Loading...
B-2016-0370 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:D-2016-0370 22393 RIVERSIDE DR CUPERTINO,CA 95014-3983(356 03 035) GREEN FOLIAGE UNLIMITED INC SAN JOSE,CA 95125 OWNER'S NAME: KIM YOUNG-WOO DATE ISSUED:03/28/2016 OWNER'S PHONE:408-747-7561 PHONE NO:(408)393-5783 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class LANDSCAPING Lic.#1005194 Contractor GREEN FOLIAGE UNLIMITED INC Date 07/31/2017 _BLDG _ELECT _PLUMB MECH X RESIDENTIAL_COMMERCIAL 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. JOB DESCRIPTION: DEMOLISH(E)630 SQ FT SWIMMING POOL(FOR LANDSCAPE I hereby affirm under penalty of perjury one of the following two declarations: PURPOSE) r. 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 e�" performance of the work for which this permit is issued. 2. 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. Sq.Ft Floor Area: Valuation:$7800.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN information is correct.I agree to comply with all city and county ordinances Number: Occupancy Type: 35603 035 and state laws relating to building construction,and hereby authorize 356 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 PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against said City i uence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant u sta and will comply with all non-point source regulations per th u unicipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. /gnature Date 3/28/2016 Issued by:ABBY AYENDE Date: 3/28/2016 OvoLu- OWNER-BUILDILARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is r. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for compensation,will do the work,and the structure is not intended or offered for inspection. sale(Sec.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:3/28/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER r. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area ality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cum i`no m i al Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code;Sect' ,2 533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revolted. r or authorized agent: APPLICANT CERTIFICATION °ate:3/28/2016 I certify that I have read this application and state that the above information is CONSTRUCTI LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 3/28/2016 Professional SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 C U P S RT 1 N (408)777-3228•FAX(408)777-3333 PROJECT ADDRESS 22393 Riverside Drive, Cupertino, CA 95014 APN# `J�J(p 62? ojb OWNERNAME Youngwoo Kim PHONE 408.747.7561 E-MAIL yhkju2@gmail,com STREET ADDRESS 22393 Riverside Drive CITY, STATE,ZIP Cupertino, CA 95014 FAX CONTACT NAME Younghee Ju PHONE 408.747.7561 E-MAu. yhkju2@gmail.com STREET ADDRESS 10839 Sycamore Court CITY,STATE,ZIP Cupertino, CA 95014 FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Filiberto Camacho LICENSE NUMBER 1005194 LICENSE TYPE C27 BUS.LIC# COMPANY NAME Green Foliage Unlimited, Inc. E-MAIL camacho@greenfoliage.us FAX STREET ADDRESS . 1490 Hervey Lane CITY,STATE,ZIP San Jose, CA 95125 PHONE 408.393.5783 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK Demolition and disposal of swimming pool concrete wall to Y-0"below grade. Drill (5) evenly spaced 12" diameter holes along centerline of pool bottom. Backfill remaining pool shell with 3/4"crushed rock to 10"deep at bottom. Place and compact clean soil fill to new grade. Install Dwarf Marathon II, Water Conservation Alliance certified turf grass. USE OF I`1�SFD or Duplex ❑ Multi-Family TYPE MATERIAL TYPE(CODE) AREA (SQ.FT.) VALUATION(S) STRUCTURE: ❑ Commercial POOL POOL/SPA MATERIAL TYPE CODES: SPA V - VINYL-LINED F - FIBERGLASS DEMO G - GiJNITE P - PREFABRICATED RECEIVED BY`. TOT V By my signature below,I certify to each of the followin : I am the property owner or auth rized a nt to act on the property owner's behalf. have read this application and the information I have4provide 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 be n. authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: ate: March 25, 2016 DC 94i4eye—_SUPPLEMENT TION REQUIRED o$FICE USE ONLY PLAN CHECK TYPE ROUTING SLIP _Commercial or Multi-Family Buildings with Public Swimming Pools: Department of Environmental Health approval required. 0aVER-TREcouivTEx • 0 Bu1i DING DErr EXPRESS ❑ PLANNING DEPT ❑ STANDARD ❑ PUBLIC WORKS,DEPT ❑ LARGE" .' ❑ ENVIRONMENTAL HEALTH ❑ :MAJOR SANITARY SEWER DISTRICT S'wimPoolApp_2011.doc revised 03/16111 t F24 vl��r L 110-19L RECERTffD u O i L V COMP UNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION CUPERTINO This set of pI .ns and specificati n'8 MUST be kept at the jaL itc c�urir�7.construction. It is unlawful to make any L� ch?n E).;or alterations on same,or to deviate therefrorn� %gilfieat e-Btild+ng-9#icial. T ha-tarsi ing of this plan and specifications SHALL NOT _ be hsd to permit or to be an approval of the violation of any provi-zions of any City-Ordinance or State Law. BY� 0,:PY DWI E -UPD-LuLu OFFIC.E C PER,' lT NO.