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11090026 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22665 SILVER OAK LN CONTRACTOR:AUGUSTINE WEAVER PERMIT NO: 11090026 OWNER'S NAME: AUGUSTINE WEAVER 22665 SILVER OAK LN DATE ISSUED:09/06/2011 ("''NER'S PHONE: 6508610784 CUPERTINO,CA 95014 PHONE NO: L1 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT F PLUMB License Class Lic.# MECH RESIDENTIAL COMMERCIAL Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMOVE 6 EXISTING WINDOWS,REPLACE WITH NEW (commencing with Section 7000)of Division 3 of the Business&Professions WINDOWS THAT WILL MEET 2010 CRC 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 Sq.Ft Floor Area: Valuation:$4800 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION APN Number:34249009.00 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 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 by: Date: Signature Date OWNER-BUILDER DECLARATION RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed.If a roof is I 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 Applicant: Date: Business&Professions Code) I,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 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. I 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 I store or handle hazardous material. Section 3700 of the Labor Code,for the performance of the work for which this Additionally,should I use equipment or devices which emit hazardous air permit is issued. contaminants as defined by the Bay Area Air Quality Management District I will 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 or uthorize age become subject to the Worker's Compensation provisions of the Labor Code,I must Date: 91612,011 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 Aork's I certify that I have read this application and state that the above information is for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws relating Lender's Name to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes.(We)agree to save Lender's Address indemnify and keep harmless the City of Cupertino against liabilities,judgments, and expenses which may accrue against said City in consequence of the .ig of this permit.Additionally,the applicant understands and will comply ARCHITECT'S DECLARATION �.... all non-point source regulations per the Cupertino Municipal Code,Section I understand my plans shall be used as public records. 9.18. Signature Date I L6 (� Licensed Professional _ CITY OF CUPERTINO 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg COPY # 1 Sec: Twp: Rng: Sub: Blk: Lot: APN 34249009. 00 DATE ISSUED. . . . . . . : 09/06/2011 RECEIPT #. . . . . . . . . BS000014672 REFERENCE ID # 11090026 SITE ADDRESS . . . . . : 22665 SILVER OAK LN SUBDIVISION . . . . . . . CITY CUPERTINO IMPACT AREA . . . . . . OWNER AUGUSTINE WEAVER ADDRESS 22665 SILVER OAK LN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM AUGUSTINE WEAVER CONTRACTOR . . . . . . . : LIC # *OWNER* COMPANY AUGUSTINE WEAVER ADDRESS 22665 SILVER OAK LN CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 TELEPHONE . . . . . . . . . FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ------ 1BCBSC VALUATION 4, 800 . 00 1. 00 0. 00 1.00 0. 00 1BSEISMICR VALUATION 4, 800 .00 0 .50 0 . 00 0 .50 0 . 00 1WINREP EACH 8 1.00 392. 00 0 . 00 392 .00 0. 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 393 .50 0 . 00 393 .50 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- --------------- CREDIT CARD 393 . 50 VISA --------------- TOTAL RECEIPT 393 . 50 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 22665 silver oak, lane DATE: 09/06/2011 REVIEWED BY: larry s APN: BP#: 'VALUATION: $4,800 PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex 2nd Unit? Yes No PENTAMATION 1 R3SFDREM USE: OTC? 0 Yes Ce No I PERMIT TYPE: WORK remove 6 existing windows replace with new windows that will meet 2010 CRC SCOPE OCCUPANCY TYPE: TYPE OF FLR AREA PC FEES PC FEE ID BP FEES BP FEE ID CONSTR. s.f. R-3 (Custom) II-B,111-B,IV,V-B 0 $0.00 $0.00 TOTALS: 0 $0.00 $0.00 MECH,HOURLY C) Yes (E) No PLUMB,HOURLY Q Yes Q No ELEC,HOURLY Yes Q No NOTE: These fees are based on the preliminary information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (F�e Resolution 11-05 Jiff. ?'l.-'II) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 © # Window/Sliding Glass Door Suppl.PC Fee: 0 Reg. 0 OT 0.0 hrs $0.00 $392.00 1 wINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee.e Reg. 0 OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Acoustical Fee: 0 Yes E) No $0.00 0 Work Without Permit? 0 Yes E) No $0.00 E) Planning Fez: $0.00 Select a Non-Residential E) Building or Structure 0 i Strony,Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $1.50 $392.00 TOTAL FEE: $393.50 Revised: 07/04/2011 // 0 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333 • building cDcupertino.orq CUPERTINO NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS LIQ f ©c APN# �IA2_ 1 _O p c� OWNER NAMEL' WeG,v /" PHONE _ /_ E-MAIL CtS at_aLA3 Lk y ' els � Ih STREET ADDRESS CITY, STATE,ZIP FAX 7-2-66S- S -Ave— oe LA-,,e- GC- e Awn e- 95-0�� CONTACT NAME PHONE E-MAIL q^s+-i S-' - 96/- a' _S4 I STREET ADDRESS CITY,STATE. ZIP FAX Z Z .EES- v , 04, le—e- CrK er '•.� So! Ilk OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC#30 �' COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE (OLis Sir �tvd C�Ips Ile �.Fs Sbss 4/6•`�sg �-2 Z ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK �� '1^S %an 4 i d ow t t c-� - cooIN +0 EXISTING USE PROPOSED USE CONSTR.TYPE I #STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXLSTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ONO ADDITION? ONO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: TOTAL VALUATION: PLANNING APPL# ONO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO go By my signature below,I certify to each of the following: I 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. I 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 Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply for demolition permit for OVER-THE-COUNTER X BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building ❑ EXPRESS 1-1PLANNINGPLAN REVIEW permit for new building. _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1.doc revised 06/21/11 OWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 (408)777-3228- FAX(408)777-3333- buiiding(d�cuoer<ino.org CUPERTINO Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS _ APN J LJ 2_4q _X 01 BP# 22G65- s;l.rwoalc (�a�-►� eYh� CA OWNER NAMEOWNERADDRESS 5.-1-i n.� t.Je�.^'-per✓ DESCRIPTION OF WORK: Z+-D .o 4V eG( e-4 Yei We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you,the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS: Please read and initial each statement below to signify you understand or verify this information.) c •1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. I understand as an"Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. ,A-A, 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars($500), including labor and materials, I may be considered an "employer'under state and federal law. 4 �- 1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal government,withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. , 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. . I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or materials. Oia,nerBuilderForyn 2010.doc revised 04/14/10 ,4r9. I understand I may obtain more information regarding my obligations as an "employer"from the Internal Revenue Service,the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB)at 1-800-321-CSLB (2752)or www.cslb.ca.gov for more information about licensed contractors. U�0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. �11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. 4c:L12. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS:Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued,this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: _ Date: g ll --------------------------------------------------------------------------------------------------------------------------------------------- (NOTE: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s)to act as my agent(s)to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OwnerBuilderFOrn1 2010.doe revised 04/14/10 PROJECT DATA - RESIDENTIAL COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CuPEFtTNC? (408)777-3228• FAX(408)777-3333 • building(d)cupertino.org PROJECT ADDRESS 2 Z 0 APN# OWNER NAME h r e v e✓ PHONE STREET ADDRESS CITY, STATE,ZIP �l�Q j FAX APPLICANT NAMEE-MAIL PHONE4�C GI Lts �,r`l -T STREET ADDRES �� CITY,STATE, oZIP C S C r FAX ❑ OWNER OWNER-BUILDER ❑ OWNHRAGENT ❑ CONTRACTOR ❑CONIRAcrORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT DESCRIPTION OF WORK.- ^ EXISTING USE(S): PROPOSED USE(S): OCCUPANCY(S): TYPE OF PARCEL CONSTRUCTION: AREA: FIRE Y N WUI AREA: Y N FLOOD AREA: Y N SIESMIC AREA: Y N SPRINKLERS: Existing Proposed Floor Area: First Floor: s.f. s.f. Second Floor: COMMUNITY R�'Et OPMENT DEPARTMENT s.f. VISION "'C❑T�rin Garage APPROVED s.f. TOTAL: 84"cifica" ST be kept at g - clurinq const!action. it is unlav+-°ful to make any r �s on s9me,or to deviate Are there at least two 10 feet by 20 feet cle "s without out app r &n the BXIdingljfficial. Is privacy protection planting required4x tbeo �this pinrj and specificatiofns Sit I-NOT or to t o an Approval of the violation Governing Codes: 2010 California Burd' {ildfcar1+ �bh y Iing Code) 2010 California Residenti b o I 1 Residential Code) 2010 California PIS o Bing Code) 2010 California MgAtgn' ec apical Code) 2010 California EIRA*I&de l Code) 2010 California Energy Code 2010 California Green Building Standards Code Cupertino Municipal Code 12 i � ProjectData-ResidentiaLdoc revised 03/09/11 Sep 06 2011 10:13 Orion 16503501494 page 1 Monday, September 6,2011 City of Cupertino Planning Department (408)777-3333 Re: Board of Directors'Approval To Whom It May Concern: The Silver Oaks West Board of Directors has approved architectural changes to 22665 Silver Oak lane involving window replacement with the understanding that the window must be lowered from its existing height in order to meet code requirements. Thank you. Ci�FI'.'�^��DrnA,RTM�NT 3Uit JGvU nili'L10N -CUPtR c ,F,i. VIO ' +the Robert C.Schwartzer :yi�l 11[lii \".. !' )I�t l:�ff4i A-to M-, any Property ManagerC{�;c; iai. Silver Oaks West HOA Orion Real Estate Group (650)350-1440 f; �,i v. T �j�i. ,a.w•:xro.+.n"'rw..++rt+s"":.s+.nmm'" i we-,C-ve"", All mee.+- -r,.iqe- C-A 6 -0 Reim /0=\ X0 XO % L— we-w Roco C 44"A S-0 -d A3 X0 STORMW,ATER POLLUTION CONTROL AND NOISE CONTROL COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ALBERT SALVADOR, P.E., C.B.O.,BUILDING OFFICIAL 10300 TORRE AVENUE•CUPERTLNO, CA 95014-3255 CUPERTINO (408)777-3228 • FAX(408)777-3333•buildino cDcupertino.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 most 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 directly to local creeks and into the San Francisco Bay without going through a water filtering/treatment process. 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 pesticides or weed killers; and • Any material dumped or spilled into streets or storm drains. IN0 The property owner and the contractor share ultimate responsib&�-`-& titliviti ing at a construction site J7 and will be held responsible for any environmental damage caused by ) day ar more information on construction-related stormwater requirements, see the.§8or �i+CQui ,ggWaiiofis`"section of the City of Cupertino website at: COMMUNITY NOISE CONTROL .L r :Y t07, Construction noise is limited to: • Residential daytime noise levels from complaint site-60 dl.$A _"` • Non-residential daytime noise levels from complaint 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 greater than 750 feet of a residential'aea 'is prohibited on holidays, except that construction conducted by a homeowner or resident of a single family dwelling using domestic construction tools is allo holidays betyyeethe hours of 9:00am to 6:00pm. For more information on noise control, p1p#se�rgfej9,Chapter 10`48`ootli upeit no Winicipal code, which can be accessed at http-//wtik-w.amlegal.comicupertino ca. Storrrmvater/Noise Control 2010.doc revised 09/22/10