03110153 CITY OF CUPERTINO A s
PEI, r, TRAC,FTR`P•Rv�T�0,O4k �BUILDING DIVISION
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le
BUILDING ADDRESS: STEVE NAN CONSTRUCTION PERMIT No 03110153
20696 SCOFIELD DR
OWNER'S NAME: PERMIT ISSUE DATE
SHIAO-MEI NAN 10599 N STELLING RD 11/26/2003
VE: SANITARY NO, CONTROL NO.
(408) 203-3933 .
ARCHITECT/ENGINEER: BUILDING PERMIT INFO
BLDO ELECT PLUMB MECH
l reO p LICENSED CONTRACTOR'S DECLARATION ..
Job Description
fu❑ 1 hereby affirm that I am licensed ander provisions of chapter 9(commencing
ZW with Scctian]IXIU)nf Division3ofthc Bumd Professions otic.and my license is
<<�,� mfeB mrc nd erre t. „ DEMO F�.NALE®
ji- Lia en ,
~� D t aaclrr
TP�TS DECLARA 10
E � dmatandmyplanaahallh aaedaspahliereenrds JAN 6' 2004
JyU
Saw Licensed Professional -- —
<3 OWNER—BUILDER DECLARATION
0 .1 hereby Maso .(beth on 11. exempt from the Contractor's License Law for the BUILDING
p O fallowing reamn.Permit
to]onstru Business and Professions Code:Any city or county �Y
5 m" which its requires a permit re enres the aalter,pplicant
impose,h ficomsn,Or repair any st(umurc $11800
_IQ Poor mitscensed e.pursuant to
thes(if forsuchle a Law(Cgned hapter
EE that heisliccnaeJpununnunthcpmvisioasnfthe Convaclur'sLiecnsclaw(Chapwr9 Sq.Ft. Floor Area Valuation
tl�m (commencing with Section 7000)of Division 3 M the Business and Predications Code)Or
that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Section 7031.4'by any applicant for a permit subjects the applicant to a civil penalty ofar Occupancy Type
not more than five hundred dollars(S500). P Y YP
0 1,as owner of the pmpcny,or my employees with wages ss Nei(so.compensation,
will dothework,ands swemreis notintendedo(ea,dos at (Sec.]041,Business
and property
Wh obs Code:The Contractor's improves thereon,
and
who Uw docs at apply to an rough of Required Inspections
properly Who builds i ed that suthereon,andwho does such work himselfor edthrough his
Own employees,to building
prsuchimprovementsarenotintendedor mpletircd for xdcowner,,
however,Neave fla, or improvement is soldheiid not year of Completion,for the owner-
builder will have tin burden of proving Nat he did not build or improve far purpose of
sale.).
❑ I,as owner of the property,am exclusively connoting with licensed contractors to
construct the project(Sec.7044,Business and Professions Code:)The Conbactoh Li-
ccnse Law does not apply to an owner of propeny who builds or improves themon,and.
who contracts for such projects with a conhamor(s)licensed pursuant to the Continuous'
License Law.
❑I am exempt under Sec. B A P C for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION -
I hereby pmt under penalty of perjury one of the following deela(mians:
eve and will maintain a Ccnifmmc ofCnnse a to self-insure for Worker's Cam eau-
on,as provided for by Section 3700 of the Labor Code,for Ne performance of the
work for which this permit is issued.
❑1 have and will maintain Worker's Compensation Insurance,as required by Section
3700of the tabor Cade,for to performance of the work for which this permit is issued. -
MyWorker'sCrm ansa ten lnsumntt carrier and Policy number am: //f3
Ca cr. �PoJa'cy No.:� '?r:x
CERTIFICATE DN PROM WORKERS'
COMPENSATICCRR INSURANCE
(This section need not he completed if the permit is for one hundred dollars(SI W)
a(toss.)
1 cof ify that in the perfavnence,of the work ror which this permit Is issued,1 shall not
employ any person in any manner so as to become subject to the Workers'Compensation
Laws of California.Data
Applicant _
NOTICE TO APPLICANT:IL after making this Cenificmc of Exam prion,you should
become sukkst to the Worker's Compensation provisions of the Labor Code,you must
Z forthwith comply with such provisions or his permit shall be deemed revoked.
z O CONSTRUCTION LENDING AGENCY
jr sName affirm Nm them isaconmmctinn lending agency for the perrarmancc of
"ls > the Murk flit which this permit is issued(Sec.31197.CO.C.)
{gl Lender's Name
= Z Lender's Address
f)Q 1 certify that 1 have read this application and Show that the above information is
U. frcorrect.1 agree to comply with all city and county ordinances and show laws minting to
C)U building construction.and hereby authoriM reprommatives of this city to enter upon the
�+a ahovcmentianed property for inspection purposes.
(We)agree to save,indemnify and keep harmless the City of Cupertino against
tifn liabilities.judgmems,costs and expenses which may in any way account againsaw'd City
in
of the
U APPLICANTOLINGERSTANDSoarti ng of tAs�WILL COMPLY WITH ALL NON-POINT Issued by: Dale
SOURCE ULAT S.
G 26� Re-roofs
rgnalureofApplicaHAZARDOUS MATERIALS DISCLOSURE Dem Type of Roof ,
Will the applicant or future building acearon"Ire or handle hasordous material
se defined by the Cupertino Municipal Code.Chapter 9.11,and the Health and Safety
cone. l .2ss3xa)7
ElYR[\, All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove
haa.Ohio.air eontaminanIs dcfncd by the Bay Area Air Quality ManaFemcnt all new materials for inspection.
tan
F7 Yes Na
I have read the haaardnus materials myuimancnls under ,Chapter6.95 of the Califor, -
nia HcalN&Safety Crae,Sccuons 25605.25533 and 35534.1 understood Nati!the ruilding
docs not currently hon a Isnot,that it is my res rssdid.y m non l'y the tw.cufont of rhe
re }emenu icn mast mmpriart issaantt aceAficamrrtxcananrr. Signature of Applicant Date
neo ser authori'rcJ aFcm Date -' All roof coverings to be Class„B"or better
` o CITY OF CUPERTIN#
DEMO
CUPEI�TINO PERMIT APPLICATION FORM
• APN# 3S-9 ,� r o Date:
�
Building Address:
aber96 e i�r.
Owner's Name: Phone#:
Ste/ d5`o -
Contractor: License#:
S 77a 3 B
Contact: Phone#:
_54_11 4tv8 - 2 33
Applicant/Contractor:
�e
,'Build g Permit Info:
Bld Elec Plu ech
Description:
Residential: Commercial:
Sq-Ft. Floor Area: $/Sq.Ft.:
/ 3vm
Architect/Engineer: Valuation:
Type of Construction: Occupancy Group:
• /
Qty- .
Appl,rcabje Fee ID Fee Description Fee Group
BPERMFEE Bldg Permit Fees BUILIDNG
BSEISMICOM Seismic Commercial BUILIDNG
BSEISMICRE Seismic Residential BUILIDNG
BPLANCHK Plan Check Fee BUILIDNG
BUSLIC Business License BUILIDNG
• 3 a
( Building Department
10300 Torre Avenue
Cupertino,CA 95014
j Telephone(408)777-3228
Fax(408)7/7-3333
CITY OF
1%JPEkJINO
PROCEDURE FOR DEMOLITION PERMITS
BEFORE DEMOLITION PERMITS CAN BE ISSUED,THE FOLLOWING STEPS
SHALL BE COMPLETED:
SIGNATURE/DATE -
y 1. Owner to make sure property is located within the City of Cupertino limits.
2. Provide a current preliminary Title Report or a"Lot Book Guarantee'which shows
�/✓{- —� ownership of property,open Deeds of Trust,and a legal description. This report is to
be issued within thirty(30) days prior to issuance of the demolition permit.
✓� 3. Provide the Building Department with a letter and self-addressed envelope to be sent
to all persons having entitlement to the property,advising them that the property is to
be demolish and they have 10 days to respond if they do not approve of the
demolition. Example: Lending institutions,banks,lease holders,partnerships,etc.
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. The permit fee shall be based on the valuation of the demolition work.
6. Apo a required showing any trees(10 inches in diameter at 3 feet above
grade onthe subject property,and what means will be taken to protect same. Two
LYS copies of this plan are required for review by the Planning Department.
7. Provide a letter of inspection,tests,and abatement of any Hazardous Materials..Letter
to be initiated by person(s)certified in asbestos and/or hazardous material
examination.
/ :W7T] 8. P.G.&E.must be contacted as early as possible prior to demolition to schedule the
abandonment. Contact P.G.&E. at(408)725-3325. A letter from P.G.&E.shallbe
provided to the City,stating that all gas and electric has been disconnected.
Piovide a letter of clearance oflall vermin from a licensed pest control contractor,or
n o Is -ict at mo.
10.Important: Prior to the issu a of the demoli n permit,the applicant must call the
Public Works Department a (4 8)777-3104 an arrange a"habitable dwelling"
ins ection.
11.Debris bin and Recycling sheet: read,sign and date. The sheet will remain in the
projects building permit file for the duration of the project.
0 12. 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.
Revised 2/4/03
Printed on Recycled Paper
11/20%2003 15:29 4087791763 ABCO CONSTRUCTION PAGE 02
OcMOLJTION CONTRACTORS
14580 LLAGA4 AVENUE',b^ANMARTL4,CA 95048`(408)779.7577•FAX(408)779-1783
November 7Q,'003
CITY'O cI,PI.It7'itdrj
Building 6on 6vis.ion
6 lns ep'
zt : 20696 SCOT IELD DRIVE
Ci,TP'IViE"tTIN0, CA. 95014
AsbestoaAhaternobt
YtS.
COMELIAAN E NQ'TIC
'yap
Ny ..
This is to *ARCO CONSTRUCTION will complete all
work as cftri
acted;for'the,above-mentioned address.
This notice canforms to aid is in strict Cotnpliance with EPA.
4•, Regulations and the Toxic Substance Control Act(?L 94-496) and
i; pursuant to 9eciion-�5193 0 !oftile Calif. Health and Safety Code.
r.;
BAAQMI)J#IXfi4t
iw:,,.. LICENSE,, #691,297
;.
Respectfatly,Xoiirs,,, .
y
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Lana S. Cltlji5
ABCOCONSTRT;ICCION
* • •SERVICE AGREEMENT/INVOICE
{� 15732 LOS GATOS BLVD.
O SUITE 544 DATE
3TCONTROL LOS GATOS, CA 95032
ERVICES (408)978.7378
ZNAME �TGU� ��-• Dl IT/t)A
C � C NAME
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ADDRESS , 2H ADDRESS
CLJp -���� z,P gsv �
Z CITY Z CITY STATE
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5 HOME PHONE ( ) 2 0 3 S 3 J ZIP HOME PHONE(—)
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y BUS.OR DAY PHONE( ) m BUS.OR DAY PHONE
WE HEREBY AUTHORIZE PEST PRO PEST.'CONTROL SERVICES TO PROCEED WITH THE FOLLOWING WORK:
Ants Animal Removal Earwigs Flies Pigeons Sowbugs Yellowjackets
Ants-Carpenter Bees Fabric Pests Mice/Rats Scorpions Spiders Wasps
Ants-Pharaoh Cockroaches Fleasrricks Mites Silverfish Stored Grain Pests Other:
THIS SERVICE INCLUDES ONLY THE INSECTS AND PESTS CIRCLED ABOVE. IT SPECIFICALLY EXCLUDES THE
CONTROL OF TERMITES, FUNGI, OR WOOD DESTROYING INSECTS. CARPENTER ANTS AND PHARAOH ANTS MAY BE
COVERED BUT ONLY IF SPECIFICALLY CIRCLED ABOVE. SERVICE IS SUBJECT TO TERMS AND CONDITIONS ON THIS
AGREEMENT.WHILE THE INTENT OF THIS SERVICE IS TO PREVENT DAMAGE FROM PESTS, PEST PRO SHALL NOT BE
LIABLE IF SUCH DAMAGE SHOULD OCCUR PRIOR TO THE DATE SUCH SERVICE IS COMPLETED.
O
SERVICE TYPE_ �_W) Initial Charge C Periodic Charge Warranty (mo.)
SIOLINSTRUCTIONS: ��✓"�� `
/►J A-rrt 4 ('+4 rr < rO2 1/EWffl/A).
-r�12 7z�lr Oni� I�S
AT Tn)r'?-Pt_
DATE OF FIRST SERVICE:i U(S . TIME l .ARO PERSON TO SEE
SERVICED BY ./( 'r_-AjN)
HOW WILL YOU PAY,(Circle One) CAH CHECK AMOUNT CUSTOMER SIGNATURE
Area Serviced
INSIDE _ PLEASE READ TERMS AND CONDITIONS ON BACK
OUTSIDE
❑ BOTH aJ ! FOR MATERIAL CODES SPF BACK OF PAGE
Material �f7 D� � L
Quantity —
• UNDER NORMAL CONDITIONS 7 TO 10 DAYS ARE OFTEN NEEDED FOR CONTROL OF PESTS.
THANK YOU FOR CHOOSING PEST PRO
-
PESTICIDES THAT MAYSED ON YOUR PROPERTY DURING COURSE OF OUR WORK:
UNLESS THE PRODUC IS MARKED WITH AN•OR",EFFECTS OF OVE XPOSURE ARE SIMILAR
TO COMMON SEASONAL ILLNESSES COMPARABLE TO THE FLU.
1. Avitrol '
2. Bold (Orthobonic Acid) 944-129.ZA 40. Pelcor (Methoprene) 2724-404-AA-50809 79. Other
3. BP-100 (Pyrethrins/Piperonyl Butoxide) 11540-9-AA 41. Precor IGR Conc. (Methoprene) 2724-352-ZA-50809 80. Other
4. BP-300 (Pyrethrins/Piparonyl Butoxide) 11540-1-AA 42. Pacer 2000 (Methoprene/Permethrin) 2724-455-AA-50809 81. Other
5. Catalyst (Propetamphos) 2724-450-AA 43. PT 170A X-Clude (Pyrethrins/Piperonyl Butoxide) 499-235-AA 82. Inspection Only
6. Contrac Blox (Bromadiolone) 12455.79-AA 44, PT 230 (Pyrethrins/Silica Gel/Piperonyl Butoxide) 499-223-AA 83. Glue Board
7. Contrac Super Size Blox' (Bromadiolone) 12455-82-AA 45. PT 240 (Bonc Acid) 499-220-AA 84. Mice Tray
8. Cynoff EC (Gypermethrin) 279-3081-AA 46. PT 265 TKO (Diazinon) 499-330-AA 85. Rat Tray
9. Cynoft WSB (Cypermethrin) 279-3085-AA 47. PT 270 (Chlorpyritas) 499-147-ZB 86. Pest Pro Rat Trap
10. Deadline G (Metaldehyde)64864-2-ZA 48. PT 279 (Chlorpyritas) 499-292-AA 87. Pest Pro Mice Trap
11. Demon WP (Cypermethrine) 10182-71-AA 49. PT 310 (Abamectin B1) 499-294-AA 88. Bell Protects RaCStatlan
12. Ditrac All Weather Blox' (Diphacinone) 12455-80-AA 50. PT 400 (Chlorpyritos/Fenoxycarb) 499-231-ZD 89. "D"size Battery
13, Olfrac Tracking Powder (Diphacinone) 12455.56-AA 51. PT 410 (Pyrethrins/Piperonyl Butoxide) 499-231-ZD 90. Tin Cat
14. Dragnet FT (Permethrin) 279-3062-AA 52. PT 412 (Fenoxycarb) 499-365-AA 91. Vector Fly Glue Board
15, Drax Gal (Orthoboric Acid) 94444-131--AA 53. PT 3.6-10 (Pyrethrins/Piperonyl Butoxide) 499-221-ZB 92. Vector Fly Light Bulb
16. Drlone (Pyrethrins/Silica Gal/Piperonyl Butoxide) 4816-353-ZA 54. PT 505 XLO (Pyrethrins/Piperonyl Butoxide) 499-290-AA 93. Bell Notecta LP Rat Station
17. Dual Choice (Sulfluramid) 11542-20-AA 55. PT 515 (Allethrin/Phenothrin) 499-362-AA 94. Bell RTU Mouse Bait Station
18. Dursban 2.513 (Chlorpyrifos) 10370-54-AA 56. PT 565 (Pyrethrins/Piperonyl Butoxide) 499-182-ZA 95, Other
19. Oursban SOW (Chlorpyrifos) 10370-54-AA 57, PT 565.XLO (Pyrethrins/Piperonyl Butoxide/Allethrin) 96. Other
20, Dursban Pro (Chlorpyrifos) 62719-166-ZA 58. PT 600 (Cyflulhrin) 499-304-AA
21. Dursban TC (Chlorpyrifos) 62719-47-ZB 59. Purge III (Pyrethrins/Piperonyl Butoxide) 9444-33-ZA
22. Equity (Chlorpyrifos) 62719--167-AA 60. Recruit (Hexaflumuron) 62719-243-AA
23. Fluor Guard (Sulfluramid) 1812-348-AA-279 61. Rozol Ground Squirrel Bait' (Chlorophacinone) 7173-50002-AA
24. Fumitoxin Tablets " (Aluminum Phosphide) 5857-1-ZB 62. Safratin 1% (Propetamphos) 2724-340-AA-50809
25. Gentrol OR Conc (Hydroprone) 2724-351-AA-50809 63. Seige Gel (Hydramethylnon) 241-313-AA
26. Gopher Getter Restricted" (Strychnine) 36029-50005-AA 64, Sevin 5G (Carbaryl) 10370-152-AA
27. Gopher Getter Type 2' (Chlorophacinone) 36029.50003-AA 65. Suspend (Deltamethrin) 432-763-AA-62719
28. Gopher Getter Type 1 " (Strychnine) 36029-1-ZA 66. Talon' (Brodifacoum) 101112-339-AA(Weather Blok)
29. Hot Foot (Polybutene) 55943-1-AA 6Z Talon' (Brodifacoum) 101 82-334-AA(Min I-Pellet Bait Pack)
30. Impel Rads (Anhydrous Disotlium Octaborate) 10356-16-AA 68. Talon' (Brodifacoum) 10182.335-AA(Pellet Bait Pack) _
31. Kicker (Pyrethrins/Piperonyl Butoxide) 4816.707-AA 69, Talon Pellets-Bulk' (Brodifacoum) 10182-336-AA
32. Killmaster (Chlorpyritos) 26693-2-AA 70. Tempo 1%Dust (Cyfluthrin) 3125-429-AA
33. Llqua-Tox II (Sodium Salt of Diphacinone) 12455-61-AA 71. Tempo 20WP (Cyfluthrin) 3125-396-AA(Power Pak)
34. Maki Block' (Bromadiolone) 7173-189-AA 72. Tempo 20WP (Cyfluthrin) 3125-377-AA
35. Maxforce (Hydramethylnon) 64248-1-7A 73. Terro Ant Killer II (Borax) 149.8-ZA
36. Maxforce Ant Killer Bait Station (Hydramethylnon) 64248-2-ZA 74. Timber (Dispel um Ocyaborato Tatrahydrate) 1624-39-ZA
37. Maxforce Ant Killer G Bait (Hydramethylnon) 64248-6-AA 75. TOX (Triethylene Glycol) S
38. Metaldehyde 7.5G" (Metaldehyde) 5481-103-AA 76, Wilco Ground Squirrel Balt'" (Chlorefract none) 36029.50004-AA
39. Musci-cide (Methornyl ) 270-255.ZA 77. ZP Tracking Powder" (Zinc Phosphide) 12455-16-AA
78, Talstar
Effects of overexposure of these materials can occur only due to ingestion. If you suspect ingestion of any of these materials,contact your physician immediately.Advanced symptoms of overexposure
of these materials can Include bleeding gums,nosebleeds and hemotomas,
Effects of overexposure to this material can occur only due io Ingestion(except for Fumitoxin)and symptoms may Include violent convulsions along with nausea and vomiting.
Pest Pro has always strived to provide its customers with the most efficient methods of pest control. We have always provided
our employees with constant, on-going education so they can provide our customers with the best possible service results, and
so we can use pesticides in the safest possible manner for our customers and ourselves, in accordance with our sense of
responsibility for the safety of our customers and employees.
TERMS AND CONDITIONS
UNLESS WORK PERFORMED IS ON A JOB BASIS WITH SPECIFIC WARRANTY AS INDICATED, IT IS UNDERSTOOD AND AGREED THIS
CONTRACT SHALL BE FOR A PERIOD OF ONE YEAR NON BINDING FROM THE DATE OF THIS DOCUMENT, AND SHALL CONTINUE
THEREAFTER MONTH TO MONTH UNTIL CANCELLED IN WRITING PRIOR TO THE FIRST DAY OF THE MONTH SERVICE IS NO LONGER
DESIRED. PEST PRO AGREES TO PROVIDE PEST CONTROL SERVICE IN ACCORDANCE WITH THE TERMS OUTLINED DURING NORMAL
BUSINESS HOURS OF 8:00 AM TO 5:00 PM, MONDAY THROUGH FRIDAY WITH THE EXCEPTION OF RECOGNIZED HOLIDAYS.
ADDITIONAL SERVICES WILL BE PROVIDED AS DEEMED NECESSARY BY THE COMPANY, OR WHEN REQUESTED BY YOU, DURING
NORMAL BUSINESS HOURS. REQUESTS FOR ADDITIONAL SERVICES DURING OTHER THAN NORMAL BUSINESS HOURS WILL INCUR
ADDITIONAL CHARGES, IN ORDER TO PROPERLY CONTROL PEST ACTIVITY, THE CUSTOMER AGREES TO MAKE THE PREMISES
AVAILABLE FOR SERVICE AND TO ACCEPT SUCH SERVICE WHEN DUE. YOUR SERVICE TECHNICIAN WILL MAKE AN APPOINTME•
FOR THE INITIAL TREATMENT AND ARRANGE A REGULAR, CONVENIENT AND SPECIFIC SERVICE DAY FOR SUBSEQUENT TREATMENTS.
Sent By: INTOTO INC; 408 566 0284; Nov-18-03 3:22PM; Page 1 /1
Page 1 of I
- `t Ifal?�'N'fiili'ah�lY;i �
s .
i
Primary Owner: SHIAOMEINAN LLC, , �
Secondary Owner:
Mall Address:
Site Address: 20695 SCOFIELD DR
CUPERTINO CA 95014
Assessor Parcel Number: 359-10-004
Phone: --
Census
-Census Treat: 5077.01
Housing Tract Number:
Lot Number:
Page Grid: 862-01
Legal Description: Subdivision: TOWN AND COUNTRY HOMESITES Abbreviated
. Description: TOWN AND COUNTRY HOMESITES BLK 2 LOT 11 i
City/MunVTwp: CUPERTINO
Property Characteristics:
Bedrooms :2 Year Built: 1950 Square Feet: 1,211 SF
Bathrooms : 2.0 Garage : Garage 1 Lot Size : 9,553 SF
Total Rooms : 5 Fireplace : Number of Units:0
Zoning : Rt B2 Pool : Use Code: Single Family Residential
Sale & Loan Information
_......:..... ......_...__.._. �.,..._,.,..._.,...-...,... _..__._......_......._.. -..._.,...._...._...._....._.......
_.., . .W...._. ....._..... ....
Transfer Date : 10/15/2003 Seller :ANTONOWITSCH, ADALBERT F MEDAN, MIROSLAV
Transfer Value : $820,000 Document# : 17415641 BK-PG: - CosUSq. Feet :$677
Firsf Loan Amount:NIA Lender : MTG
Assessment&Tax Information
•
• City of Cupertino
Public Works Department
10300 Torre Ave.
Cupertino CA 95014
• (408)777-3354
Debris Bins
Debris from a project in Cupertino can be collected and disposed of in either:
1. a Los Altos Garbage Co. bin(call 725-4020 to order), OR
2. a bin owned by the project's general contractor or demolition contractor, and hauled by a vehicle
owned and registered to that contractor (contractor should be prepared to prove ownership), OR
3. a private truck with a bed, but no bin
The Los Altos Garbage Company is the only debris bin service provider
franchised to do business in Cupertino.
Bins from other leasing companies may not be used in Cupertino.
Please check all that apply:
Q I will use a Los Altos Garbage Company bin
I will use a bin and truck owned by the general contractor or the demolition contractor.
❑ I will use a private truck, and not drop a bin.
Recyclable Materials
• Recyclable materials may be collected in private debris bins or containers leased
from ANY company, as long as the materials are both:
1. separated by type of material into separate containers, AND
2. are not contaminated by garbage.
Separated recyclable materials are materials that are separated into individual containers, each
containing just one type of recyclable material. Typical examples of recyclable materials
include: metal, wood, concrete, steel-reinforced concrete, asphalt, tree trimmings, white goods,
toilets (hardware removed), rocks and clean fill dirt. Separated recyclables must ultimately be
recycled or otherwise reused, and not disposed of in a landfill.
Contractor should be prepared to provide the name and phone number of any recycling companies being
used on the project. A list of local recycling companies can be found at: www.recyclestuff.org.
7......�2...................................
Signature: z.4 — Date:
Name (printed): h r
Title:
• Phone: 3 3,,1 3 3
1
Project address: .20 $cam
r
This form to remain in the project's building pennit file for the duration of the project.
Revised 1/03
APPRUVW
WIT
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SIGNED
• of to and specifications MUST
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PLAN
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IN P:CCDRDANCE WITN URD1�
EXISTING GROUND ! i}, E'0" GUYERTI O OD
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NOTES
This BOt P
n thD lob at nu mea ww
DB,ke t 094% or Alt f
1. THE DEVELOPER SHALL INSTALL THE la�BBEt(Akl '�dl�ltteREVICI �
PRIOR TO THE START OF GRADING OR 06. RINP} y}§pF�,R dM& "
�,dy 1`1i 1P0
2. THE CITY RESERVES THE RIGHT TO ISWfil t0id� R.tar�l�
THE "TREE PROTECTION" DEVICES ARE 'N{tET'StOR' bf �rynVthY
• DEVICES ARE NOT MAINTAINED PROPERLY,N�,
- - 3. SEE THE PROJECT GRADING PLAN FOR '�B �}°'REE _
PROTECTION. ALL SPECIMEN TREES REOGIIIPF�TECTION UNLESS
OTHERWISE NOTED.
4. NO EXCAVATIONS WITHIN THE "TREE PROTECTION AREA" ARE ALLOWED
UNLESS UNDER THE SUPERVISION OF A REGSTERED TREE SERVICE COMPANY.
3. ANY FILLING WITHIN THE "TREE PROTECTION AREA" SHALL BE DONE IN
ACCORDANCE WITH A DETAILED IMPROVEMENT PLAN APPROVED BY THE CITY.
G. NO TRIMMING, CUTTING,OR PRUNING OF DESIGNATED TREES CAN OCCUR
WITHOUT A REGISTERED TREE SERVICE COMPANY.
7. CONSULT ORDINANCE Till OF THE CITY OF CUPERTINO FOR PERMIT
REOUIREMENTS AND EXCEPTIONS.
8. TEMPORARY CHAIN LINK FENCING 1S AN ACCEPTABLE SUBSTITUTE TO
THE WOOD CONSTRUCTION, ti
TREE PROTECTION STANDARDS
C{Tv ®F CUPERTINO, g-4
STA{1@DARD DETAILS APPROVED BY : DATE
CI E IN
11/20/2003 15: 29 4087791763 ABCO CONSTRUCTION PAGE 03
Regulation 11, Rule 2
COMPLiANC, 8
Y ;,'R A ENFORCiwt'C�f�IT. ACknowledgement of
:hlxC�ru.;T)e bIVISION �Noti'iicationeannd(.
ItflwN Ali{M1NT . .. Payment ofrQQJ ..
s4 1 a T A I c T
ON
�.1. 1/18/2603, .
Abco C66suucnoi
d; JobNo:IX141
14980,L1agas Avenue.
San bfartiit.CA 95046 Invoice No:DRU17
''!he Hay Area Air Quality ManagMle f�}(st_rtot.(g yAQ )�knowl A"ROVeD :
1 yourAstfe@tfis Removal or noMolnfoij Aldai do orlbad as: Aemo1itionE �'
CUP-ERTIN ES OMMIS
Site address' 20G9btSeofie]d Drive'
Capertlno, CA 95614 DAT
1 SIGNED
This sato plan and. spetdic*ops �1
Start Date I?ecistlf+er 3; 2001 be kept n job at ad timet Brad-itis Uh 1
Cum leuon Dale " lawful ke any changes of altars
s' P December°9,2003 on same without written ItlBApIoA 11d1b
f Removal amounts of friable ACM Q fin '4 p cubic
.fe3t f9@tsquare feet the iwildkTg Dept, PQ ItdpO.
L . I
% stamping at this plea trod VeafiaYalfa
5ltoutd it become accessaryto rout> ;flitsplan,please'60 so in the spa r�M1JW1AA ftRF3
copy(be Disirict by fax or by mail approval of the violflloA'd any
of any fKV Dtdion6e Vr,Vaite Un.
REGULATION 11-2 R�VISt�JfU BAACtMQ J# 1X14'1! ;
y ' ftPb
ION#
w" SI gRT DATF. COWLET[ONDAT$
4 _/ �_--r
NOTES This form is not iriten#q&f to a i errfrcat:'on of zither the completeness ofyour original notification .
f or of its.compliance with,BA &4� 'RpguJrY[tgr,'.,l j_S,.Ifyou have any questions about this
: ..' acknowledYrnent'please cell put rjjwv tlt 913) 749-4762.
a:.'
ata,`
Pacific Gas and 10900 North Blaney Avenue
Electric Cupertino, CA 95014
Company
003
City of Cupertino
10300 Torre Ave.
Cupertino, Ca 95014
To Whom It May Concern:
Subject: Removal of Gas and/or Electric Facilities
The gas and electric facilities have been removed and/or abandoned at
o&!JIO Scori6Lb D(2- ' cL)P6-271&)O on NoV 18, ami
If you have any further questions, please contact me at (408) 725-2024.
Sincerely, .
Service Planning ������
top'�,
•
Community Development
10300 Torre Avenue
aClOF
Cupertino CA 95014 .
Telephone(408)777-3228
Fax(408)777-3333
�UPEkTINO
Building Department
JOB ADDRESS: t PERMIT # pow od j y
OWNER'S NAME: , PHONE #
GENERAL CONTRACTOR: FAX # _
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork 1 ,� ✓
Cement Finishing z�
Electrical
�c r
Excavation
Fencing
�! Flooring: Carpeting
Linoleum/ Wood
d Glass / Glazing
Heatingt
Insulation s � ✓ �� 3 /d�--
Landscaping
Lathing
Masonry ��-
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering ,g O
Plumbing C e{
Roofing ,a j
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date