13080233CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 21810 ALMADEN AVE
CONTRACTOR: PRO QUALITY
PERMIT NO: 13080233
BUILDERS, INC
OWNER'S NAME: RAVI SUNKARA
1325 E JULIAN ST STE A
DATE ISSUED: 08/30/2013
OWNER'S PHONE: 4086566115
SAN JOSE, CA 95116
PHONE NO: (408) 298 -8983
JOB DESCRIPTION: RESIDENTIAL 11 COMMERCIALU
LICENSED CONTRACTOR'S DECLARATION
License Class_ Li,. # $
DEMO (E) 934 S.F. MAIN HOUSE & 616 S.F. GARAGE
Date
Contractor
I hereby affirm that I am licensed under the provision of C apter 9
(commencing with Section 7000) of Division 3 of the Business & Professions
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
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.
Sq. Ft Floor Area:
Valuation: $4000
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 35715034.00
Occupancy Type:
Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXPIRES IF WORK IS NOT STARTED
correct. I 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 DAYS F A ALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Is by: 0 3
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
9.18.
RE- ROOFS:
Signature Date 440
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
inspection.
❑ OWNER- BUILDER DECLARATION
Signature of Applicant: Date:
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1, as owner of the property, or my employees with wages as their 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).
I have read the hazardous materials requirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
I hereby affirm under penalty of perjury one of the following three
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 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 for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupertino Municipal Code, Chapter 9. and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 255 5533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date: /
permit is issued.
I certify that in the performance of the work for which this permit is issued, I shall
not employ any person in any manner so as to become subject to the Worker's
CONSTRUCTION LENDING AGENCY
Compensation laws of California. If, after making this certificate of exemption, I
become subject to the Worker's Compensation provisions of the Labor Code, I 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
APPLICANT CERTIFICATION
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 state laws relating
to building construction, and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We) agree to save
ARCHITECT'S DECLARATION
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
I understand my plans shall be used as public records.
granting of this permit. Additionally, the applicant understands and will comply
with all non -point source regulations per the Cupertino Municipal Code, Section
Licensed Professional
9.18.
Signature Date
CUPERTINO
DEMOLITION PERMIT APPLICATION 7'I�
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 $0
(408) 777 -3228 • FAX (408) 777 -3333 • building(ftupertino.org
PROJECT ADDRESS -L I Q l D m k^ nw i. /
APN # 03
OWNERNAME gk\ , SU��I
PHONE On _ d-E-MAIL
ln,
STREET ADDRESS �q q. Q � n , , /t _� P
Tc v
CITY, STATE, ZIPj,C �� IT, � ' n ' n
�G` IJE-- -CMAIL
FAX
CONTACT NAME �r
PHONE .. �m `
STREET ADDRESS � �- 5�u I I ` S�
CITY, STATE, Zi �OQ n
FAX
❑ OWNER ❑ OWNER - BUILDER ❑ OWNERAGENT. CCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME I� A
LICENSE NUMBER f �/ Q
,Jn
LICENSE TYPE r��
BUS. LIC #
COMPANY NAME
E-MAIL ^1n A I . ,,
FAX
STREET ADDRESS 3/IS {
/
CITY, STATE, ZIP
PHONE Yog
DESCRIPTION OF WORK((�
RESIDENTIAL
# DWELLING
FFICE USE_
ONLY,
�. Fr.
v TION
FLOOR AREA
UNITS
COMMERCIAL
FLOOR AREA
TYPE OF CONSTRUCTION
# STORIES 1
`
AQMD JOB NUMBER
J #: LIZ- .- .
BY
TOTg�VALUATiON:
ToGU
-
By my signature below, I certify to each of the follow' I am the property o er or authorized agent to act on the property Owner's behalf. I have read this
agi
application and the information I have provided co . I have read the Description of Work and verify it is accurate. agree to comply with all applicable local
ordinances and state laws relating to building co n. I authorize representati rtino to enter the above-i ennttifi property for inspection purposes.
Signature of Applicant/Agent: Date:
/Provide INFO N IRED PRIOR TO ISSUANCE OF DEMOLITION RMIT
OFFICE USE ONLY
V Provide Job Number from Bay Area Air Quality Management District www.baagmd.org @ 415- 749 -4762.
PLAN CHECK TYPE . ;
El ExPREss
_ Provide three copies (Residential) or six copies (Commerical) of a site plan showing protection for any trees 10"
in diameter or more at 3' above grade.
El STANDARD
P vide letter from PG &E (408- 725 -3325) stating all gas and electric has been disconnected.
El LARGE
i/ Provide a letter of inspection, tests, and abatement of any Hazardous Materials. Letter to be initiated by person(s)
El MAJOR e
certified in asbestos, mercury and/or hazardous material examination.
anning Dept clearance to verify building is not considered an historical landmark. Allow 10 business days.
Q�
�✓
letter
rovide of clearance of all vermin from a licensed pest control contractor.
cant the Public Works Department 408 777 "habitable dwelling" inspection.
shall call at - -3104 and schedule a
Xr,pli
vide signed Debris Bin and Recyclable Materials form.
DemoApp_2013.doc revised 02113113
CITY OF CUPERTINO
FEE ESTIMATOR - BUILDING DIVISION
kalADDRESS:
21810 ALMADEN AVE
DATE: 08/30/2013
REVIEWED BY: MELISSA
Plum Check h'ee:
APN: 357 15 034
BP #:
"VALUATION: $4,000
*PERMIT TYPE: Demolition Permit
PLAN CHECK TYPE:
PRIMARY SFD or Du lex
P
Plumb. /tech. /Elec
PENTAMATION 1SFDWL -DEM
USE:
Permit Fee:
PERMIT TYPE:
WORK
DEMO E 934 S.F. MAIN HOUSE & 616 S.F. GARAGE
hrs
$0.00
SCOPE
Plumb./.- �Iech. /E1ec:
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public worKs, rare, aanuary newer visrricz, acnoot
n&.;rt_ erg_ )_ These fees are paced an the nreliminary information available and are only an estimates Contact the Deptjor addn'l in o.
FEE ITEMS (Fee Resolution 11 -053 E . 7ff /1/12)
FEE ID
FLR AREA
s.f.
MISC ITEMS
Plum Check h'ee:
. Suppl. PC Fee
1 DEMORES
1,550
Plumb. /tech. /Elec
Permit Fee:
$557.00
Suppl. Insp. Fee-.0 Reg. ® OTT
0,0
hrs
$0.00
Plumb./.- �Iech. /E1ec:
Plump./ .A,fech. /t_s'lec Permit Fee:
Construction Tax:
,ldrninistrative Fee:
Work Without Permit?
,Advanced Planning Fees:
7-71avel 1)ocutnentaiion Fees:
Strong Motion Fee: IBSEISMICR
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public worKs, rare, aanuary newer visrricz, acnoot
n&.;rt_ erg_ )_ These fees are paced an the nreliminary information available and are only an estimates Contact the Deptjor addn'l in o.
FEE ITEMS (Fee Resolution 11 -053 E . 7ff /1/12)
FEE
QTY/FEE
MISC ITEMS
Plum Check h'ee:
. Suppl. PC Fee
Plumb. /tech. /Elec
Permit Fee:
$557.00
Suppl. Insp. Fee-.0 Reg. ® OTT
0,0
hrs
$0.00
Plumb./.- �Iech. /E1ec:
Plump./ .A,fech. /t_s'lec Permit Fee:
Construction Tax:
,ldrninistrative Fee:
Work Without Permit?
,Advanced Planning Fees:
7-71avel 1)ocutnentaiion Fees:
Strong Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
_SY
$558.50
$0.00 "TOTAL''°
T
$558.50
Revised: 07/01/2013
CUPERTINO
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014 -3255
Telephone: 408 - 777 -3228
Fax: 408 - 777 -3333
CONTRACTOR / SUBCONTRACTOR LIST
JOB ADDRESS: `2' &q ALw4p 4i A'Ve
PERMIT #
PHONE# ' - 2
OWNER'S NAME: P-kVI S ()ykAi2A,
GENERAL CONTRACTOR: rs
BUSINESS >. LICENSE #
ADDRESS: 5- uc.l� S i
CITY /ZIP' ODE a4KfJOS�. CA
*Our municipal code requires all businesses working in the city to haves 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 CUPERTINO
BUSINESS LICENSE.
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information.
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring / Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
ALMADEN AVE. (WIDTH VARRIES)
9L--
"I
co
bD
EP
�4
0
Sr
DEMOLITION SITE PLAN
NORTH
COMMUNITY DEV.-:71
BUILDING Dt"11
ED
This set Of Plans and spec,"'fica-Lions MUST b,4
Job site during co
nstruction. it is k,n; 7,
changes or alterat; unlat'vh-j! tc
therefrom, without ap '01-13 on saM r,.,
e' 0 r t 0 d.,
PI*OvaI from the SUildi
The stamping Of this Plan and specifications rig D'7ic,;aj.
be held to pormit
or to be cifications SHALL
of a
Oval Of the V4"j;Ej2;
ova' 0' U011
a_- nance�or ie lave.
DATE
PERMIT NO.
DEMOLITION NOTES:
al. DEMOLITION PLAN 15 PROVIDED FOR REPEREWE ONLY.
615•IMMAL CONTRACTOR SHALL aAREM"Y COORDINATE'
DEMOLITION AND REMOVAL WITH NOTES AM DIMENSIONS
INDICATING THE EXTENT AND NATURE OF HEN CONSTRUCTION
SHOM ELSEVVERE IN THESE DOCUMENTS
2. 615NEKAL CONTRACTOR 15 RESPONSIBLE MR SWANZLY
SHORING IN PLA41! ALL OVERHEAD 57RIV-TLWZS PRIOR TO
THE REMOVAL OF ANY EXISTING SUPPORT STFIMMIKES.
S. GAP -OFF PLV?-WNS, OAS, AND ELIVOTRZAL LINES AS
REWIRED. 1
APN NO. '-S'i- - 15 -03
EXISTING LIV IW ING SPACE 934 M
GARAGE 4W SQ. FT.
G V,
ID
DATE
P.
41A
I
(;UPERTINO
Building Department
AUG 10 2013
EVVED FOR CODE COMPL'AN'
Reviewed By
Arm
am.
9L
VE1,10 SITE PLAN
DP