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14060123CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1118 YORKSHIRE DR CONTRACTOR: A-1 POOL REMOVEAL PERMIT NO: 14060123 OWNER'S NAME: TAMING & ERIC WU P O BOX 1212 DATE ISSUED: 06/18/2014 OWNER'S PHONE: 6507932888 CAMPBELL, CA 95009 PHONE NO: (408) 978-2903 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL SFDWL POOL REMOVAL 528 SQ FT License Class � % z- Lic. # &(S6(0 Contractor /d — Date 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 Sq. Ft Floor Area: Valuation: $8200 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 APN Number: 36208007 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIPPIWORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WIT F PERMIT ISSUANCE OR to building construction, and hereby authorize representatives of this city to enterupon the above mentioned property for inspection purposes. (We) agree to save 180 DAT CALLED 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 granting of this permit. Additionally, the applicant understands and will comply Issued b DateWW/P Y • with all non-point source regulations per the Cupertino Municipal Code, Section 9 18. Signa a Date G / ids/ I y 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. ElOWNER-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 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 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 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized age 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 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 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 SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ^U 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ' \�j (408) 777-3228 • FAX (408) 777-3333 • building aacupertino.org \� PROJECT ADDRESS L'( ^E-MAIL `N OWNERNAME`��,w •` PHONE �� `Z CS -0 ► STREET ADDRESS `�✓ CTTYTATE, ZiP T G r� 7� CONTACT NAME if�j� �� PHONE E-MAIL 2 STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME�'� le—LICENSE NUMBER LICENSE TYPE BUS. LIC # L Z COMPANY NAME' �{ E-MAIL FAX /196 ✓ STREET ADDRESS/0 CIT/Y� STA y,IP /! %/ ` PHONE _ Q T T j o a r / , ,(, O ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK USE OF SFD or Duplex ❑ Multi -Family TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION ($) POOL /' �� (� �2O t✓ STRUCTURE: ❑ Commercial POOUSPA MATERIAL TYPE CODES: SPA V - VINYL -LINED F - FIBERGLASS DEMO _ G - GUNITE P - PREFABRICATED CI�lbdi' iliN0l imlii a �ITOTAL �i�� ,r- .i By my signature below, I certify to each of the following: I am the property owner or uthorized 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 o ork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bu' ding cons on. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLE EN'YAL I�FORAIATION REQUIRED Eggs OICE USE ONLY — PLAN,G�E�CK Ti ROUTING SLIP = OVER THE CouNTR ' ❑ BUILDING DEPT _ Commercial or Multi -Family Buildings with Public Swimming Pools: Department of Environmental Health approval required.1-10 TI� XPRESS f f �p ❑ ELANNINGDEPT 'il❑i��ilr'�}Ii��l ❑ PUBLIC WORKS DEPT- EPT QE QE ❑ ,-ENVIRONMENTAL HEALTH 1YIAJOR .b..�.= -� _ = ❑ SANITARY SEWER DISTRICT SwimPoolApp_2011.doc revised 03/16/11 CITY OF CUPERTINO FF,E ESTIMATOR — BUILDING DIVISION ADDRESS: 1118 YORKSHIRE DR DATE: 06/18/2014 REVIEWED BY: MENDEZ 1,W APN: BP#: *VALUATION: 1$8,200 *PERMIT TYPE: Demolition Permit 111A N C 111"C i 7 } 1'/:;. PRIMARY USE: Swimming Pool, Res. PENTAMATION PERMIT TYPE: 1 SFPOOLDE WORK SFDWL POOL REMOVAL 528 SQ FT SCOPE Permit Fee: G1F c;it. Mort C her -k FEE ID # POOLS 1DEMOPRES 1 1'I iwb. Thin Che - 0(her /'aluinh lYF:S;I7. Tlttr�tn. L'd1)7. t"c e. NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Nire, sanitary Fewer District, school n.*- .. - ,.f,. 1 rl.,. ,. i-nnfnrf tho vont for nildn'l info_ FEE// ITEMS (Fee Resolution 11-053 Eff.' 7/1/13) FEE QTY/FEE MISC ITEMS 1,171171h." ilech.: J`lec Permit Fee: $319.00 Suppl. Insp. Fee. -(F) Reg. (:) OT 07 hrs $0.00 1,12 av Ill. i 12!ti7iJ.:. ,ft'C' t.i ':l C iy('7"Y3t7f 1''ee: i�,"onstri.iction T6 �2s;hI2cJ'J1.4 tt"c�tt b'c' t •'c'�; . Il'ork d'f,'Zi'hoillI''(rt`Yttf1Y "iCZ L'ta12Ce'!.-. PctYlltiYtg I'eeS:: '11'ra, el Doc u'lncnfalion fees: Strom Motion Fee: 1BSEISMICR $0.82 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 y $320.82 $0.00 h: TOTAL FEE: $320.82 Revised: 04/01/2014 1 1 I I i I I I I 1 PROPER-F#,�- oT-E- H r3AT �c� ��`,_ �R� Tat3� 5' S P - �A NoA// f3vSL p fa S Le 4 r,,E �oR L.41V fl Scamp n. rvr y 3 c -NX t 6 65T 5 z g 23'� 701fo'' a "t' s S' S �ip f'2 t -- G, o att — x (_ °UJ AvNGZ> m tr rS yoI< stij'nE 02 o o E N �" aa. n y/0 6!.a. co C �i 0-793— ZS "� FQt) NT a D E 'a. a v V' \r oT.E : C Q V '._ P Ni ,E! Y T J o l3 E cu 2"32 N"� �, = Z Cr} PP,t; D /+hrQ /c'rlVtovED LJT2LTTy LI*IV 65 T4' raj A &AAi DDlvC- D CUPERTINO ` Lu%jjrJinca Department DgT V e WY JUN 18 20% REVIEWED FOR CODE COMPLIANCE Reviewed By: STR t t I Y 0 A K St,;Re COMPACTION REPORT IS REQUIRED SHOULD THE /V°r r6 s4` ARATFn AREA RF mri Appn um m nAw csf int Tuc et tTt tnr� CUPERTINO SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building CcDcupertino.org FILE Permit No. ��i5�:? Address %2 S �. 96r- Q/il # of Alarms Smoke: Carbon Monoxide: PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. t have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: �,.�✓ `T .........Si naure./...............................r............. Date: . , ... Contractor Name: Sinature................................................................... Lic.#...................................... Date: .................... Smoke and CO form.doc revised 03/18/14