12090066CITY OF CUPERTINO BUILDING PERMIT I
BUILDING ADDRESS: 10325 MENHART LN I CONTRACTOR: DWK CONSTRUCTION I PERMIT NO: 12090066 I
OWNER'S NAME:
I CUPERTINO, CA 95014 I PHONE NO: (408) "6-1186 I
❑ LICENSED CONTRACTOR'S DECLARATION
License Class Li,. # (3 2490'�
Contractor (.. 5 ftlCe h'(1 Date 2 _7 IZ
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
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.
APPLICANT CERTIFICATION
[ 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 ~Z / —� Z
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
the following two reasons:
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)
1, 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:
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.
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
I certify that I have read this application and state that the above information is
correct. 1 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.
BUILDING PERMIT INFO: BLDG r ELECT r PLUMB F
MECH r RESIDENTIAL r COMMERCIAL r
JOB DESCRIPTION: SFDWL DEMO 814 SQ LIVING, 225 SQ FT
CARPORT/GA RAGE
Sq. Ft Floor Area: I Valuation: $8000
APN Number: 37515037.00 1 Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: - 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.
Signature of Applicant: Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I have read the hazardous materials requirements 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 1 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 Cupertino Municipal Code, Chapter 9.12 and the
Health & Safety Code, Sections 25505, 25533, and 25534.
agent:
Date:'_ / Z
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of mrk'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.
Signature Date
Licensed Professional
CITY OF CUPERTINO
MM-1 FEE ESTIMATOR - BUILDING DIVISION
ADDRESS: 10325 Menhart Ln
DATE: 09/11/2012
REVIEWED BY: Sean
APN:
BP#:
*VALUATION: 1$8,000
*PERMIT TYPE: Demolition Permit
PLAN CHECK TYPE. -
PRIMARY SFD or Duplex
USE:
PENTAMATION 1 SFDWL-DEM
PERMIT TYPE:
WORK
Demolition of 814 sq ft residence and 225 sq ft carport/garage.
SCOPE
FEE ID FLR AREA
s.f.
1 DEMORES 1,039
1,1ech. Plan Check
Plumb. Plan CheckF-T
Elue. Plan Check
rbTc:clt. Permit Fee:
Plumb. Permil Fee:
Efec, Permit Fee-
Other Mech. Insp,
Oilier Plumb Insp.El--L-
Other Elec. Insp.
1*ech. Imp. Fre:
Plurrrb, Irrsp. Fee:
/ace. Insp, 1 Kc:
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School
District, etc). These fees are based on the preliminary information available and are only an estimate. Contact the Dept jor addn 7 info.
FEE ITEMS (Fee Resolution 11-053 E(f. 711111)
FEE
QTY/FEE
MISC ITEMS
Plan Check F(-,e:
SuPf)l, PC: Fee
Plumh.111eclr./Elec
Permit Fee:
$534.00
Suppl. Insp. Fee-0 Reg. Q OT
Fo.oThrs
$0.00
Phimh.l.,Vech.lElec
Plumh.AHec-h./Flee Permit Fee:
Conywuction .Tax:
,4dtninistrative Fee:
Ifo rk {Without Permit?
Advanced Plunrting Fees:
�
Trai,el Documentation Fees.
StronP Motion Fee: IBSEISMICR
$0.80
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$535.80
$0.00 TOTAL FEE: $535.80
Revised: 07/01 /2012
CUPERTINO
DEMOLITION PERMIT APPLICATION
COMMUNITY DEVELOPMENT ELOPM T DEPARTMENT • BUILDING DIVISION CA10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 n O
(408) 777-3228 • FAX (408) 777-3333 • building(@cuper-ino.org \
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DESCRUMON OF WORK
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FLOOR AREA
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TYPE OF CONSTRUCTION .
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By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building consw Ation. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes.
Signature of Applicant/Agent: Date: Z—
SUPPLEMENTAL INFORMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT
611TICE USEONLY
PtrcCJIE[e
Provide Job Number from Bay Area Air Quality Management District www.baaamd.org @ 415-749-4762.
EXPRESS _:., •..:
Provide three copies of a site plan showing protection for any trees 10" in diameter or more at 3' above grade.
_ Provide letter from PG&E (408-725-3325) stating all gas and electric has been disconnected.
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_ Provide a letter of inspection, tests, and abatement of any Hazardous Materials. Letter to be initiated by person(s)
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certified in asbestos, mercury and/or hazardous material examination.
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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.
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.
Commercial Buildings Only: Provide Fire Dept clearance for fire suppression / alarm system review.
DemoApp_201 Ldoc revised 03116111
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City of Cupertino
Public works Department
Environmental Programs Division
10300 Torre Ave
Cupertino, CA 95014
CUPERTINOGREEN
Program (408) 777-3354
Construction and Demolition Recycling Diversion
Requirements and Instructions
Covered projects, or all construction, demolition and renovation projects that are 3,000 square feet or more
are required to complete a Waste Management Plan for the City of Cupertino demonstrating that 60% of the
material generated is recycled, in compliance with ordinance CMC 16.72.050. At the conclusion of the project
a Construction Recycling Report must be filed with the Public Works Department/Environmental Division
showing the tons recycled and disposed by material type. Use tonnage information from weight tags provided
by facilities to quantify total estimated waste and percentages for materials. Weight Tags of all material
recycled and disposed must be submitted with the final report in order to receive a Final Building
Inspection.
r- - ----.- ..-- - - - _..- - - .. - - -- --- - - - -
� Recology is the only debris bin service provider franchised to do business in Cupertino.
Debris from a project 3,000 square feet or more in Cupertino can be collected and
disposed by using:
Pleas check all that apply:
T am not using a Recology debris bin, however, the project is less than 3,000 s.f., e.g. buildings, patios,
sidewalks, driveways.
❑ I will use a Recology debris bin. By Agreement with the City, Recology will prepare my required
Waste Management Plan & Recycling Report. Contact Recology: (408) 725-4020.
❑ I am not using a Recology debris bin. I will provide the following submittals to the Citv's Public
Works Department, showing that I have recycled at least 60% of all ci aterial:
Ask for the Construction & Demolition Recycling Packet from the Building, Department and
complete the following:
✓ Submit a Construction and Demolition Waste Management Plan with )5tcr kkgrermit—y
application. No fee for this plan. Forms are available at the Building/Public Works counter and online
at www.cupertino.org/environmental. Report the tonnage recycled and disposed, by material type.
Recycling facilities must be selected from the City's approved list of Recycling Resources.
✓ Submit a Construction Recycling Report form. The report is required before the Building
Department will schedule a final inspection. The report fonn is available at the Building/Public
Works Counter and online wtvw.cupertino.org/eizvironmeiztal.
Signature:
Name: (printec
Title:
Phone:
Project Addres
This form to remain in the project's building permit file for the duration of the project.
Revised 317112 1
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TYP. POST
ELEL EVATION
NOTES:
1. THE DEVELOPER SHALL INSTALL THE "TREE PROTECTION" DEVICES
PRIOR TO THE START OF GRADING OR CLEARING WORK.
2. THE CITY RESERVES THE RIGHT TO ISSUE A "STOP WORK" NOTICE IF
THE "TREE PROTECTION" DEVICES ARE NOT INSTALLED OR IF THE
DEVICES ARE NOT MAINTAINED PROPERLY.
3. SEE THE PROJECT GRADING PLAN FOR SPECIFIC TREES THAT REQUIRE
PROTECTION. ALL SPECIMEN TREES REQUIRE PROTECTION UNLESS
OTHERWISE NOTED.
4. NO EXCAVATIONS WITHIN THE "TREE PROTECTION AREA" ARE ALLOWED
UNLESS UNDER THE SUPERVISION OF A REGISTERED TREE SERVICE COMPANY.
5. ANY FILLING WITHIN THE "TREE PROTECTION AREA" SHALL BE DONE IN
ACCORDANCE WITH A DETAILED IMPROVEMENT PLAN APPROVED BY THE CITY,
6. NO TRIMMING, CUTTING,OR PRUNING OF DESIGNATED TREES CAN OCCUR
WITHOUT A REGISTERED TREE SERVICE COMPANY.
7. CONSULT ORDINANCE 778 OF THE CITY OF CUPERTINO FOR PERMIT
REQUIREMENTS AND EXCEPTIONS.
8. TEMPORARY CHAIN LINK FENCING IS AN ACCEPTABLE SUBSTITUTE TO
THE WOOD CONSTRUCTION. if
TREE PROTECTION STANDARDS
CITY OF CUPERTIMB-I �v 16-4
APPROVED BY : DATE
STANDARD ' DETAILS rITV E IN
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(E) ORANGE TREE TO REMAIN---5' WIDE P.U.E.-------- I
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5' CANOPY
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(E) APRICOT TREE
TO BE REMOVED
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BEDROOM #2 I
LIVING ROOM
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- CUPERTINO
and specif�ations
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