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D-2016-0368 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:D-2016-0368 10241 SANTA CLARA AVE CUPERTINO,CA 95014-1216(326 22 010) HOMESTEAD CONSTRUCTION CUPERTINO,CA 95014 OWNER'S NAME: PHONE NO:408-916-8559 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#08J633 Contractor HOMESTEAD CONSTRUCTION Date 12/31/2017 _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: DEMO(E)2 SFD'S(1 ST UNIT IS 874,2ND UNIT IS 767 S.F.)AND(E) I hereby affirm under penalty of perjury one of the following two declarations: DETACHED GARAGE(574 S.F.) t. 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. 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:$8000.00 APPLICANT CERTIFICATION 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 26 Number: Occupancy Type: 3 and state laws relating to building construction,and hereby authorize 326 22 010 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 in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cuperti - Municipal Co e,Section 9.18. 180 DAYS FROM LA NSPECTION. SignatuIC001171, / 1 Date 03/25/2016 Issued AN Date:03/25/2016 OWNER-BUILDER DECLARATION 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 1. 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:03/25/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. 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 tine 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 a. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(x)should I store or handle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505 25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: au'� APPLICANT CERTIFICATION Date:03/25/2016 I certify that I have read this application and state that the above information is CONSTRUCTION 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 Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 03/25/2016 Professional DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333• buildinn (a-cupertino.org cupERT I o� - 201.,6 PROJECT ADDRESS O!/ \ APN# -?- o f OWNER NAME7 MAIL STREET ADDRESS 0 y,`� CITY, STATE,Z i. r n � Q Cfv s[1, FAX CONTACT NAME GFi ( PH /7E-/MAIL / T ff STREET ADDRESS CIT TATE, ZIP FAX 0 OWNER I:1 OWNER-BUILDER ❑ OWNER AGENT u CONTRACTOR El CONTRACTOR AGENT El ARCHITECT El ENGINEER 11 DEVELOPER El TENANT CONTRACTOR NAME o9 LICENSE NUMBER / LICENSE TYPE BUS.LIC# 1� COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STAT , PHONE ooh erg -eZIP PH`� �J DESCRIPTION OF WORK I ' 1-26vol-D 2- 7 o RESIDENTIAL P r �f 1 #DWELLING FFI E E ONLY FT FLOOR AREA t L I UNITS N COMMERCIAL FLOOR AREA TYPE OF CONSTRUCTION #STORIES i AQMD JOB NUMBER RECEI TO VALUATION: By my signature below,I certify to each of the following: I am te 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. 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 constr;.Chen— k pori esentatives of Cupertino to enter the above-identified prope for inspection purposes. Signature of Applicant/Agent: Date: .� SUPPLEMENTAL INFORMA ION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT ocE usE ONLY _Provide Job Number from Bay Area Air Quality Management District www.bgumd.org(a;415-749-4762. PC' Mu(TYPC _Provide three copies(Residential)or six copies(Commerical)of a site plan showing protection for any trees 10 171 uXPRESs f STANDARD in diameter or more at 3'above grade. Provide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected. D MAJOR _Provide a letter of inspection,tests,and abatement of any Hazardous Materials.Letter to be initiated by person(s) 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. _Provide letter of clearance of all vermin from a licensed pest control contractor. ; Applicant shall call the Public Works Department at 408-777-3104 and schedule a"habitable dwelling'inspection k Provide signed Debris Bin and Recyclable Materials form. DemoApp_2013.doc revised 02113113 D=69°51'00" Hb0„ Z 6Ro L£68 99'90 L 6��0 Zo" 'p0� R-18.29' 69'86 16 6 �° �� NOIs j D e pp� o CKED BY / o�6a (°9°° _ --------N. 0°19'00"W.£e 66 4.78' �5�� `�� 9�. 66 - -- DATE .33 � !lP / ��' k4- 66 �5' DEDICATION O�' i PLANNING D EPT 80 sf Opp' NE STORY ��6 , D ' ��. O0 ' 66 I is COMMUNITY DEVELOPMENT DEPARTMENT / ,4'l, X66 1 466 -V6.663 60'00 BUILDING DIVISION-CUPERTINO / Al «8 ro o; lb 6 I p0 I APP,a0-VED c;�� This sot of plains and specifications MUST be kept at the o job si.e during construction. It is unlawful to make any ,,�j ' �6 6�'' o a 6 p p0 �, changes ar altsrations on same,or to deviate / 66 a� �' D I 10241 SANTA CLARA AVENU �� ;o°. poi tl;erefrom,without approval from the Building Official. 6 v I EXISTING HOUSE I °� ' r? D ' FF - 100.85 w�'p` ' z Th .��. , g of this pl specifics ' ns SHALL NOT D ��o66y °s ICn L_�le�d�o s.� '�or to be an oval of the violation 4 sf(ONE STORY e rovis e or State Law. / D ' D D D 6� �° CD / D' 6 ' Co ; o oD. A d �Off' I m PEI P I NO. __ �" .e)l / Off• / 66 D D. O` 66 i 00�°p 0�� O / J1�a381f1W„ti 9� pQ� O 10 r I ty GROSS LOT AREA = 9,340±SF NET LOT AREA = 8,959.5±SF �, :°00 ' 0 � OO� I LSO° pAim 6 p i � �B 0; o H. d�.C. ASSOCIATES X60 6ti°° ' °° �uoL 0.1;1% am ��°��0 6ti�o�o ' °�o''' 12280 SARATOGA-SUNNYVALE RD. #209 aM „BL SARATOGA, CA 95070 °Fa TEL: 408-446-8418 °� P) o CD EXISTING GARAGE DEMOLITION PLAN S: 1'= 10'_0” i 574 sf , , ' 1. ALL EXIST. IMPROVEMENT SHALL BE REMOVED / 6 , (ONE STORY) N3GNV 0Q ' I 2. DEMOLITION SHALL BE UNDER SEPARATED PERMIT. I I , 3. ALL EX. UTILITIES SHALL BE RELOCATED. 10239 SANTA CLARA AVE. EXISTING HOUSE O� �� / I 767 sf(ONE STORY) ' �` o • 66 a o 0 o I o ' 0 16 8 / OZ'66 g,g ,0'L o0l Vg6,'� 66 OAA 29'66 03. 9Z'�0l03 I i 6• 6 £Z'00108 1 ez 60'LOLMG c CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10241 SANTA CLARA AVE CUPERTINO, CA 95014-1216 (326 22 010) CONTRACTOR: HOMESTEAD CONSTRUCTION CUPERTINO, CA 95014 PERMIT NO: D-2016-0368 OWNER'S NAME: PHONE NO: 408-916-8559 LICENSED CONTRACTOR'S DECLARATION License Class GENERAL BUILDING CONTRACTOR Lic. #681633 Contractor HOMESTEAD CONSTRUCTION Date 12/31/2017 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: 1.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. 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. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 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. Signature___________________________________ Date 03/25/2016 OWNER - BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor’s License Law for one of the following two reasons: 1.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) 2.I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1.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. 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. 3.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 become subject to the Worker’s Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 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. Signature___________________________________ Date 03/25/2016 BUILDING PERMIT INFO: BLDG ELECT PLUMB MECH X RESIDENTIAL COMMERCIAL JOB DESCRIPTION: DEMO (E) 2 SFD'S (1ST UNIT IS 874, 2ND UNIT IS 767 S.F.) AND (E) DETACHED GARAGE (574 S.F.) Sq. Ft Floor Area: Valuation: $8000.00 APN Number: 326 22 010 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: MELISSA NAMES Date: 03/25/2016 RE-ROOFS: 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. Signature of Applicant:_______________________________ Date: 03/25/2016 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: ________________________________ Date: 03/25/2016 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT’S DECLARATION I understand my plans shall be used as public records. Licensed Professional________________________________________________