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15040052 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19051 BARNHART AVE CONTRACTOR:MS CONSTRUCTION PERMIT NO:15040052 OWNER'S NAME: QING HONGRONG AND LI YI 80 DARRYL DR DATE ISSUED:04/08/2015 OWNER'S PHONE: 4088079289 CAMPBELL,CA 95008 PHONE NO:(408)230-5080 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL SFDWL DEMO 1249 SQ FT LIVING,280 SQ CARPORT License Class_ Lie. Contractor Date 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. Sq.Ft Floor Area: Valuation:$8000 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 ofabor C de,for the performance of the work for which this APN Number:37509036.00 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 WITHIN 180 DAY ERMIT 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 DAYS FR T CALLED INSP C ION. 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: granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 918. }�( RE-ROOFS: Signature Date v 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 Signature of Applicant: Date: 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 1,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 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 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Dater 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 918. Signature Date DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION r, 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 U CUPERTINO (408) 777-3228• FAX(408)777-3333•building aagugertino.org PROJECT ADDRESS (qV i _/ 9&,rn I APN# 0`7- -36; OWNER NAMEQ e,11 , I. t PHONE E-MAIL Yp„i�".�� STREET ADDRESS t iit.,a? �,��5 ir CITY, STATE,ZIP ( FAX � J��- CONTACT NAME PHONE E-MAIL STREET ADDRESS 7CITY,STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME " LICENSE WRp 1 LICE E TYP BUS.LIC# COMPANY NAMEo v_v ^7 / E-MAIL F STREET ADDRESS 9 ® f Y CITY ATE,ZIP 0 DESCRIPTION OF WORK RESIDENTIAL #DWELLING , . OFFICE USE ONLY,, FLOOR AREA \ ` UNrfS E `' O "YPE j'S .F7 VALUATION COMMERCIAL e z FLOOR AREA $�� ` TYPE OF CONSTRUCTIQN #STORIES AQMD JOB NUMBER {{ RECEIVED BY�, TO VALUATION: J #: �+ 9 . c� J 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 G`rer-ad this application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. 1 agree to comply with all applicable local ordinances and state laws relating to building con ction. uthorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent; Date: UPPLEMENTAL INFORMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT OFFICE USE ONLY �_V ide Job Number from Bay Area Air Quality Management District www.baagmd.org @ 415-749-4762. PLAN CHECK TYPE rovide three copies(Residential)or six copies(Commerical)of a site plan showing protection for any trees 10” El EXPRESS ��'` indiameteror more at 3'above grade. l] STANDARD P vide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected. 0 LARGE rovide a letter of inspection,tests,and abatement of any Hazardous Materials.Letter to be initiated by person(s) MAJOR C led in asbestos,mercury and/or hazardous material examination. _(';Pla ning Dept clearance to verify building is not considered an historical landmark.Allow 10 business days. icant de letter of clearance of all vermin from a licensed pest control contractor.—s shall call the Public Works Department at 408-777-3104 and schedule a"habitable dwelling"inspection. �ovide signed Debris Bin and Recyclable Materials form. DemoApp_2013.doc revised 02/13113 CITY OF CUPERTINO D FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 19051 barnhart DATE: 04/08/2015 REVIEWED BY: Mendez APN: BP#: *VALUATION: $8,000 *PERMIT TYPE: Demolition Permit I'IAN CHECK T)qT: PRIMARY PENTAMATION 1 SFDWL-DEM USE: SFD or Duplex PERMIT TYPE: WORK sfdwl demo 1249 sq ft living, 280 sq carport SCOPE FEE ID FLR AREA s.f. 1DEMORES 1,529 1-0 90s OW Mechr Plan(heck Plat�sb. Plan C'dreck E ec.Plan Check Mech, Permit Fee: Plumb.Permu hi<e: Elec. Permit Fee: 0[her Mcch. Insp. Otho`Plumb Imp. Other Glec.Insp. #laclZ. hap. Fee: Plumb. Insp. Fee: I lec.Insp. Fee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These fees are based on the prelhiniina information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS(Fee Resolution 11-053 E . 7f /f 1113) FEE QTY/FEE MISC ITEMS Plan Check Fee: .S111x1)1. .PC Fee 1�12.fmlJ.`i11ec/t.;Z;leLr Permit Fee: $574.00 Suppl. Insp.Fee-0 Reg. ® OT Q,Q hrs $0.00 P l z cm b.-'";1 Ic c•!a.iZ l e c Plr+nrh.i leclr..%l lec Permit Fee: Construction :Tax: Administrative Fee: i6'ork Without Permit? Advariced Planning Fees: 7�-avel Doc umentatic.rn Fees: Strong Motion Fee: IBSEISMICR $1.04 Select an Administrative Item BldgStds Commission Fee: IBCBSC $1.00 _s? . 0 $57604 $0.0 T TAL FEE $576.04 'r`rv„krr?ef4 za..` fil`;n.V3jA '>tl".. 10,005- b Revised: 04/01/2015 POOT Pi_ANS E ,. C? BY DAr .. P - CUPEITIIyp � � Project: QJng"s Residence OWCE r t` New Custom Homes [ �9051 Barnhart Ave r sertino,CA 95014. - OWner. !'fir. Hopgrong Qing Mrs.Yi Li x 9051 Barnhart Ave -' Cuettiiic�, C 9f ; . Tel;408.807.9289 Email: hqing200l@ " t - tEi� w Sheet Title- CUPS fl A ED . Demolition Site Plan 'keg,and sped ns M �t the i i job site duringconstruction it is un ia LI t� i�tAe any chanter alterations on same, or to {r j i therefrom,,without approval from the r„, 1 m ung of this plan and specif C@ ^s e �' ' � a� dpermit b+r hof ark prision� Project Scope 1.-Remove existing 1,,2#9 2. $OSF r �tUP.gaf 1T11e11 3 em Patio Cover DEMOUTI 4.Remove concrete Reviewed FAY- �'`