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12120027 1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 8051 PRESIDIO DR CONTRACTOR: PERMIT NO:12120027 OWNER'S NAME: MCMILLAN WILLIAM A TRUSTEE&ET AL e7— A DATE ISSUED: 12/062012 OWNER'S PHONE: 6505758771 PHONE NO: ❑ LICENSED CONTRACTOR'S DELARATION _1 BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r License CI Lic.# 1 MECH r RESIDENTIAL r COMMERCIAL r C tractorn... :�J—� I hereby a r at I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:DEMO RESIDENTIAL SWIMMING POOL (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. 1 have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$3500 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APN Number:35611072.00 Occupancy Type: APPLICANT CERTIFICATION 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 PERMIT EXPIRES IF WORK IS NOT STARTED upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION. granting of this pe it-�cd 'tionally,the new understands and will comply with all non-point re er to Cupertino Municipal Code,Section 9.18. �� Issued — Datp �9-{ Signature Date /K& ❑ .OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is 1 hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for the following two reasons: inspection. 1,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, Signature of Applicant: Date: Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to constmct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby alarm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(x)should I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the I certify that in the performance of the work for which this permit is issued,l shall Health&Safety Code,Sections 25505,25533,and 25534. 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,I Owner or authorized agent: become subject to the Worker's Compensation provisions of the Labor Code,I must Date: forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Licensed Professional Signature Date DEMOLITION PERMIT APPLICATION D COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 C 0 UPER 0 (408)777-3228•FAX(408)777-3333•buildingCdcuoertino.om APN q ✓y;PROJECT ADDRESS VSI OWNERNAh1E VIiND (OgIyr� GSo.57s.8a- 1,M5 E Y � I��Q 11�®9lv1QA I.C$7lM STREET ADDRESS So 51 Q IZE S(D)t0 R CrrY, STAT"' &LA NAL I NOJ C A 950 1 FAX CONTACT NAME S(�1 t.7Y1 yam- ,_ PHONE &MAIL STREET ADDRESS Cx�W CITY,STATE,ZIP FAX ❑OwrE ,q OWNER-BINDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCIIFECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME / LICENSETYPE` BUS.LICXrI ^ 10P in / COMPANY � a FAX ite[fir-N STREET ADDRE] - t� r CIIV,STATE,Z ^ PHONE - DESCR2TIONOFWORX TOOL k&MQVItL RESIDENTIAL X DWELLINGOTWICE USE ONLY FLOOR AREA UNITS tjsjS- VAL ATI = CONIMERCIAL ELOOR ARE ' TYPE OF CONSTRUCTION X STOR@$ AQMDIOa NUMBER VALUATION TOT VALUATION: J#: �. ItaCENED 3500 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 comet. 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 buildingnstruction. I authorize represematives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent 4140. Date: SUPPLEMENTAL INFORMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT OMCE USE'ONLY _Provide lob Number from Bay Area Air Quality Management District ww .baaemd.ore @ 415-7494762. PLAN C11669'T'iTE w —Provide three copies of a site plan showing protection for any trees 10"in diameter or more at T above grade. 44 - c3 e–__ ` _Provide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected. El STA ARD M 'Y _Provide a letter of inspection,tests,and abatement of any Hazardous Materials.Letter to be initiated by person1:1 LA s) RGE certified in asbestos,mercury and/or hazardous material examination. MAJOR _Planning Dept clearance to verify building is not considered an historical landmark Allow 10 business days. Cl/ M' _Provide letter of clearance of all vermin from a licensed pest control contractor. Applicant shall Call the Public Works Department at 408-777-3104 and schedule a"habitable dwelling"inspection. _Provide signed Debris Bin and Recyclable Materials form. Commercial Buildings Only: Provide Fire Dept clearance for fire suppression/alarm system review. �rl� r, L� DemoApp_201 Ldac revised 03/16/11 �1 CITY OF CUPERTINO D FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 8051 presidio dr. DATE: 12/06/2012 REVIEWED BY: bob s. IQ APN: BP#: 'VALUATION: $3,500 *PERMIT TYPE: Demolition Permit PLAN C/IEC K T)T/i: PRIMARY Swimming Pool, R2S. PERMIT TYPE: 1SFPOOLDEM USE: PERMIT TYPE: WORK demo residential swimminn pool. SCOPE FEE ID #POOLS 1DEMOPRES tl&ch. Plan Check Plumb, Plan Check Fle<:.Plan Check Meeh.Permit Fee: Plumb.Permit Fee: flee.Permit Fee: Othv, afech. Insp. Other Plumb Insp. Li I Other Elec.Imp. 4/ech. Insp. Fee: Plumb. buy. Fee: Elec.Insp. Pee: NOTE:This estimate does not includejees due to other Departments(Le.Planning,Public Works,Fire,Sanitary SewerDistrict,School District eta). These fees are based on the prefinWdna in ormation available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 1 l-053 Eff 7/1/12) FEEQTY/FEE MISC ITEMS Plan Check Fee: Supp/. PC Fee Phtmb./Meeh./Elec Permit Fee: $306.00 Suppl. Insp. FeelD Reg. Q OT 0,0 hrs $0.00 Phimb./jblech./Nee Plumh./Mech.lElec Permit Fee: Construction Tax: Administrative Fee: Work Without Permit? Advanced Planning Fees: Travel Documentation Fees: Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 s $307.50 $0.001,` "OTAL FEET $307.50 Revised: 10/01/2012 wEND7 l03"U$ 8'O5) pkr'n bio of,, vc-moblTIONof Tool- C,aP&k9 Tl ND C14 0150 1� p"1P'?i�r'F' `4 ;�, Frtiidina Department DEC 0 6 2012 REVEWEDFon C(Drg—C;I i?a�CE Reviewed�y:�_„� wwwlv- lh 0 r ®• ) TT 11 Loop m 8 2V