Loading...
D-2016-0362 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:D-2016-0362 18641 CYNTHIAAVE CUPERTINO,CA 95014-3873(375 23 003) (D W K CONSTRUCTION) CUPERTINO,CA 95014 OWNER'S NAME: LU SHAAND DONG MING DATE ISSUED:01/21/2016 OWNER'S PHONE:408-644-3995 PHONE NO:408.768-7530 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO' License Class la Lie.#820027 ,� Contractor j D W K CONSTRUCTION)Date fit/6 _BLDG ELECT _PLUMB MECH X RESIDENTIAL_COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9(commencing — with Section 9000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: DEMO(E)1,048 S.F SFD I hereby affirm under penalty of perjury one of the following two declarations: i. 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. 04 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 permit is issued. Sq.Ft Floor Area: Valuation:$8000.00 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 APN Number Occupancy Type: ordinances and state laws relating to building construction,and hereby 375 23 003 R-3(Custom) 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 PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said City In consequence of the WITHIN X ! PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal j[ tilt . T CALLED I `_f_ _ _-I +'— - Code,Section 9.18. Issue «''` 5--Signature' ��"t Date �? i/j Date: l/21/A OWNE -BUILDF.RDECLARATION RF,-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shalt be inspected prior to any roofing material being installed.If a roof is following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for 1. 1,as owner of the property,or my employees with wages as their sole inspection. compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professions Code) Signature of Applicant: 2. 1,as owner of the property,am exclusively contracting with licensed Date: contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and will maintain Worker's Compensation Insurance,as provided for California Health&Safety Code,Sections 25505,25533,and 25534. I will by Section 3700 of the Labor Code,for the performance of the work for which maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Section 25532(a)should I store or handle hazardous this permit is issued. a. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or devices which emit hazardous shall not employ anyperson in an manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I P y Y will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code,Sections 25505,25533,and 25534. exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall Owner ory�utrized agent ,� �f'' 4 be deemed revoked. Date: y. -1,74 T APPLICANT CERTIFICATION CONST CTION LENDING AGENCY I certify that I have read this application and state that the above information is 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 Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Address to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City In ARCHITECT'S DECLARATIOIQ consequence of the granting of this permit.Additionally,the applicant I understand my plans shall be used as public records. understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed Professional Signature Date 1 DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION F-c--( ,ya 10300 TORRE AVENUE•CUPERTINO.CA 95014-3255 ILJP ER--N fa (408) 777-3228•FAX(408)777-3333=buildingQu cuoertino.orqC /��1 r V 3 z,V i.6 0 6 7, PROJECT ADDRESS Q / O b4/ /i+A1T- Ave, / t jw AP" 37 — --.. . —t,e) OWNER NAME /.Im. 14,1 i /N($ — ------77-5c�J . M67 PTiONE `.^t)4 7F`f' 3� E.MAIL STREET ADDRESS.//' ��p (E(K, y, 1 (3 a l /7 d i.k. Ave CITY,STATE,ZIP/c_14 e-rt 1 v/ of s�'? FAX CONTACT NAME PHO]VE ..1,,,,,,,,,,,,._,,,_„, — — — � 6I if`e_ e•. _ CZ )7 g-,7.. , L'�/a 6.6, ,� STREET ADDRESS CITY,STATE,ZIP ,, J� QTarr/, FAX /86 - L--oG'E 4- __ ❑OWNER ❑ owNk.R-atTITAER n OwNERAGENT -CONTRACTOR 0 CONTRACTOR AGENT 0 ARCFSITECT 0 ENGINEER U DEVELOPER lB TENANT CONTRACTOR NAME -7– ./l C- �6 LICENSE NUMEERcy�00 LICENSE TAPLJ E BUS.LTC it r' �)_ G.'7 COMPANY NAME D 14 Y cogs Thu, ,n.,\/ E-MII (bliken �j AFAX. C STREET ADDRESS ,,,,,,pas.--- ! - tj& )4CITY,STATE,.ZI ,r-./ fQj e/7 43 to PH01jE o�� /5,..72g30 Dr.SCR1PTIoftoawoRx r IoP I -en1 512 . S Irny/e fr '>'i Il i-` -e aiA44 c..7"' or- RESIDENTIAL #DWELLING OFFICE IISE ONLY f? FLOOR AREA (b g �'� UNITS --_ _USE ten~ OCC,_ TYPE SQ i.g _— vr�T,;S A i ION -1n� COMMERCIAL. -- FLOOR AREA __ TYPE OF CONSTRUCTioN L#_STORIES 614 eM _ AQMDJOB NVMaett ,,,,,, ,. _ Tor.,.7 ATml; „ By my signature below,I certify to each of the,following: I ant the property ow u o -.: ent 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.r or an. - . '.. ectt atee I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter e above-identtiiTh 1property for inspection purposes. — Signature of Applicant/Agent —__ •Date:--I 2- /6 SUPPLEMENTAL IN RMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT - OFFICE GSE ONLY— Provide Job Number from Bay Area Air Quality Management District svtvrv.baagmd.org @ 15-749-4762. . -PLAN C ECIC TYPE— __Provide three copies of a site plan showing protection for any trees 10"in diameter or more 3'above grade. ❑ 'EXPRESS __Provide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected. © STANDARD _Provide a letter of inspection,tests,and abatement of any Hazardous Materials,Letter to be i iitiated by person(s) LARGE — certified in asbestos,mercury and/or hazardous material examination. ❑ MMOtt —Planning Dept clearance to verify building is not considered an historical landmark.Allow It 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. • _Commercial Buildings Only: Provide Fire Dept clearance for fire suppression/alarm system review. DemoApp_-20i.I.doc revised 03/16/i I CITY OF CUPERTINO B rill FEE ESTIMATOR--BUILDING DIVISION ADDRESS: 18641 CYNTHIA AVE DATE: 01/21/2016 REVIEWED BY: MELISSA APN: 375 23 003 BP#: 8-2016-0362 *VALUATION: $8,000 *PERMIT TYPE: Demolition Permit PLAN Ci1bw TYPE: PRIMARY SFD or Duplex PENTAMATION USE: p 1SFDWL-DEME PERMIT TYPE: WORK DEMO (E) 1,048 S.F. SFD SCOPE FEE ID FLR AREA (s.f.) IDEMORES 1,048 1 • 5404.045: I: ggiV.101W-51:f4:MIZT4:5E:=45ctireg.2.:: Medi Plan Check,1. L j 1'lr.atrh.Ilan Cheek.ek 1 I Elec.Plan Check n i:le tr,Perrraih.lee: Plumb.Permit Fee:: Elec.Permit Fee: O'he°r: ech..1=,.p. Ot1,er;t'lttat7sOther l;lec. l,tst3. 171 Mech. Insp. Fee: Numb, Inp.Fee: Elec. Imp. Pee: NOTE:This estimate does not include fees due to other Departments(Le. Planning,Public Works,Fire,Sanitaay Sewer District,School District,etc.), These fees are based on the preliminary information*available and are only an estimate. Contact the Dept,for addn't info. FEE ITEMS (Fee Resolution 11-053.Etr 7/1/13) FEE QTY/FEE MISC ITEMS Pkm Check.Fee: Sup?". PC Fee 4 Phonb../MechlEfec Permit Fee: $574.00 Suppl.Insp.Feer Reg. Q OT 0.0 hrs $0.00 .PIrarnh,/=l1'ech.; .lec Pltirrt .; echt: E ec;Permit Fee: Construction .4clminislr e.itive Fee: Work Without Permit? . Advanced Planning Fees: Travel Documentation Fees: A Strong Motion Fee: IBSEISMICR $1.04 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS $576.04 $0.00 TOTAL-FEE: $576.04. Revised: 01/0112016 \i,..,/ PROCEDURE CHECKLIST FOR DEMOLITION PERMITS VCOMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ,,,1.1 9,,, ALBERT SALVADOR,R.E.,C.B.O.,BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq(a)cunertino• .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 along with each of the following requirements as it applies to your specific project., E=n"'1. Three(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) 1 3. Provide Job Number from Bay Area Amir ua ''ty Management District www.baagmd.gov @415-749-4762. '- / i[/.I' - f(i 4. 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. li i % 6. Important: Prior to the issuance of the demolition permit, the applicant must call lie Public Works Department at(408)777-3104 and arrange a"habitable dwelling" d inspection. ,( lad/i- • 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. De7NoProceduj e.doc revised 2/13/13 . 1 ' . Fli Pacific Gas and , ,,, - Electric company 10900 10,131eney Avenue Cupertino,CA 915014 DATE:_01121/16 CITY OF CUPERTINO 10300 TORRE AVE OREM-I:NO eA 95014 SUBJECT: REMOVAL OF GAS SEM_._ n . M4liLN,1-IN THE STREET ON: 18641:Cynthia Ave. on 01/11/16 SUBJECT: ELECTRIC SERVICES WAS CUT AT POLE ON :- 18641 Cynthia Ave on 01/19/16 if you have any further questions,please contact me at (408) 725-2.07.6 Sincerely, IVIarkI Kennedy Pacific Gas & Electric Company DeAnza Service Planning 408/725-2076 , .. . ...._ - .......... • • . . . -,,.K sy..., .... . opt 0 so . a-< - L- ''.- )=" 0 0) • n ° LII3000000°;-1:100001:10004"'• g • Pi Ili ""4 PI P5 0 - ..--,c) 1..1 C.4 • o - • - - . 2 rgi 02-. s zir -,5 a sal r-u In cl• .g.' FA Q) 13: FD i ' ' q . -'°- 'C': 0 > ..-..a a 7, \ 0 o Vri- k 1--f • c,Iv Ch • =''''' -b t•-3 t=1 co tzi ..4*-H. 0 .,`; 10- 3 -a . -.."..:i'VR 15117A- '-g-g,V7,1' .a-• 761,f4335 aFT., ''4-, • . 2- • \ . -- -- til>.•- -4-Ild 1,--t tzi 1 -0 -10 = •-• . .;-,V..g d • - ›,,,•,,----, 4-0 d A.4-r. 0.- • - -4.: - n0 :,7,-:?'-2-g 1 8.°"0 Fi .3. • Q - - ' > "Z-5 4. 1/ ^ • 6; X .. - . -t-a .C7'4 Z Ir<MI • • • - 2 om - P P D O. -0, m • • ..,.. CO 0 . H:3:192, [I_./ E 53 2,..• 2 1 . -.3 m , . - 1 t--3 • . . . . .1. , . • 00013U000 D,- 00000013- a-0,...m .. -. -- •_. .xl. . 01._ .NI = • , -, • . J., 9,.. n ' . cri CI 1.-,1 - .0),c?la li?0.1 ,, _ •<'... . . — 6-°.=.B•.=.04 3 m 6'2.--,-3 4s,: 3 - . r ---..-.Hai ...,... • - ';', 2.,,,,--R--9,2 3. <14 3,i 3-1,-.2--R• 3 _Rt. o. in i., td .CD La • ,T, 'ID CD . • 0 .,. e • k-fr,- gEvE --d r > o •••-• - g` 3 -61-1-Rxxs: -P-;' .3.c-7)-a-'RJapi:a. . i ----az , = - • P- 0-:.-03N•Vg,tg..1 §,i c1:2-7,41.g 2 2:Eg. -, 4 2-2..13 - P Ei tn 0 tr./ Pa 0,) - 0 .„0! co .. 2- g i -0 ICD g. : V 0, 1 . 13 . ' 0• -''.'' 0> --.. = a ....- u 11.,0 irD Ili • . . .-A. c -T-i W •'5523. 3.; [1,3 .a ---&!*•-• CD Cr, ' 2)...1: "yrr- • 35 u? '-a M • CD = ' : 0- D. ; -MC CA . • CI . •on (D ., rrk s.ni rt .41. . . , gl. i z • Eits 0 'ID •11. ': t xx a . = -..,. n.41' - g -'• . . . ; •F... kf„_„: -0 • • = 7-5., -• ; • - - •= - a - 0 -7." ' . ' ' • ,, i .00 D- Er E. gi - `-' , : - i s :r7. . -h a.' ....C.' -. • . . •Z1 CD - • -,:E i 6 , Si - .8 mra. • - g, c c.... • e - - •g:g ;•:-..<-=' . ---.; - z ,, 00 -5- . ,N...=, a -,--, • , ••Z'• a 0,-,-"' -• a 0- • --z..... ,... . g ,„ • - — :- - ,. - - •-.6 5`-., ::'Sla "* Ls') '.. ' OM a ‘; . -,..s. • a -.:.! z I- 1 _t 1 , ZM 0 . .. ,r,. < ., Q a =. . -2 • ' .r.,... ,,r, •E)*0 - ',../"' 1.4 t--t•-,..1.11 Ulf C) ; . . - . f•i`.‹ pry - , . F.--N---- et- • I- 0_.>a ---:-.- ' B . .s-,•'--, a z-, - • • . - - I -, $1.1 — - a.g Hi a a - • -- . (,) co 0 0,E•4 c.„,..., P.-4 1,-, ' 0 . - a.W.1'1 .1,- a -''' r,. ••g• r7i, . 8 pa i Om 0 . :- ‘q:'A' e,g ,- :-,t ';, rn- :co : • . CD .. .. . i •X,..M , -.--7-. e ca D ' so a :a ,.. . a x, -.; :3 1 zcoo - s''-1:Lii-15:-.I P c../1 v..> 1 . :•-o›- .,. . -,v. Ei ,,D - ... -< • rn* 33 g•- .. 7 4-,--= g_ a-' . -. " =13) .9> ti) A°T'g -g `;°. 11 • - j.....• 42 I • CD ..-. :„ : tul tx.1 rt I-%Oa 1--4 12•Z 074---+ ic irl Ef li tr Ox-0 • = ..- - - - -0 . 0•.. . -ri'' i .i T.,.. 0._ H -I 0 . . 1 ..- 130..4•••0 C z0 -h 9 "7 Eir. - • - ‘.:7' !•6 1-*. - ILI 0• • 9 3- .% 1-7, EsZ C.. - . :- °- .1, -ri.%) • 41 - .p c - 0. 41) ‘'-• - ID iti . -e -= 4.D. -1K > ...... a - .-,- i, Ser, q..2 ' • i Om Ct • • • - 11; '* 0 : • -cl - 0 5 - 1-a-•VI V Ci3 . m.---s - '..-- . : .=.. ;,: .... .- . cl,0 • ......... • - 1--i•r-,A I-4 tt • ,. . r-c4)ri" . .:- -,-g: .`1•g= 5 E s ' - . •• -.3 2g .-_,, A .,2 • ' -El i-05. a , :. 0 z, --..„ . - E - S 2.:. g• • . .-,. „.....,..,-1,...S- , 11 o)rri al •- ,...''''''i _ s.,ja .: ...,;.,,, ., ,,......I .,,,.%.- c . • 0 . OM • : g---$.'-a g 2 : • . !B Ci) . , HUH *C . - • ' ! . ile„I M, : - 03 1.4. ': .t ct , > HUH - •a • . Cr • > > • I-4 • g.', - Coo .. • . • , • 'z• , I ro ' co • I * 9z • H.7., C 9.R .2 8 R3 : a LE • • •A• : di 64'El.a.:E • - : • _ . 32,19 • (3 3 c'''' it :-OA . :g R. WE•, .9., rg-: - : ' : ' '2. :7, zi -i . 0_ . • :t 0-- gn • CD g.‘..-, E . .3 cr .4: •a 0 2 -' '-''' ,. - .p ;:41- . -6 5' <1, 0. ' - . CD'CD . 1 - ' - . - .- . @ Et- -E.:g::,., • . . -• - r " ° -' a , „,.-. r'S-r-- ' • E-.13 ,,,. - - - . - ....: • - -- .-;.:,--st a - ,,;, ---, - . , - • ,2 :.F, . -, .o. . • F.-1 t--1,1-W : • . >. ..c°41. 4X3. IN-.) I .4.•@ g E.,..,-, a m .: : -'irf 7•:-D le, .0:..2,- • 4--r,..)to-- -< -c,-• -a -,,. -F.- , - . ••• •• ---;..• • - Lt- ri• M)I 1.4-to -gal: . :. ca..!0, • - co cy; .--, . C)-0-4:› . - I 6- ''7. u. ;.:: il.. 4:cicz : - : tm 0 c. ) ta r....n 0 c,-) ,-.,5 • -Er.9 D.) C CD 0 . rp f./-1- 4.-.P- - . al (JD I a • , •P •f".. .."'-i° N' _<,11 ,C3 71 E . -. • 13 . . .i7 ' C? ' 5 5•'5 11 ;z co 5' ' '- 0 R --.. (r) • w -..•3 ;' i : 7 i r' ' •01 qg ',1 -1 i . 1? • la 4 fi,,, . .-.0 0 0. i -O. •CD 0 ! ?"" .r"'"•e Z 1 ......:1 i ...,4,g Pr -4= u ; ;,, 0 • a • • o f:-.11 ca . . 6 Pti Pr a 2 . -5. - g. . '''ei ' .R a : tO ID coo- c-r 5' a . . -6, • ql.-•< 5- .5-, 41 ' .$ cs IT; Ff w. fn. q • -. .,.,-..- - • t---. 2 2 E. - -::ei• - •I ;5.75 4:::, .• • . . W ti) 0 , ' 47 , @ ig Li ; • : -rn I, !!...)03 9 - . .., .., - w • - s..„..,...,......, . . • - - ( ' t...- c".0 0 • 0 00.13 P-- ....-- 17 j2 - -0 • (0 0 T _i- i 0 0 0 ' t-.3 H P-3 tzi i-.3 i-c, - a 0 _ -4 -‹ .: ' ' II C .; trts • — a •-••to •,3• :=. t r. : 2 :2 To\.: . . .:T. ....0.-.. !- .wo, . ' ' '=0>:1"-1=_W - - Z H. -. 0 . c -M :l . 2 tv = • rn EL- = . ,,, -r" . IIWID',1 ' - -5- 3- .- 13- i ... ro -.6_ ..:•,..... •4.;.,,,,, • _ .r, - - - cia>-- r,'D En 0 . - o ; . 2 IF(-) DA -9, --,-‘ - - ', -r ‘,. z z ..„ . ,.„. cp - 3 . -0 , s .- ,,< . C.. '''- 1.• . ° ' r = 10 C lo 3: 79 -1 c tia • m g- 0 (0-- c.„\\ I ca -1\-) -a • ,-7.-E c i t, L• I ,,Ik F - .0, -I. i ' -V.:: til .< -2: i 0)5' 0. • •11 .4-5, 0 : -,• „4, z . ...,. '" 1- ,„.... il --, i.ed ,) '''' a : - zo< Nai.',"--' r n' . . 0: Ca' t4 • - • 1-4 - - ---- - ,-- ,. ' CY ...... 0 Imt. 1)B . , cl 0 o - § ._.°", CA 0 , 19„, ,..,_„..-; g g A -,, - . : ›. -.. - . .ra ...i " 0 ,.,1 .1. ' 0 . =•• c - ;ti__.h. ..,‘ N • -0 . - -- yo • ' CD ' 1.....r. r _ M 1 02 7\g- . . Fi = c" ••x - 0 For _ Fp -U1 -• \-E.- 20) • <1 114',..., - '"I a is i . \\ § = • .9 ao- 3 1 -<° LT. - cil 99 - . 4. . !N . 5- - a ,. - ., 0 . 44- • r°2- . . Of ...-:,. ...'-' -r..R , .4 . = 7 ,.. - .: e , •. .: c. § C- c:D. 0 c;,0 0 ........ I _ ..- -- -.. - - . .. ..\\..,, , . - --Mrivge: -= Regulation 11,Rule 2 Moo COMPLIANCE & ENFORCEMENT Acknowledgement of B A Y AREA Notification and A.[R QLJAL.UTY DIVISION Payment of Fees IVI,,A.NAGEMENIT DISTRICT 12/24/2015 DWK Construction Job No:45076 1308 Maria Way Invoice No: 38,175 San Jose,CA 95117 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 18641 Cynthia Ave Cupertino,CA 95014 Start Date January 15, 2016 Completion Date January 29, 2016 Removal amounts of friable ACM 0 linear feet 0 square feet .0 cubic feet Should it become necessary to revise this plan,pleasedoso in the spaces provided below and immediately copy the District by fax or by mail. REGULATION 11-2 REVISION BAAQMD J# 4S076 REVISION if START DATE COMPLETION DATE 1 / 1 / / 2 / / / / 3 t / 4 / I l l 5 1__ / / 1-_ NOTE: This form is not intended as a verification of either the completeness of notification or of its compliance with BAAQMD Regulation 11-2. If you have any questions about this acknowledgment,please call our office at(415) 749-4762. ' . K 1 5pj MT City of Cupertino �!_ f Public works Department } ,_M Environmental Programs Division w,,1 fill 10300 Torre Ave CuPERY.iNO GHEEN Cupertino,CA 95014 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. 1RecplogyisPze only debris bin service provider franchised to do busniess in Cuper in l :..:.,,k,-„g , :t do•t.-- . S:.... ;,.�t _.xi..i.,,,''�sx -4z...a--,--.;: :.... '.i.4.:i..,......,.._m.,—,,_:=- .r;w. .• Grua.ma•.•eK•.az+..,-Yca¢,n:.,.,. Debris from a project 3,000 square feet or more in Cupertino can be collected and disposed by using: r; Please check all that apply: D I arra not in Recology e than 0 . l l o using a debris bin,however,the project is less t n 3,00 s.f., e.g,buildings,patios, i4 1 sidewalks,driveways. 11 l —II 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 17 1 am not using a Recology debris but 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: 1 IAsk for the Construction &Dec tolition Recycling Packet from the Building Department and P complete the following~ ,1 ✓ Submit a Consti action(Ind Demolition Waste Management Plan with your building pernut It It application.No feefor this plan.Forms are available cit the Building/Public Works counter and online ill at www.cupertino.org/eavironmental.tino.orb/em'ironrrientaal. Report the tonnage recycled and disposed, by material type. ,II g' Recycling facilities must be Selected from the City's appr°oved IIsi of Recycling Resources, € 11 1 >f Submit ca Construction Recycling Report form. The report is required before the Building l ti Department will schedule a final inspection. The report form is available attire Building/Public ! 11 Works Counter and online www.czrpertino.oreenvironiaxental. it ..• v"sti .1 agmtva[7.IM:3'""hum'e:5 filK" £i4f= .`ti-•,:,, ._- v,,-,.1.. 3k. Wt5'ML=AVS9'+,Ki14' .Z...aetmFL Y SBE1fisfis:M F3, -3. M 7m-. " '—.t.,..-e:mk-mNm-pc.i:FSg Signature: �' 7 Date: e -f//6 Name: (printed) ji. f p e L s 64 E . Title: l Phone: ( f ttac5')'76R 72.3 "t'� Project Address: f 8611 - a Yt4'-vie Ave• C.,..t a -rf'�-rxv c4-7 f 4 _ d This form to remala in t e.projeci's buildiiigpermit file for the duration of the project. 'Remised 317/12 1 r ___.„ • . , 0 •11166...._ 1 NO ATT.Ct1MENTS • 1 +R1PL1NE j f 4 {{ • 4 SIDES ITTR! /•f •• t 70 BE KEAY ,��?la . A. =' da , `�°y �€ W��lit� In'8" ,i 5 •• EXISTING GROUND, •if ••• R; 'f..- g O" • %i'NOCK OR EQUAL o.o ID*DIA, •TYR POST • ELEVATION • NOTES3 • I. THE ,DEVELOPER SHALL INSTALL THE " TREE PROTECTION" DEVICES PRIOR TO THE START OF GRADING OR CLEARING WORK. • 2. THE CITY RESERVES THE RIGHT TO ISSUE A "STOP WORK" NOTICE IF THE "TREE PROTECTION" DEVICES ARE NOT INSTALLED OR IF THE • 1 DEVICES ARE NOT MAINTAINED PROPERLY. 3. SEE THE PROJECT GRADING PLAN FOR SPECIFIC TREES THAT REQUIRE PROTECTION ALL SPECIMEN T.REES REQUIRE PROTECTION UNLESS • OTHERWISE'NOTED. 4. NO EXCAVATIONS WITHIN THE "TREE PROTECTION AREA"ARE ALLOWED • • UNLESS UNDER THE SUPERVISION OF A REGISTERED TREE SERVICE COMPANY 5, ANY FILLING WITHIN THE "TREE PROTECTION AREA" SHALL BE DONE IN • ACCORDANCE WITH A DETAILED IMPROVEMENT PLAN APPROVED BY THE CITY. S. NO TRIMMING, CUTTING,OR PRUNING Oft DESIGNATED TREES CAN OCCUR • WITHOUT A. REGISTERED TREE SERVICE COMPANY, T. CONSULT ORDINANCE 778 OF THE CITY OF CUPERTINO FOR PERMIT REQUIREMENTS AND EXCEPTIONS. D. TEMPORARY CHAIN LINK FENCING IS AN ACCEPTABLE SUBSTITUTE TO THE WOOD CONSTRUCTION. • TREE PROTECTION STANDARDS APPROVED BY ; L ._•1 �tli.l T, DATE ; .4 ' NtE- 0 4 L-U mu r7oNG� a'Mrnrrn yG.:11, ��ifific Dmnrtr Evr 6IY Gr eui u::App>2 5: /Nu/ Lya+4i Ave; GuPe-rh'�se, �y ir+ r r, 7 ^j csar%y /douV-e 2c o/ R"C cair tl F LiaScope: Devna6r-1, e—Pit'sfi,j fern S;'e le UStato„„itatf,,- tyertnri t f NTS 1'o m,:;'an V``"c✓IHui Jcr£CN'ctal.nnorthtn p , < h nS^ a''fd07 0 w.+ ,` of^- W b SCOPE OF WORK LEGEND: 1188511 Umj _. -- -at dr .r__— to— pir-- 1it. — pis ��5v_ h\1 �o�N AE '_ y w p II Ail z 18E411 I= Lii 2'^` T: ¢ 1 PEVIS/ONS BY If' :--111 ''''°'''' \ ,P' ki-iL ' '''.'. 0--.5 tilkiallik., ` „ i m Vii, H 3AdV ati k g ",�-#, ii a Wil 'ti 11 (IL 88311 RECEI�VEJn..AVq;=P„ - N0.9TH- — op— EXISTING 1 DEMOLITION PLAN 86-41.3116,1,6 ,w A2 r RECEIVED Building Department DEC 16 2017 City Of Cupertino 10300 Torre Avenue $0, Cupertino, CA 95014-3255 BY Telephone: 408-777-3228 C U P E RTI N O Fax: 408-777-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: /g6M/ is �r� AvePERMIT# /_�1 b coo 4 OWNER'S NAME; Lt( /NG1 PDA/0 PHONE# 4 39 0 3 9 • GENERAL CONTRACTOR: Dbt) o`!S't 8fi� 4BUSINESS LICENSE# g`n y 5 %' P`f ADDRESS. 30 (, -N / O E: 5 6 *Our municipai code requires all businesses working in the city to have.a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CIJPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: V SUBCONTRACTOR 1 BUSINESS NAME BUSINESS LICENSE# Cabinets&Millwork Cement Finishing Electrical rico li�siT A.e 17-i 4933 / Excavation -=��� � ,� � Fencing • Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating Insulation • Landscaping Lathing Masonry Painting/Wallpaper Paving _ Plastering /VIA'.eS gG /�j uA'itfer-3 ,0 % ( Plumbing Roofmgers j ` l Septic Tank Sheet Metal M Sheet Rock IC Tile Owner/Contractor Signature Date