11030021CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19920 OLIVEWOOD ST BLDG OFC
CONTRACTOR: EDEN LANDSCAPE
PERMIT NO: 11030021
MANAGEMENT
OWNER'S NAME: ESSEX PROPERTY TRUST
12550 PASEO CERRO
DATE ISSUED: 03/03/2011
OWNER'S PHONE: 6508151622
SARATOGA, CA 95070
PHONE NO: (408)858-9085
❑ LICENSED CONTRACTOR'S DECLARATION
r r r
License Class Z Lic. # / r
BUILDING PERMIT INFO: BLDG ELECT PLUMB
MECH r RESIDENTIAL r r COMMERCIAL
Contractor Eiif,d L";gS ftKo%i4 i Date 3 hir
I hereby affirm that I am licensed under the provisions o Chapter 9
JOB DESCRIPTION: DEMO POOL - 920SQFT
(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
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: 31643004.OFC
Occupancy Type:
permit is issued.
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 ions per the Cupertino Municipal Code, Section
Issued by: Date:
9.18.
Signature Date J13f /
RE -ROOFS:
❑ 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)
I, 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 shallnot
& Safe de, Sectio s 25505, 25533, and 255
employ any person in any manner so as to become subject to the Worker's
;Health
or au age
V
Compensation laws of California. If, after making this certificate of exemption, I
Date:
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 work'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
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
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
CITY OF CUPERTINOTo]
DEMO
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CUPERI'INO PERMIT APPLICATION FORM
APN#� I O Oct
Date:
3
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3 11
Building Address:
1 g J Z o Ola U{.jooq 57ae4—.
Mailing Address (if different from building address):
2
Owner's Name:
Phone:
FuSkx Pi*9M,11 -7"-T.
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Contractor:
Phone : 40? 8 S"$ of o 19,r
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Fax:
Contractor License #: r10985- f
Cupertino Business License #:
Contact:
Phone:
Fax/e-mail:n1L�+goBS�y
Residential ❑ Sq Footage Commercial
[d Sq Footage
Job Description:
Rpo o1
Valuation: 4.7 �C
Duo
Project Size: Counter ❑ Express ❑ Standard ❑ Large ❑ Major ❑
Please complete relevant portions of the Green Building Checklist & attach it to the application
or if applicable, include on the plan set & the sheet index.
Quantity
Fee ID
Fee Description
Fee Group
Permit Type
1DEMORES
Demo -Residential
B
1SFDWL-DEM
1DEMOPRES
Pool Demo Residential
B
1SFP00L-DEM
1BCBSC .
Cal Bldg Standards
Commission Fee ,
B
ALL PERMIT
TYPES
1BSEISMICRE
Seismic Residential
B
M
Revised 12/06/10
EDEN LANDSCAPE MANAGEMENT
12550 PASEO CERRO
SARATOGA, CA 95070
(408)858-9085 * edenlm9085@yahoo.com
September 29, 2011
City of Cupertino
Building Department
10300 Torre Avenue
Cupertino, CA 95014
Subject: Extension of Permit Mow
Site Address: eet
Building Permit Application #: 11030021
Expiration date: 9/10/2011
Attention Building official:
This is to inform you that we need to extend this permit 11030021 because of Permit number
11070014. We have to complete the new outdoor fitness 11070014 the above permit before
we can complete the pool demolition permit 11030021.
Please let me know if you have any questions.
Thank you,
John Kim
Eden Landscape Management
Telephone: (408)858-9085
Email: edenlm9085@yahoo.com
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SWIMMING POOL REMOVAL REQUIREMENTS
CUPERTINO
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildinq(a)cupertino.orq , C -T VE�n
PURPOSEOF
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The purpose of this guideline is to clarify the minimum requirements to allow for the o' o1--ca
existing swimming pool. A demolition permit is required for the removal of all swimming pools.
PLAN REQUIREMENTS
1. Provide a completed demolition permit application.
2. Provide three sets on minimum 8-1/2" x 11" sheets of a completely dimensioned site plan showing
all property lines, all existing structures, location of existing swimming pool and setback
dimensions from the pool to the existing structures and property lines.
3. Owner -Builder Disclosure Form (for property owners applying for their own building permit)
GENERAL INFORMATION — IF THE POOL SHELL IS TO REMAIN
• Drill a minimum of three (3) - 12" diameter holes evenly spaced along the center line of the pool
bottom.
• Backfill the remaining pool shell with'/4" maximum size crushed rock for a minimum of 8" deep
at the bottom of the pool. Gravel shall be packed into place. Clean fill may be added beyond the
initial crushed rock backfill.
• Backfill shall be moistened and tractor rolled or tamped with a wacker compacting plate into place.
• Two inspections are required. The initial inspection is to verify the required drain holes at the
bottom of the pool. The last and final inspection should be scheduled after all the work is
complete.
• No fill dirt shall be stored on the street or public right-of-way without an encroachment permit
issued by the Department of Public Works.
• Owner agrees the backfill over the existing swimming pool shell may have differential settlement
and agree to use the area for landscape purposes only and not use the area for any structural or
floor slab support until the pool shell is removed in its entirety and the backfill is certified with
90% compaction.
FEE ESTIMATE FOR DEMOLITION OF SWIMMING POOL: The calculated fees are only an
estimate. Contact the Bldg Dept for additional info.
*SCOPE OF WORK: Replacement
*VALUATION: $0
*# OF SWIMMING POOLS: jo
Permit Fee $0.00
Strong Motion Fee $0.00
Bldg Stds Commission Fee $0.00
TOTAL $0.00
SwimmingPoolRemoval.doc revised 11116110
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