09080107 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7760 OROGRANDE PL CONTRACTOR:BLACK DIAMOND PERMIT NO:09080107
DESIGNS
' �VER'S NAME: PFARD WILLIAM AND MASAKO 3481 DEL NORTE DR DATE ISSUED:08/12/2009
L
Ch-t NER'S PHONE: 4085645059 SAN JOSE,CA 95132 PHONE NO:(408)272-5959
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT PLUMB-
License ClassC77 Lie.#77"/ Y —_
MECH RESIDENTIAL r�COMMERCIAL
Contractor ('rte i f `R/�i ffs�L_—Date erl5p /Z.Og
---�� � JOB DESCRIPTION:REMODEL THREE(3)BATHROOMS&
hereby affirm that 1 am licensed under the provisions of Chapter 9 ITCHEN(NON-STRUCTURAL)&
(commencing with Section 7000)of Division 3 of the Business&Professions KITRE-ROOF INCLUDED
Code and that my license is in full force and effect. NO
1 hereby affirm under penalty of perjury one of the following two declarations:
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.
1 have and will maintain Worker's Compensation Insurance,as provided for by Sq.Ft Floor Area: Valuation:$5000
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued.
APN Number:3618020.00 Occupancy Type:
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is
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 PERMIT EXPIRES IF WORK IS NOT STARTED
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, WITHIN 180 DAYS OF PERMIT ISSUANCE OR
costs,and expenses which may accrue against said City in consequence of the 180 DAYS FROM LAST CALLED INSPECTION.
granting of this permit. Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section _
9.18. Issued b Date:
ture'a Date_ /Z 4-f
❑ OWNER-BUILDER DECLARATION RE-ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1 hereby affirm that I am exempt from the Contractor's License Law for one of installed without first obtaining an inspection,I agree to remove all new materials for
the following two reasons: inspection.
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, Signature of Appli resin _ / Date:
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
I hereby affirm under penalty of perjury one of the following three HAZARDOUS MATERIALS DISCLOSURE
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's I have read the hazardous materials requirements under Chapter 6.95 of the
Compensation,as provided for by Section 3700 of the Labor Code,for the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
performance of the work for which this permit is issued. compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
I have and will maintain Worker's Compensation Insurance,as provided for by Safety Code,Section 25532(a)should 1 store or handle hazardous material.
Section 3700 of the labor Code,for the performance of the work for which this Additionally,should 1 use equipment or devices which emit hazardous air
contaminants as defined by the Bay Area Air Quality Management District 1 will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
I certify that in the performance of the work for which this permit is issued,I shall Health&Safety Code,Sections 25505,25533,and 25534.
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 Owner authorized agent:
become subject to the Worker's Compensation provisions of the Labor Code,I must Date:�LO-V9 X
forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance of work's
I certify that I have read this application and state that the above information is for which this permit is issued(See.3097,Civ C.)
correct. I agree to comply with all city and county ordinances and state laws relating Lender's Name
to hnilding construction,and hereby authorize representatives of this city to enter
'ie above mentioned property for inspection purposes.(We)agree to save Lender's Address
nIfy and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the ARCHITECT'S DECLARATION
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records.
9.18.
Licensed Professional _
Signature _ Date_
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Assessor's Parcel Number:
Name of owner. Mo.Sci o f�c�r eY�
Project address. 7? a PL - �v�eYfited, CA
Contactperson. ��� Phone. 4}a1- SG4{-5Os9'
Fax.
Net square footage of lot.
Existin Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
r'
re thereat least two 10 foot by 20 foot clear spaces inside thegarage? �<N
Is privacy protection planting required for the project? N
On what floor(s) is work being done?
Brief description of work. /��'v-r o�P .�o'c� /��f� roor.�r S �GiK�a�� 70 $5�
70 Sa -tCf ,. a_S' irs ;�i CIO x X�s,. Q 0) -44 PAK l24=cJ Csa1rflre741c
Code editions:2008 CBC 0-1)2008 CFC ?N)2008 CMC (19-N)
2008 CPC (®-N) 2008 NEC -N)
APPROVED
IN ACCORDANCE WITH THE CITY OF
CUPERTINO CODES AND ORDINANCES
Z 'D 9 ..
Effective 1/1/08 DATE— --- -
SIGNE _— _— - - --
This set of plans and specifications MUST
be kept on the lob at all times and it is
unlawful to make any changes or alterations
on same without written permission from
the Building Department,City of Cu ,no.
The stamping of this plan and spec,cations
SHALL NOT be held to permit orto ro be
an
approval of the violation of any pions
of any City Ordinance or State Law.
BMP SHEET ,
Plan Review Process Work Book Page-8-Revised 1/1/08
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Assessor's Parcel Number:
Name of owner. Masa o f e-ekP,a �
Project address. 77(=0 Oro ' � �� - Cv,�en�'"&, C A
Contact person. e, T'naY Phone. qQ 4{—50�9'
Fac.
Net square footage of lot.
Existing Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
re there at least two 10 foot by 20 foot clear spaces in:ide the_garage? �<
Is privacy protection planting required for the project? N
On what floor(s) is work being done?
Brief description of work. ��'trt o�/P ®'c� %3c�}!� roor.N s N�iKsg-�-
Masf�r /3�f� 7D Sa -�f "Ti�wa sY�airs 2 4,osa�, cs�+oo�P �ifr`rPc� vtcaJ cs���lh
Code editions:2008 CBC a-N)2008 CFC (a N)2008 CMC (6)-N)
2008 CPCY 1)2008 NEC -1� �S'S�C
s60
Effective 1/1/08 � c O/dy
Plan Review Process Work Book Page-B-Revised 1/1/08
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CITY OF CXPERTINO
ADDITIOPI/REMODEL
CUPEkTINO PERMIT APPLICATION FORM
APN # v 9_0 ,<;�\ Date: -v 'r7jS � n
Is a 2° unit being added? Yes ❑ No If yes, ;Tease fill out the permit application for 2 unit.
Building Address:
(O 0 V-0 r,_%A_CQP_ 7 C--0 perg�o SO
Mailing Address (if differ nt from building address):
Owner's Name: Phone#
D eor440S
Contractor: Phone#:
'Q�o.c�c �cai.cKoc�� S�S� Fax#: 7l>g O- Z.Co S
Contractor License#: 7 74`T 1
Cupertino Business License#: l Qq-
Contact: Phone#:
Fax #:
Building Permit Info:
Bldg. Elect. [� Plumb. Mech. ❑ Hillside ❑
Job Description:
Addition-What is being added?(Be Specific):
What is being remodeled(not including addition,? 77,re-e- 3c.;�-4r
YX ark
Remodel Includes Re-Roof: Yes ❑ No [l"_ f yes list number of squares
Remodel Includes Structural: Yes ❑ No [
Do you have the pre-application planning approval? Yes ❑ No [K
If yes, please provide a copy of your planning approval letter. Planners name:
Square Footage:
Addition: Porch: Deck: Garage: Detached Attached
Remodel: Kitchen ath -?-C>C>n 1�0 Other
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/IIUV-A ❑ IUIII B, IV-HT, V-B
R-53
Valuation: � , c�c'� Please check this box if the project is a
second-story addition ❑
Project Size: Express E'Sdard ❑ Large ❑ lgg2r❑
Please complete relevant portion of the Green Building
Checklist& attach it to the application or if applicable, Green BuildinPg Points Achieved:
include in plan set& the sheet index.
***For Office Use Only***
Over-the-Counter ❑ Revised 07/06/09
CITY OF CUPERTINO
ADDITION/REMODEL
CUPEI�TINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
ADDITIONS 1R3SFDADD
1PLLONGRNGR Long Range PL
Planning/Residential
1R3INSP 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 Dwellings Hillside plan B
check
1 R3HREINSP Dwellings Hillside B
Repeat Inspection
1R3HREPLNC Dwellings Hillsice. B
Repeat Plan Check
1R3ALTINSP Dwellings Alternate B
Materials Inspection
1R3ALTPLNC Dwellings Alternate B
Materials Plan Check
1PCESS Cesspool P
1PPRSEWG Ea. Private Sewa;;e P
Disposal System
1 PRSEWER Sewers P
1BPSPRINK Lawn Sprinkler/Ftackflow P
1BPWSVCS Main Water Service P
1BCBSC Cal Bldg Standards B ALL PERMIT TYPES
Commission Fee
1BSEISMICRE SeismicResidential B
1RER00FRES Residential Re-roof Each B
100 SF
CITY OF CUPERTINO
ADDITON/REMODEL
FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
DECKS 1R3SFDADD OR
IR3SFDREM
1DECKWOOD Deck (Wood)-Each B
(Each)
1 DECKRAIL Deck Railing-Each B
(Each)
GARAGES 1R3SFDADD OR
DETACHED 1R3SFDREM
1 GARDTW<=1 K Wood Frame up to B
1,000 SF (each)
1GARDTM<=1K Masonry up tc, 1,000 SF B
(each)
1 BCONSTAXR Construction lax Res
(new detaches garage)
PATIO'S OPEN 1R3SFDADD OR
IR3SFDREM
1PATIOWOOD Wood Frame up to 300 B
SF
1PATIOMETAL Metal Frame tip to 300 B
SF
1PATIOOTHER Other Frame tip to 300 SF B
PATIO'S CLOSED 1R3SFDADD OR
& SUN ROOMS 1R3SFDREM
1PATIOENCLW Enclosed Woad up to 300 B
SF
1PATIOENCLM Enclosed Metil up to 300 B
SF
1 PATIOENCLO Other Enclose d Patio up B
to 300 SF
1 COVPORCH Porch Covered-Each B
(Each)
REMODELS 1R3SFDREM
1 REMRESKIT Kitchen Remodel up to B (Deduct "$"for ea plan
300 SF check
1REMRESBAT Bath Remodel up to 300 B "
SF
1 REMREOTH Other Remod:,l up to 300 B 46
SF
INPUT Resourc:Ls Energy IAD/Health
M.Indoor Air Quality and Finishes
1.Use LowMo-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes 0
5.Use Engineered Sheet Goods with no added Urea
Formaldehyde 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for interior Uses 1 IAQ/Health pts y=yes 0
7.Sea]all Exposed Particleboard or MDF 4 IAQ/Health. pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
N.Flooring
1.Select FSC Certified Wood Flooring E Resource pts y=yes 0
2.Use Rapidly Renewable Flooring Materials Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles Resource pts y=yes 0
4.Install Natural Linoleum in Place of Vinyl i IAQ/Health pts y=yes 0
5.Use Exposed Concrete as Finished Floor Resource pts y=yes 0
6.Install Recycled Content Carpet with Low VOCs Resource pts y=yes 0
Total Points Available: 140 1301 5'1
Total Points Project Received: 01 01 0
G:data/progslgree ibuildingguidelin2s/remodelers/greenpointsfinal2.12.04protected.xls