11060124 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21820 GARDENVIEW LN CONTRACTOR:RICHIE BOBCAT& PERMIT NO: 11060124
HAULING
OWNER'S NAME: SHTEYN YEVGENIY EUGENE 396 PATCH AVE DATE ISSUED:06/14/2011
l ?R'S PHONE: 4082424981 SAN JOSE,CA 95128 PHONE NO:(408)529-2531
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB
License Class C61-,0,03 Lic.# G// 9-Y/D
��"" MECH RESIDENTIAL COMMERCIAL�
Contractor-(,c�� ��(e o 4 Date G 7-- /l
I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE EXISTING GUNITE POOL(168SQFT)
(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:$10000
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
permit is issued. APN Number:32619097.00 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 PERMIT EXPIRES IF WORK IS NOT STARTED
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save WITHIN 180 DAYS OF PERMIT ISSUANCE OR
indemnify and keep harmless the City of Cupertino against liabilities,judgments, 180 DAYS FROM LAST CALLED INSPECTION.
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Issued bye'' Date:
9.18.
Signature Date (P ` 17- 1f
RE-ROOFS:
CJ OWNER-BUILDER DECLARATION 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
I hereby affirm that I am exempt from the Contractor's License Law for one of inspection.
the following two reasons:
I,as owner of the property,or my employees with wages as their sole compensation, Signature of Applicant: Date:
will do the work,and the structure is not intended or offered for sale(Sec.7044,
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations: I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain a Certificate of Consent to self-insure for Worker's California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Compensation,as provided for by Section 3700 of the Labor Code,for the compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
performance of the work for which this permit is issued. Safety Code,Section 25532(a)should I store or handle hazardous material.
I have and will maintain Worker's Compensation Insurance,as provided for by Additionally,should I use equipment or devices which emit hazardous air
Section 3700 of the Labor Code,for the performance of the work for which this contaminants as defined by the Bay Area Air Quality Management District I will
permit is issued. 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,I 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 Ow F or
pputhorized agent
Compensation laws of California. If,after making this certificate of exemption,I ,_)tel 0-4_ 04 Date: G — —
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of%ork's
APPLICANT CERTIFICATION for which this permit is issued(Sec.3097,Civ C.)
I certify that I have read this application and state that the above information is Lender's Name
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 Lender's Address
upon the above mentioned property for inspection purposes.(We)agree to save
i nify and keep harmless the City of Cupertino against liabilities,judgments,
I- 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 I understand my plans shall be used as public records.
with all non-point source regulations per the Cupertino Municipal Code,Section
9.18. Licensed Professional
Signature Date
CITY OF CUPERTINO
3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 32619097 .00
DATE ISSUED. . . . . . . : 06/14/2011
RECEIPT #. . . . . . . . . BS000013763
REFERENCE ID # . . . : 11060124
SITE ADDRESS . . . . . : 21820 GARDENVIEW LN
SUBDIVISION . . . . . . .
CITY CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SHTEYN YEVGENIY EUGENE
ADDRESS . . . . . . . . . . : 21820 GARDENVIEW LN
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : RICHIE BOBCAT
CONTRACTOR . . . . . . . : RICHARD MAES LIC # 31554
COMPANY . . . . . . . . . . : RICHIE BOBCAT & HAULING
ADDRESS 396 PATCH AVE
CITY/STATE/ZIP . . . : SAN JOSE, CA 95128
TELEPHONE (408) 529-2531
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
---------- ---------- ------
1BCBSC VALUATION 10, 000 .00 1. 00 0 . 00 1 .00 0. 00
1BSEISMICR VALUATION 10, 000 . 00 1. 00 0 . 00 1. 00 0.00
1DEMOPRE EACH 1. 00 291. 00 0. 00 291.00 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 293 . 00 0 . 00 293 . 00 0 .00
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: PERMIT# /?-
OWNER'S NAME: PHONE# Ifo$ -- s- q-
GENERAL CONTRACTOR: '; , b �, BUSINESS LICENSE#
ADDRESS: CITY/ZIPCODE:
*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. pp
I am not using any subcontractors: k � -- - 1 3- 1
Signature Date
Please check applicable subcontractors and complete the following information:
V 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
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Master Bathroom
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5'-8 3/16"
8'-5" }
3'-9"
SHOWER = �" U � �Ott)
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Current: frameless swinging door(tempered glass)
3 3 New:frameless sliding shower door(tempered glass)
C.0
2
Keep same dimensions: L 50"x H 69"
BON
z Replace ceramic floor&shower the with porcelain tile.
O - 47 sqr ft of floor; 350 sqr.ft. of shower surface area
' M
+°+ cv Add 2nd sink.
Replace 1 sink vanity with same size vanity
Current: 61.25"x 22.25"&single sink
5'-8 3/16" New: 61"x 22.25" & dual sink
From: Eugene Shteyn<eugene.shteyn@gmail.com>
Subject: Pool removal drawing and application.21820 Gardenview Ln,Cupertino.
Date: June 14,2011 10:27:29 AM PDT
To: richard maes<rmaes457 9 sbcglobal.net>
2 Attachments, 162 KB
Hi Richie,
Attached are 2 pages:drawings with sizes and permit application information. � '�'�
Please let me know if you have any questions.When do you think you
are going to get the permit?
Thanks,
Eugene.
21820 Gardenview Lane,
Cupertino, CA 95014
If Mann Drive —�
.Aq Q*
0
Fence
Z
_ __44'_ _ _
-
to
32'10' 25' 18' �vi1� R�j�
3 '
IU
Pool 12'
' 10'
House
x
DEMOLITION
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: 21820 gardenview In. DATE: 06/14/2011 REVIEWED BY: bobs.
APN: BP#: '"VALUATION: j$10,000
"PERMIT TYPE: Demolition Permit
PRIMARY Swimming Pool, Res. PENTAMATION 1SFP00LDEM
USE: PERMIT TYPE:
WORK remove existing unite pool
SCOPE
FEE ID #POOLS
1DEMOPRES 1
NOTE: Thesefees are based on the preliminary information available and are only an estimate. Contact the De t or addn 7 info,
FEE ITEMS (Fee Resolution 09-051 I�tf. FEE QTY/FEE MISC ITEMS
r
Permit Fee: $291.00
Suppl. Insp. Fee<D Reg. 0 OT 0.0 hrs $0.00
-1 ; :--T--T
Strong Motion Fee: IBSEISMICR $1.00 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS; $293.00 $0.00 TOTAL FEE: $293.00
Revised: 04/29/2011
I rt,� (.00 \ .2_y
SWIMMING POOL / SPA PERMIT APPLICATION
is, COMMUNITY DEVELOPMENT DEPARTMENT- BUILDING DIVISION
10300 TORRE AVENUE -CUPERTINO, CA 95014-3255
(408) 777-3228- FAX(408)777-3333- buildingCa)cupertino.orq
=UPERTINO
PROJECT ADDRESS TAPN# C �C
L I S -?_0r e A e_Lv � ri . 0
OWNER NAME PHONE E-MAIL
STREET ADDRESS CIT STATE,ZIP ' FAX
r^ �r v � G ISO I(�T
CONTACT NAME PHONE E-MAIL
4A Ma2s tCo4$ - 32q-Z.S3i
STREET ADDRESS CITY STATE ZIP FAX
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT o CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC#
lQtc1arj tips ( C'� - 0(,y
COMPANYN E7 [ / E-MAIL FAX
sK 1 sk ;-a— J , cx r . k4 ✓1 I» �YI C. ci e f S `+�— -1
STREET ADDRESS CITY,STATE,ZIP PHONE
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
1
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
-SCRIPTION OF WORK
`p N'l�L^'Q J uJ� ✓h M •/� �O.3 l � cs Q f''e 0.�� � •l
USE OF SFD or Duplex ❑ Multi-Family TYPE MATERIAL TYPE(CODE) AREA (SQ.FT.) VALUATION (S)
STRUCTURE: ❑ Commercial POOL -
V:•al�iR'
POOL/SPA MATERIAL TYPE CODES: SPA
V - VINYL-LINED
F - FIBERGLASS DEMO
G - GUNITE
P - PREFABRICATED RECEIVED BY: TOTAL VALUATION:
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 behalft hav'6'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 building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agenr Date: (o—t`E— 1 k
SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY
PLAN CHECK TYPE ROUTING SLIP
Commercial or Multi-Family Buildings with Public Swimming Pools:
Department of Environmental Health approval required. VER-THE-COUNTER BUILDING DEPT
❑ EXPRESS ❑ PLANNING DEPT
❑ STANDARD ❑ PUBLIC WORKS DEPT
❑ LARGE ❑ ENVIRONMENTAL HEALTH
❑ MAJOR ❑ SANITARY SEWER DISTRICT
SwimPoolApp_2011.doe revised 03/16/11