HomeMy WebLinkAbout14080037CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 22772 ALCALDE RD
CONTRACTOR: ROCHA'S COMPANY
PERMIT NO: 14080037
OWNER'S NAME:
SAN JOSE, CA 95125
PHONE NO: (408)593-7405
JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL
❑ LICENSED CONTRACTOR'S DECLARATION
INTERIOR DEMO ONLY- SEE DETAIL SHEET 5A
License Class (! ZD Lic. # SS l 1 12
Contractor Date
I hereby affirm that I am licensed u der tl 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:
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: $700
I have and will maintain Worker's Compensation Insurance, as provided for by
APN Number: 34244014.00
t>ccupalic) .1 `pc:
Section 3700 of the LaborCode. for the performance of the work for which this
permit is issued. �r
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
PERMIT EXP ORK IS NOT STARTED
correct. I agree to comply with all city and county ordinances and state laws relating
WIT 80 DAYS OF P ISSUANCE OR
to building construction, and hereby authorize representatives of this city to enter
180 DA O ST CA LED INSPE I N.
upon the above mentioned property for inspection purposes. (We) agree to save
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
the
jn `�
costs, and expenses which may accrue against said City in consequence of
Issued by: Date cf�
granting of this permit. Additionally, the applicant understands and will comply
with all non -point sou a regulations per the Cu 'no Municipal Code, Section
9.18.
— >
Signature Date
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.
❑ 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)
1, 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. 1 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 Cupert' o Municipal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25 , 2553 d
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized gent: 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
CITY OF CUPERTINO
lit Ill TIFF FQTIMATOR—RITILDING DIVISION
FEE ID FLR AREA
s.f.
1DEMORES
ofiw, ET Li
Thsnih. tors/� 1%;1 .
NOTE: This estimate does not include jees due to other Departments (i.e. rianning, ruoac rvorKs, ,r[re, auauury newer
n:..._:... ..... TL6..o-1 s tha nraliminany infnrrnatinn availahle and are anh, an estimate. Contact the Dent for addn7 info.
"&at,
FEE ITEMS (Fee Resolution 11-053 Ef: 711:73)
ADDRESS: 22772 alcalde rd
DATE: 08/06/2014
REVIEWED BY: Mendez
Plant Check Fee:
APN:
BP#: ��Q�3
*VALUATION: $700
*PERMIT TYPE: Demolition Permit
"
PRIMARY SFD or Duplex
Plaonh.: 11ech.:'l le
PENTAMATION 1 SFDWL-DEM
PERMIT TYPE:
USE:
Permit Fee:
i
Suppl. Insp. Fee -(F) Reg. Q OT
0.0
WORK
interior demo only- see detail sheet 5a
SCOPE
FEE ID FLR AREA
s.f.
1DEMORES
ofiw, ET Li
Thsnih. tors/� 1%;1 .
NOTE: This estimate does not include jees due to other Departments (i.e. rianning, ruoac rvorKs, ,r[re, auauury newer
n:..._:... ..... TL6..o-1 s tha nraliminany infnrrnatinn availahle and are anh, an estimate. Contact the Dent for addn7 info.
"&at,
FEE ITEMS (Fee Resolution 11-053 Ef: 711:73)
FEE
-
QTY/FEE
MISC ITEMS
Plant Check Fee:
Plaonh.: 11ech.:'l le
Permit Fee:
$574.00
Suppl. Insp. Fee -(F) Reg. Q OT
0.0
hrs
$0.00
i
Strum; Motion Fee: IBSEISMICR
$0.50
Select an Administrative Item
Bldt Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
j $575.50
j $0.00 TOTAL FEE:
$575.50
Revised: 07/10/2014