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B-2017-0025CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: D-2017-0025 10212 PRADO VISTA DR CUPERTINO, CA 95014-2622 (342 14 089) A K CONSTRUCTION ENTERPRISES INC MORGAN HILL, CA 95038 OWNER'S NAME: ADODRA SNEHAL TRUSTEE & ET AL DATE ISSUED: 05/10/2017 OWNER'S PHONE: 408-460-1874 PHONE NO: (408) 666-1585 LICENSED D ONT A TOR' DECLARATION BUILDING PERMIT INFO: License Class @ Lic. #850864 Contractor A K CONSTRUCTION ENTERPRISES INC Date 10/31/2018 —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) SFD (1090 S.F.); ATTACHED GARAGE (414 S.F) I hereby affirm under penalty of perjury one of the following two declarations: 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. 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by ♦j Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: Valuation: $10000.00 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 342 14 089 342 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 source regulations per the Cupertino Municipalpode, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. SignatureDate 05-10-2017 Issued by: Kim Dunbar Date: 05/10/2017 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: t. 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: 05-10-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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. 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 maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. s. 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 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: APPLICANT CERTIFICATION Date: 05-10-2017 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending 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. 3097, Civ C.) relating to building construction, and hereby authorize representatives of this city 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, 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 DECLARATION Ahall and will comply with all non-point source regulations per the Cupertino Municipal be usedECTa I understand my plans shall be used as public records. Code, Section 9.18. r Licensed Signature Date 05-10-2017 Professional CUPERTINO -Zn I-4.6025 DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building0kupertino.org PROJECT ADDRESS 0212 L '31' APN #1_/` O� OWNER NAME PHONE �'�9r-q601��% E-MAIL / d U SLI S - �e.�C o STREET ADDRESSO w C/ 112 K0110 CITY, STATE IP FAX CONTACT NAME 1 PHONE E-MAIL U(MI, 1 0 s ti� STREET ADDRVb CI Y, STATE, ZIP FAX / fl O ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT XCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NA 1�2 14, 1L AAA 1k to LICENS NUMBE LICENSE To BUS. LIC # COMPANY NAMEAJdVVIAZ J�+E a �f AX / STREET ADDRESS P� 0 ATE, ZIP Ilu W 1 / 6 n 5 � ( ' l7 P D _ 6� 6 ^ /A? VY,� �j DESCRIPTION OF WORK Q t RESIDENTIAL # DWELLING FLOOR AREA UNITS COMMERCIAL FLOOR AREA TYPE OF CONSTRUCTION V-0 # STORIES AQMD JOB NUMBER TUTAL VALUATION: By my signature below, I certify to each of the following: I am the 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 Qf Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildin construction. I authorize representatives o Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: 57-- SUPPLEMENTAL INFORMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT Provide lob Number from Bay Area Air Quality Management District www.baagmd.or:; @ 415-749-4762. Provide three copies of a site plan showing protection for any trees 10" in diameter or more at 3' above grade. Provide letter from PG&E (408-725-3325) stating all gas and electric has been disconnected. 1/ Planning Dept clearance to verify building is not considered an historical landmark. Allow 10 business days. V Provide letter of clearance of all vermin from a licensedest control contractor. p Applicant shall call the Public Works Department at 408-777-3104 and schedule a "habitable dwelling" inspection. Provide signed Debris Bin and Recyclable Materials form. z� Y Commercial Buildings Only: Provide Fire Dept clearance for fire suppression / alarm system review.�� DemoApp_2016.doc revised 03129116 . CA>" DR W limaI 0 I - DESIGN STUDIO X TRE IT. 11 D NUOER RErvww AND vxoTEcrED I lupe ZEVISIONS/\'N, '°� IIS o Ool N 'oIl GROUND E VR �Y O 0a a Oa_ Ov h.. O , a� \ w DEIGNBY:BY:CN MO LECTFENCEate_ SEETREE VROTEC�ON `bsJ STANDARDNOTES //7 TREE To sERErvtovED TAEf\vAOTECT SEETRcsr—,TON STANDARD ���ppp��,� ONF NCE. taeS--' '"jvir° PROJECT o �' �`�� / h &• "\ �` gm,„;N�N� ����`x r�a`F NEWSINGLE FAMILY HOUSE � I •, iz r�,a, -res " � s ,�� � �y \.J I � �" I ie I � I ro5TJNI IIONIOo vAD o,, I�0 `x sE OE DisHfo vAD 9 rREErO SE RErmovED � �Po°, '.•� ate° ,••1 3�_ a Ro'rFa oN FINef °� ° Tkffv •a�mawa�,-.s�sG�-a..®.:�e»:xa�mssv�" ��(KT�l$iAN6A�S crry �r+czmrmvQraoD�o ar: ra ��aa� STADIDe1RD nETAGis cy' ADODRA-HEI PEI O s - 4w� I e VPoak �'��� I ,\ sEETREE veOhcr ON STANDARD NOTES 102 PNAF'J I TSTA C'k CTll OTECTON FENCE � CUPERTINQ, S. eL]FO.\1.A, V H A b T ///////////�fJA',' `R / �� t \ SCE)OPE OF WORK f C _ GARAGE Ousc� SHEETCONTENTS 'm„ I� 10 ;� Ex sEN�MOT SHEownv ,°° r �°°°° ° °e ... � e a °° ° �� ° ' a mss, ii -1 �'D' i� fI Ste , C / ; J N-'W'f 5— CRETERAD -- i DEMOLITION g / BE DE ISHED PLAN i i I DATE 03-29-17 SCALE AS SHOWN 10B 1708 FMV SHEET D--1.0 DEMOLITION PLAN - '` ' "� SCALL 1/8 -1 Monday, May 8, 2017 at 11:28:50 AM Pacific Daylight Time Subject: Historical Clearance for 10212 Prado Vista, Cupertino, CA Date: Monday, May 8, 2017 at 11:27:58 AM Pacific Daylight Time From: Colin Jung To: Andy Kwitowski The single-family residence at 10212 Prado Vista, Cupertino is not considered a historical structure/building. Colin Jung Associate Planner City of Cupertino Page 1 of 1 Randazzo Enterprises, Inc 13550 Blackie Road Castroville, CA 95012 Regulation 99, Rule 2 Acknowledgement of !Notification and Payment of Dees J#.- 5B042 Invoice No : 3ZH00 The Day Area Air Quality Management District (BAAQMD) acknowledges receipt of your payment and your Asbestos Removal or Demolition Dian described as: Demolition Site address 10212 Prado Vista Ave Cupertino, CA 95014 Start Date May 18, 2017 Completion Date May 19, 2017 Removal amounts of friable ACM 0 linear fest 0 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 mail. REGULATION 11-2 REVISION BAAQMD J# 5111042 REVISION # START DATE COMPLETION DATE 2 3 ( 1 1 I 4 ! I 1 1 5 NOTE, This form is not intended as a vertf cation of either the completeness of your original notification or of its compliance with B MQMD Regulation 11-2. If you have any questions about this acknowledgment, please call our once at (415) 749-4762. COMPLIANCE & ENFORCEMENT BAY AREA A.IRQUJA.LITY DIVISION MAKXCiGMENT 01 XT R 1 CT Randazzo Enterprises, Inc 13550 Blackie Road Castroville, CA 95012 Regulation 99, Rule 2 Acknowledgement of !Notification and Payment of Dees J#.- 5B042 Invoice No : 3ZH00 The Day Area Air Quality Management District (BAAQMD) acknowledges receipt of your payment and your Asbestos Removal or Demolition Dian described as: Demolition Site address 10212 Prado Vista Ave Cupertino, CA 95014 Start Date May 18, 2017 Completion Date May 19, 2017 Removal amounts of friable ACM 0 linear fest 0 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 mail. REGULATION 11-2 REVISION BAAQMD J# 5111042 REVISION # START DATE COMPLETION DATE 2 3 ( 1 1 I 4 ! I 1 1 5 NOTE, This form is not intended as a vertf cation of either the completeness of your original notification or of its compliance with B MQMD Regulation 11-2. If you have any questions about this acknowledgment, please call our once at (415) 749-4762. lnllPacific Gas and Electric Company. WE DELIVER ENERGY." MAY 9TH, 2017 FRANCISCO HERRERO 10212 PRADO VISTA AVE. CUPERTINO, CA 95014 RE: 10212 DRAW VISTA AVE., CUPERTINO, CA. 95014 Order Number: 112653854 To whom it may concern, The gas meter at the above referenced address has been removed and the gas service was cut off at main on (05103117). The electric service & meter at the above referenced address has been disconnected and removed on (03113117). 5 i ncerely, tl"V44 & 00 Justin Pigg Project Coordinator i Pacific Gas & Electric Co I DeAnza Division) 10900 N Slaney Ave, Cupertino, CA 95014 32PYCa q. eq _corn ]Office: 408.725.2165 M+ 7,OOAM -- 3:30PM **AVAILABLE BY APPOINTMENT ONLY** "Safety is a full time job; don't make it a part time practice" pwark 4 om 3 �' City of Cupertino Public works Department Environmental Programs Division n10300 Torre Ave uP> Hr,JJ�hGREJ'c�J Cupertino, CA 95.014 pogrom (408) 777-3354 Construction and Demolition Recycling Diversion Requirements and Instructions Covered projects, or all construction, demolition and. renovation projects that are 3,000 s care feet rrr more are required to complete a Waste Management .flan for the City of Cupertino demonstrating that 60% of the material generated is recycled, in compliance with ordinance CMC 16.72.050. At the conclusion of the project a Construction Recycling Report must be filed with the public Works Department/Environmental Division showing the tons recycled and disposed by material type. Use tannage information from weight tags provided by facilities to quantify total estimated waste and percentages for materials. Weight Fags of all material recycled and disposed must be submitted with the final report in order to receive a Final Building Inspection. Debris from a project 3,000 square feet or more in Cupertino can be collected and disposed by using: Please check all that apply: V1 am not using a R.ecology debris bin, however, the project is less than 3,000 s.f., e.g. buildings, patios, sidewalks, driveways. 11 1 will use a Recology debris bin. By Agreement with the City, Recology will prepare my required Waste Management Plan & Recycling Report, Contact Recology: (408) 725-4020. © 1 am not using aRecology debris bin. 1 will provide the following submittals to the City's Public Works Department, showing that 1 have recycled at least 60% of all construction demolition material: Ask for the Construction & Demolition Recycling Packet from the Building. Department and complete the following: Submit a Construction and Demolition Waste Manugentent Plan with your building permit applicartior , No feefor this plana. Farms are available at the BuildinglPublic Works counter and online at www..cupertino.orglenvironmenfal. Report the tonnage regcled and disposed, by material type. Recycli g facilities must be .selected from the City's approved list of Recycling Resources. Submit a Constrtaciinn ReeyclingReport f6rm. The report is required bq/bre the Building Department will schedule a ftntal inspection. The report,fr�wn isavailable at the Budding/Public Forks Counter and airline Ewwxupgri nra.r�rglenvirannrarttal. Signature: Name: (printed) V U W1 1^0 o 5V Title-- Phone: itle;Phone: L(cl -- S 6 Ja Project Address: JD 212 f4SgdQ U S tn This form to remain in the project's:building permit file for the duration of the project. .Devised 3171.12 1 Date: .5 r '1 — r.��1� l lstr�i 13�s,�27 1 040 Commercial Ave., Suite 101* San Jose; CA 85112. q (400) 2804497 • (8.00) 31.0-2900 Foo E–j DEMON MAX 1 GENTROL. Su5PENC DELTA DUST MAX FORCE ANT BAtT Oft PRECOR CONTRAO SLt KS TALON jBrQdtaMM 0,005-Q'. 0 OTHER BAIT STATIONS FIAT TRAPS MOUSE TtAS FkY MACHINES GLUE BOARDS BAIT STATIONS fiAT TRAPS iy10Q$E TRAPS OLVE BOARDS i', WHANI AL TRAMS GENERAL SANITATION? C.] GOOD 0 FAIR. CI#?C.OR l 1, Attic —25, Fixture Stororoct — 49. 'A acalving Area Bakery 26. Flower Shop , „ 80e Receiving moors 3. ear .27. Frozen Foods Caw — x6l, Ems, floors. rccety 4. Bar Lounge „„ W . 28. Garbage Cans 52, Roe, Doors, Pmdu S. f, BasementStotago Booths � 29. _ 30, Gondolas Grocery Storemom. wa. Reo,Dooi-s, heat 54E Hi • Doers, S kory Battle Stnrag at . Ice cream. Dip s., tesirra9 ns, ulillo fl. 1Sreak.l loam 52.. ice Machine SS.. flestrooms, t piny w 0. Candy Sales Arra 33. .Janitor Room S Salad Bar _ 13. Caddy Storemm _ 34. Kitchen — 68, wales Floor 11:, Ch%ksta"nds —.3-5, Kitchen Stororoom, „ 69. Salvage Are. _ Machin 1 ay-A-Vlay 60; Service Counts r 13 14 W1d6 Shop CoMpressor f7s+n 37, 38. Liquor Sales Liquor Store. 0K' a 61. Snack Bar 62. Storeroom,. Mon»Food- `1 . C'e netics 39, Loek i�, Empl $3, Swreroom,:lip ire. i'C D iry Sax 40, Lott Area —04., Tush Bins. 47. illi Case 41. Meat Cooler. 65. Trash Room 1£I, '0411 Service. �2, i�It3atCutling Room 81� Tobacco Storeroom 9, Dining. Room #3. Meat:i'�lsplay Cases 67• Vending Machin t2. Dishwasher Area 44. Meat Paper. Storage,= 68. Waitress Station 21, Electric Panels 45, AB. Office 69. Plater Fountain Other 2-, Emergency Exit w -Pbaf riacy —70, -- 23, Entry Door 47. 'ProdU00 Prep. Rclorra . 71.. .. Fish Case _ 48. Produce Stands _ 72, Other HOUSING AND SANITATION Aocumuiated trash, dirt, or debris Spillage or food residq Standing or pudd wator Moor drains dirty Old rodent evidtr Old insect evideneo other STtr RA0E PRACTICES Storage on floor £forage in cardlstt° Storage against'II Storage on. invert miie:r?r opousa Other Surface di�tQnioratlon Loose walloovering . Loose ba"board or NO 09ft Holes or gaps In walls unseated cracks and dumbing repairs needed Doors needing rodent -proofing Qtheropenirtgs needing pf%?0rlg Doom notsell-dosing Vly "iaa or Eilt lrtaln ne-00 Cthor � [OUT] ' s r s a 0. rrr�. RSON IN HAROE? 0 YES No,