D-2017-0055CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: I PERMIT NO: D-2017-0055
10424 STERLING BLVD, CUPERTINO CA (375 24 003) GILBERT FERNA19DEZ
JR INC'
CAMPBELL, CA 95008
OWNER'S NAME: MAGED ATTIA
OWNER'S PHONE: 714-222-4410
LICENSED CONTRACTOR'S DECLARATION
License Class 5 Lic. # 0 9550
Contractor GILBERT FERNANDEZ JR INC Date 10/31/2018
I hereby affirm that I am licensed under the provisions of Chapter 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:
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
erformance of the work for which this permit is issued.
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.
APPLICANT CERTIFICATION
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 indemnify and keep harmless the
City of Cupertino against liabilities, judgments, costs, and expenses which
may accrue against said City in consequence of the 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.
S' • ature Date 8/14/2017
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
r. I, 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)
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
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.
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.
3. 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 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 forthwith comply with such provisions or this permit shall
be deemed revoked.
APPLICANT CERTIFICATION
1 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 indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
consequence of the 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.
Date 8/14/2017
ISSUED: 08/14/2017
PHONE NO: (408) 500-8511
PERMIT INFO:
BLDG —ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
DESCRIPTION:
.0 SINGLE STORY SFD (1011 S.F.); CARPORT (268 S.F.)
Sq. Ft Floor Area: J Valuation: $10000.00
Number: I Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby Ayende
Date: 08/14/2017
RE -ROOFS:
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.
Signature of Apl
Date: 8/14/2017
ALL ROOF COVERINGS TO BE CLASS "A"
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials fequirements under Chapter 6.95 of the
California Health & Safety Code, Sections 25505„25533, and 25534. I will
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Section 25532(a) should I store or handle hazardous
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cu tino Municipal Code, Chapter 9.12 and
the Health & Safety Co ections 25505, 25533, and 25534.
eror authorized agent:
14/201
CONSTRUCTION LENDING A
I hereby affirm that there is a construction lending agency for the performance
of work's for which this permit is issued (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed
Professional
ooss
DEIMOLITIOWPERMIT APPLICATION
COMMUNtTY'DEVELOOMENT DEPARTMENT 4 BUILDING DIV18ION
I 6360-TORRE AVtNU#- allPERTINO, CA 96014-3255
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.10424 Sterling Blvd Cupertino, CA 95014
375-24-003
Maged Attia
(714)222-4410 1 "Am magedaa@yahoo.com
842 San Petronio Ave Sunnyvale, CA, 94085 None
catrrAcartt Gil Fernandez
(408)722-0057
FWAM
gf.gilfernandez@gmaii.com
2643 S Bascom Ave #30
MY. YrATE, W Campbell, CA, 95008
None
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Gilbert Fernandez Jr, INC.
gilbert-fernandezjr@yahoo.com
FAX (408)963-6185
1821 SBascom Ave. #258
',"T-' Campbell, CA, 95008
MONT- (408)500-8511
tat seRrtctoFwer Demolition of entire existing home. Removal of all unprotected trees. Add tree protection
measures to the protected trees.
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geonsmictibn
Signature of4pjieatavxgent: Data:: 07/14/2017
SUPPIXWqTA. ns&b*A -nox'RAQUIRED PRIOR TO ISSUANCE OV DEMOLMON PEILNUT
x Provide J6-N=berfr01m'Bay Atex Air Quality Mmagement. District wAwbaagmd=@ 415-7494761.
XProvide dtree.6opi4 for any trees or more at Vaibove.gra8c.
oft site,plknshowing protectiot
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Provide letter 1rotnTCY&E:(408872573325) stating all gas and electric Ms,been disconneaed.
x Planning D*zjearmcd to verify building isnot considered an historical landrnwk. Allow 10 business days. 4-&rlv
X. Provide letter rpfcjtirixtdd ofall vermins from a licensed pest control comtraaori
ffApplieant inspection,
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shalt -call thePiibliq Works .Department,at408-777;8104 and schadule a:'habitable:dUlelline
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x Prw&tigned Debris Bin, =dRecyclable Materials. form.
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N/A Co==- mal Buildings Onl}:- Provide Fire Dept clearance, for ffi-e suppressioa alarm rystem review
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7'
7'
5'-6"41'-8"13'57' PROPERTY LINE 153.19' PROPERTY LINE148.20' PROPERTY LINE57.22' PROPERTY LINE
24" MODESTO ASH
STREET TREE
(E) 16" MAGNOLIA
TREE TO BE REMOVED
(E) 8" TREES
TO BE REMOVED
(E) 8" TREES
TO BE REMOVED
(E) CARPORT TO BE REMOVED
268 SF
(E) HOME TO BE REMOVED
1,011 SF
(E) FENCE TO BE REMOVED
(E) SIDEWALK
TYPICAL TREE PROTECTION FENCING
SEE TREE PROTECTION STANDARDS
1
A1
1
A1
(E) FENCE TO BE REMOVED
(E) GAS METER
(E) ELECTRICAL METER
STERLING BLVD
2' P.U.E PER R1
P.U.E & DRAINAGE
EASEMENT PER R1
AREA = 2,899+- SF
NTREE PROTECTION SITE PLAN
1/16" = 1' - 0"10424 STERLING BLVD CUPERTINO CA, 95014A1
1
A1
1
A1
PROJECT DATA
OWNER:
MAGED ATTIA
714.222.4410
SCOPE OF WORK:
DEMOLISH EXISTING HOME &
CARPORT. FENCING
ATTACHED TO CARPORT TO
BE REMOVED. FECNING IN
REAR YARD TO BE REMOVED &
REPLACE. 4 TREES TO BE
REMOVED (SEE SITE PLAN).
LOT:
8,590 SF
Abby Ayende
08/15/17
08/15/17
D-2017-0055
Abby Ayende