10080050 CITY OF CUPERTINO BUDDING PERMIT
BUILDING ADDRESS: 11572 MORNING SPRING CT CONTRACTOR: 6 BE PERMIT NO: 10080050DETT"NED
VNER'S NAME: JAMES GILL
aSQ10
DATE ISSUED:08/06/2010
PHONE NO:
OWNER'S PHONE: 4082526845
[•�" LICENSED CONTRACTOR'S DECLARATION
JOB DEQ CRIPTION: RESIDENTIAL COMMERCIAL
Lic.# REPLY&E 900 SQ OF MASONITE SIDING W/HARDIE
License Claes BACKER
Contractor ��V"�y � Date SIDING REPLACE 8 MILGARD WINDOWS LIKE FOR LIKE
I hereby affirm that I am licensed under the provisions of Chapter 9
(commencing with Section 7000)of Division 3 of the Business&Professions
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 Valuation:$43000
performance of the work for which this permit is issued. Sq.Ft Floor Area:
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 thi APN Number:36652037.00 Occupancy Type:
permit is issued.
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is P ERMIT EXPIRES IF WORK IS NOT STARTED
correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save 130 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Issued bye Date: F- L�
granting of this permit. Additionally,the applicant understands and will comply
with all non-point spurce regulations per the Cupertino Municipal Code,Section
9.18. �U�� RE-ROOFS:
Date L All root;shall be inspected prior to any roofing material being installed.If a roof is
installer without first obtaining an inspection,I agree to remove all.new materials for
inspecti>n.
❑ OWNER-BUILDER DECLARATION Date:
Signatu"e of Applicant:
I hereby affirm that I am exempt from the Contractor's License Law for one of
ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
the following two reasons:
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,
Business&Professions Code) HAZARDOUS MATERIALS DISCLOSURE
1,as owner of the property,am exclusively contracting with licensed contractors to
construct the project(Sec.7044,Business&Professions Code). I have -ead the hazardous materials requirements under Chapter 6.95 of the
Califor nia Health&Safety Code,Sections 25505,25533,and 25534. I will
I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous
I have and will maintain a Certificate of Consent to self-insure for Worker's materi d. Additionally,should I use equipment or devices which emit hazardous
Compensation,as provided for by Section 3700 of the Labor Code,for the air con taminants as defined by the Bay Area Air Quality Management District I
performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance,as provided for by
the Health&Safety Code,Sections,25333,and 25534.
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: Date: P�-�Q
permit is issued.
I certify that in the performance of the work for which this permit is issued,I shall
not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY
Compensation laws of California. If,after making this certificate of exemption,I
become subject to the Worker's Compensation provisions of the Labor Code,I must I heret y affirm that there is a construction lending agency for the performance of
forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.)Lender's Name
APPLICANT CERTIFICATION Lender's Address
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
building construction,and hereby authorize representatives of this city to enter
n the above mentioned property for inspection purposes.(We)agree to save ARCHITECT'S DECLARATION
—Jemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records.
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section Licen:.ed Professional
9.18.
Signature Date
Building Department
City Of Cupertino
10300 Torre Avenue
Cupertino, CA 95014-3255
Telephone: 408-777-3228
CUPERTINO Fax: 408-777-3333
CONTRACTOR/ SUBCONTRACTOR LIST
JOB ADDRESS: // 'L' (��ivN .�'J C�- PERMIT# ®J
OWNER'S NAME: pbj C7 % PHONE# �.
GENERAL CONTRACTOR: _h&gAl BUSINESS LICENSE#
ADDRESS: g�j ,Qt/S! � CITY/ZIPCODE: ��
*Our municipal code requires all businesses working in the city :o have a City of Cupertino business license.
NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE
GENERAL CONTRACTOR AND ALL S BCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO
BUSINESS LICENSE. / �.6�o
I am not using any subcontractors: Date
Signature
Please check applicable subcontractors and complete the f allowing information:
SUBCONTRACTOR BUSINESS NAN[E 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
CITY OF CUPERT CNO
5 ITEMS OF 5 PERMIT RECENT OPERATOR: SylviaM
COPY # : 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN 36652037. 30
DATE ISSUED. . . . . . . : 08/06/2010
RECEIPT # . . . . . . . . . BS000011106
REFERENCE ID # . . . : 10080050
SITE ADDRESS 11572 MORNING SPRING CT
SUBDIVISION . . . . . . .
CITY CUPERTINC
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : JAMES GILL
ADDRESS 11572 MOF.NING SPRING CT
CITY/STATE/ZIP CUPERTINO CA, 95014-5121
RECEIVED FROM MASTERKE"' CONSTRU
CONTRACTOR TBD - TO BE DETERMINED LIC # 00096
COMPANY TBD - TO BE DETERMINED
ADDRESS
CITY/STATE/ZIP . . . : ,
TELEPHONE . . . . . . . . .
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -------------
----------
------- --- ---------- -
1BCBSC VALUATION 4, 300 . 00 2 . 00 0 .00 2 . 00 0 . 00
1BSEISMICR VALUATION 4, 300 . 00 4 .30 0 .00 4 . 30 0 . 00
1BUSLIC FLAT RATE 1 . 00 114 . 00 0 .00 114 . 00 0. 00
1SIDEOTHER SQ FEET 900 . 00 760 . 00 0 .00 760 . 00 0. 00
1WINREP EACH 8 8 . 00 380 . 00 0 .00 380 . 00 0 . 00
---------- ---------- ---------- ------
TOTAL PERMIT 1260.30 0 .00 1260 . 30 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- -
CHECK 1, 260 . 30 9609
---------------
TOTAL RECEIPT 1, 260 .30
RESIDENTIAL PROJECT C"'OVER SHEET
Assessor's Parcel Number:
Name of owner. 1!*e11fy
Project address.
ContactP erson. ANT �,� C�y���i�o,� Phone.
Fax. -5-/4)— 72-6-v Z� �--
Net square footage of lot.
Existiniz Proposed
Square footage: First floor:
Second floor:
Garage.
TOTAL:
Are there at least two 10 foot by 20 foot clear spaces inside the gz rage?
Is privacy protection planting required for the project? Y
.3uild it Green Total Points
On what floor(s) is work being done?
Brief description of work. lelloCe LG���QCr�S ��/�� � 161 e
Code editions: 2007 CBC (Y N)2007 CFC (Y -N)2007 CMC (Y-N)
2007 CPC (Y-N)2007 NEC (Y -N)
Effective 1/1/08
BY:
Plan Review Process Work Book Page-8-Revised 8/05/08
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CITY OF CUPERTINO
CUPEI�T1NO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # Date:
CSC p 5� D3
Building Address:
Mailing Address (if different from building address):
Are Hazardous Materials being used as part of this project? Yes No
HOA: xterior work only) Yes [] No If es, provide letter from HOA
Owner's Name: Phone#:
Phone: _,510, VZ _ S'/Z
Contractor: `� r � /� CFax; :5 V 6
Contractor License#: 4t,�'��j /!
Cupertino Business License#:
Contact: Phone:
Fax:
Residential Commercial
Job Descriptio - /,, ,� �Jr�
�1A
I r
�i�✓2GJ�/�: L��C'i��`�' -J/CJ1R�/�jfy k/A�C-��,/ l y7E
Building Permit Info:
Bldg a. Elect ❑ Plumb ❑ Mech ❑
Type of Construction(Usage Class): Occupancy Type:
1-A, 1-B ❑ 11111I/V-A ❑ IUIII B, IV-HT,V-B [�'' � *�► _
Square Footage:
Valuation:
Project Size: Express tandard El Large El Major ❑
'
Green Building: Please complete relevant portion of the Green Pudin gfLEED Checklist & attach it
to the application or if applicable, include in plan set& the sheet index.
x oints Achieved: -
For help, contact Build it Green at www.builditgreen.o�g�
Revised 07/14/09
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
1121 ADDRESS: DA'Z'E: REVIEWED BY:
APN: BP#: "VALUATION: $43,000
*PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/Addition/ Repair
PRIMARY APPLICATION
01 Ai. 1 GENRES
USE: SFD or Duplex TYPE:
xW
as
00
3 �
,pecA
P, wil
T7
C�.iaci ,11tc'it_ litsi>_
t)p/i , F'lrrr,l- /r„1. C)t,.rl�lc°c, Inci.
NOTE. These fees are based on the preliminary information availab le and are on1v an estimate. Contact the Dept for addn'l info.
FEE ITEMS (Fee Resolution 09-051 Eff 7,/1/091FEE QTY/FEE
MISC ITEMS
Plan Check Fee: $0.00 8 # Window/Sliding Glass Door
Suppl. PC Fee: (F) Reg. OT 0.0 hrs $0.00 $380.00 1 WINREP Replacement
PME Plan Check: $0.00 900 s.f. Siding
Permit Fee: $0.00 $760.001ISIDEOTHER All Other
Suppl. Insp. Feer Reg. 0 OT rO.0 I hrs $0.00
PME Unit Fee: $0.00
PME Permit Fee: $0.00
o17N11'{t,a,,.on 7("V
Acoustical Fee: 0 Yes Q No $0.00 0
Work Without Permit? 0 Yes (E) No $0.00
Plannin&Fee: $0.00 Select a Non-Residential
Building or Structure 0
1 rttrc-1 r)ai<rtt'tie�ltrdi«tt 1e�s:
i
Strong,Motion Fee: IBSEISMICR $4.30 Select an Administrative Item
Bldg Stds Commission Fee: IBCBSC $2.00
SUBTOTALS: $6.30 $1,140.00 TOTAL FEE: $1,146.30
Revised: 7/28/2010
Seven Springs Owners Association
Application For Approval of Architectural Change/Addition
CATEGOKY C
E_•ategor, C. Modifications that are exterior modifications i~.kh io changes to the original hujlding structure or floor
plan. All roolina.siding.or\%indo�N material change.or exterior paint color change. or addition ofa roof attic tail. Call
into this categm.
Datc:a_7
fo: ;Architcetural Contri�l Committee
Suhject: RegUest Cor Appro%al of Proposed Change
PLEASE PRINT THE EOLLC WING INFORMATION
.�:_�`1 -� { ire- �r .\. ,e,.: IIS?� / acnrlly
ILI-
I Ionic Phone:�{ok—e�-� � &K Phone:
t:Cti
Description of Proposed Change:
1) Paint Color Change:
I.�terie,t Si�lin Color(please pick one color comhination ,170111 approved paint list).
('omhination
') Roofing:Material Change(please check one choice)
,. i.ightneigN Concrete Ile from kWnkd "He-sq lc"t"Hhe 571K color "'�1uir��ood
h .
(;,\l laminated I tbeylass;Asphalt-st)Ie"(nand C'am on .color Mission ----
c. E;;\(J. Laminated I iherelass:\sphalt-stele"(;rand C anion eolor'"'Stonc��oud' __.-----------._----____--
Decra Stime Coated StecI Rood stem-';t�le Decca Shak K solar"SK(IOV,ood' __--
e. (Ins "A" fArc Retardant Roo ltn g S stem using Pressured treated cedar Nkood shingles N%it11 fire retardant Irhu-gl ,s
cap sheet underlay. Need to have a Citi oCCupertino my,accompam ing this application for all\t oocl shingle
rool-5.
;y Siding Material Change(Please check one choic
tic\\ Sidin Material : I lardiplank Select Ced )armill - ---_IlOMNI; Smooth F inish
ou are changing material(fr�nt.hack. left or right?)
4) Pt'in(lokj tilaterial and Design change
1 Please cheek this hos): Rlilgard Vim l \�indo�� -sty lc `I use am"'. color�\bite _ _
5) adding a roof attic Can or Tubular Skylight
Please attach information regarding,the proposed change. :\pplication must include dimension.color uCthe proposed fan
;ntd its location on the roof. Please include detailed dra"inas, .pceilications.and product brochures iCa�uilahle.
ltomeo,�ner's SQMturc: -/' � . -` - -- -- - - - -
AIt.( NI f f.E I l;it''\I. C ON IROI, t E)�'I!�,tl I I I�L'liOr\RI),AC v IE)'.
'\ppro\'ed Appro\-eel I cndinL� - -- -------
----------------------
Denied Denied Pending
'\rrhiieumm! Control Conunilice
%lioartl Cununritis:
'� ` .� � ' Date:
\rehitectural C 0111.1-01 C'omnuttec Board Signature:_/- _._� _ _- -��_-. -=----- _-