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15070177M I CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: 20924 ELENDA DR OWNER'S NAME: GALLOWAY SARAH E CONTRAC I�C)f ,�& C / �I C I PERMIT NO: 15070177 DATE ISSUED: 07/24/2015 OWNER'S PHONE: 4085292533 1 , 1 PHONE NO: I LICENSED CONTRACTOR'S DECLARATION License Class (�� -b/ Li.. # / 3 f -T& ( /! Contractor�/.f'� F (? ��ii� Date r%— 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. JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL UPGRADE (E) 100 AMP PANEL TO (N) 200 AMP PANEL, SAME LOCATION 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. 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 this APN Number: 32630021.00 permit is issued. APPLICANT CERTIFICATION 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of tq 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. // Signature Date _�T ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: I, 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 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 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 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 Compensation laws of California. If, after making this certificate of exemption, I Valuation: $2000 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS -OF -PERMIT ISSUANCE OR INSPECTION. a77! Date: � RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent: /L��— Date: CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I mustI I hereby 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 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the 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. Signature Date Lender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional VA6 CUPERTINO GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildina(a1cuoertino.org MISC ❑ PLUMBING ❑ MECHANICAL NrLECTRICAL ❑ ) /HSCELLANEOUS PROJECT ADDRESSj, APN # ONiJI ERNA1 Akre (I -4L `d W P Ov EMAIL STREET ADDRESS CITY, SjfE, ZIP FAX CONTACT NAME�rt PH i-5,7 / 3k / ( E-MAIL a �l STREET ADDRESS CITY, STATE, ZIP FAX 13o)= ElOwiTR•B= R ❑ OW.KER AGENT �dCON7P-1.CTOR ❑CO:.TRACTORAGENT El ARCHITECT 11 ENGA'E'cR El DEVELOPER ❑ TENANT CONTRACTOR NAI,LICENSE NUI LICENSETY BUS. LIC r C COMPANY NAMEArk E•MAI FAX STET DRESS CITY, STA"TP 0 A"r• �O o � SZ� -3f9 ARCHITECT/ENGINEER NAMM LICENSE NUMBER BUS. LIC n COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX ❑ MULTI-FAD11LY PROJECT N WILDLAND ❑ YES PROJECT IN ❑ YES IS THE BLDG AN ❑ YES BUILDIlAG: ❑COMMERCIAL URBAN'LNTERF.ACEAREA ❑ NO FLOOD ZONE ❑ NO EICHLERHOME? ❑ NO DESCRIPTION OF WORKqec • S C: l.�oG1�'77 v TOTAL VALUATION:200 '°''IiEc `��Il�£16Bi�..I�,� By my signature below, I certify to each of the following: I am the property owner or authorized agent to act Sn 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 vtrify it ismurate. I agree to comply with all applicable local ordinances and state laws relating to build tion. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: !// a----=— S- -' Date: SUPPLEMENTAL D\TORMATION REQUIRED ;: r�OFFSCE LSE QI�LI OVER THE COUT�TER.; } � EXPRESS � U ;LARGE h AltiJOR A,fEPA7iscApp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION APPLIANCE / EQUIP TYPE 20924 ELENDA DR DATE: 07/24/2015 REVIEWED BY: MELISSA PAIADDRESS: APN: 326 30 021 BP#: 1 "VALUATION: 1$2,000 °PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: SFD or Duplex Amps PENTAMATION PERMIT TYPE: 1 REAP WORK UPGRADE E 100 AMP PANEL TON 200 AMP PANEL SAME LOCATION SCOPE t'YJ�}t hi �'o k"" APPLIANCE / EQUIP TYPE FEE ID Plumb. Plan Check QTY UNITS BP FEES Elec. Permit Fee: IEPERMIT Services 1 ERT<200 Other Elec. Insp. L0 hrs $48.00 100 Amps $48 t'YJ�}t hi �'o k"" PME Unit Fee: $48.00 PME Permit Fee: $48.00 :ittit'ttc°tFr?tt lax: Administrative Fee: IADMIN $45.00 Work Without Permit? Yes (F) No $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee: IBSEISMICR NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addh7 info. FEE ITEMS (Fee Resolulion 11-053 E[L711113) loch. Plat: Check Plumb. Plan Check Elec. Plan Check 0.0 hrs $0.00 14ech. Permit Fee: Phimb, P Elec. Permit Fee: IEPERMIT tther.,i4ech. Irish. �;hev 1,1211 ) Other Elec. Insp. L0 hrs $48.00 PME Plan Check: $0.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addh7 info. FEE ITEMS (Fee Resolulion 11-053 E[L711113) FEE QTY/FEE MISC ITEMS "tan (,heck.Fee: SitppL PC Fee PME Plan Check: $0.00 t'YJ�}t hi �'o k"" PME Unit Fee: $48.00 PME Permit Fee: $48.00 :ittit'ttc°tFr?tt lax: Administrative Fee: IADMIN $45.00 Work Without Permit? Yes (F) No $0.00 r �{gt'e r`71£ f'Lt 1".tfl itltt%? c'v':'i. Travel Documentation Fee: ITRA VDOC $48.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item 1 Bldg Stds Commission Fee: IBCBSC $1.001 SUBTOTALS: $190.50 $0.00 TOTAL FEE: 1 $190.50 Revised: 07/02/2015 in Address SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingacupertino.org Joz- t)r 4 P 1 R _U i, �-N-No `I BE Fl�v_� I_I:i) �N'I� C0_Nll'Li t %I3 L HAS 13E X TNF+D AN1► RF TL NFT) TO TS W9_l ILEP05rw� , 50-101-1-1 PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon. Monoxide Alarms be installed in the following locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms have been tested and are operational, as of the date signed below. 1 have read and agree to comaly with the terms and conditions of this statement Owner (or Owner Agent's) Name: C-JrA0wk\ Si natur .......... Date........ Contractor Name: Signature...................................................................Lic.#...................................... Date: ................... Smoke and COform.doc revised 03/18/14 CUPERTINO Owner Name Address �� FILE WATER -CONSERVING PLUMBING FIXTURES �1149a5� OWNER CERTIFICATE OF COMPLIANCE "V COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 • FAX /4081 777-3333 • huildinnOnunertino.oro PERMIT CANNOT BE FINALED AND COi1'IPLETED UNTIL THIS CERTIFICATE HAS BEEN - CI ;'QED <VND RETURNED TO THE BUILDING DIVISION Please refer to the attached California Civil Code Sections 1101.1 — 1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sia below and skip the rest of the form. Owner' Signature: Date: /1'No Go to Question 2. 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. Owner' Signature: '/� Date: ,0 --No Go to Question 3. I 3. Is water service permanently disconnected for your ding? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. X" Owner' Signature: Date: G 1VO Go to Question 4. ✓�— �J 2 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: (Z%� �YeMy real property is built and available or use or occ��l n or before January 1, 1994. WOnCivil Code Sections 1101.1 through 01.8 apply. Re attached. erty is a single-family residential real property. See Civil Code Section 1101.4. anafter January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non-compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant - plumbing fixtures to be replaced with water -conserving plumbing fixtures. SB40 7 2015. doc revised 02104115 On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or. improvements). INde, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 110 1. 1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water -conserving plj�nbing fixtyres corpp v with the requirements as indicated in the table bejow. Owner's (or Owner Agent's) Signatures _) 44 �� U��C. 1�1��3-vim vj Date: 'I I Upon completing and signing this Certificate, please return it t� thq Building Division(m g1rder to final your permit. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB4072015.doc revised 02/04/15 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons/flush I Gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall riot exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB4072015.doc revised 02/04/15