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B-2017-0311 CANCELLED5!4117 City -of Cupertino 1.0300 Torre Ave. Cupeilino, CA. 95014 Attn: Abigail A. Re: BLD2017-0311 Abigail, The project permitted for decommissioning a cell site at 10602 N. Poral Ave., Cupertino has leen cancelled. Work to be clone was removal ©.f.chain link fence, concrete slab and a cell tower. The site is novo going to remain and our contract with the owner is terminated. A Tease cancel the permit and confirm in writing. Call if you have -any questions. Sincerely ECHO PACIFIC COMNUJNICATIONS A Brian Fay Estimator (760) 546-4312 "The resonance of Quality" 2066 Aldergrove Ave. Escondido, GA 92029 Te{ (780) 737.3003 Fax (760) 737-9487 CITY OF CUPERTINO BUILDING PERMIT BUH,DINGADDRESS: CONTRACTOR: PERMIT NO: B-2017-0311 10602 N PORTALAVE CUPERTINO, CA 95014-2449 (316 32 053) ECHO PACIFIC COMIAMCATIONS LLC ESCONDIDO, CA 92029 OVMER'S NAMT: TOMAMIDORI TRUSTEE DATE ISS D: /2712017 OWNER'S PHONE: 561-257-05$7 PHONE NO: 161))731-3003_ LICENSED CONTRACTOR'S DECLARATION BOLDING PERNPER License Class B C10 Llc. #995246 ContractorECHO PACIFIC COMMUNIC jTiON25 LLC Date 7 1 2 1 X BLDG —ELECI &ereby afirrm that I am licensed under the provisions ofCI►apter 9 (commencing_MEGA RESIDwith Section 7000) ofDivision 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTIOCOMPLETE REMSIONED CELL ITE;I hereby affirm underpenalty ofperjury aneofthefallowing two declarations: EQUIPMENTAND 1. I have and will maintain a certificate of consent to self-insure for Worker's Compensation, as provided far by Scetion 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 th for which this permit is issued q Ft our Area: Valuation: $29000.00 APPLICANT t'F.RTIFICATION I certify that I have read this application and state that the bove information is correct. I agree to comply with all city and unty ordinances P Number: Occupancy Type: and state laws relating to building construction, and here y authorize 316 32 053 representatives of this city to enter upon the above men oned property €or inspection purposes. (vile) agree to save indemnify and keep harmless th City of Cupertino against itabilitles, judgments, costs, an expenses which PERMIT ' PIR S jet' WORK IS T SSTARTED may accrue against said City in consequence of the gra ting of thin perm' . Additionally, the applicant understands and will comply h all non-poln iVITHIN 150 DAYS OF PE NCE OR source regul 'ons per the Cupertino Municipal Code, Se ion 9.18.; 1$0 DAYS FROM � �e ' Ii CTION. Signature 9E���DateO2127120117 Issued by: 11IELI Date: 02/27/2017 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 inspa d prior to any roofing material being installed. If a roof is x. I, as owner of the property, or my employees with wages as their sole installed without firs taining 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. 1, as owner of the property, am exclusively contracting with licensed Signature Applicant: contractors to construct the project (See.7044, Business & Professions Code). Date: I hereby afiirut under penalty of perjury one of the fallowing three declarations: ALL ROOF COVERINGS TO BE CLASS "A1l OR BETTER +. 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 performance of the work for which this permit is issued. HAZARi7oUs MATERIALS 131SCLOSURE 2. I have and will maintain Worker's Compensation Insurance, a Xwhich I have read the hazardous materials requirements under Chapter 6.95 of the Section 3700 of the Labor Code, for the performance of the w 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 pe, 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 contaminants defined the Quality District I Worker's Compensation laws of California. If, after making flits certificate of ode, Chaptementr will maintain compliance with the Cupertino Mfunicipal Coda, Chapter 9.12 and i pl h Cupertay ino M exemption, I become subject to the Worker's Compensation provisions of the the Health & Safely Cad ctions 2550 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall / be deemed revoked. Owner or authorized agent: > APPLICANT CERTIFICATION Date: 02127/2017 1 certify that I have read this application and state that the above information is CONSTRUCTIONLE INGAGI&CY 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''llabilitles, 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 AR IiIT T'S DECI A TION U CL and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. I understand m tans shall used as records. y p p Signature Date 02/2712017 Licensed Professional CONSTRUCTION PERMIT APPLICATION � COMMUNITY DEVELOPMIENT DEPARTMENT • BUILDING DIVISION ' 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408;) 777-3333 - building rr5cullertino,org CUPERTINO- 11FiIJCCS•NIM'(l('.TlnW 1' 1 A)T-wmr)U ATTIM .1TTI'1WITT l7 nriricrn�trncrcnnr nne rte,.. PROJECYADDRESS /� . d U fiPN 031 .. — r7 O\k'NERKA.MB r%- PHONE �V PT PHO?�FE r LI�, �����. I E-MAIL S7REET,413DP.F.SS CI STAT ,ZIP hItoe FlsX ���` -- E , g 7-0;$7 J CO\TACT N4A4E I PHO?v� E-IJAIL AW •I p STREET A Yhh , f4j!! / %y �.. P .. Sit ae ®s CI 7�� FAX / � ��l © OWJ>EF ❑ OA'NTM—BLMDER ❑ Ati'htRAGEnT ❑ CONTRACTOR COkTRACTORAGHT.'T ❑ ARC= . G tER ❑ DEvELOPER ❑ TE?�r-"T COICTRACTOR NAME L?CE ' t CE?vSE TT'P BUS. LIC n U ' P Q 1 COMPANY = 4E P&IF r -L A/ (� firr E I ATI - A- p 41-7 `/ T STATE, i ® w I �►D 9 360 g:&�f ' ARCHITECTlEiYGINEERNAJiE - ( LICENSENI�11iBER BUS. IICIff COh§PA.NY NAME �4AIL FAX STREET ADDRESS CITY, STAT$, . P 1 PI30tr'E. DF_SCRIPTIGhUFWORK J/ 6 i3 d '" 6 4"AV F F i 4 EXISTP..G USE PROPO cD USE Co. \STR.1" ESTO �RTFS USE TYPE oca SQ,FT', ! VALUATION (S)� E7yISTG NMwnqbR DEMO TOTAL AREAAREA AREA NrETAP.EA RATHPOOM RE 5ODPLLAREA REMODEL AREA REMODELAREA PORCH AREA DE AREA TOTAL DECI:,-'PORCH AREA GARAGE AREA: DETACH- '© ATTACH P AtixLIM L. S I5 A SECOND UNIT [:)YES SECO!iD STORY YES-- ' BUNG ADDED? [].NO ADDITION' S THE BD A:❑]ES N3-iVALUA'rf0 X1 PRE APPLICATIOV YES LF 3TS, PROVIDE COPT OF PLA,.tGAPPL= ❑efl PL.0.-N:iLhGAPPROVAL LETTER £ICiLFLIiOE? :O 0 +cnt By Illy signature below, I certify to each ofthe following: l am the property owner or au* 5, to acton the property owner`s behalf, I have read this application and the information I have provided is correct. I have read the Description ofWork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating b' to constr uction, 1alQ%ori7e. renr esentatives of Cupertino to enter the above -identified property 'iOr inspection purposes. Signature of ApplicandAgent: Date: %.^ 177 SUPPLEMENI'AL.YNFORR4AT10N121rQ�112.1;}.7 ;�;,�;3�_.Pi;.'-s.'1C13ECTiTIPE-. - _ _� - .-.bs°..t � 5'�-�:�av;� �.---•_ ��a-_ 3%:�s3�;t • OTrI'II�G SLIPS `- - l !P Q 1xbr Ne+a SPD or Multifalnil� d�� _llim�s Apply for demolition permit for xL� _ _ _ _ __ :�,,,_x:a _- ys4"_�';3". ,- : x; ''_� :.z °�,❑°-,a�6tlR,_s>�°`- �::+�3iSK':=.:._, _ :,5i✓?,3•� �$i� _ _ -- _ existins u� v •f �r i a b Ildrn�(sj. Delnall Ion penult Is reyulred pnc. to Issuance of bu.Idil?_ T�;- .ci,;:`:, °`.. =,rir d==- _-cs. - _-___ .'`--�,a-BTSST.DLT�GPLA?�S;E�7£nr'�'�''�';4': 11..;-s .• ri_:r-_a _N __;:" - - - pernlitforne%,, building, _ {'���SrRl:ss=°i>�>;<`�-�^-�}_:•s�:�-:��rl:�'�:i?,�ri�al�r.��`i>i-= �, - - == --- Commercial Bldgs: Provide a completed Hazardous 7%laterials Disclosure1.111RII,? 1 >> foi-i1 ?f al Hazardous at I is are he1 oQ used a5 art of this ro eL:`E -_ - - - E CopY offlanningAppmval Letter or Meeting with Planning prior to - '- '3 :i :.-- - �ry '�`%SiIT4RYSE,ii�RDI�TRTC. sublllittal of Building Pennit application. a =„r::' ; F,, -' - _ _- =- = '��?�>-'z.�"'s”=-= _ ---�E�'=�" >a�n.��M�""°�.: B1dg1pp-_:201 J.doc ?•evised 06121111