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08020172 (2) CITY OF CUPERTINO -ac ' X r a�aYvth ' ' `� ' x ✓;..di. k BulLomc DrviSION PERMIT CONT] .CTQR�INFORIVIATIO,N BUILOI - PERMITNO. �'T1��ENILLOW GROVE LN OTEWALT DAVID A 08020172 OWNER'S NAME: - PERMIT ISSUE DAM OTEWALT DAVID A 6148 WILLOWGROVE LN 02/26/2008 E. - SANITARY NO. CONTROL NO. ARCHITECTYENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH Q 0 0 0 o p LICENSED CONTRACTOR'S DECLARATION ta 1 hereby affirm Nat I am licensed once,provisiam of Chapter 9(cemmendm{ lob Description ;zm with Section 7")of Division 3oftheBusinmandProfmmusCode.andmylicensa BTHRM RMDL,CHNG GFI ONLY NO LIGHTING,NO—MECHCL ?�y in full face and effect. ,�J? License Class Lic.A F, DateCmuncsf ARCHITECTS DECLARATION sI understand my plana shall W used as public roeards . )yU °ot; Licensed professional OWNER-exempt pr DECLARATION I;ashy atm on 1 sic exempt from to ConlnnMa License law for nc O O fallowing rtawn.(Satan 703 1.5,Business and Rofesdam Code:Any city of county <20! which requires a Permit to eonswtt alter,hnprom demalids or repair any structure 1z0 pniora its issuana.alsomeprims the applicator fmshoch pctmile file assigned stalemml -Ro din W;s licensed pursuanuotW provisions of me COnuacarYtMnsn taw(CAaihter9 Sq.Ft. Floor Area $1500 Valuation tFG (eommencingwi6ScWon70DD)of Diveion3oft Businm dPmfmin=Cade)m 3 3 Nal he Ice exempt theefrom and the basis for the alleged evmpu.Any violation of Seedon 7031.5by.1 appllun,fs a permit subjects Ne apuicstm he a Civil Perohy of p Number Occupancy e mat mon Nan five hundrd edollars(M). 37S.38O1.3 . 1/V umPane y P ❑1,u owner of tiie ProPmYa my wplaym wits vagi u tee sole eompenhatim, win do tic wart,and Ueswcturt lstetin(•nAnA aefraredfavle(sec.7014.Budrcsa Required Inspections and Professions Code:The Comsactofenawns s Licensee Law does not apply to an Of 9 P property who builds or impmvea thereon,andwbo daessuch wslthimselfurtuuugh he EWERprovided that such impmwshntsate vatintended araffered tarsale IL however.the Wilding or Improvemem Is sold width arse year efcompledon.Ile:owar- builder will have the burden of proving that he did an,Wild or improve for purpose or salt.). girl,as Owner M the property,am exclusively contracting with Bnmed conttaceta an consumer the project(See.7044,Business and Pm2esions Cade:)The Coahnctnes U. cense law does not apply m an own o proprny wed Wids or imProvm thertoa,aM, wedconwcss larni h projects wi c tr aw1M..dpunuanne Ute Unuseme. License law. ❑ism sxeml of See - ,B&Pcim�aud�a�wm nuh11 Dae 1w aIN a0 N DECLARATION - 1 beeby afro ueder pemlty of perjay ase of the following decluuienc ❑I haw and wall maintain a CertiRmte of Cahaenl m self-invert fa WarMsCanpw- utian,az Frailest!for by Seedan 3700 of the labor Coo,fa the petforns.of the wort for which this Permit is;cued. 0 1 have and will maintain Workefs Compensuion Ituu.as required by Serian 37W of the labour Coot.for the performame Ofthe wak forwhich this Permit is ivn ' My Workeh Campenuadon Insurance carrier and Policy numW ve: Canner.. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ' (This xctirn need notal<ampleedif permit iscuummhundrtA MllansfIl 0) n,leu.) 1 cenify Nat m the p Once of the f hich thisyermH a issued,I shall not employ any Person i y enncrsnaz m i fro rte WorWn'Compertsaton Laws of California. APPlicanr NGTICE TO APPMr ng the Cenifictte of Exemption,you thouhl become subject m I e Wotkar'a C:Ptnsnion provisions of due labor Code,you rand •,z forthwith comply with such Provisions OF this Permit shall W doomed rcrokcd. z CONSTRUCTION LENDING AGENCY (r Ibeebyaftm that time isacmctom lending agency for Nc perfotmass of ori the work for which this permit Is issued(Sou.3097,Civ.C) - 6Wi Q Lender's Name 7 z Lendefs Aderm U O 1 Gasify Nat I have read this applicator and note Na the a Wve information e L, — conect.I agme to comply with all city and county ordinances and state Ian relating m O U building comuuetian.and herebyaashApu�� Nis city m truer upon tc P_ W almve-mcmianed Progeny to,m',ct (We)agme m taw,indemnifyGty of Culture all.liablitis.judgmen oro and expcmyacmhc'mrstaidCryzAPPLICANT RSTANDS AN1TH ALL NON-POINT Qfssued by: DatesoURCER TIONS. Y Re-roofs Signatue App ears Canmcmr Dae HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will to applicant or filum building arupantaIOM ahandle hanNous mamrial az d.flned by the Cupenln0 Municipa Code.Chapter 9.12.and the Healthand Safe,, Co.,Section 21532(a)7 All roofs shall be inspected prior to any roofing material being installed. 0 Yu u Will the applicant or future building oaapart ase equiprem adevfaa which If a roof is installed without first obtaining an inspection,I agree to remove emit ha mb us air comorrom,ss az der by the Bay Ama Air Quality Manage— all new materials for inspection. Diaries 0 Yes nus naralsrequhemcmunce,Chape6.95afte Calfs. ria HouralIthavere ved5533 ' 534.1understand!ductifthe buklhrg cera not c t Iww a ten y msphhsslNlitY b naifY the aasgant of the mquirtmc ; maz no of aCntrrseofOccupancy Signature of Applicant Date Owner raamarixeaagemywti Da All roof coverings to be Class"B"or better • CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 37538013 . 00 DATE ISSUED. . . . . . . : 02/26/2008" RECEIPT # . . . . . . . . . : BS000004035 REFERENCE ID # . . . : 08020172 SITE ADDRESS . . . . . : 6148 WILLOW GROVE LN SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . : OWNER OTEWALT DAVID A ADDRESS . . . . . . . . . . : 6148 WILLOWGROVE LN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014 RECEIVED FROM . . . . : DAVID A OTEWALT CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY . . . . . . . . . . : OTEWALT DAVID A ADDRESS . . . . . . . . . . : 6148 WILLOWGROVE LN CITY/STATE/ZIP . . . : CUPERTINO CA, 95014 TELEPHONE . . . . . . . . : FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---- -- -- ---------- ---------- ---------- 1BSEISMICR VALUATION 1, 500. 00 0 .50 0. 00 0.50 0. 00 1REMRESOTH SQ FEET 35 . 00 367 :00 0. 00 367 . 00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 367 . 50 0. 00 367 .50 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 367 .50 MC --------------- TOTAL RECEIPT 367 . 50 DAVID OTEWALT 6148 WILLOWGROVE LANE CUPERTINO •408 221-8225 BATHROOM REMODEL 7' .— 70' 40" �— 21" ► f—27" ► s-13"—►) �— 14"—► (wj LET TER b DRAIN) DRAIN m N o-43"- �� DRAIE N HT vT 7m0 nZ a i z n +I o 0 0 m EA y J F x Q OSI TUB m PAPP g.00 OROtNP 5 �N p h0 DOES NVQ � pps Mg p a\\t� aSo< a�o� pop �ttpo` e k to of eo K) ON \ paIN roo t..��rl p aoa s01 .0 C O`alobDeo \ v`�g got to p. O , i FFB2670pB TOILET: Low flow SHOWER: Non-scalding WINDOW: 23"w x 34"h, 11" from ceiling j ZCIF Community Development 10300 Torre Avenue • Cupertino CA 95014 Telephone(408)777-3228 1U INI NO Fax(408)777-3333 Building Department All Cupertino building permits must meet certain conditions related to maintaining environmental quality and public peace and safety. The two most common conditions are described below. STORMWATER POLLUTION CONTROL State law requires that Cupertino, 12 other Silicon Valley cities, Santa Clara County and. the Santa Clara Valley Water District control stormwater pollution. Educating local residents and businesses and enforcing stormwater pollution control laws are key parts of the City's compliance efforts. Stormwater pollution prevention: It's up to us In northern Santa Clara Valley, storm drains flow directly to local creeks and San Francisco Bay, with no treatment. Stormwater pollution is a serious problem for wildlife dependent on our waterways, for people living near streams and baylands, and for the local water supply. Common sources of stormwater pollution include: • Dripped oil, fuel, and antifreeze from vehicles and heavy equipment; • Construction debris, including dirt, concrete and paint; • Landscaping runoff containing pesticides or weed killers; and • Any material dumped or spilled into streets or storm drains The property owner and the contractor share ultimate responsibility for activities occurring at a construction site and will be held responsible for any environmental damage caused by subcontractors or employees. For more information on construction-related stormwater requirements, see the Stormwater Quality Regulations section of the City of Cupertino web site at: http://www.cupertino.org/city government/departments and offices/ environmental services COMMUNITY NOISE CONTROL The basic noise control requirements for construction sites are as follows: • Typical construction work hours are: - .Weekdays - 7 a.m. to 8 p.m. - Weekends - 9 a.m. to 6 p.m. • Construction other than street construction is prohibited on holidays. • Residential daytime noise levels from complaint site - 60 dBA • Nonresidential daytime noise levels from complaint site - 65 dBA For more information on noise control, please see Chapter 10.48 of the Cupertino Municipal Code, which can be accessed at httr)://www.amlegal.com/cupertino ca/ Greg Casteel Building Official DAVID OTEWALT 6148 WILLOWGROVE LANE CUPERTINO • 408 221-8225 BATHROOM REMODEL 7' --a-- 70' f— 40'1 f- 21^ �—27" s-13"—►� f— 14" ► f 1 TER DR/�IN� DRAIN m G-1 "- I LET `/ K N a-43"- LIGHT SLI HT HT m DRAIN M J N+ y O N EA y cJ K TUB m s 5' TOILET: Low flow � SHOWER: Non-scalding ® WINDOW: 23"w x 34"h, 11" from ceiling �� ® • OWNER-BUILDER VERIFICATION 1. (Check one) I or my immediate family (parent, spouse or child) will perform:y • A. All the work authorized by this permit B. _ A portion of the work C. _ None of the work If B or C is checked, com Tete 2 or 3 below. 2. A state licensed contractor will be hired to do: A. _ All of the work B. _ A portion of the work (complete section below) Contractor - Address/City Phone # State License # Type of work to be performed . 3. _ I will utilize unlicensed person(s) other than my immediate family to perform all or portions of the authorized work. I understand that I may be an employer (see reverse side). A Certificate of Insurance covering workers' compensation must be on file at the City of Cupertino Building Department office. PersonlFirm Address/City Phone Number Type of work to be performed I declare under penalty of perjury that the above is true and correct. I have read and understand the Owner-Builder Information (reverse de). Property Owner's Signature: r Date: 1 ' 26 O g Job Address: (o I Ll (C" 1 SLOW 6r""r Permit# Any changes to the information provided on this form shall be submitted to the City of Cupertino Build • Department. S(M P City of Cupertino Building Department. CITY OF 10300 Torre Avenue L U P E IST I N O Phone: (408)777-3228 Dear Property.Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as owner-builder you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work,with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. If you are an employer,you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding,federal social security taxes,workers' compensation insurance, disability insurance costs, and unemployment compensation. contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. For more specific information about your obligations under federal law,contact the Internal Revenue Service (and,if you wish,the U.S. Small Business Administration). For more specific information about your obligations under state law,contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale,property owners who are not licensed contractors are allowed to perform their work personally or through their own employees,without a licensed contractor or subcontractor,only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an owner-builder building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your coriimunity or at 1020 N Street,Sacramento, California 95814. Please complete and return the enclosed owner-builder verification form so that we can confirm that you are aware of these matters. The building permit-will not be issued urlti the verification is returned. Very truly yours, Building Department, • City of Cupertino Printed on Recycled Paper . . Odd a o17a CITY OF CUPERTINO ADDITION/REMODEL • CUPEI,TINO PERMIT APPLICATION FORM APN# � Date: 3753 c�� 3, UU a - 20 - 200 Building Address: ( l/ Q` ,o 6 I K S L L 6W a ve An G �-v/Jcoti7l acv Mailing Address (if different from building address): Owner's Name: Phone# ASO c K a g ;;2 -21- Contractor: 12t-Contractor: Phone#: Fax #: Contractor License#: Cupertino Business License #: Contact: Phone#: Fax#: Building Permit Info: S ��¢!?d „tpna�, nh,N - Srtr vylo t. Bld . er� Elect. ❑ Plumb. ©� Mech. ❑ Hillside ❑ Job Description: Addition (adding sq footage): What is being remodeled? Ale Lwrrriril s.- Y\O w' C�) , Remodel Includes Re-Roof: Yes ❑ No X If yes list number of squares Remodel Includes Structural: Yes ❑ No Square Footage: Addition: Porch: Deck: Garage: Detached Attached d Remodel: Kitchen Bath '3 ,5- Other Type of Construction (Usage Class): Occupancy Type: //�� 1 FR, 11FR❑ 11, 111, V-lHR ❑ 11, 111, lV V-N OW OL e Valuation: .0V Please check this box if the project is a 'T second-story addition ❑ Green Building Check list must be completed and Green Buildin Points Achieved: attached to the plans. g ***For Office Use Only*** Over-the-Counter ❑ CITY OF CUPERTINO p ADDITION/REMODEL CUPEI,TINO FEE SCHEDULE Quantity Fee ID' Fee Description Fee Group Permit Type Sq Ft ' ADDITIONS 1R3SFDADD PLLONGRNGR Long Range PL Planning/Residential IR3INSP . Dwellings Inspections B 1R3PLNCK Dwellings plan check B 1R3REPINSP Dwellings Repeat B Inspection 1R3REPPLNC Dwellings Repeat Plan B Check 1R3HINSP Dwellings Hillside B inspection 1R3HPLNCK D*fillings Hillside " '` '13 plan check 1R3HREINSP Dwellings Hillside B Repeat Inspection IR3HREPLNC Dwellings Hillside B Repeat Plan Check 1R3ALTINSP Dwellings Alternate B Materials In5pection IR3ALTPLNC 'D'wellings Alternate B Materials Plan Check 1PCESS Cesspool P 1PPRSEWG Ea. Private Sewage P Dis osal S stem 1PRSEWER Sewers P IBPSPRINK Lawn P Sprinkler/Backflow 1BPWSVCS Main Water Service P 113SEISMICRE SeismicResidential B DECKS IR3SFDADD OR 1R3SFDREM IDECKWOOD Deck (Wood)-Each B (Each) 1DECKRAIL Deck Railing-Each B (Each) CITY OF CUPERTINO ADDITON/REMODEL FEE SCHEDULE Quantity Fee ID Fee Description Fee Group Permit Type Sq Ft GARAGES 1R3SFDADD OR 1R3SFDREM 1GARDTW<=1K Wood Frame up to B 1,000 SF 1GARDTM<=1K Masonry up to 1,000 B SF BCONSTAXR Construction Tax Res (new detachedgarage) PATIO'S OPEN 1R3SFDADD OR 1R3SFDREM 1PATIOWOOD Wood Frame up to 300 B SF 1PATIOMETAL Metal Frame up to 300 B SF 1PATIOOTHER Other Frame up to 300 B SF PATIO'S CLOSED 1R3SFDADD OR 1R3SFDREM 1PATIOENCLW Enclosed Wood up to B 300 SF 1PATIOENCLM Enclosed Metal up to B 300 SF 1PATIOENCLO Other Enclosed Patio B up to 300 SF 1COVPORCH Porch Covered-Each B Each 1REROOFRES Residential Re-roof B Each 100 SF REMODELS 1R3SFDREM 1REMRESKIT Kitchen Remodel up to B (Deduct LI"for ea plan 300 SF check 1REMRESBAT Bath Remodel up to B " 300 SF 3 1 REMREOTH Other Remodel up to B « 300 SF REMODEL PLNCK 1 STPLNCK(1-3 For Standard Plan Check B NOT FOR OVER THE remodel) COUNTER PLAN CKS. 3 of 3 CITY OF CUPERTINO •� ADDITON/REMODEL FEE SCHEDULE QuantityFee ID Fee Description Fee Group Permit Type Sq Ft WINDOW/SLIDING 1R3SFDREM GLASS DOOR 1WINREP Replacement windows B ea 8 windows 1WINNEWNSTR New Window (non- B structural 1WINMEWSTR New Window B (Structural Shear Wall/Masonry) 1 WINBAYSTR Bay Window B Structural SKYLIGHTS IR3SFDREM 1SKYL<10 SF Skylight less than 10 sf B 1SKYU10SF Skylight greater than B, 10 sf or structural 1STAIRS Stairs-first flight/ea B addt'l 1BUSLIC Business License . B 4 of 3 Community Development 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408) 777-3333 UPEkTINO Building Department JOB ADDRESS: PERMIT # 6 u.n rr 14o'. L1 eL D r 2 OWNER'S NAME: 9AVIO C?73S0&4— PHONE #q U g. 2A i GENERAL CONTRACTOR: p FAX # I am not using any subcontractors: •-. c. o p Si attire Date Please check applicable subcontractors and complete the following information: 60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood Glass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Til Af Val2-�t,� •0 8 Owner/Contractor Signature Date