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13020086 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20620 HOMESTEAD RD CONTRACTOR:SOUTH BAY PERMIT NO: 13020086 CONSTRUCTION,INC OWNER'S NAME: THE SOBRATO ORGANIZATION 1711 DELL AVE DATE ISSUED:02/142013 OWNER'S PHONE: 4084480700 CAMPBELL,CA 95008 PHONE NO:(408)379-5500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL U COMMERCIAL License Class_415 Lie. REMOVAL OF INTERIOR LIGHT FIXTURES Contmctor�� Dat,A I hereby affirm that I am lice[sed under the provisions of Chapter 9 (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:$500 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:32610066.20620 Occupancy e: permit is issued. p y Typ 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 concoction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY ROM 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. Ad '' nally,the applicant understands and will comply Issued by: Date: with all non-point sot ations per the Cupertino Municipal Code,Section 9 I8. 1�y� j RE-ROOFS: Sign D.. _ 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[am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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 concoct 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(a)should I store or handle hazardous I 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 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&Safe ode,Sections 25501— , 5533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized a permit is issued. age I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner$o as to become subject to the Worker's Compensation laws of California. If after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the tabor 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.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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, 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 CONSTRUCTION PERMIT APPLICATION, U COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISIION n 10300 TORRE AVENUE•CUPERTINO.CA 95014-3255 V C (408)777-3228•FAX(408)777-3333•buildinci( cuoertino.org \ ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFEEBED ORIGINAL PERMIT# PROJECT ADDRESS APN# 1 'Zoro2v o�� 66 .7 8 r�i'• A'I7/ //fih PRO5� rrrua STREET ADDRESof ", � CITY. CONTACT CITY,BTATEyP ,�( Y� XOWNER ❑ owNER-BULDER ❑ OWNER AGENT ❑ CONTRACTOR . ❑CONTRACTOR AGENT ❑ ARCKIT c ❑ENGINEER ❑ DEVELOPER ❑TENANT JQ9IACENSE NUMBER�, LICENSE'I`YPEB BUS.LIC#56 COMPANY NAM AI �74jLSr//y�G✓Zg�/� E-MLJYQ Ir✓iQ�f¢� ��G'./.. G'L✓Yj E ���', E STREET ADDRESS/7j� DE�/ 'A &� — CRY,STATE.ZJ � �j_QO Px �/ ARCHfTECT/ENGMEERCFjr`TO QrO GI/S'� LICENSE NUMBER G` m BUS.LICA T COMPANYNAME /l�,fLfTT /Mp1 6 /T —'.'L QI'pi✓S.�cY�4/-CfEri/v/�.Ca FAX o���I�� STREET ADDRIS ,t J %{/q. � CITY.STATE.lJP Com`/ ✓a//s L'�-9$J/� PH O�_ �`0676 DESCRIPTION ofWORK EXISTING USE 1 PW U$E CONSTR.TYPE NSTORIES Y om/ �] ;/ / USE TYPE OCC. SQ.FT. VALUATIONS) EXLSTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KRCHEN OTHER REMODELAREA REMODEL AREA REMODELAREA PORCH AREA DECK AREA T0TALD6CX/P0RCHAREA I GARAGEAREA: DETACH ATTACH NDWELINGUNDS: IS A SECOND ON11' 13YES SECONDSTORY YES BEING ADDED? ONO ADDITION? 0 N PRE-APPLICAMN OYES WYES.PROVEDECOPYOF ISTHEBLDGAN OYES RECE TOTAL-VALUATION: PIANNINGAPPL# ONO PLANNING APPROVAL TETTER EICHLERHOMEF ONO ��)) V. BY my signature below,l certify to each ofihe following: 7 em the property owner or authorized agent to ac on a 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 ordinaDces and slate Taws relatiD ' g coTlsvtleti Is oriu Lives of Cupertino to enter the abovdoideDU qPd prepary for inspection purposes. Signature ofApplicant/Ag Date: SUPPLEMENTAL INFORMATION REQMED pI;Ag CHECKR: ROUTING SUP _New SFD or Multifamily dwellings: Apply for demolition permit for 1�iCbVEtt_THE-COUNTIIA 1;4�11.DING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD.. ❑ PUBLIC WORxs Tom— if any Hazardous Materials are being used as part of this project .❑ Ptµg DEPT �❑ LAnce. Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR .❑ SANITARY SEWER DTSTRILT submittal of Building Permit application. i ❑,.ENVIRONMENTAL HEALTH BldgApp_201 Ldoc revised 06/2111/ .. . ,r;n•r^dT DEPARTMENT AREA OF WORK �'eul'ol ""Dr;-i;;N-CUPERTINO fir Pk' -_may HOMESTEAD SQUARE RETAIL ° SOUTH BAY �+pia.^s end specifications MUST be kept at the CONSTRUCTION l constwcton. It is unlawful to make any •axxrnnxx.mu xx rrvm. - a -u ns on same, or to deviate II I, a v ithout pproval from the Building ff_I�j' . �:-�:,�•:.1m:.__n'x--:_.c�-_]-x---_�n--_--:w•i--_._'-l.II----"---,.�SS-' -�IIIIII-,I�.�-�--1_u...=;�. °.-,.1.J�_:�•�-.-----,--=-,—o�srw!,—_a,-xxn°x.--x,.i.°_uuxs.---u,-x " -? —r,s.�s.Ls"s•Ixs«r"°�urw�uu.e',a' I ' I IIIiIII ---- -B_ � nI oI 1f�this -4s-P-. l§n-a-n-d-s ece-l-fidlati-os SHALL — ------- r-- __--�1.02T+ y SHEAAND 106 iIIIIII O 18�_K= , ' + I — ` -r--- ---- — I ----I --------------- ---- it -- -, I I�LJ I.I 12 II ," SHEET A1.05 I I I I CI II 1- i — I _ SHEETS A1.04 AND A1.0a I I \K I , IIIIII I 12 III III I I h -_ _ �1 I I _n -�-�• I iLJ i.l I •II I I I Ilii .` -- .<v-.. I I I � i I vmws.ssw j I li �: 1 n _ S 'DIs _ � ddir DA�_ �a HO_Tu'f TEADTOAD.—_I"'_�-_§'yr — 2 / �' � • a� 'i C.�+ � li 2��3 PLANNIN DEPT• � ��C� F= DATE vi `iC Regulation 11, Rule 2 o COMPLIANCE & ENFORCEMENT Acknowledgement of „R_A Y A It E A Notification and -:SRQUALI1Y DIVISION Payment of Fees MANAGEM ENr D l s 'r R 1 C T 1/30/2013 Jakela Inc. Job No:3Y747 32I{amilion Dr,Suite A invoice No:3BR54 Novato,CA 94949 The Bay Area Air Quality Management District(BAAQMD)acknowledges receipt of your payment and your Asbestos Removal or Demolition Plan described as: Renovation Site address 20620&20580 Homestead Rd Cupertino,CA 95014 Start Date February 11, 2013 Completion Date Manch 31,2013 Removal amounts of triable ACM 0 linear feet 34 200 square feet 0 cubic feet Should it become necessary to revise this plan,please do so in the spaces provided below and immediately copy the District by fax or by mail. REGULATION 11-2 REVISION BAAQMD J# 3Y747 REVISION# START DATE COMPLETION DATE; I 2 4 5 NOTE. T his form is not intended as a verification of eidjer the completeness of your original notification m•of its compliance with BAAQMD Regulation 11-2.If you have any questions about this acknowledgment,.please-call our office at(415) 749-4762. Al Regulation 71, Rule 2 4: COMPLIANCE & ` ' ENFORCEMENT Acknowledgement of -DA Y AREANotification and . RCiUALITY DIVISION payment of Fees MANAGEMENT D I S T R I C T 1/30/2013 Jakela Inc. Job No:3Y748 32 Hamilton Dr, Suite A Invoice No:3BR55 Novato,CA 94949 The Bay Area Air Quality Management District(BAAQMD)acknowledges receipt of your payment and your Asbestos Removal or Demolition Plan described as: Site address 20620&20580 Homestead Rd Cupertino,CA 95014 Start Date February 11,2013 Completion Date March 31,2013 Removal amounts of friable ACM Q linear feet 74,000 square feet 0 cubic feet Should it become necessary to revise this plan,please do so in the spaces provided below and immediately copy the District by fax or by mail. REGULATION 11-2 REVISION BAAQMD J#3Y748 REVISION# START DATE COMPLETION DATE 1 --- 2 - ---t-- 3 -- 4 -- 5 NOTE. This form is not intended as a verification of either the completeness of your original notification or-of its compliance with BAAQMD Regulation 11-2. If you have any questinns about this acknowledgment,please call qui office at(415) 749-4762.