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Permit Information
Permit Number
OF7030176 t
Status "
C • Closed
Master Number
f�
Notes 0'
Project
r
Apply Date "
0j- 2 12007
Operator kiersaw
Permit Issue Date
04I12l2007
Operator kiersaw
Certificate Issued
05l04l2007
Operator =
Certificate Type
Certificate Number
Location Information
Address " 18661 STARRETT CT
City/State/Zip �CUPERTINO
APN �37526022 - - -
Unit �-- - —
L______
Owner Entity Information
Owner Name" WINNIE CHOW
Use Default ❑
Address (Home -18661 STARRETT CT _ V 1
[CA 195014
City/State/Zip iCUPERTINO ® 95014
Permit " Property JrZoning Applicant Contractor " Defined Fields
Permit Details
Permit Type "
SFDWL•DEM
160 NOT USE
-
Usage Class "
N/A
NON APPLICABBLE
_
Applied Value `
5000
SQUARE FT.
0,
Calculated Value
0 �J
US C-404 Type
1645
[ i I
DEM:SFD,DETACHED
_
Permit Form "
LAUTOPERM PERMIT
*✓_
Ownership
1 Private v,
—_-
Project Size
Permit issued 0411212007
Enter the purpose or any special conditions for this permit
Purpose/Special Conditions
jDEMOLITION OF A 1 STORY SFD
FILMED-2011I
l[QAdd Default Text
VOK
is Back
Contractors
FW Fees
,.� Plan Reviews
Ainspections
j�! Print Permit
Adjustments
�(. Holds
l� Copy Permit 1
l� Close Permit
%Overrides
Supplemental fields
Notes
Attachments
,':J11f1- IJt= Jiff.:
Ferrrit Information
Permit Number 07030176 Status .Closed
Address 118661 STARRETT CT
Inspection Type Sequence Inspector
704 1 JG
APN 37526022
Owner Name WINNIE CHOW
Scheduled Date Inspect Date
04/30/2007 04/30/2007
I YI��Ir�riJr-1
Inspection Type 705 - INSPECTION OF BLDG COMPLAINT
Sequence 1
Confirm 8834
Details Results Inspection Notes
Inspection Area
Inspector
GST --STREAM, GARY
Requested Date
05/03/2007
Scheduled Date
05/04/2007
Scheduled Time
Instructions
PM PLS 646-7362
Contact Information
Contractor
00096 f
TBD - TO BE DETERMINED
.�J
Result Notes
F
Comments
ill
OK
� B ack
CITY OF CUPERTINO
BUILDING DIVISION PER
BUILDING ADDRESS:
PERMIT NO.
OWN A
PHONP.ONY WONG
IWM 21-2 0 0 7 CONTROL NO.
ARCHITECTYENGINEER:
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
j LICENSED CONTRACTOR'S DECLARATION
Chapter 9
Job Description
I hereby affirm that 1 am licensed under provisions of (commencing
j with Section 70(0 of Division 3 of the Business and Profess- ns Code, and my license is
and effect Lie a
Licens Cl�.y
DEMOLITION OF A 1 STORY SFD
DamContractor
3 C rS DECLARATION
? I used as public records
i
Licensed Pmiessional
OWNER -BUILDER DECLARATION
1 hereby affirm that 1 am exempt from the Contractors License Law for the
i following reason. (Section 7031.5. Business and Professions Code: Any city or county
which requires a permit to construct, alter, improve, demolish, or repair any structure
r prior to its issuance, also requires the applicant for such permit to file a signed statement
' that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9
Sq. Ft. Floor Area
Valuation
(commencing with Section 7000) of Division 3 of the Business and Professions Cndc) or
that he is exempt therefrom and the basis for the alleged exemption. Any violation of
APN Number
Occupancy Type
P Y YP
Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of
not more than five hundred dollars ($500).
❑ 1, as owner of the property, or my employees with wages as the(r sole compensation,
Required Inspections
will do thework and the structure is not intended or offered for sale (Sec.7044, Business
and Professions Code: The Contractors License Law does net apply to an owner of
property who builds or improves thercon, and who does such work himself or through his
own employees, provided that such improvements are not intended or offered for sale. If.
however, the building or improvement is sold within one year of completion, the owner -
builder will have the burden of proving that he did not build or Improve for purpose of
sale.).
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to
construct the project (Sec. 70". Business and Professions Code:)The Contractor's Li-
cense Live does not apply to an owner of property who builds or improves thereon, and
who contracts for such projects with a conuactor(s) licensed pursuant to the Contractor's
License Law.
❑ I am exempt under Sec. , B & P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 hsve and will maintain a Certificate of Conscnt to self -insure for Workers Compen-
sation, as provided for by Section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ 1 have and will maintain Workers Compensation Insurance, as required by Section
3700 of the Labor Code, for the performance of the work for which this permit is issued.
'
My Workers Compensation
� �Inssuirance carrier and Policy numb r am.
Carried f� FW �-R Policy No.:I ~0
ERTI ItVATE OF F-XEMPTION FROM WORKERS'
COMPENSATION INSURANCE
,
(This section need not be completed if the permit is foronc hundred dollars ($100)
or less.)
1 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 Workers' Compensation
Laws of California Date
Applicant
NOTICE TO APPLICANT: If, after making this Certificate of Exemption, you should
become subject to the Worker's Compensation provisions of the Libor Code- you 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
the work for which this permit is issued (Sec. 3097, Civ. C.)
Lenders Name
'
Lender's Address
I certify that 1 have read this application and state that the above information is
corrccL I agree to comply with all city and county ordinances and state laws relating to
building construction, and hereby authorise representatives of this city to enter upon the
ahove-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 in any way accrue against said City
inconsequence of the granting ofthis IL
APPLICANT UNDERSTANDSS ANDD WILL COMPLY WITH ALL NON -POINT
Issued by: Date
SOURCE REGULATION J
—/lr p
Re -roofs
Type Of Roof
Signature of Applicant/ ntraclor D le
HA ARDOUS MATERIALS DISCLOSURE
Will the appl- t or future building occupant store or handle hazardous material
as defined by the Cupertino Munici al Code. Chapter 9.12. and the Health and Safety
Code, scenes 25532(a)?
All roofs shall be inspected to any roofing material being installed.
❑ Yes o
prior
If a roof is installed without first obtaining an inspection, I agree to remove
Will the applicant or future building occupant use equipment or devices which
emit hazardous air contaminants as defined by the Bay Area Air Quality Management
all new materials for inspection.
District?
❑Yes o
1 have read the hazardous materials requirements under Chapter 05 of the Califor-
nia Heal lh & Safety Code, Sections 25505, 25533 and 25534.1 undcrstand that if the building
does not currently have a imam. that it is my responsibility to notify the occupant of the
requirements which be me Ito issuance of a Certificate of panty
Signature of Applicant Date
'1 1O
All roof coverings to be Class "B" or better
Owner or authorise age t D to
0 CITY OF CUPERTINO
DEMO
CITY OF
CUPERTINO PERMIT APPLICATION FORM
p1p3Dllta
APN # _� f ZC
r O 2 2
3
Building Address: (
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Owner's Name:
P49f),
Contractor:
License #:
7 7
Contact: � � L
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Phone #:
Applicant/Contractor: Ci,V V
B Ilding Permit Info:
ld le
lumb
e
ToDescription-
Residential: �- l
s' F D
O S' Commercial:
Sq.Ft. Floor Area:
$/Sq.Ft.:
4(15,0o
Architect/Engineer:
Valuation: $ �
Type of Construction:
Occupancy Group:
Qty. if
A licabl
Fee ID
Fee Description
Fee Group
BPERMFEE
Bldg Permit Fees
BUII.IDNG
BSEISNIICOM
Seismic Commercial
BUILIDNG
BSEISMICRE
Seismic Residential
BUII.IDNG
BPLANCHK
Plan Check Fee
BUII.IDNG
BUSLIC
Business License
BUILIDNG
PMD 15IL, 3laalo�-