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08030154CITY OF CUPERTINO77 7777 �k1a,g7�+ BUILDING DIVISION PEPMUT yry, T CTdt i' x � f c BUILDING ADDRESS: PERMIT NO. 20900 HOMESTEAD RD WEST BUILDERS, INC. 08030154 OWNER'S NAME: PERMIT ISSUE DATE VSII, A CALIFORNIA LIMTD 1608 4TH ST STE 120 07/09/2008 PHONEP M'K777D r'u T 7) SANITARY NO. CONTROL NO. (510) 525-9378 ARCRITECT/ENGINEER. BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CON-IRACTDR'S DECLARATION Job Description I here atBrm that I am licensed under provisions or by P Chapter 9 (commencing with Section 7000) of Division 3ofthe Business uAProfessions code, and mylicense is DEMO OF LANDSCAPE, CONCRETE, PAVING, CARPORTS, in tuts force and ellen. License Class Lk. s az 3g 5 REC / LEASING . ' Date, -Cwr Contractor T-,� ARCHnECI'S DECLARATION 1 understand my plans shall be used ss public records Licensed Professional OWNER -BUILDER DECLARATION 1 hereby affirm that 1 am exempt from the Contractors license Law for the following mason. (Section 70313, Business and Professions Code: Any city or county which requites a pemit to construct. alter. improve, demolish, or mpair any strumum prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 Sq. Ft. Floor Area Valuation (commencing with Section 7000) of Division 3 of the Business and Professions Code) or $17225 that he is exempt therefrom and the basis for the alleged exemption. Any violation of 2 60 9 0 2 9. Number Occupancy Fane Y Type Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ofN not more than five hundred dollars (5500).3 ❑ I, as owner of the property, or my employees with wages as their sole compensation, Required Inspections will do the work and the structure is not intended or offered for sale (Sec 7044. Business and Professions Code: The Contractors License Law does not apply to an owner of property who build%or improv thereon. and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If. however, the budding or improvement is sold within one year of completion, the owner - builder win have the burden of proving that he did not build or improve for purpose of sale.). ❑ I. ss owner of the property, am exclusively contracting with licensed contractors to construct the pmjea (Sec 7044, Business and Professions Code) The Contractors Li. . cense Law does not apply to an owner of property who builds or improves thereon. and , who contracts for such projects with a conwactor(s) licensed pursuant to the Connor's License Law. ❑ I am exempt under Sec B & P C for this mason Owner Due WORKERS COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations ❑ I ham and will maintain a Certificate of Consort to self -insure for Workers Compen- sation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is resod. ' ❑ I have and will maintain Workers Compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of the wort for which this permit is issued. My Workees Compensation inu,r.nce carrier and Policy number are: carrier: ST&F— Ria PolicyNo.: 7!2&120r200' CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need Rothe completed if the permit is for one hundred dollars (S 10D) or less) I certify that in the performance of the work for which this permit is isaucd. I shall out employ any person in any manner so as to become subject to the WorkesCompensation Laws of California. Due Appficam NOTICE TO APPLICANT: If, after malting this Certificate of Exemption, you should become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction (ending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ. C.) Lenders Name Lenders Address I certify that I have rid this appiicadcm and sate that the above information is correct I agree to comply with all city and county ordinances tad state laws misting to budding construction, and hereby authorize representatives of this city to enter upon the +hove -mentioned property for inspection purposes. (We) agree to save, indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs and expenses which may in any way acme against said City Aconsequence of the granting of permit APPLICANT UNDERSTANDS W COMP ALL NON -POINT Issued b y. Date _..� SOURCE REGULAMCS Re -roofs Type of Roof signature orApplicanUCon' Date HAZARDOUS MATERIALS DISCLOSURE Will the applicant or future building occupant store or handle hazardous material as defined by the Cupertino Municipal Cock. Chapter 9. 12, and the Health and Safety Code, section 25532(x)1 All roofs shall be inspected prior to any roofing material being installed. ❑Ya ❑No If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future bolding occupant use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management all new materials for inspection. District? ❑ Yes ❑ No I have mad the hazardous materials requirements under Chapter 6.95 of the Califor- nia Health & Safety Cade. Sections 25505.25533 and 25534.1 undersand this if the building don not CU" ndy hove a tenant, i responsibtiit notify the occupant of Ne requirements which must be met or n an n ora -� Signature of Applicant Date All roof coverings to be Class 'n' or better Owner or luthoozrA agent Wte CTTY OF CLTPER=O C P6'H ,'SON q/I &W(8rlday, at least 24 hours before ❑ MW- ❑ MMIEN REMODEL BUILD(NG OMMON PER MT ❑ ADI)MON ❑ PLUMBING RE -?SPE are needed when requesting an inspection. PERMIT NO. BUI.DING ADDRESS: 20900 HOMESTEAD RD WEST BUILDERS, INC. 08030154 J ►- OWNERS NAME HAZAROI'1'1LFS FIRE AREA ❑ BATH REMODE AUTAIR ❑ DEMOLrnON P13'L�I�DAIF VSII, A CALIFORNIA LIMTD 1608 4TH ST STE 120 6/09/2008 ❑ No laidal LC -2.0. 0 pg&fflNT L-0 C'v n C_nhfldEar-rer- C 6 0 9.0 2 9TEx?sn>TrG ROOF COVERING SANITARY NO. CONTROL NO. BUILDING ( 10) 525-9378 IMPROVEMENT ARC I' EC 94GWEEK: PHONE N ❑ OTHER To be removed To be retained SUMDING PERMr INM 13LDG E= PLZMB MEM FOUNDATION7PIER_,gAu-S. UFER GROUND PAD/SET BAC -CERT GARAGE SLAB&TREGUNTTE UNDERGROUND/SLAB UNDERGROUND PLUMBING UNDERGROUND ELECTRICAL UNDERFLOOR ELECTRICAL UNDERFLOOR FRAMING VENTS ROOF SHEATH/DIAPHRAGM PLUMBING TUBS &SHOWER PAN MECHANICAL ELECTRICALIPOOL BOND FRAMING/STAIRS/E. EGRESS INSULATION/VENTII.ATIO N EXTERIOR LATHNV-SCREED SHOWER LATH SCRATCH COAT S EW ERIWATER TEMPORARY APPROVALS OCCUPANCY 71 r92=MEP�' 4. RE, PA C P6'H ,'SON q/I &W(8rlday, at least 24 hours before ❑ MW- ❑ MMIEN REMODEL required inspection. Job address and Permit Number ❑ ADI)MON ❑ PLUMBING RE -?SPE are needed when requesting an inspection. ❑ M= -UNIT ❑ SIItuCITIRAL Q MODIFICATION RESIDENTIAL ' COWAMCIAL OTHER ❑ INTERIOR , ❑ CUMIINEYREPAIR J ►- SMPROVEMENT ❑ SWIMMING POOLS HAZAROI'1'1LFS FIRE AREA ❑ BATH REMODE AUTAIR ❑ DEMOLrnON r p ❑ anffiR ❑ YES U yes • I uad-. and rhu a Clan A roof usembly is required MECHAMCAL ❑ No laidal LC -2.0. 0 $17229 C_nhfldEar-rer- C 6 0 9.0 2 9TEx?sn>TrG ROOF COVERING ❑ N9W 13L.DGIADOMCN ❑ DEMOL MON BUILDING ❑ TE24ANT FOOD SERVICE Number of existing coverings, IMPROVEMENT ❑ OTHER To be removed To be retained C Z -- Z ❑ Asphalt Shingles ❑ wood Shalxs PLANNING 777-3308 x > GAS TEST Q GRADE (P.W.777-3354) Z FIRE - CALL (408) 37" 10 J ►- HANDICAP U ELECTRICAL r p PLUMBING J Z MECHAMCAL ENERGY VISUAL FINAL ONLY BUILDING PRE -INSPECTION: INSP. TEAR OFF INSPECTION: TYPE OF ROOF COVERING - EXISTING: PROPOSED: ❑ Btalt-Up Rmf ❑ Built-up Roaf ❑ Asphalt Shingles ❑ Asphalt Shingles ❑ wood Shalxs ❑ woad Shah ❑ Wood Shingles ❑ Woad Shingles ❑ Other(spedfy) ❑ other (Speofy) NO FINAL INSPECTIONS P—;de I.CB.O. Repast No. UNTIL ALL REQUIRED BUSINESSPravide Mfgc Installatf® spec. INSPECTION SPECIAL INSPECTION REQUIRED ❑ N CUPERTINO SANITARY DISTRICT Closed circuit video inspection of property line cleanout, point of connection and street lateral required prior to passing FINAL CITY PLUMBING INSPECTION. Call the District (408-253-7071) for an appointment. IMPORTANT When a permit has expired,, a charge totaling one-half the fees to obtain a new permit must be paid to reactivate the permit. If a permit has been expired for more than one year, a charge totaling the full fees to obtain a new permit must be paid to reactivate the permit. CERTIFICATE OF OCCUPANCY ❑ PLYWOOD: DATE NSF. — BATTENS: DATE IN -PROGRESS: INSP. FINAL DATE DATE I INSP INSP. DATE INSP. DATE INSP. DATE NOTE: OSHA APPROVED ACCESSTO ROOF SHALL BE PROVIDED FOR INSPECTION �LL tj CITY OF CUPEkTINO Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone (408) 777-3228 Fax (408) 777-3333 Building Department JOB ADDRESS:, Gotao ` 0 PERMIT # , 3 l OWNER'S NAME: Y-OAN d , --- 2e., -A T--- b G PHONE # to GENERAL CONTRACTOR FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: ull�� Own ontractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal eet Rock e ull�� Own ontractor Signature Date 03/07/2008 15:22 FAX 408 777 3333 CITY CUPERTINO ,4-7,7)' /LtIIJQ Acs o k CITY OF CUPERTINO DEMO LUPE TINO PERMIT APPLICATION FORM (0 04 o�2 q_"tv-,uD 10001/005 ,� Sa ?Jl -,:?&-5 ;� 63i7190,?(0 _?� 0 / �5y )- APN# Z>2( `Date: -3. Building Address: Fee Group Mailing Address (if different from building address): 1DEMORES Owner's Name: Phone: v S j Com- �� ,rU � L vv�6 �� .� P (o 5o 92-A-345-7 Contractor: Phone: SIC) 5-ZS--cA WZ-_A- ?�� e�5 Fax: Sl0 SZ 5� O �Sr� Contractor License #: 1DEMOCOM Cupertino Business License #: �� cl B Contact: Phone: 21 c c,.VA o 2 o•.ww v -C , s "� Fax: Residential V Sq Footage Commercial ❑ Sq Footage Job Description: D( e. 1`{� crAA 1 �,nnr� I C --1A cNkJ4. Valuation: �- y -I �. Attach Green Building Checklist to demo playas. Quantity Fee ID Fee Description Fee Group Permit Type 1DEMORES Demo -Residential B ISFDWL-DEM / IBSEISMICRE Seismic Residential B 1DEMOCOM Demo -Commercial B 11COMM—DEM 1BSEZSMICOM Seismic Commercial B 1 BUSLIC Business License B