Loading...
15070222CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 18650 RUNG CT CONTRACTOR: MORRIS MANDEL PERMIT NO: 15070222 OWNER'S NAME: MORRIS MANDEL 18650 RUNO CT DATE ISSUED: 07/30/2015 OWNER'S PHONE: 4082555905 CUPERTINO, CA 95014 PHONE NO: LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL DEMO (E) 1,127 S.F. SFD License Class Lic. # Contractor 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: $11500 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: 37525030.00 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 THIN 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) agre ve 180 AYS ED 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 Issued granting of this permit. Additionally, the applicant understands and will comply b with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. RE -ROOFS: Signature Date 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 nstmct 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(x) 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, Ses 25505, 2 6 3, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Owner or authorized age Date: 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 l 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 l 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 I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non-RgnTtyource regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date 77 /�� 45 CUPERTINO DEMOLITION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org 11 PROJECT ADDRESS /p CJ T APN # 3 -7 .� 2 5 / OWNER NAME ff� ✓l((` � PHONE E-MAIL Z-�j- r�f'1 h`�my cC/1�� -- a O%T/11- Q. C' o . STREET ADDRESS CITY, STATE, ZIP FAX —� .. CONTACT NAME D . ^/ -MAIL J PHONEO �� 2 (/ ` / ✓ �m STREET ADD E (✓ D (2 L) r CIT Z `A,TE, ZIV � FAX ^ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT El CONTRACTOR ❑ CONTRA`-C-TIOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER -LICENSETYPE " ' BUS. LIC # COMPANY NAMEi, E-MAIL FAX STREET,ADDRESSCI �/ Y, STATE, ZIP 7 -PHONE _ _7711-111,93-3 7 DESCRIPTION OF WORK RESIDENTIAL ( # DWELLING OFFICE USE ONLY FLOOR AREA UNITS USE OCC. TYPE so. FT. VALUATION COMMERCIAL , FLOOR AREA TYPE OF CONSTRUCTION#STORIES i --- - . . ' ��'_L I Sl. P_1l -_ 1 AQMD JOB NUMBER TOTAL VALUATION: J #: Soo n the pr owner's beha ead this By my signature below, I certify to each of the following: 1 am the property owner or authorized agCffrto acisa application and the information I have provided is correct. I have read the Description of Work and verify it e. I agree to comply with all applicable local ordinances and state laws relating to ding constructi a orize re esentatives of Cupertino to ent above -identified property for inspection purposes. Signature of Applicant/Agent:. Date: / 5 SUPPLEMENTAL INFORMATION REQUIRED PRIOR TO ISSUANCE OF DEMOLITIO PERMIT OFFICE USE ONLY PLANCHECK TYPE Provide Job Number from Bay Area Air Quality Management District www.baa mG d.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. ❑ STANDARD _ Provide letter from PG&E (408-725-3325) stating all gas and electric has been disconnected. ❑ LARGE Provide a letter of inspection, tests, and abatement of any Hazardous Materials. Letter to be initiated by person(s) certified in asbestos, mercury and/or hazardous material examination. ❑ MAJOR 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 03/16/11 M CITY OF CUPERTINO RM -7 FEE ESTIMATOR - BUILDING DIVISION FEE ID FLR AREA 1DEMORES 1,127 ADDRESS: 18650 RUNO CT I DATE: 07/30/2015 REVIEWED BY: MELISSA ------ APN: 375 25 030 BP#: 56) -VALUATION: 1$11,500 *PERMIT TYPE: Demolition Permit PRIMARY SFD or Duplex USE: PENTAMATION 1 SFDWL-DEM PERMIT TYPE: WORK DEMO (E) 1,127 S.F. SFD (BP PERMIT IS 15040152) SCOPE Suppl. Insp. Fee.(F) Reg. Q OTT FEE ID FLR AREA 1DEMORES 1,127 NOTE. This estimate does not include fees due to other Departments (i.e. 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 Deptfor addnl info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1 ,13) L13) FEE QTY/FEE MISC ITEMS ------ ------ -I- El El NOTE. This estimate does not include fees due to other Departments (i.e. 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 Deptfor addnl info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1 ,13) L13) FEE QTY/FEE MISC ITEMS Pen -nit Fee: $574.00 Suppl. Insp. Fee.(F) Reg. Q OTT 0.7011TS $0.00 Strong, Motion Fee: IBSEISMICR $1.50 Select an Administrative Item fl"Id, Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $576.501 $0.001 TOTAL FEE: 1 $576,501 Revised: 07/02/2015 CUPERTINO OWNER -BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build ing(a.cupertino. org - Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property imnrnvamantc cnarifiarl at• </ 1�'- (� r * SITE ADDRESS. g �O �d APN �' [� �3 BP OWNER N M Cl WNER AD RESS 2 c L/ o DESCRIPTION OF WORK: P,/ti �_ T We are providing you with an Owner -Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner -Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) (1�1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner - Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner -Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner -Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. n'!�U. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. �3. 1 understand as an "Owner -Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. el_�6. I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. Z I understand under California Contractors' State License Law, an Owner -Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. ��✓`8. I understand as an Owner -Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010,doc revised 04/14/10 A4V) tel. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. (�Av. I am aware of and consent to an Owner -Builder building permit applied for in my name, and understand that I am the parry legally and financially responsible for proposed construction activity at the site address listed above. (/� 1. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner -Builders as well as employers. 1/1, �. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by, laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner -Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS: Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the ppperty owner's sl naf Property Owner's Signature: L Date: --------------------------------------------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner -Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner -Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: Address of Authorized Agent: Tel No I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OwnerBuilderForm 20IO.doc revised 04/14/10 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: [0:0-o p C -r, 'til o, PERMIT # 5 O ZZZ OWNER'S NAME: p PHONE # C 0 GENERAL CONTRACTOR: Ze,0�,O61 BUSINESS LICENSE # &57 2 ADDRESS: ,? CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino business licehse. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information:�f-�,� Owner / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock 1 �► O d �L_��E�� lI �j"�� l Owner / Contractor Signature Date DATE: _07/29/15 City of Cupertino 18650 Runo Ct Cupertino 95014 10900 No. Blaney Avenue Cupertino, CA 95014 SUBJECT: REMOVAL OF CAS SERVICES (CUT @ MAIN IN THE STREET) ON: 15 SUBJECT: ELECTRIC SERVICES WAS CUT AT DOLE ON : 07/20/15 If you have any further questions, please contact me at (408) 725-2076 Sincerely, Pacific Gas & Electric Company DeAnza Service Planning 408/725-2076 jamN ` dam City of Cupertino Public works Department tti Environmental Programs Division 10300 Torre Ave Cupertino, CA 95014 CUPERTINO GREEN 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. 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: Please check all that apply: 1 am not using a Recology debris bin, however, the project is less than 3,000 s.£, e.g sidewalks, driveways. buildings, patios, ❑ 1 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 City's Public Works Department, showing that I have recycled at least 60% of all construction demolition material: Ask for the Construction & Demolition Recycling Packet from the Building Department and complete the following: ✓ Submit a Construction and Demolition Waste Management Plan with your building permit application. No fee for this plan..Forins are available at the Building/Public Works counter and online at vvww.cupertino.orglenvir•oratnetztal. Report the tonnage recycled and disposed, by material type. Recycling facilities must be selected from the City's approved list of Recvcling Resources. ✓ Submit a Construction Recycling Report form. The report is required before the Building Department will schedule afinal inspection. The report fibrin. is available at the Building/Public Works Counter and online ivwiv.cu no.ot /environmental. Signature: Date: Name: (printed) no r &-r Title: Phone -�-� U 5-( c) Project Address: �/ �'/r �-�rLv�o ' �5��� This form to remain in the project's building permit file for the duration of the project. Revised 317112 1 PROCEDURE CHECKLIST FOR DEMOLITION PERMITS % ��" 2-T COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O., BUILDING OFFICIAL CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 •FAX (408) 777-3333 •building a(�cupertino.ora 'TkO (P 1,_4 ' -7-7) 7�957 -7-7 f -:2 - PURPOSE �7Vi [cQ//� r✓olrc c=am, C Y'1%1� ��?�� r fQ(Ic ��" �i���9�%6 The demolition application should be applied for before or at the same time as the new construction �� 3 3 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 pernit is issued". The letter needs to be signed by both the property owner and general contractor. �elV` (-74 yA4yV", 1rr� Ifo Ptt'c s( REQUIREMENTS GL,,,,.�.t � � `� To obtain a demolition permit in the City of Cupertino, please complete a Demolition permit application a oftg with each of the following requirements as it applies to your specific project. let, C 1,,r.V 17"a •-I `7lr/ *It- 1. 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 �7? 7,7 these trees. 2. PG&E must be contacted AS EARLY AS POSSIBLE prior to demolition to 3. schedule the abandonment. Contact PG&E at (408) 725-3325. A letter from IV ,-_Z PG&E shall be provided to the City, stating that all gas and electric c has been //`` -- 1p�//S dis nnected. ( is step can e n u g, so iFis important o begin the _ J,- rocess irririnediately) Provide Job Number from Bay Area Air Quality Management Distric w-vvw.baagmd.gov @ 415-749-4762. 0-t - T- r4-% �e-xy1 Adoek-t,_( u t Check to see if the building is considered an historical landmark. Obtain clearance from the Community`Develo�pment Planning Department. Allow 10 working y j days. 5. Provide a 1 tter o ranee of all vermin from a licensed est control contractor. l c,,�jF •�7,c, (,t f7me * Important: Prior to the issuance of the demolition permit, the applicant must call b Iq�1s the Public Works Department at (408) 777-3104 and arrange a "habitable dwelling" 7TH inspection. r 7. Debris bin and Recycling sheet: read, sign and date. The sheet will remain in the (�Or Kt - project's building permit file for the duration of the project. 8. Commercial only -prior to issuance of the demolition permit, the Fire Department must revieiv 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. 1 DemoProceeiure.doc revised 2/13/13