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12100011 CITY OF CUPERTINO BUILDING PERMIT I UILDING ADDRESS: 11517 SILVER SPRING CT CONTRACTOR:IiIBM CONSTRUCTION PERMIT NO: 12100011 OWNER'S NAME: CAROAIARK LANDGENEVIEVE If 4250 WESSEX DR DA'Z'E ISSUED: 10/012012 OWNER'S PRONE: 4082533426 SAN JOSE,CA 95136 P[[ONE NO:(408)315-4663 LICENSE[)CON-TRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT IJ PLUMB r license Class"—..�h. _ Lic?d Ke:l�g'j Z - - - r NIRESIDENTIAL COMMERCIAL Cont_mc[o Dmc1%/�/2� 1'hercbyiiflirm that 1 am licensed under the provisions of Chnptcr 9 JOB DESCRIPTION: REPLACING SELECTED SIDING ON SOUTH FACING WALL (commencing with Section 7000)of Division 3 of the Bushiess&Professions & Code and that my license is in full force and effect. TRIM AROUND THREE WINDOWS 24"BELLY BAND&LIKE FOR LIKE hereby affirm under penalty of perjury one of the following two declarations: 1 have and will maintain a certi licate 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 I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of die work for which this permit is issued. Sq.Ft Floor Arca: Valuation:$15000 APPLICA,N t'CT.R'1'IFIC,\TION I certify that I have read this application and state that the above information is APN Number:36651026.00 Occupancy Type: correct.1 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 ol'Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accme against said City in consequence of the granting of this permit. Additionally,the applicant understands mid will comply WITHIN DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DA OM LAST CALLED INSPECTION. 9.18. _ Signora _ r" — Dmc //' — Issued by: Date: O O\YNER-BUILDER DECLARA'T'ION I hereby affirm that I am exempt from the Contractor's License Lawfor one of RE-ROOFS: the following hyo reasons: All roofs shall be inspecled prior to any roofing material being installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sce.7044, inspection. Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Dale: consumer the project(Sec.7044,Business&Professions Code). 1 hereby affirm under penalty of perjury one of the fallowing three ALL ROOF COVERINGS TO 6Ii CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Workers 11.\%.\RDOIIS d1AT'FRL\IS DISCLOSl1RF, Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505.25533,and 25534. 1 will maintain Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code.Chapter 9.12 and the Health& Safety Code,Section 2553_(a).should 1 store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of die work for which this permit is issued,1 shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws ofCalifomi0. If,after making this certificate of exemption,1 llealth&Safety Code.Sections 25505.25533,and 25534. become subject to the Worker's Compensation provisions of tire Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANTCERTI FIC\T'ION CONSTRUCTION TENDING AGENCY I terrify that I have read this application and State that the above information is correct.I agree to comply with all city and county ordinances mid state laws relating I hereby affirm that there is a conslrucrion lending agency for the performance of work's to building construction,and hereby authorize represenlatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property I'or inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the Cit'Of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCI1ITECI"S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date Licensed Professional ) � v ► l CONSTRUCTION PERMIT APPLICATION 210 2 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333• building(akupertinO.org CUPERTINO ❑ NEN'CONSTRUCTION El ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT" PROTECT ADDRESS APN M I ► s O\VNER NAME 1 PHONE E-MAIL C T O STREET ADDRESS CITY,STATE,ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE. ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR ADEM ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT 52NI RAC OR NAME LIC 'SE NUMBER LICE; TYPE BUS.LI COMPANY NAME E- TAIL FAX STREET ADDRESS CITY TATE ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC 0 COMPANY NAME EMAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK L / Ipse 2 cir / row o S F=T- EXISTING USE PROPOSED USE CONSTR.TYPE I #STOKES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DE.rO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA I TOTAL DECKRORCH AREA GARAGEAREA: DETACH ❑ATTACH p DWELLING UNITS: ISASCCONU UNIT 01'FS SECONDSTORY ❑YES RCIN'GADDF.D'. 0O ADDITION' E]NO PRE-APPLICATION ❑YES IF YES,PROI'mE COPY OF I ISTIIEBLOGAB ❑YES RECEIVED HYT"�'"STr;�s r�.µ�4PZ TOTAL VALUATION: PLA•\'NINGAPPLM []NO PLANNING APPROVAL LETTER EICHLER ITONE! C)NO T iT :`ir^t� ��FF _-„T'� ,t �f'w.�' By my,signature below,I certify to each of the following: 1 am the property owner or authorized agent to 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 of Work and verify it is accurate. 1 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 ApplicanVAgenC Date: 10 -1-12— SUPPLEMENTAL D -1-12SUPPLEMENTAL INFORIOATI0N REQUIRED M Pu,,cilrcR+i -e?n 1tiS- P10 —T ie:j” New SFD or hlultifamily dwellings: Apply for demolition pennit for •'' ¢.Czc,��c ��-� I ,O\FR-THF COU\-rE:R ©1 BUILDING P A\REVI IEl\ existing.building(s). Demolition permit is required prior to issuance of building I L P 4.^'tt �,nR+- ri e +n �,g i `}- permit for new building. a❑ �,Re�.s' 3',p°� i� £¢),v 1 InINdP1aN Rr IeIY�.,s q4 hl4'�'�';'I'4' �'39 I�IiT i. 41 Fr^�'�b5t cyL� d 7.'�,�41 f's.*•S T' _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD `1',+• Etr y'�❑-I'PUBLICv ORRs�\ Conn if any Hazardous Materials are being used as art of this ro'ect. a'"` .v r_ }''` p �I"I=I,'��' #-��`�'`" P P 1 y❑1LARcv. _Copy of Planning Approval Letter or Meeting with Planning prior toOR '4 S❑^'S�uTARI SEeIi msTmrr submittal of Building Pcrmit application. dre z: '4' �lrn�r S it 5,y1'�ct� r a4v; { �FFis rLJx. Ii❑❑rF\\'IRONME\IAL HKALTII£y. 'tl± BldgApp_1011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 11517 Silver Spring Ct. DATE: 10/01/2012 REVIEWED BY: gs AP N: BP#: 'VALUATION: $15,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY PENTAMATION USE: SFD or DuplexPER�IITTI'PE: 1GENRE i WORK SCOPE Mech. Plan Check Phunh.Plan Cheek Elec.Plan Check Mech. Peri/Fee: Plumh.Permit Fee: E/ec•. Permit Fee: Other Mech./nsp, Other Plumh Insp. Ll I Other Elce.Insp. ,11ech.Insp.Fee: Plumb, hn.sp.Fee: Dec.Insp.Fee: NOTE: This eslinmte does not includejees due to other Departments(i.e. Planning, Puhdic Narks, Fire,Sanitary Sewer District,School District,etc. . These feev are based on the prefintinan•information available and are nodi,an estitnate. Contact the De t or addn 7 in a. FEE ITEMS (/-'cc Resalncion 11-053 Elf 7/1/1/1 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 1,000 s.f. Siding Suppl. PC Fee: Q Reg. Q OT 0.0 hrs $0.00 $1,000.00 ISIDEST/BK I Stone and Brick Veneer(Int PME Plan Check: $0.00 3 I # Window/Sliding Glass Door Permit Fee: $0.00 $400.00F1 FI'/NREP Replacement Suppl. Insp. FeeQ Reg. Q OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tux: Adcninistratice Fee: Q Work Without Permit? 0 Yes Q) No $0.00 E) Advanced Planning Fec: $0.00 Select a Non-Residential 0 Building or Structure 0 Travel Documentation Fees: A Strong Motion Fee: IBSEISMICR $1.50 Select an Administrative Item Bldg Stds Commission ['cc: IBCBSC $1.00 SUBTOTALS: $2.501$1,400.001TOTAL FEE:F$1.402.50 Revised: 07/01/2012 L &;5 Ne media Seven Springs Owners Association , Application for Approval of Architectural Change/Addition CATEGORY C Category C-Modifications that are exterior modifications with no changes to the original building structure or floor plan.All roofing, siding,window material change,exterior paint color change.addition of a roof attic fan,or garage door, fall into this category. Date: `/ /Z7/ 2 042 Request for Approval of Proposed Change PLEASE'- PRINT THE FOLLOWING INFORMATION Name: MARfC C/9/?O Address: //S/7 Silver Sn^inT Home Phone: `/08 .253-342 6 Work Phone: email: Description of Proposed Change: Sld. 19 - Gv'r`//Ser"ef e"/Y Paint Color Change: Please choose from "approved list"(Garage doorouter trim should be diamond white or frost) A'ete F_rterior Siding Color& Garage door(s)-same color,specified color Trim color: diamond white or frost Front door color:diamond white_frost_natural oak_or specified"approved color 2) Roofing Material Change(please check one choice) a. Lightweight Concrete Tile from MonierLifetile-style"Cedarlite 5780",color"Muirwood" b. GAF Laminated Fiberglass Asphalt -style"Grand Canyon",color"IMission Brown" c. GAF Laminated Fiberglass Asphalt -style"Grand Canyon",color"""Stonewood" d. Decra Stone Coated Steel Rood System-style"Decra Shake",color"Shadowood" e. Class "A" Fire Retardant Roofing System using pressured treated cedar wood shingles with fire retardant fiberglass cap sheet underlay.Need to have a City of Cupertino Permit accompanying this application for all wood shingle roofs. 3)Siding Material Change(Please check one choice) New Siding Material: I-fardiplank Cedarmill (wood grain finish) or 1-iardiplank Smooth Finish Which sides are you are changing material?(front_back_left X right 10gk•^7/i�1 w.// 40, &,r Sa .+P C010i4s_ 4) Window Material and Design change: (Please check this box): Milgard Vinyl Windows-style "Tuscany",color White S)Adding a roof attic fan,Tubular Skylight,or satellite dish Please attach information regarding the proposed change.Application must include dimension,color of the proposed fan and its location on the roof. Please include detailed drawings, specifications,and product brochures if available. Tubular A'ylighi up to l4"diameter. one roof attic jar up to 26"in tridth&height—paint to match roof 6) Garage doors: a. Recessed wood panel,not raised in center same style for windows("PLAIN"—non decorative) Style 84 (8 panels across.64 (6 panels across).44 (4 panels across). Style with windows or Style no windows b. Insulated wood, insulated metal w/wood facing or"Carriage House" style 303C windows 303 no window I Homeowner's Signature: 4✓� r/ �� The request is in compliance with Seven Springs HOA Architectural Guidelines: littp:Hseven-springs.org/files/architecntal-guidelines.pdf i##t#t#4###tt#Wt#WWW##WW#kW##W#iW WWiiiW iWiiirt Wt i#Wi#kkiiti##k#fitki itt##kit###i#tR#t##4#it Architectural Control Committee/Board: Approved ' Pending Denied Pending Architectural Control Committee Board: Signatu Date: 1.27.11 cat C