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13090015 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21104 TULITA CT CONTRACTOR:RODERICK COOPER PERMIT NO: 1,3090015 DEMOLITION(REBUILD OWNER'S NAME: ANJALI PALK.AR 2625 MIDDLEFIELD RD APT 106 DATE ISSUED:09/04/2013 OWNER'S PHONE: 4087999350 PALO ALTO,CA 94306 PHONE NO:(650)720-1301 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL Ll COMMERCIAL License Class Lie.i1,4 _1 3 77 DEMO(E) 1053S.F. LIVING SPACE &300 S.F. GARAGE Contractor /� ate / 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: 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 Wav rtnance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$9000 e and will maintain Worker's Compensation Insurance,as provided for by on 3700 of the Labor Code,for the performance of the work for which this APN Number:32628070.00 Occupancy Type: 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 1 T CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said Cityin consequence of the granting of this permit. Additionally,the applicant understands and will comply Issue Date: with all non-point source regulatjonsper the Cupertino Municipal Code,Section 9.18. J /' RE-ROOFS: Signature Date_'//3 All roofs shall be inspected prior to any roofing material being installed.If a roof is TT' installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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(See.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. 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 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 255 3-.hnd45534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Dater 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 Compensation laws of California. If,after making this certificate of exemption,I CONSTRUCTION LENDING AGENCY 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 indemnify and keep harmless the City of Cupertino against liabilities,judgments, ARCHITECT'S DECLARATION costs,and expenses which may accrue against said City in consequence of the 1 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 DEMOLITION PERMIT APPLICATION Q1) COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION l O 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 GUPERTfI?dQ 1 (408)777-3228•FAX(408)777-3333•build ing(d.)cupertino.org PROJECT ADDRESS 1 ry i APN N OWNER NAME PH C E-MAILV d v� 7 STREET ADDRESS CITY, STATE,ZIP FAX CONTACT NAME (� PHO (0567 j V _ i (E-MAIL STREET ADDRESb, I- t� „ CITY,STATE, ZIP G Y 4 1�r, FAX all ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT 'CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ` LICENSE NUMBER LICENSETYPE BUS.LIC N COMPANY NAME f d n E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP P ONE DESCRIPTION OF WOlR v)I-AP 'U✓> t IVA lou i i RESIDENTIAL p� N DWELLING OFFICE USE ONLY FLOOR AREA I L(,J v S UNITS USE occ. TYPE so,FT. VALUATION COMMERCIAL FLOOR AREA TYPE OF CONSTRUCTION N STORIES AQMDJOB NUMBER f T#: T VALUATION: J � i By my signature below,I certify to each of the following: I am the property owner ora orized agent ❑ e ty owner's behalf. I have/-ad this application and the information I have provided is correct. I have read the Description of Work and verify it is urate. I agree to comply withal]applicable local ordinances and state laws rela onstruction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date:jc%:5:��Ae��,6.14 SUPPLEMENTAL FO ATiON REQUIRED PRIOR-TO-'ISSUANCE OF DEMOLITION PERMIT OFFICE USE ONLY Provide Job Number from Bay Area Air Quality Management District www.baadmd.org @ 415-749-4762. PLAN CHECK TYPE Provide three copies(Residential)or six copies(Commerical)of a site plan showing protection for any trees 10" ❑ EXPRESS in diameter or more at 3'above grade. ❑ STANDARD Provide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected. El LARGE Provide a letter of inspection,tests,and abatement of any Hazardous Materials.Letter to be initiated by person(s) ❑ MAJOR/aj certified in asbestos,mercury and/or hazardous material examination. Planning Dept clearance to verify building is not considered an historical landmark.Allow 10 business days. Provide letter of clearance of all vermin from a licensed pest control contractor. ��JJ Applicant shall call the Public Works Department at 408-777-3104 and schedule a"habitable dwelling"inspection. Provide signed Debris Bin and Recyclable Materials form. i i DemoApp_20/3.doc revised 02//3//3 i CITY OF CUPERTINO D FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 21104 TULITA CT DATE: 09/0412013 REVIEWED BY: MELISSA APN: 326 28 070 BP#: �b *VALUATION: $9,000 *PERMIT TYPE: Demolition Permit PL-1N Cl/ECK TYPE PRIMARY SFD or Duplex PENTAMATION 1SFDWL-DEM USE: PERMIT TYPE: WORK DEMO E 1053S.F. LIVING SPACE & 300 S.F. GARAGE SCOPE FEE ID FLR AREA s.f. 1 DEMORES 1,200 Plumb, Plcot Check Ek,. Plun Cltcek L t. P,>; 1t Fee: Plumb, Permit F e. Elec. Permit Fee: Other.Uech. In p. Other Plumb In. Other Eley. Insp tech. Inep. Fce: Plumb. hula. Fez: Elec.Insp. Fee: Li NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Thesefees are based on the prelimina information available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS (Fee Resolution 11-053 Eff 7/1/12) FEE QTY/FEE MISC ITEMS Plan Check Fee: Supt:/. PC A e Plurn/�.: ?;tc<ar.;Flec Permit Fee: $557.00 Supp/. Insp. Fee:Q Reg. Q OT 0,0 hrs $0.00 Plumb.lAleei .%Elec Plumb./MecklElec Permit Fee: Construction Tax: Aclininistrative Fee: YVork O'ithout Pet"mit? Aa'vcrnc'ec/Plaiming Fees: Travel Docu,inentation Fcos: Strong Motion Fee: IBSEISMICR $0.90 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $558.90 $0.00 TOTAL FEE: $55$.90 Revised: 07/01/2013 Building Department City Of Cupertino 10300 Torre Avenue Cupertino,CA 95014-3255 Telephone: 408-777-3228 C U P E RT I N O Fax: 408-777-3333 CONTRAC'T'OR I SUBCONTRACTOR LIST JOB ADDRESS: �� PERMIT# d Q OWNER'S NAME: PHONE# D8 GENERAL CONT CTOR: ' , BUSINESS LICENSE# ADDRESS. CITY/ZIPCODE: *Our municipal code requires all businesses working in the c ty to .have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBC RACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractor : �� GJ ; Signlure Date Please check applicable subcontractors and complete the following information: W SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE# I ' Cabinets & Millwork Cement Finishing Electrical I Excavation l I 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 i' Owner 1 Contractor Signature Date ELIPROCEDURE CHECKLIST FOR DEMOLITION PERMITS COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION ALBERT SALVADOR, P.E.,C.B.O., BUILDING OFFICIAL CUPERTiNO 10300TORRE AVENUE •CUPERTINO, CA 95014-3255 (408)777-3228 •FAX(408)777-3333• building(abcupertino.org PURPOSE i The demolition application should be applied for before or at the same time as the new construction permit application (these are separate permit applications and fees). Permit fees are due at the time of the application/plan submittal. The new construction permit will not be issued until the demolition permit is issued, unless a letter obtained from the Building Department is submitted stating that "The existing house will not be demolished until the new construction permit is issued". The letter needs to be signed by both the property owner and general contractor. I > REQUIREMENTS To obtain a demolitionpen-nit in the City of Cupertino, please completelete a Demolition permit application along with each of the following requirements as it applies to your specific project. Eii1. Three (3) copies of a Site (Demolition) plan for Residential or six (6) copies for Commercial will be required showing any trees 10 inches in diameter at 3 feet above grade on the subject property, and what means will be taken to protect these trees. '3 2. PG&E must be contacted AS EARLY AS POSSIBLE prior to demolition to schedule the abandonment. Contact PG&E at(408) 725-3325. A letter from PG&E shall be provided to the City, stating that all gas and electric has been disconnected. (This step can be time consuming,so it is important to begin the process immediately) 3. Provide Job Number from Bay Area Air Quality Management District www.baaqmd.gov@415-749-4762. c— vx4+ 4. Check to see if the building is considered an historical landmark. Obtain clearance If from the Community Development Planning Department. Allow 10 working d 13 5. Provide a letter of clearance of all vermin from a licensed pest control contractor. !J 6. Important: Prior to the issuance of the demolition permit, the applicant must callq.� the Public Works Department at (408) 777-3104 and arrange a"habitable dwelling" inspection. ii IvOvq 7. Debris bin and Recycling sheet: read, sign and date. The sheet will remain in the I project's building permit file for the duration of the project. j 8. Commercial only-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. DemoProcedure.doc revised 2/13/13 Pacific Gas and Electric Company 10900 No.Blaney Aventm Cupertino,CA 95014 1 City of Cupertino 10300 Torre Avenue 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: - Gas service cut at main in street on: 8/15/13 at 21104 TULITA CT CUPERTINO CA 95014 - Electric service cut at pole on: 8/21/13 at 21104 TULITA CT CUPERTINO CA 95014 Sincerely, Teresit r nadosin Pacific Gas & Electric Company DeAnza Service Planning r -Z HD Design & Engineering JOB 18965 TUGGLE AVENUE,CUPERTINO,CA 1570 Mission Avenida SHEET NO. Lateral Analysis OF Morgan Hill, CA 95037 CACULATED BY HD DATE 2/8/2013 PHONE: (408) 605-8859 FAX: (408) 351-7463 CHECKED BY DATE Email: VVstructural@yahoo.com SCALE REVISION 1 ti k U USE SIMPSON HDU5 HOLDOWN (ALLOWABLE TENSION) HDU2-SDS2.5ALLOW 3075# HDU4-SDS2.5ALLOW 4565# HDU5-SDS2.5ALLOW 5645# HDU8-SDS2.5ALLOW 6970# HDU11-SDS2.5ALL0W 9535# (6x EDGE MEMBER) HDU11-SDS2.5ALL0W 11175# (8x EDGE MEMBER) SIMPSON CS16 (COIL STRAP) HOLDOWN (ALLOWABLE TENSION) i I EXIST , HOUSE , M ANTOINE MEO Custom TO BE REMOVED ------- � Residential \ Design \ ` 0 VERHEAD \ ELECTRIC \ O (TC) \ w P.O. Box 610 \ CS P•U•E• Sunol, CA. 94586 N 90'00'00" W ` 1J7.13' (TC) 925-963-8646 \ A i StonymeoCaol.com 0 EX. WO OD FENCE \ Iv E 9S 9- �+ \\ IL DIRT 2�1 33 Associate Member I \\ 0E ___J. (� — The American Institute of Architects I DIRT -' J REIVOVE COI�1CR (Tc) (TC) (TC) r nn 30 7E (Tc)d=711747 R=4000' (TC) Tli a aT Of^1a 7 S r . h u �r fC i n I (TQ) 1 ► L=49.77' Nr tr 1 1 1 y D T // �� til:. .,i,m,lhiti:9u��z,�-n ;t:`?Y`I��1� �:i�U �,,J1 .,ir✓'�. 12" Thi; S I t,ping of tills nR 7,i it 1.-;v�-1catit-',t , r (TC) (TC) O's Ell)/ !y' f ``nanc. 3 c. mac» N� � ` (TC) REMOVE / 'j %' c'6p� (Tc) PEIRN41, N'O. / I 1 EXG HOUSE WA TER METERS �>>6„ �// / CONCRETE / L.MOW STRIP PALKAR EX. WOOD FENCE it , \ 6TED FRCKYARD :., R E S I D E N C E O Aw 114 BY Cl 14 lwi'� PLANNING DEPT � -f-----TREES TO BE REMD l/ED; TYPICAL 4 I / � 21104 TULITA CT •rk2 DG-i )tZ-'-V0 CUPERTINO TREE t DR/PLINES CALIFORNIA TO BE REMO QED W (V O � O \ O / EX. WOOD FENCE I DEMO SITE PLAN i \ DIRT 6" REL CA TE \ TO FR T `o \ 4» , O PRELIMINARY 12' OAK TO REMA .,o -1 NOT FOR CONSTRUCTION 12 CUPERTINO NOT FOR BE) I iil 1n APN 326-28-070GRAPHIC SCA: , S TRACT # xxx I 10 0 5 10 20 SET LOT # XXX I110 Oo REVIEWED FOR CODE COMPLIANCE PLN # XXX I I o0 8„ B Reviewed �— XXX FEET I Z { IN ) y �y BLDG # 1 inch = 10 it 6" �6, SUB DATE SUBMITTAL EX. WOOD FENCE 0,10 6 1. 11/8/12 Planning 1 2• 12/20/12 Planning 2 N 90-00-00-- W 75.00 3. 03/15/13 Planning 3 4. 5.., CONTRACT DATE 7/20/2012 1s ISSUE DATE 03/15/13 SCALE AS NOTED DRAWN AM / JS ---- JOB 2012-552 SHEET Al . 3 EXIST. HOUSE EXIST. HOUSE OF SHEETS All ideas. designs & Ions represented this are owned b & the property f An P o ine Meo & were developed for use n i 9 PYdrawing Y P P Y p o & n connection with the specified project. None of such ideas, desi ns or pions shall be sed by or disclosed to any person, firm or corporation for any purpose whatsoever without the written permission of ntoine P. Meo. Owner & reprod coon companies shall not reproduce copies from these drawings without the permission of Antoine P. Meo. All work shall be performed in accordance with the Prevailing building codes & all local applicable codes & ordinances. Written dimensions on these drawings shall have precedence over scaled dimensions. P 9 9 PP 9