Loading...
15070189CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 6630 JOHN DR CONTRACTOR: HOMESTEAD PERMIT NO: 15070189 CONSTRUCTION INC OWNER'S NAME: KO ESTHER M TRUSTEE 10080 STERN AVE DATE ISSUED: 07/27/2015 OWNER'S PHONE: 4083160505 CUPERTINO, CA 95014 PHONE NO: (408) 255-8999 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL (� DEMO (E) I STORY SFD (1248 S.F.) License Class Lic. li Contractor Date % I hereby of .; 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: 1 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 Sq. Ft Floor Area: Valuation: $7000 performance of the work for which this permit is issued. 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: 36923011.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that l 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 DAYS OF 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 D FROM LAST CALLED INSP TI N. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 0 granting of this permit. Additionally, the applicant understands and will comply W�/JvA�/ Issued by: Date: with all non -point source regulations per the Cupe ino Municipal Code, Section RE -ROOFS: 9.18. 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. ❑ 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.and I have and will maintain Worker's Compensation Insurance, as provided for by the Health &Safety Code Sections 25505, 2. 3�„art6 25 Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: Date: 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 CONSTRUCTION LENDING AGENCY 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 1 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, ARCHITECT'S DECLARATION 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 CUPERTINO DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255ae/`' l V�V 1 (408) 777-3228 • FAX (408) 777-3333 • building cupertino.org Q�% PROJECT ADDRESS 6t b J50 y �APN OWNERNAMEe Yde- STREET O PHO Q /4 _eT E-MAIL CJUs�uQ 5lh-l7 ADDRESS :, / i �,� �D� , CITY, STATE, ZIP�� �; N 0 FAX CONTACT NAME j__, PHONE - /4/� Q� E-MAIL nA �l STREET ADDRESS CITY, STATE, ZIP `j o J FAX /od o SherN Grp -p `1 r� pd, --)Q I- (x--®� ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT X CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ja� G1 LICENSE NUMBER / (Y/ LICENSE TYPE /� BUS. LIC N COMPANY NAME S y / E-MAIL S u%'�'�% ( q OG ce FAX Y� STREET ADDRESS (�� (�CITY, STATE ZIP%7 ��I y� © PHONE -r. DESCRIPTION OF WORK b J RESIDENTIAL N DWELLING / FLOOR AREA L UNITS COMMERCIAL R AREA TYPE OF CONSTRUCTION H STORIES , AQMD JOB NUMBER RECEIVED pyi TOT V ATIOONN' D l/LIr 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 rtad 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 authoriprefresentatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: G` (411s- SUP INFORMATION RPQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT oaf cr���►rvt a "' " P vide Job Number from Bay Area Air Quality Management District www.baagmd.org @ 415-749-4762. Provide three copies (Residential) or six copies (Commerical) of a site plan showing protection for any trees 10" i diameter or more at 3' above grade. STANDARD " Y_ Provide letter from PG&E (408-725-3325) stating all gas and electric has been disconnected. 1c Provide a letter of inspection, tests, and abatement of any Hazardous Materials. Letter to be initiated by person(s)�gtt certified in asbestos, mercury and/or hazardous material examination. /Planning Dept clearance to verify building is not considered an historical landmark. Allow 10 business days. V Provide letter of clearance of all: vermin from a licensed pest control contractor. leant shall call the Public Works Department at 408-777-3104 and schedule a "habitable dwelling" inspection. v Provide signed Debris Bin and Recyclable Materials form. DemoApp_2013.doe revised 02/13/13 CITY OF CUPERTINO 15 M 'M FEE ESTIMATOR -'BIJILDING DIVISION NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School lNetrirt otr ) Thovo fpgv aro havpd an the nroliminary intarmatinn availahip and are nnlv an estimate. Contact the Dent for addnl info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) ADDRESS: 6630 JOHN DRIVE DATE: 07/27/2015 REVIEWED BY: PAUL Plan Chvck Fee: APN: 369 23 011 BP#: *VALUATION: $7,000 *PERMIT TYPE: Demolition Permit T('111"CK7 YJ11-11� PRIMARY SFD or Duplex USE: PENTAMAT10N 1SFDWL-DEM PERMIT TYPE: WORK Demo (E) 1 Story SFD (1248 S.f.) SCOPE Suppl. Insp. Fee.E) Reg. () OT NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School lNetrirt otr ) Thovo fpgv aro havpd an the nroliminary intarmatinn availahip and are nnlv an estimate. Contact the Dent for addnl info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Chvck Fee: Permit Fee: $574.00 Suppl. Insp. Fee.E) Reg. () OT 1 0.0 1 hrs $0.00 P/on"?h Pci mii ]''ce: Conslruclioll "hly" F71 /1(1117" it arw ive 11"ork Ifil"how 'Ie 117MCc,("I I'lannint) /' ce"', '1'ravel Dociuncntcaion Fees, Strong Motion Fee: IBSEISMICR $0.91 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00, 7777=777 Tq,.. ...... T/ $0.00 TTX FE , $575.91$575.91 ] Revised: 07/02/2015 CUPERTINO PURPOSE PROCEDURE CHECKLIST FOR DEMOLITION PERMITS 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(a7cupertino.org The demolition application should be applied for before or at the same time as the new construction pen -nit application (these are separate permit applications and fees). Permit fees are due at the time of the application/plan submittal. The new construction permit will not be issued until the demolition permit is issued, unless a letter obtained from the Building Department is submitted stating that "The existing house will not be demolished until the new construction permit is issued". The letter needs to be signed by both the property owner and general contractor. REQUIREMENTS To obtain a demolition permit in the City of Cupertino, please complete a Demolition permit application along with each of the following requirements as it applies to your specific project. 1. Three (3) copies of a Site (Demolition) plan for Residential or six (6) copies for Commercial will be required showing any trees 10 inches in diameter at 3 feet above grade on the subject property, and what means v,7ill be taken to protect these trees. (/ 2. PG&E must be contacted AS EARLY AS POSSIBLE prior to demolition to schedule the abandonment. Contact PG&E at (408) 725-3325. A letter from PG&E shall be provided to the City, stating that all gas and electric has been disconnected. (This step can be time consuming, so it is "important to begin the process immediately) 3. Provide Job Number from Bay Area Air Quality Management District www.baagmdgov @ 415-749-4762. [ 4 Check to see if the building is considered an historical landmark. Obtain clearance from the Community Development Planning Department. Allow 10 workup days. l',P( 1, 5. Provide a letter of clearance of all vermin from a licensed pest control contractor. Important: Prior to the issuance of the demolition permit, the applicant must call the Public Works Department at (408) 777-3104 and arrange a "habitable dwelling" inspection. Debris bin and Recycling sheet: read, sign and date. The sheet will remain in the project's building permit file for the duration of the project. S. Commercial only -prior to issuance of the demolition permit, the Fire Department must revietiv the plans for fire suppression/ alarm systems that shall remain iut service or be modified during Demolition or that shall be replaced with the new construction. DemoProcedure.doc re 4yed 2/13/13 DATE: June 17, 2015 CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO CA 95014 10900 No. Blaney Avenue Cupertino, CA 95014 SUBJECT: REMOVAL OF GAS SERVICES (CUT @ MAIN IN THE STREET) ON: June 14 20 �� � ,6 3 0 J o h r � .fir S, qj -_,rtj n SUBJECT: ELECTRIC SERVICES WAS CUT AT POLE ON : [ " Ca 6630 John June If you have any question contact us at (408) 725-3325 Sincerely, John Gambucci Pacific Gas & Electric Company DeAnza Service Planning Dept. 10900 N BLANEY AVE CUPERTINO CA 95014 RAPID RODENT REMOVAL LICENSE 103387 Owner Carlos Gutierrez Date 8295 Cavalier Lane, Dublin Ca, 94568 ' ✓5 Phone 925-336-0334 / 650-716-9558 The Following work was done on www.rapidrodentremova1.net pate carlosgutierrez@rapidrodentremoval.net We Service Alameda County & Santa Clara County QW,ornees Name Addren We hereby propose to furnish materials and labd necessary for the completion of: /go 107PeC-4 C) P/ rip" e r d ov p t See 1A4 ✓' ! C,p .5;,1n 5 ®' AC � j\U e V9 1( rt . -,L ,n .5 P e C�Q G /t/d /"'009" r a rcI , - 12_V,'.t o t:, k 3 Month service Warranty Payment to be made day work be s Authorized by (Name & Signaturel '✓ Approved Costumer Signature Subtotal Tax Total �. Deposit Balance goo iii � poi 2 COMPLIANCE & 3 ENFORCEMENT BAY AREA / / AIR(DUALITY DIVISION MANAGEMENT D I s T R l c "r Homestead Construction 10080 Stern Avenue Cupertino, CA 95014 Regulation 11, Rule 2 Acknowledgement of Notification and Payment of Fees 7/20/2015 Job No: 4P382 Invoice No: 3QH26 The Bay Area Air Quality Management District (BAAQMD) acknowledges receipt of your payment and your Asbestos Removal or Demolition Plan described as: Demolition Site address 6630 John Dr. Cupertino, CA 95014 Start Date July 30, 2015 Completion Date August 6, 2015 Removal amounts of friable ACM 0 linear feet 0 square feet 0 cubic feet Should it become necessary to revise this plan, please do so in the spaces provided below and immediately copy the District by fax or by mail. REGULATION 11-2 REVISION BAAQMD J# 4P382 REVISION # START DATE COMPLETION DATE NOTE: This form is not intended as a verification of either the completeness of your original notification or of its compliance with BAAQMD Regulation 11-2. If you have any questions about this acknowledgment, please call our office at (415) 749-4762. 2 3 4 _/._.____.. _..._ _ ......._._ / / 5 NOTE: This form is not intended as a verification of either the completeness of your original notification or of its compliance with BAAQMD Regulation 11-2. If you have any questions about this acknowledgment, please call our office at (415) 749-4762. 1-2 City of Cupertino Lr- 97-dil Public works Department. 111 Environmental Programs Division 10300 Torre Ave Cupertino, CA 95014 6UPERTMoCAtE 1. Program (408) 777-3354 Construction and Demolition Recycling Diversion Requirements and Instructions Covered projects, or all construction, demolition and renovation projects that are 3,000 square feet or more are required to complete a Waste Management Plan for the City of Cupertino demonstrating that 60% of the material generated is recycled, in compliance with ordinance CMC 16.72.050. At the conclusion of the project a Construction Recycling Report must be fled with the Public Works Department/Environmental Division showing the tons. recycled and disposed by .material type. Use tonnage information fiom weight tags provided. by facilities to quantify total estimated waste and percentages for materials. Weight Tags of all mat.eriat recycled and disposed must be submitted with the final report in order to. receive a Final Building Inspection. rovider Debris from a project 3,000 square feet or more in Cupertino can be collected, and disposed by using: Plea�sg'check all that apply: I am. not using a Recology debris bin, however, the project is less than 3,000 s.f, e.g. buildings, patios, sidewalks, driveways. ❑ 1 will use a Recology debris bin, By Agreement with.the City, Recology will prepare my required Waste Management flan & Recycling Report. Contact Recology: (408) 725-4020. ❑ 1 am not using a Recology debris bin. I will provide the following submittals to the,City's Public Works Department, showing that I have recycled at least 60% of all construction demolition material: Ask for the Construction & Demolition Recycling Packet from the Building Department and complete the following: ✓ Submit a Construction and Demolition Waste Management Plan with your building permit application. No fee for this plata, 1~ornis are available at the Building/Public Works counter and online at wtiww,cupertino,orglenvironrnental, Report the tonnage recycled and disposed,. by material type. Recyclingfacilities must be selected from the City's approved list of Recycling, Resources., ✓ Satbmit a Construction RetyelirzgReport.forrn. The report is required before the Building Department will schedule a final inspection. The report form is available at the Building/Public Works Counter and online www.cipertino.orgleni vonmental. Signature: Name: (printed) \ 7, kl— 1 '-1 Title:a— Phone: Project Address: v f1 t This form to remain in the project's building permit file for the duration of the project. Revised 317112 1 Date: