The URL can be used to link to this page

D-2017-0054CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: D-2017-0054 19200 TILSON AVE CUPERTINO, CA 95014-3529 (375 40 06 1) RADIANT HOME CONSTRUCTION LLC CUPERTINO, CA 95014 OWNER'S NAME: LEE. JOHN C AND NGUYEN NGOC DATE ISSUED: 08/14/2017 OWNERS PHONE: 858-774-2413 PHONE NO: (408) 888-2898 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #856154 Contractor RADIANT HOME CONSTRUCTION LLC Date 03/31/2019 —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) ONE STORY SFD (1032 S.F.); ATTACHED GARAGE (252 I hereby affirm under penalty of perjury one of the following two declarations: S.F.) 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 pe ormance 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 Sq. Ft Floor Area: Valuation: $5000.00 \ permit is issued. APPLICANT CERTIFICATION 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 375 40 061 representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to s ve indemnify and keep harmless the City of Cup rtino against liabilities, jud ments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue gainst said.City in copse uence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, t applicant understands and will comply with all non -point source regulati s per the Cupertino unicipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 'log on. ture Date 8/14/2017 Issued by: Abby Ayende OWNE Date: 08/14/2017 -BUILDER 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 roofmg material being installed. If a roof is 2. I, as owner of the property, or my employees with wages as their sole installed without fust 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) is 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: 8/14/2017 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 permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 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 andle hazardous shall not employ any person in any manner so as to become subject to the material. Additionally, should I use a ipment or devices w ich emit hazardous air contaminants as defined by the ay I=Air Quality M nagement District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the pertino Municipal C de, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, ections 25 0 , 55 , and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. er or authorized agent: APPLICANT CERTIFICATION Date: 8/14/2017 1 certify that I have read this application and state that the above information is CONS UCTIO ING GENCY 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 Si nature Date 8/14/2017 9 Professional . 0-Z® ►q--obg� DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 C.UPERTI'NO (408) 777-3228 • FAX (408) 777-3333 • building(a.cuoertino.org PROJECT ADDRESS /Q 1 �V �1"�+� � i/.uprre 1 !1 � i;R I �J d l $ "�w�v,,J JY /V APN # 1 VE f /.Ave OwNER NAME �S/o' G� N C PHONE ?r -719 �- 1H3 -MAH, 'Nu ho c�� , +nenn l ,1•r Ise, ? l I Vp FAX CONTA NAME F C�1)eC C' P10 d / 016 c �c %t7 e SS�y P& CU VZ,)P� 93 FAX y� ❑ OWNER ❑ OWNERBUH.DER ❑ OwNERAGENr CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER 13TENANT CONTRACTORNAME, L IQI1�Bflt 7 LICEN2TYPE BUS. LIC #/00 -1/� � N %o E-MAII r�►e�I 0-6) 6 @,� t l ` O' / FAX �AxX n C ORS C � WORE a r CrTY,SjAbE 23P Pt�o�N L,9� V 0 d FJ Db°fid` hove o�'c' drive wa Cts -W , CS2, RESIDENTIAL #DWELLING OFFICE USE ONLY • r, . , - `. , ."., USE oce. TYPE . ':SQ FL� VALUATION FLOORAREA UNTrS COMMERCIAL FLOORAREA TYPE OF CONSTRUCTION # STORIES - AQMD JOB NUMBER `- RE BY TOW VALUATION _ By my signature below, I certify to each of the following: I am the property owner or authorized agendo act on t6 property owner's behalf I have read this application and the information I have prqwded is c I have read the Description of Work and verify it is accurate. Iagree to comply with all applicable local ordinances and state laws relating to build' g co I ooze representatives of cupertmo to enter the abovo- entified property for inspection purposes. U ::1 Signahue ofApplicant/Agent ! Date: RBUPPLEmENTAL lNFoRwmoN3REQumm PRIOR TO ISSUANCE OF DEMOLITION PERmrT OMCE USE ONLY CHECK TYPE fPLAN P' vide Job Number from Bay Area Air Quality Management District www.baagmd.orQ @415-749-4762. t/ P vide three copies of a site plan showing protection for any trees 10' in diameter or more at 3' above grade. I ❑ STANDARD Provide letter from PG&E (408-725-3325) stating all gas and electric has been disconnected. �� ❑, I:ARGE , arming Dept clearance to verify building is not considered an historical landmark. Allow 10 business fkyswoR Pro 'de letter of clearance of all vermin from a licensed pest control contractor. / ) 7 I cp c t lall call the Public Works Department at 408-777-3104 and schedule a "habitable dwelling" inspection. k u l Provide signed Debris Bin and Recyclable Materials form , o �� Commercial Buildings Only: Provide Fire Dept clearance for fire suppression / alarm system review. I 4 DemoApp 2016.doc revised 03/29/16 Ad mss ] (d-00 I; JEW (-N-e. , � u�eR,�r✓ , cp Y `U0 '','Dl- WA I < p�Ne W ay amu& --I o �f- C�� I 1 I A SGwcr- I waL. =�cfr ca I panel 61) dw rc► lam' coca Q -tom Scop- of ,ort �n�)N � DeMv Ick �,ls�n �v2 Mian (; C►'r) r.VF Cif) lo(8') en,F;(e A