B-2016-0419 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:D-2016-0419
20683 SUNRISE DR CUPERTINO,CA 95014-2928(359 10 025) TITAN GENERAL
CONSTRUCTION INC
FREMONT,CA 94539
OWNER'S NAME: 2HANG 7UNLIANG TRUSTEE&ET AL DATE ISSUED:10/24/2016
OWNER'S PHONE:408-881-3068 PHONE NO:(408)883-8668
LICENCED COMTRACTOR'S CONTRACTOR'SDECLARATION BUILDING PERMIT INFO:
License Class B Lie.#948867
Contractor TITAN GENERAL CONSTRUCTION INC Date 06/30/2018 —BLDG —ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTIAL—COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
DEMO EXITING ONE STORY HOME(1153 S.F.);ATTACHED
I hereby affirm under penalty of perjury one of the following two declarations: GARAGE(396 S.F.)
1. 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.
2 -/I'have and will maintain Worker's Compensation Insurance,as provided for by
Section 3.700 of the Labor Code,for the performance of the work for which this
, permit is issued.
Sq.Ft Floor Area: Valuation:$18000.00
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 359 10 025
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 PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence the granting all
this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and willl comply with all non-point
source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM L CTION.
Signature/_I�,�r�– Date 10/24/2016 Issued by:MELISSA NAMES
Date: 10/24/2016
OWNER-B TIL D R DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
2. 1,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:10/24/2016
I hereby affirm under penalty of perjury one of the following three declarations; ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
1. 1 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. HAZARDOUS MATERIALS DISCLOSURE
2. 1 have and will maintain Worker's Compensation Insurance,as provided for by I:have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
a. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agent:I/
APPLICANT CERTIFICATION Date: 10/24/2016
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for inspection,purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. I understand my plans shall be used as public records.
Licensed
Signature Date 10/24/2016
Professional
DEMOLITION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333 a building -cupertino.org
CUPERTINO
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❑.OWNER ❑ OWNER-BUILDER ❑ owNERAGENT Y-GONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME &U�� ` LICENSE NUMBER �� 4� LICENSE TYPE BUS:LIC#
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DESCRIPTION OF WORK
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RESIDENTIAL #DWELLING OEFTCl USE f913
FLOOR AREA ( 17" UNITS USE OCC. .,.TYPfi SQ:FL. VAL{JATION-
l " -
COMMERCIAL '
FLOOR AREA
TYPE OF CONSTRUCTION #STORIES. '
AQMD JOB NUMBER `� REC IVEI?BYGTaT 1re
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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 properly owner's behal`_ I have red this
application and the information I bave 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 construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION QUIRED PRIOR TO ISSUANCE OF DEMOLITION PERMIT oFTCE CTSE'ONI Y"
Provide Job Number from Bay Area Air Quality Management District www.bammd.org g @ 415-749-4762. E TPn
Provide three copies of a site plan showing protection for any trees 10"in diameter or more at 3'above grade.
❑ rxEss
❑ STANIDARD "
Provide letter from PG&E(408-725-3325)stating all gas and electric has been disconnected. x❑ LAxcE
a Planning Dept clearance to verify building is not considered an historical landmark.Allow 10 business days.
L7 avlA3ox
v✓ Provide letter of clearance of all vermin from a licensed pest control contractor.
VApp icant shall call the Public Works Department at 408-777-3104 and schedule a"habitable dwelling"inspection.
y/Provide Construction and Demolition Recycling Diversion signature form.
Commercial Buildings Only: Provide Fire Dept clearance for fire suppression/alarm system review.
DemoApp_2016.doe revised 05110116