Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
D-2016-0387
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: D-2016-0387 7425 HEATIIERWOOD DR CUPERTINO, CA 95014-5823 (359 26 045) HOMEOWNER/BUILD ER OWNER'S NAME: MEHTAAPURVAAND SWATI ET AL DATE ISSUED: 06/02/2016 OWNER'S PHONE: 408-421-1080 PHONE NO: LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic. # Contractor HOMEOWNER/BUILDER Date — 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 HOME 1692 SQ FT AND 3 SHEDS I hereby affirm under penalty of perjury one of the following two declarations: n. 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. z.% 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 Sq. Ft Floor Area: Valuation: $15000.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances 359 26 045 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 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 9.18. 180 DAYS FROM LAST CALLED INSPECTION. source regulations per the Cupert'• o Municipal Code, Section Signature r _ Date 6/2/2016 4 Issued by: ABBY AYENDELot Date: 06/02/2016 O R -B DER DE RATI N that I a4n` exempt from the Contractor's License Law for one of the RE -ROOFS: being installed. If a roof is I hereby affirm All roofs shall be inspected prior to any roofing material following two reasons: I, as owner of the property, or myemployees with wages as their sole installed without first obtaining an inspection, I agree to remove all new materials for n. 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 Applicants contractors to construct the project (Sec.7044, Business & Professions Code). Date: 6/2/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER n. 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued.. Worker's Compensation Insurance, as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain California Health & Safety Code, Sections 25505, 25533, and 25534. I will Section 3700 of the Labor Code, for the performance of the work for which this maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. Health & Safety Code, Section 25532(a) should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued, I 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 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 ha ter 9.12 and P exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, a d �5 4. Labor Code, I must forthwith comply with such provisions or this permit shall f be deemed revoked. , "6Wner or authorized agent: � { APPLICANT EC RTIFICATION " Date:6121201 T T LENDIN N I certify that I have read this application and state that the above information is I hereby affirm that there is a co ruction lendKg agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 097, Civ C.) relating to building construction, and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands ARCHITECT'S DECLARATION and will comply with all non -point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 6/2/2016 Professional CUPERTIHO PROJECT ADDRESS OWNER NAME STREETADDRESS �. CONTACT NAME t ir STREET ADDRESS ❑ OWNER . CWNER i CONTRACTOR NAME COMPANY NAME STREET ADDRESS DESCRIPTION OF WORK DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION' 10300 TORRE'AVENUE CUP.ERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(ftupertino.org D1Uco -OUT .PHONE p g..J. EMAIL 93 CITY, STATE, ZIP A PHONE E-MAIL CITY, STATE, ZIP ply FAX �/r / sZ �h � Aad � 1 -1 -0 �� VIA-, �1�1"'I' SCJ � ® - ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTOR. AGENT ❑. ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT LICENSE NUMBER I LICENSE TYPE I BUS. LIC # E-MAIL I FAX CITY, STATE, ZIP I PHONE RESIDENTIAL # DWELLING ©FPiCL I7SF 01\LY FLOOR AREA UNITS USE',` „ OCQ -SQ. FT-:VALTTATIOIv, :'; COMMERCIAL FLOOR AREA TYPE OF CONSTRUCTION # STORIES. 051 DemoApp_2016.doc revised 05/10/16 El DATE: 03/01/16 CITY OFCUPERTINO 10300 TORRE AVE CU PERTI NO CA 95014 10900 No. Blaney Avenue Cupertino, CA 95014 SUBJECT: REMOVAL OF GAS SERVICES (CUT MAIN IN THE STREET) ON: 7425 HEATHERWOOD DR on 02/24/16 SUBJECT: ELECTRIC SERVICES WAS CUT AT POLE ON: 7425 HEATERWOOD DR on 02/24/16 if you have any further questions, please contact me at (408) 725-2076 Sincerely, Mark Kennedy Pacific Gas & Electric Company DeAnza Service Planning 408/725-2076 Cityof Cupertino Public works Department Environmental Programs Division .. 10300 Torre Ave CUPERTINO GREEN- i Cupertino, CA 95014 ftfr° (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 CIVIC 16,72.050:; At the conclusion of the project a:Construction recycling Report must be filed with the Public Works Depar-ti ent/Environmental Division showing the tons recycled and disposed; by material type. Use tonnage information from weight tags provided by facilities to quantify total estimated waste and percentages for materials. Weight Tags of all iaterial. recycled and disposed must be submitted with the final report in order to recei ve a Final Building Inspection. Debris. from a project 3,000 square feet or more in Cupertino can be collected and disposed by using: Please eck all that apply: EV I am not using a Recology debris bin, however,. the project is less than 3,000 s.f., e.g. buildings, patios, sidewalks, driveways. I. -Will use a Recology debris bin. By Agreement with the City, Recology will prepare my required Waste Management Plan & Recycling Report. Contact Recology: (40$) 725-4020. 0 1 am not using a Recology debris bin. I will provide the followingsubmittals 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 folio vving Subinit a Construction and Demolition Waste ll2anagement Flan with your building per mit application. No fee fort this plata, Forms ane available at the BuildinglPublic TVorks counter and 'online at wu.,v.catpertino.vt,-lerzr� ronnaeiztciL Rep art the tonnage recycled and disposed, by nraterial O;pe. Recycling_ facilities must be selected front ilre City's approved list of Recycling Resources., Submit a Construction Recycling Report form. The report is required before the Building Departnzerzt will schedacle cr f 3zal inspection. Tlie. report for izz is available at tl7e Birildirag/Public Noor ks Counter and online .vv w. c:-uper t no. ot:R Vvironmental. Signature: Name (pri Title: Phone: Project Ad, This form to ren}ain in the project's building pennit file for the duration of the projecE., Revised 317112 I TYPICAL BARK PROTECTION NOT 'f TO SCALE 4+00r:M + % TYPICAL TREE PROTEMON FENCiNty NOT TO SCALE 1. Prior to any construction operations contractor shall construct and maintain, for each protected tree on a construction, site, a protective fencing which encircles the outer limits of the critical root zon e(CRZ) of the tree to protect it from. eonstruciion activity. The GRZ is calculated 1.25 feet times the -diameter of the trunk measured in inches 4.5 feet above the natural grade). 2. All protective feoaing shall be in place prior to commencement of any site work and remain in place until all exterior construction activity attire sits has been completed, 3. Protective fencing small be at least six N feet /sigh, clearly visible, and shall have a tree protection sign affixed to the fence every twenty (20) feet la such a manner to be clearly visible and legible to workers on the site at a distance of twenty -rive (25) feet. The signs) shall read' Tree Protection Zone Keep our. 4. The owner shall cause the required fencing and signage to be installed and maintained for the duration of the construction, 5. In situations where a protected tree remains in the immediate area of intended construction and the tree maybe in danger ofbeffig damaged by construction equipment or other activity, the contractor or subcontmetur shallprotect the tree with 21x4" lumber encircled r -6th wire or other means that do not damage the tree. The intent is to protect the trunk of the tree against incidental contact by large. constriction equipment. 6. Material Storage: No storage or placement of materials intended for use in construction orwaste materials aeeutnuhated due to excavation or demolition shall be placed wilbin the. Emits of the critical mot zone of any protected tree. 7. Equipment CIeaning/Mquid Disposal No equipment shall be oicaned or oilier liquids, including, without limitation, paint, oil, solvents, aspha% concrete; mortar or similar materials deposited or alloyed to flow into the critical root zone of a protected tree. 8. Tree Attachments: No signs, wires or other attachments, other than those of a protective nature, shall,be attached to any protected tree. 9. Vehicular Traffic: No voNcuiar and/or construction equipment traffic or parking shall take place within the critical root zone of any protected tree other than on existing stroll pavement. 10. No heavy cquipmme inolud ng but not limited to trucks, tractors, trailers, bulldozers, excavators, skid steer tractors, trenchers, compressors, and hoists, shall be allowed inside the drip-Iine of any protected tree on any construction site. 11. Grade Changes: No grade changes shall be allowed within the limits of the critical root zone of any protected tree unless adegnate. protective construction methods are approved in advance m writing by the city. 12. Impervious Paving: No paving with asphalt, concrete or other impervious materials shall be placed within the limits of the critical root zone of a protected tree, unless expressly permitted by the public works Dept 13.:Rootlruningt All roots two inches or larger in diameter which are exposed as a result of trenching or other excavation shall be cut off square with a. sharp medium tooth saw and covered with natural rf ber burlap within two hours of initial exposure. 14. All public sidewalks shalt remain open, free and clear for public access, unless closure is permitted by the P-oblie Works Department. TREE PROTECTION STANDARDS_ REVISED 5[13 M11 } �T OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINQ CA 95014-3255 (408) 777-3228 •FAX (408) 777-3333 • building (a)cupertino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS oA APN BP# OWNER NAME C -A. OWNER ADDRESS 0. Evx 2_6 o z r9�rh�lo CA DESCRIPTION OF WORK: 414 Z We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information,) 1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. 1, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. 1 am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. SG 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. SL -3. I understand as an "Owner -Builder" I am the responsible party of recordon the permit. 1 understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. SL 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 9(_ 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, l may be considered an "employer" under state and federal law. VC- 6. 1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 7. 1 understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 5C-8. 1 understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. OWnerBuilderFonn 2010.doc revised 04114110 SOS PEST CONTROL &TERMITES SOS PEST CONTROL 214 Christich Lane # 103 Campbell, CA 95008 Rodent Inspection Clearance Date: February 18, 2016 Re: Property Address: 7425 Heatherwood Dr, Cupertino, CA 95014 To whom it may concern: The property at the above location was inspected today for any infestation of rodents. No active infestation was found. If you have any further questions, please call our office at (408) 866-6609. a Q -- Mike Stadmiller Branch II Field Representative 214 Cristich Lane, Campbell, CA 95008 . Phone: (408) 866-6609 . Fax: (408) 371-2371 . www.SOSPestControl.com Regulation 11, Rule 2 == COMPLIANCE ENFORCEMENT Acknowledgement of B i y A P- E A Notification and AtttQuALn-v DIVISION Payment of Fees MANAGEMENT' Di ST A l C T 511312016 Randazzo Enterprises, Inc 13550 Blackie Road Castroville, CA 95012 Job No: 4IJ531 Invoice No: 3UM60 The Bay Area Air Quality Management District (BAAQMD) ael mowledges receipt of your payment and your Asbestos Removal or Demolition Plan described as: Demolition Site address 7425 Heatherwood Dr Cupertino, CA 95014 Start Date May 24, 2016 Completion Date May 26, 2016 Removal amounts of friable AGM 0 linear feet a 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 avail. REGULATION 11-2 REVISION BAAQMD J# 411531 REVISION 4 START DATE COMPLETION DATE 2 t 1 1 t 3 t 1 1 1 1 1 NOTE. nisform is not intended as a verification of either the completeness of your.original notification or of its compliance with BA,4QAM Regulation 11-2. If you have vinyl questions about this acknowledgment, Tease call our office at (41 S) 749-4762. 9. 1 understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. 10. 1 am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. X11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. W 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) 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.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: �, I --------------------------------------------------------------------------------------------------------------------------------------- (NOTE. The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, 1 hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work):0 r0'", Q� Project Location or Address: ' %�.Q ,. /79 Name of Authorized Agent: Address of Authorized Ager M I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: t OwnetBuilderFonn 2010.doc revised 04114110 I DocuSign Envelope I : AtD678C1-F261-492E-A565-74734B09ACOA Building Department City Of Cupertino 10300 Torre Avenue C:u ei-t no, CA 95014-1253 Telephone: 408-'777-3-)1)8 tJ P E IST t CI Fax: 408--177-"3' ADDRESS:CONTRACTOR /SUBCONT%ACTOR LIST JOB 7425 Heatherwood Drive 1 t'FtT #D-2016-0387 OWNER ' -S NAME:SarahChan 408-4211080 PHO E -- GEINRAL, CONTRACTOR: � BUSINESS LICENSE y LI3R SSk j CITY ZIPCODE_ *Our tnuniai al code requires all husinesses wor king in Me cite to Iaiive a Citi f Cupertino business license. O BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WI :L BE SCCIrEII L.ED UNTIL THE GENERAL CONTRACTOR AND LI_, SUBCONTRACTORS AC:'TORS IIA' OBTAINED A CITY OF CUPE TI O BUSINESS LICENSE. arcs not using any subcontractors: -- - Signature Date Blease check applicable subcontractors and complete the following information: s/ SU CON TR CTOR BUSINESS NAME I [I IESS LICENSE Cabe ets & Millwork C:emr nt Finishing Li�4 ileal - Excavation Demolition - Randazzo Enterprises Inc. 23853 f f J Fencing . Floorhjilg Carpeting Lino m , foo --- --- Glas! ."Glazing Insulation Landscaping _ ___.... _ Lath tag Masbnr y j fainting.` 4 "a4pa er ---- -- Pavific, Plastering Plurnbina ----- Roo 'inn Septic Tan i I Sheet Metal ! Sheet Rocl Tile a:l 8/22/2016 Owner / Contractor Signature Date