D-2017-0049 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:D-2017-0049
10640 TUGGLE PL CUPERTINO,CA 95014-3628(375 34 067) ROCHA'S COMPANY
SAN JOSE,CA 95125
OWNER'S NAME: SINGH RANJANA TRUSTEE DATE ISSUED:09/25/2017
OWNER'S PHONE:408-813-8530 PHONE No:(408)593-7405
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class)} Lic.#817112 BLDG —ELECT —PLUMB
Contractor ROCHA'S COMPANY Date 02/28/2019 —
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 I STORY SFD(1222 S.F.);ATTACHED CARPORT(180 S.F.);
I hereby affirm under penalty of perjury one of the following two declarations: PATIO COVER
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.
have and will maintain Worker's Compensation Insurance,as provided for by
diSection 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$10000.00
APPLICANT CERTIFICATION
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 APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 375 34 067
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 of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the appli t understands and will comp) ith all non-point
source regulations p the Cupertino Munici•- •.,- ection 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Si at Offiel
, < Date 09-25-2017 Issued by:Kim Dunbar
Date:09/25/2017
OWNER-BUILDER 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. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:09-25-2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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. HAZARDOUS MATERIALS DISCLOSURE
2. I 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 1 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 Califomia. If,after making this certificate of will maintain compliance with the Cuperti / unicipal Code,Chapter'. and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Se ns 25505 33,an'2
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authoriz= age• '
APPLICANT CERTIFICATION
Date:09-25-2017 S ` �
I certify that I have read this application and state that the above information is i` tit •` `t
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 09-25-2017
Professional
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11 DEMOLITION DEMOLITION PERMIT APPLICATION i' ,
Zr• COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION t•
410,1", 10300 TORRE AVENUE•CUPER7INO,CA 95014-3255 x'•`
(408)777-3228•FAX(408)777.3333•DulkllnctCdtwmtlltplo
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Iy to'signature below,I certify to Beet of die following: I en the propariy 00110'0U anhorired wilt toRa on thr,rnporty,.acv's behalf' I have roan this
application sad the ion-manna(have j1,001.164-i%rano, I Moe rnd thr th•ac(gtk a of Wolk anti comfy it is nutuale I agree m comply stub all srphrablo local
anhnar'r maid stoic laws relating g construction. I. thnnze tem.Lair m of Cep\otnw to rater the alxrvcmdauitled prmtp.!ty Ito-inspection pnrpoinz.
Stgnaturc of Applirai*•Ag.i t- . .-_ „�/
SUPPLEMENTALINPORMATION REQUIRED PRIOR TO ISSUANCE CII DEMOLITION PERMIT O P•iC F.ME ONLY
,.__Provide Job Number from Jay Area Air Quality Managctneal District r•ww.ba.tamd.orit(ig 413-749-4762. W..•ri.v''CIWIC'MTV
..__Provide three c opicr.of a siw.plau showing protection Ira any Dass 10"in diameter or more td 3'Above rude. 0 r.xrnp_\s
0 STANTLTRD
Provide,letter nom PG&E(40R-715-3323)slating all gas and electric.boa been disconnected.
0 Lwnct
Mug DopI clearance to ecmi m'building is not considered at historical landmark Allots 10 business days.
0 AMR
Prondr.tetter of clearance of all vermin tram a Hommel pent control amine-tor.
1 _, liana!Mall all the Public Works Dalrattmon at.10g-777.3104 and schedule a'huttiaablz dwelling'insyetdi0n.
G_-_Provide.Construction and flemelitinn Rco yeiing Diversion signature Omit.
„__•C(ntenercial Buildings Only. Provide fire Dept clearance for lire suppression alarm system review.
Deow.410._1016.dos revised O t.'i0.'f 6
E-Mail: inncpt@sbcglobal.netPhone: (408) 985-1078 Fax: (408) 985-13433550 Stevens Creek Boulevard Suite 225San Jose, CA 95117ByRevisions C up e rtin o, C A . 9 5 0 1 4R a n ja n a S in g h D e m olition P la n for :1 0 6 4 0 Tug g le P la c eA
1"=10'
07/13/2017
GF
Abby Ayende
09/25/17
09/25/17
D-2017-0049
Abby Ayende