10090069 e—
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 7535 WATERFORD DR CONTRACTOR: PERMIT NO: 10090069
OWNER'S NAME: JOHN&KATHI LUCAS DATE ISSUED:09/10/2010
ER'S PHONE: 6507042116 PHONE NO:
❑ LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT I— PLUMB
License Class Lic.# V 3 ` 3 a f—
MECH RESIDENTIAL COMMERCIAL r
Contractor<�)Cjys 1 eSw ate /
JOB DESCRIPTION:REMODEL 2 BATHROOM COMPLETE(120SQ);NON-
I hereby affirm that I am licensed under the provisions of Chapter 9 STRUCTURAL
(commencing with Section 7000)of Division 3 of the Business&Professions -NO RE-ROOF&POSSIBLE NON-BEARING WALL
Code and that my license is in full force and effect.
I hereby affirm under penalty of perjury one of the following two declarations:
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.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
Sq.Ft Floor Area: Valuation:$23000
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:36617023.00 Occupancy Type:
correct.I 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 of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regul ons per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18. C
Signatur I Date [ ���'�� Issued Imo.'L �' �'�-��---- Date: 5;t (a �✓
CJ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected 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(Sec.7044, inspection.
Business&Professions Code) Date:
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant:
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
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
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. I will maintain
compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Section 3700 of the Labor Code,for the perfonnance of the work for which this Safety Code,Section 25532(a)should I 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 the work for which this permit is issued,I 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 of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must O ner or auth gent
ate•
forthwith comply with such provisions or this permit shall be deemed revoked. -'- 0--(3
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
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 and state laws relating I hereby affirm that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
mnify and keep harmless the City of Cupertino against liabilities,judgments,
and expenses which may accrue against said City in consequence of the Lender's Address
granting of this pen-nit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO
3 ITEMS OF 4 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk.: Lot:
APN 36E17023 .00
DATE ISSUED. . . . . . . : 09/ 10/2010
RECEIPT #. . . . . . . . . BSC,00011427
REFERENCE ID # . . . : 10090069
SITE ADDRESS . . . . . : 75_.5 WATERFORD DR
SUBDIVISION . . . . . . .
CITY CUI BERT INO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : JOHN & KATHI LUCAS
ADDRESS . . . . . . . . . . : 75:35 WATERFORD DR
CITY/STATE/ZIP CU:?ERTINO, CA 95014
RECEIVED FROM . . . . : JA14ES P LOWEECEY
CONTRACTOR . . . . . . . : TB's - TO BE DETERMINED LIC # 00096
COMPANY . . . . . . . . . . : TB:) - TO BE DETERMINED
ADDRESS . . . . . . . . . .
CITY/STATE/ZIP . . . :
TELEPHONE . . . . . . . .
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
---------- ---------- ----
1BCBSC VALUATION 23, 000 . 00 1. 00 0. 00 1 . 00 0 .00
1BSEISMICR VALUATION 23, 000. 00 2 .30 0 .00 2 .30 0 .00
1REMRESBAT SQ FEET 120 . 00 570 .00 0.00 570 . 00 0 .00
---------- ---------- ---------- ----------
TOTAL PERMIT 573 .30 0 .00 573 .30 0 . 00
CITY OF CUPERTINO
FEE ESTIMATOR- BUILDING DIVISION
ADDRESS: DATE: REVIEWED BY:
APN: BP#: "VALUATION: 1$23,000
q:rPERMITTYPE: Building Permit PLA AN CHECK TYPE: Alteration /Addition / Repair
PRIMARY SFD or Duplex l(1I;`1E- PENTAMATION 1GENRES
USE: I'1-000 4 i% PERMIT TYPE:
WORK
SCOPE
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NOTE: These fees are based on the preliminary in ormation a vailable and are only an estimate. Contact the De t or addn'l info.
FEE ITEMS ,(Fee Resolution 09-05I Etf 7%1110) FEE QTY/FEE MISC ITEMS
Plan Check Fee: $(1.00 = s.f. Remodel,Bath(<=300 sf)
Suppl. PC Fee: (F) Reg. 0 OT0.0 hrs $(1.00 $570.00 IREMRESBAT
PME Plan Check: $C.00
Permit Fee: $C.00
Suppl. Insp. Feed Reg. 0 OT 0.0 hrs $(1.00
PME Unit Fee: $0.00
PME Permit Fee: $(1.00
C_`onsw-root Tax
Acoustical Fee: 0 Yes (F) No $0.00 0
Work Without Permit? 0 Yes 0 No $0.00 E)
Planning E ee: $0.00 Select a Non-Residential E)
Building or Structure 0
7r-ilr�>l t)o�tttrtc�ntt:atiozl 1'`c't's°:
Strong Motion Fee: 1BSEISMICR $2.30 Select an Administrative Item
Bldj4 Stds Commission Fee: IBCBSC $1.00
SUBTOTALS: $:3.30 $570.00 TOTAL FEE: $573.30
Revised: 9/01/2010
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
C U P E RT I N O Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: PERMIT# U 6
OWNER'S NAME: QhWv ka: PHONE# L CC, 760
GENERAL CONTRACTOR: pry,, �tiuMc e7BUSINESS LICENSE# (6-31 3 V� -
ADDRESS: I(C� 9 /vim r L L oS�- ��R S(Z CITY/ZIPCODE: 1 �SL� S(2
*Our municipal code requires all businesses working in the city to have a City of Cupertino business icense.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL SUBCON RACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. ip /::!� ?— I c--�v
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and comp ete the following information:
%/ SUBCONTRACTOR BUSINUSS NAME BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring/ Carpeting
Linoleum /Wood
Glass/ Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Painting/Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/Contractor Signature Date
RESIDEN'T'IAL PROJECT COVER SHEET
Assessor's Parcel Number: r3 Gy- 11- U Z-3
Name of owner. O� 4-f - ( L(i C e1 S
Project address. �S S tJM-,er C-vi J )Q
\ n LC Contact person.y aMe-s ec-�-P hone. �2 g .7 ��
F ax.
Net square footage of lot.
Existing Proposed
Square footage: First floor:
Second floor:
Garage:
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces i lside the garage?
Is privacy protection planting required for the project! Y
Build it Green Total Points ID
S art
On what floor(s) is work being done?
VL Y�' L' G,�`d.�- C-��c�•�T� �cSy� �:r'�CiC-� �P�! ��eL�t'���
Brief description of work. .
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STORMWATER POLLUTION CONTROL AND NOISE CONTROL
COMMUNITY DEVELOPMENT DEPAR'-MENT• BUILDING DIVISION
ALBERT SALVADOR, P.E.,C.B.O., BUI-DING OFFICIAL
10300 TORRE AVENUE•CUPERTINO CA 95014-3255
CUPERTINO
(408)777-3228•FAX(408)777-3333• 1buildingCa.cupertino.org
GENERAL INFORMATION
All construction work must meet certain conditions related to maintaining environmental quality and public
health and safety. This policy described the two moss common inquiries regarding construction: Stormwater
Pollution Control and Noise Control.
STORMWATER POLLUTION CONTROL
State law requires that the City of Cupertino, along with 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 diroctly to local creeks and into the San Francisco Bay
without going through a water filtering/treatment proi;ess. Stormwater pollution is a serious problem for
wildlife dependent on our waterways, for people livir.g near streams and baylands, and for the local water
supply. Common sources of stormwater pollution include;
• Dripped oil, fuel, and antifreeze from vehicle:, 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 website at: http://www.cup-rtino.org/index.aspx?page=487
COMMUNITY NOISE CONTROL
Construction noise is limited to:
• Residential daytime noise levels from comph int site—60 dBA
• Non-residential daytime noise levels from co nplaint site—65 dBA
Daytime hours are defined as being between the following hours:
• Weekdays—7:00am to 8:00pm
• Weekends—9:00am to 6:00pm
Construction, other than street construction, is prohibited on holidays, except that construction conducted by
a homeowner or resident of a single family dwelling using domestic construction tools is allowed on
holidays between the hours of 9:00am to 6:00pm.
For more information on noise control,please refer to Chapter 10.48 of the Cupertino Municipal code,
which can be accessed at hgl2://www.amleizal.com/c1pertino ca.
Stormwater/Noise Control-20 10.doc revised 08106110
CITY OF CUPERTINO
ADDITIOINUREMODEL
CUPER-rINO FEE SCHEDULE
APN# Dat�j
Is a 2°0 unit being added? Yes El �
No f"es, )lease fill out the permit application for 2" unit.
B ioin Address: �w� 6(",U,
Mailing Address (if different from building address):
Owner's Name: Phone#
fi r, A- 11 (�c�as (� � LY 2-1 f �
Co4tractor: 6 y Phone#:
Fax#: yo Z ^, )'701
C)
Cupertino Business License: State Contractor License t
Contact: Phone#:
Fax#:
Landscape Ordinance Compliance:
Landscape area in sq. ft. (includes all irrigated are as): A
If 2,500 sq. ft. or less, compliance with the Landscape Water-Efficiency Checklist is required.
If more than 2,500 sq. ft., a complete Landscape Project Submittal is required.
Compliance Method: ❑ Plant Type Water Budget
Building Per
,�nit Info:
Bldg. Elect. (�' Plumb. Mech. F1Hillside ❑
Job Description:
Addition-What is being added?(Be Specific):
L
What is being remodeled(not including addition)?
Remodel Includes Re-Roof. Yes ❑ No ?l If yes list number of squares
Remodel Includes Structural: Yes M No ❑ /v L r.,' 6-0- r(—�
Do you have the pre-application planning approval? Yes ❑ N'0 ,a
If yes, please provide a copy of your plann!R&approval letter. Planners name:
Square Footage:
Addition: Porch: Deck: Garage: Detached Attached
Remodel: Kitchen Bath 2.0 Other
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B Valuation: 2 060
Please check this box if the project is a
Project Size: Ex ress �tandard ❑ Large ❑ 1a'or ❑ second-story addition ❑
Please complete relevant portion of the Green Building
Checklist& attach it to the application or if applio.able, Green Building Points Achieved:
include in plan set& the sheet index.
Revised 05/18/10