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14100037 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18454 EDMINTON DR CONTRACTOR:FOUR SEASONS PERMIT NO: 14100037 GARDENING OWNER'S NAME: SAN JOSE,CA 95124 PHONE NO:(408)426-1131 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL REMOVE HOT TUB FOR LANDSCAPING License Class Z 7 Lic. Contractor K4 AC.Ze ro 4 Date GY.'r 7^ 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 ompensation,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:$5000 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:37522080 00 Occupancy Type: permit is issued. 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 WIT A PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY FRO 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 Issued by: Date: 7 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. /� +�/� RE-ROOFS: Signature //���/ Date-A/ 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 Date- Signature of Applicant: I hereby affirm that I am exempt from the Contractor's License Law for one of 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) HAZARDOUS MATERIALS DISCLOSURE I,as owner of the property,am exclusively contracting with licensed contractors to construct 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. I 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&Safety Code,Sections Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: G 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 CONSTRUCTION LENDING AGENCY 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 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 SWIMMING POOL 1 SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �\ GUPERTINQ (408)777-3228•FAX(408)777-3333•buildingCa-cupertino.org PROJECT ADDRESS LIS-k/ APN# 3-752,:2 G O -67-" , STREET ADDRESS CITY, STATE,ZIP .. FAX I � CONTACT NAME f P VA Y Po E-MAIL STREET ADDRESS - CITY,STATE,ZIP 7' FAX if YL ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER L LICENSE TYPE BUS.LIC# COMPANY NA ®: P E-M L -q FAX = v� Lsr� STREET ADDRES§Z 2 CITY,STATE,ZIP VE,— s S ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK CY USE OF ❑ SFD or Duplex ❑ Multi-Family TYPE MATERIAL TYPE(CODE) AREA (SQ.FT.) VALUATION (S) STRUCTURE: ❑ Commercial POOL POOLISPA MATERIAL TYPE CODES: SPA V - VINYL-LINED F - FIBERGLASS DEMO G - GUNITE P - PREFABRICATED - TOTAL VALUAT Atd: �" � D���a4t 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. 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 buildin onstructio . I authorize representatives of Cupertino to enter the above-identifiedpropertyfor inspection purposes. Signature of Appl icant/Agent: Date: L(( /-7— 1 V SUPPLEMENTAL INFORMATION REQUIRED � ONCE USEQNLY PLAN CHECK TYPE ROUTING SLIP _Commercial or Multi-Family Buildings with Public Swimming Pools: 0 VElt E COUNTER ❑ $ulLDuvG DEPT Department of Environmental Health approval required. EXxPRESS, ❑ PLANNING DEPT STANDARD"` ❑ wiJBLIC WORKS DEPT F ❑>LARGE -: ❑ ENVIRONMENTAL HEALTH- MAJOzi,„ ❑ 'ANITARY SEWER DISTRICT- C', SwimPoolApp_2011.doc revised 03/16/11 CITY OF CUPERTINO D FEE ESTIMATOR-BUILDING DIVISION ILIJADDRESS: 18454 edminton dr DATE: 10/07/2014 REVIEWED BY: Mendez BP#: *VALUATION: 1$5,000 *PERMIT TYPE: Demolition Permit P/AX C"1tlx'h 7 l 1'1 PRIMARY PENTAMATION USE: Swimming Pool, Res. PERMIT TYPE: 1 SFPOOLDE i WORK remove hot tub for landsca in SCOPE FEE ID #POOLS 1DEMOPRES � x�s °�` "33 _ " F t 1'c,,,n C 1"'ef1, 1'himh. Plan Cha�rc:,i 1'eF;fut Fee.. Plum?3. 1'r nz;r r1l,"I",1h, ET_L___ Other Plumb 7rnsj� �I'F>e?�,'r z r�stz/f sp- l'e"e 1 t'7ttr0. Ir¢s)J. Fee: Fec: NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These fees are based on the prelimina information available and are only an estimates Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check F,�e: Permit Fee: $329.00 Suppl. Insp.Fee:Q Reg. ® OT F-01hrs $0.00 11/fli7sh. ,/lair.%1>'lc>c P rrtnait Fee: !' t-11'r°its,= T4IX. .�f.t�fZri'rIS,i�4rtrvE>1.4�",. fru''ct .i{; 81ti1t'ilJt (7(1f'l FE'•E,s: A Strong Motion Fee: IBSEISMICR $0.65 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 B $330.651 $0.00 TOTAL FEE:- $330.65 Revised: 08/20/2014 - I6g5Lf GINnIN-T`ON fie7 14, CUPTE-P—TI N0 CA 650ILt 2 �t (4©F) 3Ig- 34(,lt f i1 II G;ff ,Vf W ��sC4rj COMP�tLlN'1TY L�fkrEl.OI�ME BUILGIidO [;IV-SION_C Pq}a-CIVfENTT CU ERTINO APPROVE This set of lens and s ( p specifications, , job site during construction, It is unia T be kept at the Changes or alterations on same, o ul to Make any therefrom, without a;,praPs from the to daviate T;;e Stam in uildi,lg Cificial. p g of tris plan and specificat ns ti, a r b2 heid to 0,7riit r to be an a-� -SHALL ,40T Cf ar�y provisicr of y p',{{�rGaGl f trs violation BY Y l y City Or Uiri'm"C or C"tga4'1 V l4�Y Law. E r;i "ZWIT E COPY 0F: J: jC UPERTI IVO RL ilding nepatnent 0" � 72014 REVIEWED FOR t:�i) COMPLIANCE Ravit�vvL-dl 'Boy. 17 P 4SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE �0. ZO COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 / CUPERTtNO (408) 777-3228 • FAX (408) 777-3333 • building Ca7cupertino.org Permit No. Address qLAS y L � )-A % aTD� p� b # of Alarms Smoke: Z. Carbon Monoxide: PURPOSE 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 ever level of a dwelling unit including basements X X Within each Slee in room 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. .. a a t -y .,ifh fhc forme and ronrlitinns of this statement Smoke and COform.doc revised 03/18/14 Owner ( ......... f......./.�t : .................. Contractor Name: Signature................................................................... Lic.#...................................... Date: ................... Smoke and COform.doc revised 03/18/14