14030094 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10033 SA1CH WAY CONTRACTOR:'!;[LI X PERMIT NO: 14030094
C a/t/lep il1v G77 O^-1)
OWNER'S NAME: DIANA TAYLOR TRUSTEE DATE ISSUED:06/26/2014
OWNER'S PHONE: 5592712167 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL
SAICH WAY STATION-COMMERCIAL DEMO 8,883 SQ FT
License ClassLic.# Ire ;5ZY BLDG 2
Contractor L 1150yy 6 4Date 2& r t
1 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:
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. Sq.Ft Floor Area: Valuation:$10000
1 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 APN Number:32632041.10033 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is PERMIT EXP ORK IS NOT STARTED
correct. 1 agree to comply with all city and county ordinances and state laws relating WIT 0 D�� RMIT 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 DAY T 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
granting of this permit. Additionally,the applicant understands and will co I Date: (, /
with all non-p int source ion er the Cupertino Municipal Code,Section
9.18.
/ G RE-ROOFS:
Signature Date ts' 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
Lyvw inspection.
❑ WNE -B ILDER DECLARATION
Signature of Applicant: Date:
I 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
1,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). I 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 I store or handle hazardous
[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 th upertino unicipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sect s 3 d 25534.
Section 3700 of the Labor Code,for the performance of the work for which this r
Owner or authorized agent: 171 Date
permit is issued.
I certify that in the performance of the work for which this permit is issued,I 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,1 CONSTRUC ION LENDING AGENCY
become subject to the Worker's Compensation provisions of the Labor Code,I must I 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 I 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,Scction Licensed Professional
9.18.
Signature Date
DEMOLITION PERMITAPPLICATION -
l\u�
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION (�„V
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 N�
4;VPERTINA (408)777-3228• FAX(408)777-3333•build ingCcbcupertino.org \
A.
PROJECT ADDRESS 10033 Saich Way APN# 326-32-041
OWNERNAME Diana Taylor PHONE (559)271-2167 E-MAIL dmm.taylor93722@yahoo.com
STREET ADDRESS 5539 W. Bluff Ave. CITY, STATE,zip Fresno, CA 93722 FAX
CONTACT NAME Tony Gonzalez, SiliconX Construction PHONE (408)418-0099 7
E-MAIL tony@siliconxconstruction.com
STREET ADDRESS 2051 Junction Ave., Suite 100 CITY,STATE, ZIP San Jose, CA 95131 FAX (408)453-5636
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT I9 CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME Tony Gonzalez LICENSE NUMBER LICENSE TYPE BUS.LIC#
COMPANYNAME SiliconX Construction E-MAIL torly@slllconxconstructlorl.com FAX (408)453-5636
STREET ADDRESS 2051 Junction Ave., Suite 100 CITY,STATE,ZIP San Jose, CA 95131 PHONE(408)418-0099
DESCRIPTION OF WORK demolish existing 1-story commercial building.
RESIDENTIAL 4 DWELLING OFFICE SE'ONLY
FLOOR AREA UNITS TT,1F OCC, TYPE so Fr VALUATION
COMMERCIAL 8,883+1-S.F.
FLOOR AREA
TYPE OF CONSTRUCTION 4 STORIES 1
AQMD JOB NUMBER # RECEIVED BY: , TOTA�1640190—
J 0
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 of Work and verify it is accurate. I agree to comply with all applicable Iocal
ordinances and state laws relating to building construction.j authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agen. Date:
SUPPLEMENTAL&ORMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT OFFICE USE ONLY
Provide Job Number from Bay Area Air Quality Management District www.baaamd.org a 415-749-4762. PLAN CHECK TYPE
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. El 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.docrevised 02'13'13
CITY OF CUPERTINO D
FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 20803 SCB DATE: 03/17/2014 REVIEWED BY: IMendez
APN: BP#: N-0 "VALUATION: $10,000
'PERMIT TYPE: Demolition Permit
PRIMARY PENTAMATION
USE: Commercial Building PERMIT TYPE: 1COMMLDE i
WORK
SCOPE
FEE ID FLR AREA
s.f.
1 DEMOCOM 11,833
NOTE. This estimate does not include fees due to other Departments(i.e.Planning,Public Works, Fire,Sanitary Sewer District,School
District,etc. . These fees are based on the prelimina information available and are only an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 11-053 1%l3) FEE QTY/FEE MISC ITEMS
Permit Fee: $1,391.00
Suppl. Insp. Fee:Q Reg. Q OT 0.0 1 hrs $0.00
i
Strong Motion Fee: 1BSEISMICO $2.10 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $1,394.10 $0.00 TOTAL FEE: $1,394.10
Revised: 01/15/2014
DATE: `3•--19—
Pacific Gas and Electric Company
Customer Service Planning&Local Design
10900 N.Blaney Ave.
C.ipertino,CA 95014
RE: GAS ABANDONMENT REQUEST
To Whom It May Concern:
I,request to have a letter sent to the City of Cupertino,Building Division, 10300 Torre Ave, Cupertino,
CA 95014 to verify the removal of the Gas and/or Electric Meter(s)at the following location.
SERVICE 20803 Stevens Creek Blvd Cupertino, CA 85014 CROSS STREET:
LOCATION r l -�Syaiich+Way
APPLICANT ...... y.n...".�.! ....! .`. [ .'..�3...CR.I. ;...N.. �.,,1.s.?..m.�,',`.. !✓ ..1�I.. .I/�.��. �.,.: .
ADDRESS Q. .`...... tilC.-;; O L...,.. V ,j.. .j.U..1< y. .�,�.�J.�..J..........................................
!+MAIL 1 1 �C�- r. :4`�.[ �?...`.4. y}t.,l,t�..J.J,. h PHONE ^40. ..:'G5..3 ..
CONTRACTOR I. .r. .C�. 1Yc�..1 .?.Nv. ..l..!`M.{,! .U'.r{,1... .'• .4...................................1.1,.................. ................ ..
ADDRESS .fr.4��..L..bA. „a.I�LC�T�i.Cl.N..../%Vr .......................:................................................................I........ ..............,....1...........
Eh1AILCzl�4 .@� [� t. ..D�IIXLUY)!` `C1ZU.G '.�C,.fa,N'I.. PHOHCI. i..... 1. .. . ,.
ACCOUNT# ACCOUNT IS: ❑ OPEN l� CLOSED
PARTY RESPONSIBLE FOR BILLING:
4 APPLICANT la CONTRACTOR El OTHER:
REASON!FOR REBUILDING YES 0 NO
ABANDONMENT: 3111.LDIt46 -rmoc l-rt ON
NOTt: Abandomnent fees are at customer's expense and is collected prior to construction. DO NOT
SCHEDULE DEMO CONTRACTOR UNTIL ADVISED BY PG&E OF CUT SCHEDULE.
FOR OFFICE USE ONLY
GAVE I MAILED APPLICATION TO CUSTOMER: ❑ YES DATE: ❑ NO
PG&E Cleramwe.doc re Wd 03127112
Pacific Gas and Electric Company 10900 N.Blaney Avenue
Deflnza Division Cupertino,CA 95014
1 r
City of Cupertino
10300 Torre Avenue
Cupertino, CA 95014
To Whom It May Concern:
SUBJECT REMOVAL OF ELECTRIC FACILITIES
The secondary feeds from electric transformer#C2094 have been removed
and/or abandoned at:
20803 Stevens Creek Blvd & 10061 Saich Wy. on 6/21/14
If jyoh ve any furth questions, please contact me at (408) 725-2146
SPonce
r
Service Planni Lg
DATE: "3—n— �-�
Pacific
j•—n--
Pacific Gas and Electric Company
Customer Service Planning&Local Design
10900 N.Blaney Ave.
Cupertino,CA 95014
RE: GAS ABANDONMENT REQUEST
To Whom It May Concern:
I.request to have a letter sent to the City of Cupertino,Building Division, 10300 Torre Ave,Cupcl lino,
CA 95014 to verify the removal of the Gas and/or Electric Meter(s)at the following location.
SERVICE 20803 Stevens Creek Blvd Cupertino, CA 95014 CROSS STREET:
LOCATION Saiich Way
APPLICANT0.•IaIC..n.. �� (( .!Y...L.r. l/.. .. ...1.r.l..m.� !✓.....�1..�.. 1♦.�rl. i1...: ,. .
ADDRESSQ. ....... : .!.t`I C.- O]�L...... U ..j...,�,j.Q. ...I.� ...,j ,,).� t.................... ...........................................
EMAIL l.y..\, � :4`. ? !.`.�. - ?. J.. J PHONE .C?. 9.`...`..,3......14700...............
CONTRACTOR. .r. .Ly.+1i.`ICZ...l .t ..l..S"�/.Cl !Z .. .►..................................................... ................ ..
ADDRESS .. .. .. A.�„�.I C. .Q. ..../~��L ............................................ ..................................................................
..............
EMAILI.. PHot�Er . .. .. �. .. .+ .
ACCOUNT i1 ACCOUNT IS: IJOPEN I� CLOSED
PARTY RESPONSIBLE FOR BILLING:
1 KAPPLIGANT 13 CONTRACTOR ❑ OTHER:
REASON FOR REBUILDING YES 0 NO
ABANDONMENT: 14(v V U—Wou-aON
NOTE: Abandomnent fees are at customer's expense and is collected prior to construction. DO NOT
SCHEDULE DEMO CONTRACTOR UNTIL ADVISED BY PG&E OF CUT SCHEDULE.
FOR OFFICE USE ONLY
GAVE 1 MAILED APPLICATION TO CUSTOMER: 17 YES DATE: ❑ NO
PG&E Cleraeuce.doc rei,Udd 03/27/12