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D-2016-0394CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: D-2016-0394 10265 JUDYAVE CUPERTINO, CA 95014-3524 (375 08 043) CRAIG AROGERS ' CONSTRUCTION INC SAN JOSE, CA 95136 OWNER'S NAME: BAINS KULVINDER SINGH AND SUKHVANT K TRUSTE DATE ISSUED: 07/14/2016 OWNER'S PHONE: 408-891-9637 PHONE NO: (408) 978-5484 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic. #978553 Contractor CRAIG A ROGERS CONSTRUCTION INC Date 11/30/2016 —BLDG —ELECT _ PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing MECH X RESIDENTIAL COMMERCL4,L with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: DEMO EXISTING HOUSES -F.)( �d> 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. 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: $15000.00 APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 375 08 043 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 regulatio per the Cupertin Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. /� AA Signature /l Y L , Date 7/14/2016 Issued by: Abby Ayende Date: 07/14/2016 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. safe (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature ofAppiicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 7/14/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 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 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 a. 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 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 h x be deemed revoked. - " Owner or authorized agent: APPLICANT CERTIFICATION / Date: 7/14/2016 I certify that I have read this application and state that the above information is CONSTRUCTION L INGAGENCY 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 II non -point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code, Section 9.1 • : I understand my plans shall be used as public records. J � Licensed Signature d Date 7/14/2016 Professional t� DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO', CA 95014-3255 CUPERTINO (408) 777-3228 • FAX (408) 777-3333 • building(bcupertino.ora PROJECT ADDRESS/ APN#-�- �� Qj f hk �TY OWNER NAMED P l, I � Yi bal ,,, PHO ��� E-MAIL STREET ADDRESS / wy CTTY STATE, ZIP ti FAX l (!tel y CONTACT NAMEPHOLE "N ST T SS CTT TAT Z F (Aga WC OWNER ❑ OWNER -BUILDER ❑ OWNER AGENTCONTRACTOR ❑ CONTRACTOP ,,.rL ❑ ARCHITECT ❑. ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACT NAME Q Ti- LIC E NUMBER LICEIE TYPEy BUS. LIC # P-M -�` (� j�% J T ` E COMP NAME 6 � `ls' E-MAIL ^ FAX STREET AD RESS _ CITY, S DESCRIPTION OF WORK. �. _ e 1 �„j.. e' ! - ¢ldak # DWELLING . OFFCUERESIDENTIAL Y FLOOR AREA UNITS Y.F AIIATION° COMMERCIAL «, ;`ss ✓,' TYPE OF CON TRUCTIO;e # STORIES v AQMD JOB NUMBER REECENED BY TOTAL VALUAT N:._ By my signature below, I certify to each of the following: I am the property owner or authorized algent to let on the property owner's behalf. 1 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 'lding constructi2n. I ant ' e representatives of Cupertino to enter the above-ideolified groperty for inspection purposes. Signature of Applicant/Agent: a� Date: PG3 SUPPLEMENTAL INFORMA ON REQUIREEORIOR TO ISSUANCE OF DEMOLITIOVPERMIT OF FtCE'osa ONLY Provide Job Number from Bay Area Air Quality Management District www.bmmd.org @a 415-749-4762. �LANCIIEC TYPE"-' Provide three copies of a site showing for any trees 10° in diameter or more at 3' above grade.�s �= ` plan protection ❑ sTaNnAxn Provide letter from PG&E (408-725-3325) stating all gas and electric has been disconnected. LA$GE � Planning Dept clearance to verify building is not considered an historical landmark. Allow 10 business days. Q X Provide letter of clearance of all vermin from a licensed pest control contractor. MAJOR Applicant shall call the Public Department at 408-777-3104 and schedule a "habitable dwelling" inspection. %WC/irks �}BCllu �s- Oly� �le (�6 3< Provide Construction and Demolition Recycling Diversion Signature form. Commercial Buildings Only: Provide Fire Dept clearance for fire suppression / alarm system review. Den7oApp_2016.doc revised 05110116 `illi LEGEND EXISTING CONTOUR LINE ---200--- NATURAL GRADE CONTOUR UNE p FOUND CITY MONUMENT BOX, OR AS NOTED BOUNDARY OF PROPERTY SURVEYED () RECORD INFORMATION CENTERUNE 0 CURB INLET a CURB UNE DRIVEWAY APRON 0 ELECTROUER —x —x —x — FENCE .b. FIRE HYDRANT 19 FLAT GRATE INLET G.H. Pa OVERHEAD POWER UNE O.H. TFi OVERHEAD TELEPHONE UNE ss--• SANITARY SEWER UNE TANTAU AVENUE O SANITARY SEWER MANHOLE ® SANITARY SEWER CLEANOUT j s -a- SIGN If 1 = so STORM DRAIN UNE I ` OO STORM DRAIN MANHOLE i zt C UTILITY BOX -o- UTILITY POLE w WATER UNEI 75.00' �—SO'23'00"E 75.00' 75.00' WATER METER i = I �. /''� ,. ' wok• �' •, SHIfD � _ c WATER VALVE x x EXI CARPORT) I 99 ELECTRIC METER Q WATER HEATER x ` % x� x, 20" REDWOOD zj t _! © GAS TREE LOT 9 6 o x i R1 o LOT 9 4 0 !! LANDS OF BAINS z R1 LOT 9 8 0 APN. 375-08-043' y x�" o~ Lys co . to ::-12.9' -, EX. "HOUSE i ✓ FF 10:1.24±' ! ? I EX. GARAGE I j J. ti GFF 100.87;; W I 13.1' 0` W 30.0' 3 X jy �x o x x, z `- O Q G N n �4"CITRUS ov r- I N TREE ti o0 zr7 •� 'Y n, �., � W O N 75.00' = t x`� " 55.00._. _. .... c/')S923'00 E 75.00' •-'�� a"-`— c a •` `.. is x x x" x" xx" oI FOUND 3, 12" TREE ��--- ciI It JUDY AVE-N70-E----- xI MONUMEN -- — —`` (BASIS OF BEARING) SO'23'00"E 1110.28 (1110.00)R1 / BENCHMARK: -_ELEV. 100.00' o EX. SANITARY 1� MANHOLE LID FOUND 3/4" IP IN CITY MONUMENT BOX 1. 1 ;I i ! it :u ! it ' =1 'I I I it 30.0' t 10 30 50 0 20 Y 40 100 �gl lCH SCALE 1 20 o THE BEARING SOUTH 00'23'00" EAST OF THE CENTER LINE OF JUDY AVENUE AS o o 6 SHOWN ON THAT MAP OF TRACT NO 550 FILED FOR RECORD IN BOOK 22 OF MAPS o PAGE 4, SANTA CLARA COUNTY RECORDS, AND AS FOUND MONUMENTED, WAS TAKEN AS THE BASIS OF BEARING FOR THIS SURVEY. NOTES: � <I 1. DISTANCES AND DIMENSIONS ARE SHOWN IN FEET AND DECIMALS THEREOF. 2. THE DISTINCTIVE BORDER LINE DENOTES THE BOUNDARY. 3. TREES SPECIES NAMES ARE APPROXIMATE, AND LABELED BY THEIR COMMON NAME TO THE BEST OF OUR KNOWLEDGE. IT IS NOT BASED ON AN ARBORIST REPORT. REFERENCES: TRACT NO. 550 Rt LOREE ESTATES 22-M-4 UNIT NO. 2 BENCH MARK DESCRIPTION: ASSUMED BENCHMARK, EXISTING SANITARY MANHOLE LID, AT FRONT OF LOT AS SHOWN: ELEV.: 100.00' ABREMTIONS i APN ASSESSOR'S PARCEL NUMBER BM BENCH MARKx�NAU LA J CAN CABLE TELEVISION OVERHEAD c5 G?,` M D CURVE DELTA PORFIRIO OSCAR OSUNA `0 DRWY DRIVEWAY DS DOWNSPOUT ° No. 8921 8 FL FLOW LINE ELEVATIONExp. 9-30-16 IP IRON PIPE T9 xP 10 30 50 0 20 Y 40 100 �gl lCH SCALE 1 20 o THE BEARING SOUTH 00'23'00" EAST OF THE CENTER LINE OF JUDY AVENUE AS o o 6 SHOWN ON THAT MAP OF TRACT NO 550 FILED FOR RECORD IN BOOK 22 OF MAPS o PAGE 4, SANTA CLARA COUNTY RECORDS, AND AS FOUND MONUMENTED, WAS TAKEN AS THE BASIS OF BEARING FOR THIS SURVEY. NOTES: � <I 1. DISTANCES AND DIMENSIONS ARE SHOWN IN FEET AND DECIMALS THEREOF. 2. THE DISTINCTIVE BORDER LINE DENOTES THE BOUNDARY. 3. TREES SPECIES NAMES ARE APPROXIMATE, AND LABELED BY THEIR COMMON NAME TO THE BEST OF OUR KNOWLEDGE. IT IS NOT BASED ON AN ARBORIST REPORT. REFERENCES: TRACT NO. 550 Rt LOREE ESTATES 22-M-4 UNIT NO. 2 BENCH MARK DESCRIPTION: ASSUMED BENCHMARK, EXISTING SANITARY MANHOLE LID, AT FRONT OF LOT AS SHOWN: ELEV.: 100.00' ABREMTIONS i APN ASSESSOR'S PARCEL NUMBER BM BENCH MARKx�NAU LA J CAN CABLE TELEVISION OVERHEAD c5 G?,` M D CURVE DELTA PORFIRIO OSCAR OSUNA `0 DRWY DRIVEWAY DS DOWNSPOUT ° No. 8921 8 FL FLOW LINE ELEVATIONExp. 9-30-16 IP IRON PIPE T9 xP L CURVE LENGTH OF Coo' R# REFERENCE DOCUMENT M -M MONUMENT TO MONUMENT O.H. PWR OVERHEAD POWER LINE O.H. TEL OVERHEAD TELEPHONE LINE PCL PARCEL P.M. PARCEL MAP PTN PORTION R RADIUS SD STORM DRAIN SS SANITARY SEWER TC TOP OF CURB ELEVATION n TEMP. 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