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14060087CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21900 OAKVIEW LN CONTRACTOR: A -1 POOL REMOVEAL PERMIT NO: 14060087 OWNER'S NAME: KINGKAY CAPITAL LLC P O BOX 1212 DATE ISSUED: 06/13/2014 OWNER'S PHONE: 4088576560 CAMPBELL, CA 95009 PHONE NO: (408) 978 -2903 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL f SFDWL POOL REMOVAL 888 SQ FT / License Class C Z Lie. # ��� 61/0 Contractor }� — I °c Date �3 I hereby affirm that I am licensed 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. 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. 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 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 granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9 18. Sq. Ft Floor Area: I Valuation: $7500 APN Number: 32619105 00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 9 OF PERMIT ISSUANCE OR 180 DAY ROM L ST CALLED INSPECTION. Issued by: Date: U-C.1 RE- ROOFS: Signature Date 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. ❑ OWN R -BU DER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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 construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three 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. 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. I certify that in the performance of the work for which this permit is issued, I shall 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 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. 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 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 granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9 18, Signature Date Signature of Applicant: Date ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air 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 Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized age n Date: D �3 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C ) Lender's Name Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION +' 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255` (408) 777 -3228 • FAX (408) 777 -3333 • building0kupertino.org \ USE OF ❑ SFD or Duplex ❑ Multi - Family TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION ($) F-1 STRUCTURE: Commercial PROJECT ADDRESS } `��is w lc� Lv APN # 2n 1 _ SPA OWNER NAME N V - VINYL -LINED PHONE �6 b E -MAIL STREET ADDRESS CITY, STATE, DEMO FAX CONTACT NAME v-1 ' -Poo c AA7.0 P O �� O E -MAIL b , STREET ADDRESS PO O 2 / 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 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 constructio o 'ze representatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent: Date: CITnTE, ZIP C/ 9�-o a FAX ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT CCTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT � I` v Q�� CONTRACTOR NAM!:: // //'' LICENSE UMBER NI LICENSE CTYPE Z BUS. LIC # COMPANY NAME E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECT /ENGINEER NAME LICENSE NUMBER BUS. LIC k COMPANY NAME Kl 7 E -MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK /� 14 C IC/ F"W i c-,- -e- pep C, USE OF ❑ SFD or Duplex ❑ Multi - Family TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION ($) F-1 STRUCTURE: Commercial POOL } `��is 7 �© U POOL/SPA MATERIAL TYPE CODES: SPA O ,EXPRESS ,,, ❑ PLANNING DEPT V - VINYL -LINED "❑ STANDARD .` ❑ PUBLIC WORKS DEPT 4, F - FIBERGLASS DEMO 1VIeIJ,OR — G - GUNITE P - PREFABRICATED b , TOTS sT �I UATION: 1� 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 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 constructio o 'ze representatives of Cupertino to enter the above - identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAr, INFMMA ION RE UIRED Q " ` d�G a r I'9 a .OFEICE 'USE ONLY SwimPoolApp_2011.doe revised 03116111 I'` ",PLC GICTYPE _ ROUTING SLIP Commercial or Multi - Family Buildings with Public Swimming Pools: ovER CovzrER -. F-1 BUILDING DEPT Department of Environmental Health approval required. T O ,EXPRESS ,,, ❑ PLANNING DEPT "❑ STANDARD .` ❑ PUBLIC WORKS DEPT 4, ❑ LARGE`t °a� = r ❑ ENVIRONMENTAL HEAL 1VIeIJ,OR — '❑ SANITARY SEWER DISTP SwimPoolApp_2011.doe revised 03116111 CITY OF CUPERTINO FFF ESTIMATOR — BUILDING DIVISION 1-11 im, ADDRESS: 219100 oakview In FEE DATE: 06/13/2014 REVIEWED BY: Mendez APN: BP #: *VALUATION: 1$7,500 *PERMIT TYPE: Demolition Permit PLAN, ('i/�('K '1T111�: PRIMARY USE: Swimming Pool, Res. PENTAMATION PERMIT TYPE: 1 SFPOOLDE sfdwl ool removal 888 s ft $319.00 S 0.0 hrs Oflxr Ilccf - "' h'1:5T Phutrb. Plur1 C'rrx'k t'tr rnf1. 1' ;sett l'ec. (lrher• Plumb h' u'u Pr`ttnub. I,rsh. Fee: iie�. P r� C`laerl, Ei( -,'C- jr / ' NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School r►:.,: * .,fn r'antart the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Ejf. 711113) FEE QTY /FEE MISC ITEMS Plan Check F,, e: sztppl N , Pee Permit Fee: $319.00 Suppl. Insp. Fee-.(D Reg. ® OT 0.0 hrs $0.00 Pern il. 'ee: Con ;i <J'LlC'll i)tt L i3pi: r�Ci1'EdFlC`' /' C'olzbtrrg t "<'£?S: Travel Dt3t'wnenlaiio n Fees-_ Strong Motion. Fee: IBSEISMICR $0.75 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 J" $320.75 $0.00 TOTAL FEE• $320.75 Revised: 04/01/2014 rry t is set plans and spec' b sited iring construs tic chal ges or aiteratiol erefrot 1, without aporo e Sta ping of th is plan be held o mit or o i of any rovi on �ny TE y7' DN - CUPERTINo EST ®VED it is unia ul to make any on same, o to deviate I from the uilding Official. id �ecif ons SHALL NOT an approva of the violation 4. nrdinan a or State Law. 12• i✓-ST -,Qgrx C, F LIVE I 2 7' /V a -t'F9 i- 1 `ale A(3RrrMEhlT ,gReA �D 13 E A AldN�t3���p AR 4 Fo►2 Li,A1D 5C-A P� u" 7 EQUr pm mT ?o 66 -P r= 42- 12 F_ t'vlo v f U � LT-r r5, aN6 %AYDOWO Sr 9, G of?,-�F Wain Z9�o� 4AK V��W L C ✓ 4-�' p..p L40'; gs7 - (o S(0 f f ' r s I PR E Vr, � CUPERTI O J� f R!,ildina Deprartn er .1 N P 3 2014 STi� ='� — WE F ° ` +MOUE CCMPLIANI E CDA k V1-- W �. Al e COMPACTION DEPORT IS REQUIRED SHOULD THE _ABATED AREA RE nFCI-ARFn "RUll nAR1 Fps IN T W: Pi M IPff CUPERTINO Address SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(d cuoertino.oro i f0 DCfii°�v r PURPOSE :1EE E N This affidavit is a self - certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single - family and multi - family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit includin basements X X Within each sleeping 'room I X Carbon Monoxide alarms are not required in dwellings which do not contain fuel- burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above - referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. I have read and agree to comp! y with the terms and conditions of this statement Ownneer'(or Owner Agent's) ame:, C � e / Signature ............. ..................... I ................... I........ Date: �0.... .... Contractor Name: Signature.................................... ............................... Lic.# ....... ............................... Date: ................... Smoke and CO fom.doc revised 03118114 s[�, -