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14070069 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18650 CYNTHIA AVE CONTRACTOR:HOMESTEAD PERMIT NO: 14070069 CONSTRUCTION INC OWNER'S NAME: LI KUO TSAI AND LIU PEISHAN 10080 STERN AVE DATE ISSUED:07/16/2014 OWNER'S PHONE: 4088871382 CUPERTINO,CA 95014 PHONE NO:(408)255-8999 0 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL EA6 -3 SFDWL DEMO 1048 SQ FT,GARAGE 264 SQ FT License Class_ LG�ic.# Contractor/7n 1(4 � l 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. I hereby affirm under penalty of perjury one of the following two declarations: 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. Sq.Ft Floor Area: Valuation:$9000 have and will maintain Worker's Compensation Insurance,as provided for by �, ection 3700 of the Labor Code,for the performance of the work for which this APN Number:37522028.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct, I agree to comply with all city and county ordinances and state Laws relating WITHIN SOF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAY OM LA CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the —7 /e_', granting of this permit. Additionally,the applicant understands and will comply Issued by: Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature 7 Date 6 / All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant Date: 1 hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I,as owner of the property,or my employees with wages as their sole compensation, will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code), 1 have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should 1 store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,255 3,Rnd 255 Section 3700 of the Labor Code,for the performance of the work for which this �� , Owner or authorized agent: C Date: permit is issued. 1 certify that in the performance of the work for which this permit is issued,1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If,after making this certificate of exemption,[ CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code,I must 1 hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 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, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the 1 understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date DEMOLITION PERMIT APPLICATION ''\\,� ► COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION V 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUFERTINO (408)777-3228•FAX(408)777-3333•buildinq(akupertino.org \{� PROJECTADDRESS jD \ VQ- APN# OWNER NAME ka D 75 A4 I E, L/ PH0N � -o jn —L� E-MAIL ,.. "r� STREET ADDRESS 1\n CITY, STATE,ZIP {�,� FAX CONTACT NAME \10 71 6\ PHONE / E-MAIL a % © /IpCT ti t` STREET ADDRESS ve ` CITY,STATE, ZIP /� r G F", ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPERJ ❑TENANT CONTRACTOR NAME LICENSE NUMBER /f 74ICENSE TYPE BUS.LIC COMPANY NAME � 'P ��� E-MAIL gap?/ y���j�j C�m FAX STREET ADDRESS �OV ✓ Y '/� t CITY,STATE,ZIP PHONE DESCRIPTION OF WORK Y �,, 'l C /S �C.Xne KJ . RESIDENTIAL. / #DWELLING I OFFICENL FLOOR AR' r r UNITSUSE Ocr TYPE SO Fr. VAIIIATIM COMMERCIAL FLOORAREA TYPE OF CONSTRUCTION "-4 #STORIES AQMD JOB NUMBER RECEIVED BY: T UATION: J #: � � By my signature below,I certify to each of the following: I am the property owner or authorize gent to act on the prope wner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work IiLid verify it is accurate. ee to comply with all applicable local ordinances and state laws relating to building construction. kwuhqnze represegatives of Cupertino to enter t le above-identified property for inspection purposes. Signature of Applicant/Agent: ^, Date: SUPPLEMENTAL 1NFORMA ON REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT OFFICE USX ONLY _Provide Job Number from Bay Area Air Quality Management District www.baaamd ore @ 415-749-4762. PLAN CHECK TYPR _Provide three copies(Residential)or six copies(Commerical)of a site plan showing protection for any trees 10" E EXPRESS in diameter or more at 3'above grade. ❑ STANDARD _Provide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected. ❑ LARGE _Provide a letter of inspection,tests,and abatement of any Hazardous Materials.Letter to be initiated by person(s) El MAJOR certified in asbestos,mercury and/or hazardous material examination. Planning Dept clearance to verify building is not considered an historical landmark.Allow 10 business days. 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. DemoApp_2013.d6c revised 02/13/13 CITY OF CUPERTINO D FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 18650 cynthia ave DATE: 07/16/2014 REVIEWED BY: Mendez APN: BP#: 'VALUATION: 1$9,000 -PERMIT TYPE: Demolition Permit PRIMARY SFD or Duplex PENTAMATION 1SFDWL-DEM USE: PERMIT TYPE: WORK sfdwl demo 1048 sq ftgarage 264 sq ft SCOPE FEE ID FLR AREA s.f. 1 DEMORES 1,312 Ll Ej _L_ NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Thesefees are based on the preliminar information available and are only an estimate. Contact the Dept for addn'l info. FEE ITEMS (Fee Resolution 11-053 Fff 7,1%13) FEE QTY/FEE MISC ITEMS Permit Fee: $574.00 Suppl. Insp. Fee:Q Reg. OOT F0701 hrs $0.00 i Strong, Motion Fee: IBSEISMICR $1.17 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $576.17 $0.00 TOTAL FEE: $576.17 Revised: 07/10/2014 PROCEDURE CHECKLIST FOR DEMOLITION PERMITS COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228 • FAX(408)777-3333•building(c-Dcupertino.org PURPOSE The demolition application should be applied for before or at the same time as the new construction permit application(these are separate permit applications and fees). Permit fees are due at the time of the application/plan submittal. The new construction permit will not be issued until the demolition permit is issued, unless a letter obtained from the Building Department is submitted stating that "The existing house will not be demolished until the new construction permit is issued". The letter needs to be signed by both the property owner and general contractor. REQUIREMENTS To obtain a demolition permit in the City of Cupertino, please complete a Demolition permit application alon ith each of the following requirements as it applies to your specific project. r , 1. ree (3) copies of a Site (Demolition) plan for Residential or six (6) copies for Commercial will be required showing any trees 10 inches in diameter at 3 feet above grade on the subject property, and what means will be taken to protect these trees. 2. PG&E must be contacted AS EARLY AS POSSIBLE prior to,demolition to schedule the abandonment. Contact PG&E at(408) 725-3325. A letter from PG&E shall be provided to the City, stating that all gas and electric has been disconnected. (This step can be time consuming,so it is important to begin the process immediately) �> %�: " �� .� > _ ".' P 3. Provide Job Number from Bay Area Air Quality Management District www.baaqmd.gov @ 415-749-4762. Check to see if the building is considered an historical landmark. Obtain clearance from the Community Development Planning Department. Allow 10 working days. 5. Provide a letter of clearance of all vermin from a licensed pest control contractor. y 6. portant: Prior to the issuance of the demolition permit,the applicant must call the Public Works Department at(408) 777-3104 and arrange a"habitable dwelling" inspection. 7. Debris bin and Recycling sheet: read, sign and date. The sheet will remain in the project's building permit file for the duration of the project. 8. Commercial only-prior to issuance of the demolition permit,the Fire Department must review the plans for fire suppression/alarm systems that shall remain in service or be modified during Demolition or that shall be replaced with the new construction. DemoProcedure.doe revised 2/1.3/1.3 Pacific Gas and Company'ompany 10900 No. Blaney Avenue Cupertino, CA 95014 DATE: JULY 15T",2014 CITY OF CUPERTINO 10300 TORRE AVE CUPERTINO CA 95014 SUBJECT: REMOVAL OF GAS SERVICES (CUT @ MAIN IN THE STREET) ON: JULY 9T",2014 @ 18650 CYNTHIA AVE CUPERTINO CA 95014 SUBJECT: ELECTRIC SERVICES WAS CUT AT POLE ON : JUNE 19TH, 2014 @ 18650 CYNTHIA AVE CUPERTINO CA 95014 If you have any question contact us at (408) 725-3325 Sincerely, C.P. Pacific Gas & Electric Company DeAnza Service Planning 10900 N Blaney Ave CUPERTINO CA 95014 SOUTH BAY PEST CONTROL RESIDENTIAL • COMMERCIAL • INDUSTRIAL Juiy 3, 2014 Homestead Construction, Inc. 18650 Cynthia Ave. Cupertino, CA 95014 RE: Vermin Inspection To: Whom It May Concern: The above property was inspected for vermin on July 3th, 2014. In completing the inspection,there was no pest activity (insects or rodents)found in the structure. Should you have any questions, please do not hesitate to contact me at 650-964-7272. Sincerely, Bert Cardoza Pest Control Operator Lic. #OPR 9025 569 Clyde Ave.Suite 560 Mountain View,California 94043 650-964-7272 408-929-7272. pwvi'V�Wl- 1-4w ok*,0010W Regulation 11, Rule 2 COMPLIANCE & ENFORCEMENT Acknowledgement of B A Y A R r A Notification and ilQj ,\ DIVISION Payment of Fees M D „ T P. , _ 6/13/2014 Homestead Construction Job No: 4G612 10080 Stern Avenue Invoice No: 3JQ10 Cupertino,CA 95014 The Bay Area Air Quality Management District(BAAQMD) acknowledges receipt of your payment and your Asbestos Removal or Demolition Plan described as: Demolition Site address 18650 Cynthia Avenue Cupertino. CA 95014 Start Date June 25, 2014 Completion Date June 30, 2014 Removal amounts of friable ACM 0 linear feet 0 square feet 0 cubic feet Should it become necessary to revise this plan. please do so in the spaces prov ided below and inunediately copy the District by fax or by mail. REGULATION 11-2 REVISION BAAQMD J# 4G612 REVISION = START DATE CUMPL -1-ION DATE 1 � 2 ; 3 4 _ NOTE: This form is not intended as a i,crification of either the conipletcness of_vonr original notification or of its compliance with BAAQMD Regulation 11-2. 11'You hove anti•questions about this acknowledgmew, please call our office at (41 5) 749-4762. City of Cupertino Public works Department Environmental Programs Division 10300 Torre Ave Cupertino, CA 95014 CUPERTINOGRE'F.N Program (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 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 tonnage information from weight tags provided by facilities to quantify total estimated waste and percentages for materials. Weight Tags of all material recycled and disposed must be submitted with the final report in order to receive a Final Building Inspection. t Recology is the only debris bin service provider franchised to do business in Cupertino. Debris from a project 3,000 square feet or more in Cupertino can be collected and disposed by using: Please check all that apply: I am not using a Recology debris bin,however, the project is less than 3,000 s.£, e.g. buildings,patios, sidewalks, driveways. t r=F ❑ I 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. r ❑ I am not using a Recology debris bin. I will provide the following submittals 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 following: ✓ Submit a Construction and Demolition fKiste Management Plan with your building permit application. No.fee for this plan. Forms are available at the BuildinglPublic Yf'orks counter and online cit vs wx.cupertino.orglenvirown-enlal. Report the tonnage recycled and disposed by material type. Recycling facilities must he selected from. the City's approved list of Recycling Resources. ✓ Submit a Construction Recycling Report form. The report is required before the Building Department will schedule a f nal inspection. The report form is mailable at the BuildinglPtrblic 1-Yorks Counter and online wIt iy.cr.r rcrtino or ,,/cnvn omrrcntell. Signature: Date: Name: (printed) T"-71 ►aM Title: (' � - e--t' %— Phone: 9 / ~ Project Address; l2� C `.m A itP 0 0 This form to remain in the project's building permit file for the duration of the project. Revised 317/1 1 REVISIONS BY OFFiCS CF COM M1MTY DEVELOPMENT 1,31TY HA..i. AIV y� ft a;){0 7 Imo E` E..14'JE f t.,Ia ^T#`f CA-:6 14 ?a "4 SFYitl f4??z?t7' t.va F<.Yj�fC LO � O 00 CV v�j, by W SSP £;'tiO . R' s'i.3y�: r : �.a::�X7 1.`':!"I'F:t ,..:����ti���-ior -22 1"'-3- 'h. .,t tta,r i s„2fY.ml7, l .1..:.#GI 3F.:f•dy e�3ii k€4 of#�C?mo t 2"i tv �.3Fi'f k,L i£`ent, given ton£i's?Eob Y-i, 2W,,•#, ap t 1rlg a Ti3>o L t:7rV 1:)i i' if ihtw Ci' ti i )F} of aFw. .,; Jqu ro foot sir;wle fiingi'ai ucili:C. <sfa.Ld �t R t }nthia Avenue,�.it:h f;.,fviloVk1llg COWtc.i:rt1£,s: z 1l approval .4,bax>>3 tin a-plan£ et e._1,60&1, "l.'q .Residelncel 8630 Cynthia Ave., cllp(>rt rio, Ca, 0 "s,Aie:`ts dated &,T 4,mb'r .1,%•:r1 , t.''xf:.ept its.€m1 bw amended by con #;ii`>ns,inca tlt €e>c?lufii>i?. 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I t l S. :y ^o' tC Y 3y �Y...,��-.. „,.3;. ,..1 rizl£t.`a t a.r.et:z `ts;.�,. ,de,C..: c. � 1 I SL'ir,z:..f. i:l.bilt;Cl7rl .t;r"?€t .Hifi .<3.r CI:L' i t Hl a 1€s.. L14tiii ' aisll s.t. LL3_1"inter i'vi la tl?�Cil � l Pd p � I c� be rr€?tl within 14 cast=.z2�ar a}s fznz�l tt€c date sr�this IettL�r.. If€12is happens,you z will ts�;:ratifi.e�o�a D a 4 4 u v p v4e ' Q O s i public hearing,which v ill be scheduled beforetete Ptan2�ing£:o',11,mission, � noa�a� � - a� !'I Y A( 10 Tt ISL}' i�t� .. ,t,a:l' n tl? C7?trsL iii .tt'r She;ll 't{ti CL i 111x.21 C?zt tl?lq isl(sl rll tie 2a101l l tl<t111G 1' s?�?t3't t t ri pw of tree Ir,r€.✓r2S��'1;t3'i'tiNL..o-c's'sl iI1-a,3E;S.i:€'y c.7.kCl'ti t.c;l"3'Ce.3t£as..tY.C.>;;;E�f L.7,Lia 'i'Yt•,.'LS is"3s,s,yti?i?.t t1€'ila Y.<h RA'OrdiiX€c3€1ce. for Yti1di t:€ow's';nk)nei�hbor t.1gj S isf i'ls and a sq!h: light d-vit is.5 feet or :TG:"`?the ,iiort'finished floor, The T3recise language will%-a,b?ect t:3 apprC vall b >l1G Director of Col.";ill`,ndtI REMOVE EXIST. 10"04o Development Proof of nioorda3to lwst be submitted to the Cr.nnuatur;jo ,Qw opine>nt Dep.1r>Tne;::t TREES ASH (3) P �--• A �� � f;r#z�l 4'4f.Ir r�r?r of ther:,i-derwe. �, q0 p� Dodi g rh 8. C '4. l TA"rION WITH't l ,R l-�l'.=�Z L .,I @F) `�j`r:: applkaant is i:E;s ollsi le ts3 considt with o0hir rttpartt'2Ents aaid;C2£' rMlc:2if.£r. Lv2tti. regard fi3#.iii � yfi t` ( -� ra � ����t�0 © � a ©� � JU � ���q 0 propfJs�'Cl Project tilt lCl(lrti 1n31 L ?i>iltt Cilli k rl rpt€ Iifl'2(Yft 5.2'€ ! +)1TYl�tlfL'l.tdtt)12 of2r 37' �/ kl 44 C ... ..` .p�Q�O Q n p i W �t:.l rai fed daty im,atidate may a n approval by t1 i..f•n)T'Tl nity r,1.3f V£ltl^3rnL`TF#'I•:�•ar 2 1cr rt:. 7\it€trf l ,.;isYi7i Y.r'� I D v O D I l��Vl�€�� ' � (S J 2T22..ti.r3l7i:3c.las€r`siTlt'rti ° �� Q +3f6 �i0 �eO�P LAIC Q 0 9. X11I�Xf3 l3ltit 3 T ~C„fitAs"1 1q �.�n..��l���..�_::.>m_1� 11i ter I I Reviewed By. e v Filial build)g 2 v#t€it31 `iY�r.tkltt�Y3t plan includ rig but not 'z 3`I tee; 0.%r tajs.sari Qxteri r LiC+,I£ir,materia' W Q l,?itic , crl f rt:irl=.i,ti:l; archl.ef t'fital trPaUments and/or shall b reviewed ame approved by they D.recur of C i,11m€111i€ €}f>v,.Ao1,z t<<.rii tt;ic:r to if,suance of bu Ittlm; l cr x?E.t 11 v, fi21Aa1 burl2'li: z.L rl=.>r }1:1z2 1”. �y. Z >w£I al tielc ,L S-t"r7 ble t t �i'? dl: 4111'41 it P", 't1Y« t?1 i.�y33#axl approved C+ z?�; I l it exterior C€?3.€1 f h 2 3' p2 dr?ttmiuirie.d to be 41tbstr3_rat al: by the Director of Co-mm-unity Developn'€ei=t shall regtnire a 131121or LLJ Z nloei,f zt'lnn�ppi'c?i all 1111 re: l:b rhood input. t;". 3s}`'i'i?#x f.i.t��.:t i.1 ;Iiia>=+:1•.a,£.�utsii;i tzt C":t n�;i•.; C/) ( l 1`ci the t.xtemt lis:>':i.it ed by i,2 v;the Applicant t'hall and holm[E•tarmles-. the C_ yr its City I Lj cf'u..16.1, l€S officers, f.ri'.plfsv . agents ""ne"�inde<z:'iaes�' '.ed -mrt" s from alld sai girt st an, i?i?l:_`:t;. � 0 ILJ'_' is"t<h21,t>r l r. .t.t1.i:1' bi't ur J b-,,-a U-ir 1 1 t ''a!lainst ill's'.2nCitt,'rmlitied pr't€e5 3£15. the, clpptii:.s'.1t t<? L. LJ 'Af,ack aY'.`t.a s2,.'ic,or Void t'lls,5 or 3 I1;.:,li:".Y'f.nit or c,l?pr'f:al '. sjl,ol ized hel-dov f T rhe is ro:ect, (� Izi l i{l <;l ttS tl'2t7ilt U0110 r't.I,7 3?" s ii? 11£'City itsslCail�< :,tfC� iii 1'S SCE;S a1.r€Lz dL?lt titCk#"rtktl l.rl (Yl of ti'Ft 'xt£?ya7t2f3":i. �Ph City may, ?ri :te: cCt;i dkc;�t:tt#'3; elect to tEi,'"en--1 any such ;dc�iioll -,,di'Y `tel 3th'frnevI s t;f it,el G 0 I 1 ''QTlCF OF FEES�}�L�l���tt)14 I�f� IZ�w,� l 5., Cil:t`r11�,I; .�:,���i �lt� Date 11 /01 /13 i lli' Conditions of Project Approval set forth hcr,,i't m1 y certalin fees,, dodicatiort 'C:`'l+Ir4T314,;;€? A.€tia�'Sb itilyii i'L'C:i3,$$C??It-:ts ;€.T?4 £7t.lt t'X�?L'tS#?il.,, a. :t t t• ;`= r Scale AS SHOWN W20(Q('1'),these CcmdiOonzs cops.tit•i?te writ-Im noti.re ttf: ? of the amount t,;i sudl IziS;and. it ti<al.,iptitl.ii of the i1telicafi -,4,ref.,:atio .;s. '2i,tl £Ittlt3r kt.tactN?xm Yo--j re. hel'f by farfli r.io4...f�"S.t.>t,.l Drawn DP :hat thL:90-dayapprovr.l pt�rlt?L`I In which you,�a�.pro,H,�l a11�..�.foes, rle�cjlt:atl��ni:Ii�e5e�'r:.t��tnc andEXISTING SITC C D C M ID PLAN Si 1u=10,_Oa Job PD245—LI Sheet %01 Ca i Of N Sheets