D-2019-0026 (2) CITY OF CUPERTINO BUILDING PERMIT
UILDING ADDRESS: CONTRACTOR: PERMIT NO:D-2019-0026
)744 MORENGO DR CUPERTINO,CA 95014-3515(375 35 058) HERMES HENRIQUE
MUNIZ
SAN MATEO,CA 94401
WNER'S NAME: JAGANNATH RAMANUJAM AND SRINIVASAN RAMYA DATE ISSUED:05/08/2019
WNER'S PHONE:408-209-5412 PHONE NO:(650)888-4901
JCENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
cense Class c-21 Lic.#1044500
ontractor HERMES HENRIQUE MUNIZ Date 09/30/2020 —BLDG —ELECT —PLUMB
hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENTIAL_COMMERCIAL
ith Section 7000)of Division 3 of the Business&Professions Code and that my
,ense is in full force and effect. JOB DESCRIPTION:
DEMO POOL(6 10 SF)AND COMPACT FOR 95 %, OPTION B-POOL
hereby affirm under penalty of perjury one of the following two declarations: SHELL TO BE REMOVED
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.
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:$19000.00
APPLICANT CERTIFICATION
,ertify that I have read this application and state that the above
formation is correct. I agree to comply with all city and county ordinances APN Number: Occupancy ape:
id state laws relating to building construction,and hereby authorize 375 35 058
presentatives of this city to enter upon the above mentioned property for
spection purposes. (We)agree to save indemnify and keep harmless the
ty of Cupertino against liabilities,judgments, costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
ay accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
lditionally,the applicant understands and will comply with all non-point
►urce regulatiorupper 01 the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
gnature Date 5/8/19 Issued by: Haley McKee
NV
NN Date:05/08/2019
WNER-BUILDER bECLARATION
iereby affirm that I am exempt from the Contractor's License Law for one of the
RE-ROOFS:
[lowing two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without first 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)
2. 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:5/8/19
iereby 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
3. 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 handle hazardous
material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the air contaminants as defined by th ay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the ertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code, tions 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:
APPLICANT CERTIFICATION Date: 5/8/19
ertify that I have read this application and state that the above information is CONSTRUCTIO LE DING AGENCY
rrect. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a cons"ruction lending agency for the performance
ating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
save indemnify and keep harmless the City of Cupertino against liabilities,
igments, costs,and expenses which may accrue against said City in Lender's Address
nsequence of the granting of this permit. Additionally,the applicant understands
d will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
)de,Section 9.18. 1 understand my plans shall be used as public records.
Licensed
nature Date 5/8/19 Professional
DEMOLITION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT * BUILDING
DIVISION 10300 TORRE AVENUE * CUPERTINO,,CA 95014-3255
CUPERTINO (408)777-3228 * 777-3333 * building@cuRertino.org CA
❑BUILDING/STRUCTURE SWIMMING POOL/SPA PERMIT#13
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DESCRIPTION
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El SINGLE-FAMILY/DUPLEX 1:1 MULTI-FAMILY 13 INDUSTRIAL El COMMERCIAL USE TYPE SQ.FT. VALUATION
SWIMMING POOL 0 ATTACHED SPA El DETACHED SPA
LANDSCAPE PURPOSE ONLY ❑STRUCTURE TO BE BUILT
No structural or floor slab support shall be built unless the pool shell is removed in its entirety.
Backfill must be certified by a licensed Geotechnical or Civil Engineer to verify backfill materials, REI (ED TOTAT,
fY V Byr�
soil hjpe and compaction percentage of 90%maximum density prior to inspection.
#DWELLING UNITS ASB# OTHER:
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 uilding construction. I authorize representatives of Cupertino to enter the above-identified
g t
property for inspection purposes.
I acknowledge and authorize all information relating
n this application form to be made available for public recor
0 Signature of Applicant/Agent: Date:
NOTES:
DemoApp_2018.doc revised 04114118