The URL can be used to link to this page

12060076 CIT 'OF CUPERTINO BUILDING,PERMIT BUILDING ADDRESS: 20680 HOMESTEAD RD CONTRACTOR:SOUTH BAY PERMIT NO: 12060076 CONSTRUCTION,INC OWNER'S NAME: THE SOBRATO ORGANIZATION 1711 DELL AVE DATE ISSUED:03/20/2013 OWNER'S'PHONE: 4084460.700 CAMPBELL,CA 95008 PHONE.NO:(408)379-5500 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:. RESIDENTIAL El COMMERCIALE] License'Class L'ic.# � DEMO OF EXISTING CARL&JR;2854 SQFT **SEE NOTES** • Contracto ._ Daltr l hereby affirm that I am licen;oUilloffuo'-rce.and der the pro sions of apter 9 (commencing with Section 100ivision'3'of'the Business&Professions Code,and thaLroy license.is in effect. I hereby affirm under penalty of perjury one of the following two declarations: Lhave.and will maintain a certificate ofeonsent to self-insure for Worker's Compensation,as provided for'by Sectior0700 of the Labor„Cbde;,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$500000 [have and will,maintain Worker's Compensation Insurance;as provided.for by "Section 3700,of the,LaborCode',for the performance of the work4or'which this permit issued. APN Number326106.1.20680 Occupancy Type: • APPLICANT•CERTI FICATION .1 certify that:1,have read this application and staie,that.the above information.is PERMIT EXPIRES IFVORK IS NOT STARTED correct.1 agree to comply with.all;city and county ordinances and state laws relating WITHIN 180 DAYS OF 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 DA ROM.LAST CALLED INSPECTION. indemnify and keep harmless the Cit of Cupertino against liabilities,judgments, / costs,and expenses which may- against said City in consequence of the granting of this permit: Ad ona the applicant,understands and will comply Issued by: Date: w'h all non-pointsOur, eg ons p rthe Cupertino Municipal Code,Section 9. RE-ROOFS: Signature, Date All roofs shalfbe inspected prior to any roofing material being,installed:Ifaroof is installed without first obtaining anninspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION/ � Thereby affirm that.1 am exempt from.the Contractor's.License Law for one of Signature of Applicant: ;Date: the�followiing two-reasons: ALL ROOF_ COVERINGS TO BE CLASS"A”OR BETTER l;'as owner of the property,or my employees with wages astheir 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;herebyaffirm under penalty of perjury one,of the,following,three maintain compliance with the Cupertino Municipal Code,Chapter 912 and the declarations: Health&Safety Code,Section 25532(a)should'I 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 forby Section 3700 of the Labor Code,for the air contaminants as defined by the Bay ea.Air Quality Management'Distriet 1 performance of the work for which this.permit.is issued. will maintain compliance with the fCu�' _ Municipal Code,-Chapter%12jand- I`have and will maintain Worker's Compensation.Insurance,as'provided for by the Health&S ety_ Code,Sectio55331,and,25534. Section3,700 of the,Labor Code,for the;performance of the work for which this Date- permit is issued. Owner or authorized ag' Date• I;certify that in the performance of the work for which this permit is issued,I shall not employ any personinany,manner so as to become subject to the Worker's Compensation.Iaws:of California. If,"after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY become;subject to.the Worker's Compensation provisions of the Labor Code,l 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. APPLICANTCERTIFICATION 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.statetlaws relating to building construction,and hereby.aut_horize representatives of this city to enter • upon.the.above mentioned,property for inspection-purposes;(We)agree to save indemnify;and kee.p'harmle'ss the,City of Cupertino against liabilities;judgments_, ARCHITECT'S DECLARATION costs,and expenses which niay'accrue against said City in consequence of the I understand my plans:shall be used as public records. granting.ofthis permit.Additionally,the applicanfunderstands and will comply with all non-pointsource regulations per the Cupertino Municipal Code,Section Li censed'Prof_ession all 9.18. :Signature Date CITY .OF CUPERTINO D FEE ESTIMATOR-BUILDING DIVISION z .� -ADDRESS: 20680 homestead rd. DATE: 06/13/2012 REVIEWED BY: bobs. APN: BP#: .2Q �9a *VALUATION: 1$500,000 *PERMIT TYPE: Demolition Permit PIAN ChIECK TYPE?` •PRIMARY PENTAMATION Commercial Building 1COMMLDEM USE: PERMIT TYPE: WORK demo of exisiting carls SCOPE FEE ID FLR AREA s.f. 1 DEMOCOM 2,854 taANi a .IK lLficlr.F'l'an Check /'h iub. Plait Check E;'ec-!.Plan Check Lfech. Perwil.Fee: Plumb. Permit Fee. Floc. Pernsir Fee: Other Mech. Insp. Other Plumb Insp. Other Elec. Insp. El 4iech:/rasp.-I'ee: Pluihb. hrsp,Fee: Ekx./nsp..I°'r:e 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• reliMina 4tiformation available and,are onl an estimate. Contact the De t or addn'l info. .FEE ITEMS(Fee Resolution 11-053 Eff.' 7.!1,11) FEE QTY/FEE MISC ITEMS Plan Check Fee: Supp/. PC Fee Phtmb.!llec/r.%Elec. - Permit Fee: $523.00 Suppl. Insp. FeecQ Reg. Q OT 0 0 hrs $0.00 Plumb.ijIlech./Elea P/untb.;']I?eclr./Elcrc Per-ntit l''ecr: 77 Conswuc:tion Tory: Aclininis'trative Feer: 4fork Without.Pei*mit? .Advanced Plarming files': 7 navel't3oe:'rrrr;entuticarr.rccc:rs': � Stron$4 Motion Fee: IBSEISMICO $105.00 Select an Administrative Item Bldg Stds Commission.Fee: /BCBSC $20.00 ag *44 ;iSUB ,OT�ALS $648.00 $0.00 $648.00 Revised: 0610512012 1 7iv Lo Uv� DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300,TORRE AVENUE •CUPERTINO, CA 9501473255 (408)777-3228 • FAX(408)777-3333•building(Dcupertino.org GUP.ERTINO PRO]ECT.ADDRESS °Q�j�,�{ "^ ,fx�'; N` APN NIP "I .OWNER NAME -Nr-- T PHONE 4 A + �I E MAII '`f 1 1�V IVe GJ O 'vy W STREET ADDRESS /,rib® C E �� CITY,STATE IIPV ` y,,,1/) GYM Sb� FAX V " -Y/�l CONTACT NAME I(e�J PHONE+ „f✓ Y,/071'2 E-� jn?4�A,<f , (/ �(�U�l'J STMET ADDRESS R a ALK4y6u Crr,Y;STATE,ZIP . ` �95� 2511-2 FAX`'Y��` _8Z ❑OWNER ❑ OWNER,BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑,CONTRACTOR AGENT J9 ARCHITECT ❑ENGINEER ❑ DEVELOPER 1: TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E MAIL FAX' - STREET ADDRESS CITY,STATE,,zIP. PHONE, DESCRIPTION OF WORK RESIDENTIAL 9 DWELLING FLOOR AREA UMTS .-IISE. z OCC:= _TEFF 5 .FT.- V'ACUAI'10T1 -'ti- COhIIvIERCIAL ems/ KIN ` FLOOR AREA O' W _ �i �^ TYPE OF CONSTRUCTION A STORIES a F AQMD JOB NUMBER REEL4EDt - TOTAL VALUATION: 5VP, 000 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 local ordinances and state laws relating,to bugding cons on. I a horize representatives of Cupertino to enter the above-identified,property for inspection:purposes. Signature ofApplicant/Agent Date: SUPPLEMENTALINFO ON. QUIRED PRIOR TO ISSUAiNCE OF DEMOLITION.PERMIT Y,__ o xer usiwor G' - _Provide.Job Number from Bay Area Air Quality Management District www.baagmd.ors @ 415-749-4762.. P S T Provide:three copies of&site plan showing protection for any trees 10'"in diameter or more at Y above grade. 5� � sx�rmaxn — � _Provide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected. x C1 BARGE �.N Provide.a letter of inspection,tests,and abatement of any Hazardous Materials._Letter to be initiated by person(s) _: certined•in asbestos,mercury and%or hazardous material,examination. - z Planning Dept clearance'to verify building is not.considered an historicahlandmark.Allow 10 business days. s` Provide letter of clearance of all verminfrom a licensed pest control contractor. . . —Applicant shall call the Public Works Department at 408=777-3104 and schedule a"habitable dwelling"inspection r _ = — Provide signed Debris Bin and Recyclable Materials form. Commercial Buildings Only: Provide,Fire Dept clearance for fire suppression/alarm,system review. 1 DemoApp_201.1.doc revised 03/16/1.; r Pacif r Gas and Electric Company 10900 N.Blaney Avenue DeA�r_a Division Cupertino,CA 95014 1 �! City of Cupertino 10300 Torre Avenue Cupertino, CA 95014 To Whom It May Concern: SUBJECT REMOVAL OF GAS'FACILITIES The gas feeds are scheduled to be.removed and/or abandone at: 20680 Homestead Rd on 3/4/13 If y u have any further questions, please,contact:me at (408) 25-2146 Se ' Olive Service Planning 1 r �O 20600 +{oMQS-15.60 Lan City of Cupertino o L° C&.&L:S J V- �� " Public works Department E2 Esto'. Environmental Programs Division 10300 Torre Ave Cupertino, CA 950.14 CUPERTINOG.REEN _ ;4 '(408) 777-3354 Program Construction and Demolition Recycling Di ersion Requirements and Instructions Covered projects,or all construction, demolition and renovation projects that are 3,000 square feet or more are requiredto complete a Waste Management Plan for the City of Cupertino-de onstrating that 60%of the material;generated is recycled, in compliance with ordinance CMC 16.72.050. Althe conclusion of the project a Construction Recycling Report must be filed with the Public Works DepartmenEnvironmental Division showing the tons recycled,and disposed by material type. Use tonnage informatio 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 ordo"o receive a Final Building Inspection. Recoldgy is ttie only ciebr><s bm service.provider f a�chisP;d td-d business i®:Cuperti®o Debris from a project 3,000 square feet or more n C p rtin can~be collected;a6 H disposed by using: N �''11ti J Please.check all that apply: - I ❑ lam not using a Recology debris bin, however,.the project is less than.3'OQ f g, . tngs;patios, sidewalks, driveways. 0 I will:use.a.Recology debris.bin. By Agreement with the prepare my required Waste Management Plan & Recycling Report. Contact Rego 0 ) 7254020. 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 Waste Management Plan with our building permit application. No fee for this plan. Forms are available at the Building/Pub lie Works counter and online at www.cupertino.org/environmental. Report the tonnage recycled and disposed, by material type. Recycling facilities must be 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 final inspection. The reportform is available at the Building/Public Works Counter and online www.cupertino.org/environmental. Signature: '� Date:, Name` (printed) T2�,,,, Title: O tUt SAO r.. wo- r.e► e. rr✓t Phone: ) '171-1 '7�i't 9 Project.Address: 6-t- 91 3 t nom— S; Sr �ds C� �S 1 This.form to remain in the project's building permit file for the duration of the project. Revised 317112 1 Waste Management Plan Environmental Programs Division ® Construction & Demolition Debris 408 777-3354 City Of Cupertino environmentai@cupertino.org CUPERTINO GREEN MUST BE SUBMITTED WITH PER MIT APPLICATION. All projects which exceed 3,000 square feet must recycle 60%of the.material generated.Permit pplicants that fall within the Covered Project'guidelines are required to complete the following Waste Management Plan for the City of Cupertino. At the conclusion of the project,the permittee must file a"Construction Recycling Report"with t he Public Works, Department/Environmental Division showing the tons recycled and disposed by material type.U e tonnage information from weight tags provided by facilities to quantify total estimated waste and percentages for materials. Ask our hauler,recycler or site cleanup vendor to assist you with this plan. Weight tags of all material recycled and disposed must be su 3mitted a once the project is completed in order to receive a Final Building Inspection, Project Name: ¢(OpA�c rr,�D��,u�,y _ Permit No: ').D6 0 Q-1 U Location: 1-b to So Ra.Mru_STV3-Ao LoAo 8 C,&,2 CL Jt.- Prepared By: 111, Phone: 40A -t-L = _IA-t Company Name: 9 tACC Email: �jd low ca, Company Address: y J Project Type: ❑New Construction XDernolition ❑ Renovation Project Square Footage: 15v- A. 5v -A. Material to Recycle or Reuse. The facility to which the materials will be hauled should bechosen from the attached list of facilities.Alternative facilities,special salvage or reuse options may be requested by the Environr iental Programs Division, Public Works.Check all boxes that apply for each material type 0. This is your plan-you can make changes on your final report.,' C WLU i MATERIAL J a DESTINATION FACILITY D, �' a I (indicate"to Newby Island landfill'by..Recology"or provide name of i O z :. cc facility for self-haul) - Mixed C&D Debris ------- - ' 1 i N ?.F-4-_t_.— f Asphalt&Concrete oL y` a ti S i Brick/Masonry/Tile _ i Cabinets,Doors,Fixtures,Windows ---- j f»---_• ----------- -------- - ------� - - -- pet f _1 -------------•-- Carpet,Padding/Foam ;Cardboard- - ----------------; ,•� .----- - - --------- --- - I Ceiling Tile(acoustic) I Dirt/Sod -_------------ _------•------------__...... -i Drywall(unpainted) j Landscape Debris s -Metals Roofing Materials L Wood/Lumber T ti _Other Material(list): _ _ ---- ----- - -- —---i Trash - --------- i -- - -- —'— — -- -- -- ---__ ----- -- ---- o e . X Self-Haul ❑ Roll-off Box(franchised w/City of Cupertino) ❑. Both Approval by the Environmental Programs Division,Public Works of this Waste Management Plan as complying with CMC 16.72.050 shall be a condition of any building or demolition permit for all covered projects. NOTE:If you enlist the services of a hauler or clean-up company to take the materials to o facility for you, ensure they are aware of the Construction and Demolition Recycling Program and CMC 16.72.050 and can provide you with the required information.Inform the hauler they must take material to an approved facility and are required to provide weight tickets showing proof of recycle. (.understand l am responsible for"com'p)ying with the requi�emeiits;of the=Cupertino C&D"Ordinance:I agree tmsubmit-a Final Report,for.tFtis-project wi in 60'calendar days a completion: Applicant Signatur _ Dater 'Covered Projects include all construction,demolition and renovation projects that are 3,000 square feet or greater.Applicants seeking building or demolition permits for the above mentioned projects are required by Ordinance 16.72 to recycle or reuse 60%of the material discarded. The City of Cupertino contracts with:Newby Island Landfill„owned by Browning-Ferris Industries(BFI)for waste disposal. Revised'1/10/12