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10060201 CITY OF CUPERTINO 13UILDING PERMIT BUILDING ADDRESS: 21470 COLUMBUS AVE COIN TRACTOR:BLACK DIAMOND PERMIT NO: 10060201 DES GNS " VNER'S NAME: SCOTT PARCEL 3481 DEL NORTE DR DATE ISSUED:06/30/2010 OWNER'S PHONE: 4086916224 SAN JOSE,CA 95132 PHONE NO:(408)272-5959 ❑ LICENSED CONTRACTOR'S DECLARATION r r r— ^7—7 � / BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# / f �y7` � ]� �� MECH RESIDENTIAL COMMERCIAL Contracto _p �1�_Date 30 I hereby affirm that I am licensed under the provisions of Chapter 9 JOE DESCRIPTION: REMODEL BATHROOM&NEW TUB,TOILET,VANITY,TILE (commencing with Section 7000)of Division 3 of the Business&Professions FLOC(45SQ) ) 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.lit Floor Area: Valuation:$7000 permit is issued. APPLICANT CERTIFICATION APIN Number:36205002.00 Occupancy Type: 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 to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save PERMIT EXPIRES IF WORK IS NOT STARTED indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally,the applicant understands and will comply t80 DAYS FROM LAST CALLED INSPECTION. with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Issued by _ Date:G �nature— Date D ❑ OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of All r Hofs shall be inspected prior to any roofing material being installed.If a roof is the following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for I,as owner of the property,or my employees with wages as their sole compensation, insp,;otion. will do the work,and the structure is not intended or offered for sale(Sec.7044, Business&Professions Code) Signature of Applicant: Date: 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 — declarations: HAZARDOUS MATERIALS DISCLOSURE 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 I ha re read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain I have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. Additionally,should I use equipment or devices which emit hazardous air permit is issued. conlaminants as defined by the Bay Area Air Quality Management District I will I certify that in the performance of the work for which this permit is issued,I shall maiiutain compliance with the Cupertino Municipal Code,Chapter 9.12 and the not employ any person in any manner so as to become subject to the Worker's Heath&Safety Code,Sections 25505,25533,and 25534. 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 Owner or orized agent::;!2Z forthwith comply with such provisions or this permit shall be deemed revoked. =��l!:Z si�G�Date:� APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY I certify that I have read this application and state that the above information is I her eby affirm that there is a construction lending agency for the performance of work's correct.I agree to comply with all city and county ordinances and state laws relating for which this permit is issued(Sec.3097,Civ C.) to building construction,and hereby authorize representatives of this city to enter Len ler's Name n the above mentioned property for inspection purposes.(We)agree to save ,mnify and keep harmless the City of Cupertino against liabilities,judgments, Len Ier's Address costs,and expenses which may accrue against said City in consequence of the granting of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. I understand my plans shall be used as public records. Signature Date Lic(nsed Professional CITY OF CUPERTINO 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: ]got: APN 36205002 .00 DATE ISSUED. . . . . . . : 06/30,12010 RECEIPT #. . . . . . . . . : BSO00010737 REFERENCE ID # . . . : 10060201 SITE ADDRESS . . . . . : 21470 COLUMBUS AVE SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . . CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : SCOTT PARCEL ADDRESS . . . . . . . . . . : 21470 COLUMBUS AVE CITY/STATE/ZIP . . . : CUPERPINO CA, CA 95014-4971 RECEIVED FROM . . . . : BRADFORD S MUELLER CONTRACTOR . . . . . . . : MUELLER, CRAIG D LIC # 18104 COMPANY . . . . . . . . . . : BLACK DIAMOND DESIGNS ADDRESS 3481 :DEL NORTE DR CITY/STATE/ZIP . . . : SAN JOSE, CA 95132 TELEPHONE (408) 272-5959 FEE ID UNIT QUANTITY AMO 7NT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BCBSC VALUATION 7, 000 . 00 1 . 00 0 .00 1. 00 0 .00 1REMRESBAT SQ FEET 1. 00 570 . 00 0 . 00 570 . 00 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 571 . 00 0 . 00 571 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 571 . 00 #1654 --------------- TOTAL RECEIPT 571 . 00 CITY OF CiJPERTINO ADDITION/IF.EMODEL CUPERTINO FEE SCHEDULE APN# ��a ' Date: Is a 2"d unit being added? Yes ElNo ❑ If yes, please fill out the permit application for 2°d unit. Building Address: Mailing Address (if different from building address): Owner's Name: Phone# ,57c_o YO Z Contractor: -13 G.c T�c cot-,CD— Phone#: V--, Fax#: -2! C) d �S Cupertino Business License: 7M zO State Contractor License#: Contact: Phone#: Z O SHS Fax#: 'JR!7 Landscape Ordinance Compliance: Landscape area in sq. ft. (includes all irrigated areas): 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 ❑ `Vater Budget Building Permit Info: Bldg. [t]� Elect. 9— Plumb. ©- " Mech. ❑___� Hillside ❑ Job Description: Addition-What is being added?(Be Specific): What is being remodeled (not including addition)? / .^m o r� N�1'..� Tc> ?o i l C 7' 1��a��? T je /�/o o✓ Remodel Includes Re-Roof. Yes ❑ No ,® if yes list number of squares Remodel Includes Structural: Yes ❑ No Do you have the pre-application planning approv09. Yes ❑ No ❑ If yes, please provide a copy of your planning app:-oval letter. Planners name: Square Footage: Addition: Porch: Deck: _ Garage: Detached Attached Remodel: Kitchen Bath Other Type of Construction(Usage Class): Occupancy Type: 1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B �r Valuation: 7 060 , pa Please check this box if the project is a Project Size: Express Standard ❑ Large ❑ Major ❑ second-story addition ❑ Please complete relevant portion of the Green Building; Checklist& attach it to the application or if applicabh, Green Building Points Achieved: include in plan set & the sheet index. Revised 0511H10/10 LANDSCAPE WATER-EFFICIENCY CHECKLIST Community Development ment Department 10300 Torre Avenue 408.777.3308/Fax 408.777.3333 Cupertino, CA 95014 planning@cupertino.org E�T E O http://cupertino.org/planninc, CUPApplicant Name: Email: Project Site Address: Phone: Total Landscape Land!,cape area: All the planting areas, turf areas, and water Area (square feet): features in a landscape installation. The landscape area does not include footprints of buildings or structures, sidewalks, dril-eways,parking lots, decks,patios, gravel or stone walks, Turf Area: oth°r pervious or non-pervious hardsca}�es, and other non- irri;ated areas designated for non-development (e.g., open spa res and existing No ildland vegetation). Non-Turf Plant Area: Turf: A ground cover surface consisting of non-native grass spe--ies that is customarily moxved. Am-Lual bluegrass, Kei.tucky bluegrass, perermial ryegrass, red fescue, and tall Special Landscape Area: fescue are examples of cool-season turf grasses. Bermuda Water Feature Wet Surface Area: gra>s, kikuyu grass, seashore paspalum, St. Augustine grass, zoysia grass,and buffalo glass are ivarm-season turf grasses. If>10%of landscaped area,water budget calcu- See reverse side for other definitions. lation required with landscape project submittal. NOTE: If landscape area exceeds 2,500 sq.ft.,a landscape project subrlittal shall be required. If no landscaping is proposed,enter "0"above and proceed directly to the signature block at the bottom of his form. Landscape Parameter Requirements Project Compliance Turf Total turf area shall not exceed 25% of the landscape ❑ Yes ❑ ]'�o .t- �'l:et.'el : :•�l'_l`l el. area,or 1,250 square feet,whichever is Lesser in area. �-� _r. i':ater Ca,c-alatc , o lh lCi:d_CG 2}:elect 5::1,1n:Ltal; All portions of turf areas shall be wider than eight(8)feet. ❑ Yes Turf(if utilized)is limited to slopes not exceeding 15%. ❑ Yes Non-Turf At least 80% of non-turf area shall consist of native or ❑ Yes a low water use plants. [lf no.;'eater i rid_et calculation:•equirec. v ith landscape pa•oiect submittal, Hydrozones Plants with similar water needs shall be grouped within ❑ Yes ❑ Nc, hydrozones. Each hydrozone shall be controlled by a Plan's can be trouped per separate valve. Table r Irrigation System Systems shall be designed and maintabied to minimize ❑ Yes ❑ 11\1c'water waste(e.g.,runoff,low head drainage,overspray). Low-volume irrigation shall be utilized in non-turf areas. Irrigation shall only occur between the hours of 8:00 pm [ii no,Fro;ide e>alanation cli ackj and 10:00 am. Soil A minimum of eight(8)inches of non-compacted topsoil ❑ Yes ❑ No shall be available in planted areas. _;T�; �; F,1-,,z.tio;, ;Dacld Soil amendments,such as compost or fertilizer,shall be appropriately added according to the s ail conditions at ❑ Yes Q \'o the project site and based on what is aypropriate for the [li no,Provide ei;p l liatlOn Oil L'aCk selected plants. Mulch A minimum two(2)-inch layer of mulcli shall be applied ❑ Yes ❑ '�'o on all exposed soil surfaces of planting areas,except in areas of direct seeding application(e.g.hydro-seed). no,Fi-ci-ide e::-ianaticii ar rack I am aware of available informational resources regarding native and low water use plants,irrigation efficiency,and other aspects of water-efficient landscaping. I certify that the information provided on this checklist is correct,and the installed landscape complies with the requirements of Chapter 14.15.1 also understand that any charges to the project will necessitate a new checklist. Signature of property owner or authorized representative Date Page 1 of 2 Now M.Indoor Air Quality and Finishes 1.Use Low/No-VOC Paint 1 IAi)/Health pts y--yes 0 2.Use Low VOC,Water-Based Wood Finishes 2 IAOJHealth pts y=yes 0 3.Use Low/No VOC Adhesives 3 IAQ1Health pts y=yes 0 4.Use Salvaged Materials for Interior Finishes 3 RE source pts y--yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQJHealth pts y=yes 0 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAO/Health pts y=yes 7.Seal all Exposed Particleboard or MDF 4 IAI)/Health pts y=yes 0 8.Use FSC Certified Materials for Interior Finish 4 RE source pts y=yes D 9.Use Finger-Jointed or Recycled-Content Trim 1 RE source pts y=yes D 10.Install Whole House Vacuum System 3 IAD/Health pts y=yes _iii6irm0 N.Flooring 1.Select FSC Certified Wood Flooring B Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IACdHealth pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes D Total Points Available: 1 1401 1301 57 Total Points Project Received: 0 0 0 G:data/rogs/greenbwldi igguidelines/remodelers/greenpointsfinal2.12.04protected.xls RESIDENTIAL PROJECT COVER SHEET Assessor's Parcel Number: -3 O ?- 'q"_ Name of owner. S C-O-77 Pa✓'c *r I Project address. M l y 20 e4 /y tM L Vs Contact person. Phone. _ Z o t/a 7_ S Fax. 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 inside the garage? Y AI.� Is privacy protection planting required for the project? ,A' N 3uild it Green Total Points On what floor(s) is work being done? Brief description of work. v 'Pe- !-Al o 10 1 e �a h ,S 1'ry C7Le-,>V' k-Co e-- ( f Code editions: 2007 CBC -N)2007 CFC N)2007 CMC <W N) �y 2007 CPC (Y N)2007 NEC ( N) �Y Effective 1/1/08 nPE'f+k)VE D IN ACC11tJ)w('4, 1,"01", RDIN NODES CUPE R Q> /f! ©AlE—W- - S1 "� This set of plans a",f�Pr`rf�t:abc ns MUST This kepi on the��:c;rpt "II 11"Ies;,nd it is r"a„fir s or 1lterations unlawtut to mak"• . + c ,perm+s;ion from withou' " �;ity of Cupertino. on name d �n ofSFrfications the F;."dd��,9 Uel:,r'tn . The stamp y e.rmit��r to tie an THAI L NO h�•n";ri � Pot env provisions app«r„�tl vl th"r N�tl'i�t�n'•�;g 01 `G le LaW- Plan Review Process Work Book Page-8-Revised 8/05/08 RE ROOF ES'C.SHEET ESTIMATOR DATE--f--j EXIST.ROOF 'ADDRESS I" TOTAL C.RAFTER 1 FOOT O.0 OVERHANG:F.Porch F.EntryALL A 1.5" TOTAL C.RAFTER 2 FOOT O.0 PATIO COVER S 2" TOTAL B.RAFTER PITCH I EXT.FBV R 3" TOTAL SHEETING PITCH 2 OCT.FBH V 4"P. TOTAL FACIA LOW P._ ADD FBV G 4" TOTAL GtJTTER VENT. GABLE EV. NFA 6" TOTAL 8" TOTAL NOTES: VV TOTAL HV TOTAL MISC. I i I ' I V i I : r , r I _ -- -- C- i 1 � y I Y_� ... - - - - - _. _.... - r r , _.. _ - -- -- - - - " : i fi I _ .. _...-.. -_ _..._ _ .. r i i I i i �. .. _._ __.. __. 1- _ : L ._.-.__.. _...._ : ... I i i : : I i __ _...._.. r , r i � r 1_ r i I i. .1 ; i : ......................... .......... .............. .............. i r ------ i Community Development ` 10300 Torre Avenue " t Cupertino CA 95014 Telephone(408) 777-3228 CITY OfAA 11 Fax(408) 777-3333 DT CUPEI\.I IO 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 stor-nwater pollution control laws are key parts of the City's compliance efforts. Stormwater pollution prevention: It's u>> 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 pestic des 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 Field responsible for any environmental damage caused by subcontractors or emplo,tees. For more information on construction-related stormwater requirements, see the Stormwater Quality Regulations section of tie City of Cupertino web site at: htti)://www.cur)ertino.org/city government/departments and offices/ environmental services COMMUNITY NOISE CONTROL 1 The basic noise control requirements for coristruction 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 http://www.amlegal.com/cupertino ca/ Greg Casteel Building Official Community Development a 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY Of Fax(408) 777-3333 CUPEkTINO Building Department All Cupertino building permits must mee-: 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 stor nwater pollution control laws are key parts of the City's compliance efforts. Stormwater pollution prevention: It's u 3 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 pestic des or weed killers; and • Any material dumped or spilled into :streets or storm drains The property owner and the contractor sham ultimate responsibility for activities occurring at a construction site and will be field responsible for any environmental damage caused by subcontractors or emplo,tees. For more information on construction-related stormwater requirements, see the Stormwater Quality Regulations section of tie 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 cor struction 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 http://www.amlegal.com/cur)ertino ca/ Greg Casteel Building Official