i==N'�eeA.v;�acTmea�_p�,���_..er-�aRoctaNcscrP::t�?��a _Commercial or Multi-Family Buildings with Public Swimming Pools: Department of Environmental Health approval required. `dTVEIr' SawBurdDt cLDP.VEr�s*-ri FrE�yLAN06i -_4''^�k.��-i' �t�a�'`BNVmON{4:aTALHSA�SH� .I . `sAnaARssEwRicuTSBRrQu<. Swim PooL4oDj011.doc revised 03/15/11 --- 15 zo Njo CA 1��CE [VED Ky o w�� MAY l 8 2012 COMMUNITY ELOPMENT DEPARTMENT BUILDING DI ON-CUPERTINO BY ----�-"' APPRO This set of plans and specifications MUST be kept at the Job site during construction. It Is unlawful to make any changes or alterations on Same,or to deviate Z therefrom,without approval from the Building Official. The stamping of this plan and specifications SHALL NOT be held to permit or to be an approval of the violation Of any Provisions of any City Ordinance or State Law. BY DATE PERMITNO. A90'1O/ ya 1 N u P/) ly , z �1 1.5 z.z' ' 700 z<4 �/Z 5' FILE COP": • W V I hlo `:4� 5..