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D-2017-0040
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: D-2017-0040 10700 MORENGO DR CUPERTINO, CA 95014-3515 (375 35 06 1) WING ON CONSTRUCTION INC SAN LEANDRO, CA 94579 OWNER'S NAME: ZIIAI JIANJUN AND WEI LI DATE ISSUED: 06/30/2017 OWNER'S PHONE: 510-304-5004 PHONE NO: (510) 786-8838 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class @ Lie. #949206 Contractor WING ON CONSTRUCTION INC Date 06/30/2018 _ 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 (932 S.F.); DETACHED GARAGE (297 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. 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: $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 and state laws relating to building construction, and hereby authorize 37535 061 375 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 Municipal Code, Section 9.18, 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 6/30/2017 Issued by: Abby Ayende Date: 06/30/2017 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: 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 (See.7044, Business & Professions Code). Date: 6/30/2017 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 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 3. 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, a 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 6/30/2017 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 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 6/30/2017 Professional CUPERTINO W40 DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build in-g(a cupertino.org PROJECT ADDRESS O o ,L' -0APN (( # ( y -b _ l)(C OWNER NAME 2-k&,N PHONE c �O� % ,L E -MATT, ' 0 , • L ,L``�/► •1 STREET ADDRESS {� ^ gie4U CITY, STATE, ZIP ' / ` FAX CONTACT NAME _ / G PHONE J i n J E-MAILr�v f� (7,4(7,4 STREET ADDRESS CITY, STATE, ZIP) A FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT El ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME {/IA(Tq . 1 C - , �M ` LICENSE NUMBER Q , !/t Z / LICENSE TYPE /� BUS. LIC # COMPANY NAME ` o •n o o �n �� E-MAIL ;1M f � � n � FAX ©✓ ^ STREET ADDRESS (12" 1 -to n ^ Av� LVv , CITY, STATE, ZIP PHONE��� DESCRIPTION OF WORK s S� Ci�2 s� 1c,I � RESIDENTIAL # DWELLING OFFICE USE ONLY USE OCC. TYPE SQ. FT. VALUATION FLOOR AREA UNITS COMMERCIAL FLOOR AREA TYPE OF CONSTRUCTION # STORIES AQMD JOB NUMBERn O J #: S- l�/ll RECEIVED BY: E0,AL VALUATION: By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the prop ity 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 b ilding construction. I auth ze representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicanUAgent: Date: SUPPLEMENTAL INFORk4ATION QUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT OFFICE USE ONLY PLAN CHECK TYPE Provide Job Number from Bay Area Air Quality Management District %vww.baagmd.org @ 415-749-4762. ✓ Provide three copies of a site plan showing protection for any trees 10" in diameter or more at 3' above grade. ❑ EXPRESS ❑ STANDARD Provide letter from PG&E (408-725-3325) stating all gas and electric has been disconnected. ❑ LARGE Planning Dept clearance to verify building is not considered an historical landmark. Allow 10 business days. ❑ MAJOR 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.' Provide signed Debris Bin and Recyclable Materials form. (� Commercial Buildings Only: Provide Fire Dept clearance for fire suppression / alarm system review. DemoApp_2016.doc revised 03/29/16