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1511013151 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10698 LARRY WAY CONTRACTOR: ABLE SEPTIC PERMIT NO: 15110131 OWNER'S NAME: EANEFF CHARLES S JR AND LORRAI 1020 RUFF DR DATE ISSUED: 11/18/2015 OWNER'S PHONE: 4084805015 SAN JOSE, CA 95110 PHONE NO: (408)377-9990 CONTRACTOR'S DECLARATION LICENSED CONTRA O L JOB DESCRIPTION: RESIDENTIAL E] COMMERCIAL j INSTALL (N) CONNECTION TO SANITARY **CUPERTINO License Class Lic. # (l '�J �S5 SANITARY" Contractorf Date —� I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions NITARY Code and that my license is in full force and effect. --l-, 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 Sq. Ft Floor Area: Valuation: $9885 performance of the work for which this permit is issued. rave and will maintain Worker's Compensation Insurance, as provided for by APN Number: 31602036.00 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT 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 180 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 ( 8 granting of this permit. Additionally, the applicant understands and will comply ` Issued by: Date: v with all non -point source regulations per the Cupertino Municipal Code, Section 9.18., `— RE -ROOFS: Signature Date ( 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. ❑ OWNER -BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 (Scc.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California 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 material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants 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 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this % (� Owner �� Date: permit is issued. or authorized a eirt: g 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must 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 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 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, ARCHITECT'S DECLARATION 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 Licensed Professional 9.18. Signature Date CUPERTINO GENERAL PERMIT APPLICATION 15110131 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 T ORRE AVENUE • CUPERTINO, CA 85014-3255 (408) 777-3228 • FAX (408) 777-3333 • bUIIdIn0(F2)CUDer Ino.Orq LPLUh1r3Ne LJN1ECHAl\ICAL LJELECTIUCA? L-jI SCELLANTE0US OS�TT 1TA1✓.E n � I PiIO � � / � I c-1✓i-.�Z STREET <.D S ` (i CIT//Y, ST. TE, Zip LI cx/d � e 1 if c A C �'TA N.ZJE e5 i Pr? i r r - E-MAIL STREET ADDRESSr I C --I —IaZoV19 12--loQ CITY, STATE, ZIP F. ❑ cmwER ❑ OR'2 Z-3iJII D=R ❑ OWNER AGt.'T ❑ COhTIP ACTOR ❑ CO .-1?ACT OR AG ----:T ❑ :SRC =l CT ❑ DNGI�wR ❑ DEVELOPER ❑ 7EKA11-r 1 C NT ACTORI A�� I LIC .SE?.LhE I LICnSE 1 P' I BUS LIC= � e - C 1✓,P -Y TAIL y E-MAIL F. v e �1 iG O' >sce.Ci ' Q STREETADDRESS I CITY, STATE, ZIP I p 01\E kRMTECT/ETGD, 7TERT.4T4E I LICEi\SENUMMER I BUS. LIC COI✓,PA-W ;SAN,_, E -M Few STREET ADDRESS I CITY, STATE, ZIP I PHONE USE OF ❑ sr -D, or DUPLEX ❑ MIULTI-F;AhM-Y . PROi:CT L\ R ZDLA-ND ❑ YES PROIEECT IN ❑ YES IS THE BLDG AN ❑ Y n B U-=I!N1G: ❑ COl'i-=-P.CIA- URBAN'' P.TI E ACF AURE4 ❑ I.'0 I FLOOD Z011'^. ❑ I:0 EICFII - HOMB? ❑ NO DESCPdPTI01\' OF WORK TOTAL VJ-UATIO?N': REC By my signatu-e below, I certify to each of the following: Ian the property owner or authorized agent to act on the p ope- ty ovwner's behalf. I have read this application and the i_nfornation I have provided is correct. I have read the Desclipt pn of'Work and ven-y it is accurate. I agree to comply with all applicable local ordinances and state la�,,s relating to building construction. I authorize representatives of Cupertino to enter the above -idea ifi�d property for inspec ion purposes. Signatere of ADD!icant/.",gent: . D-4te SU''t PLEMEN 1 AL L'\TFORM-ATION REQULRED � := �`, c., _. „�•r,... ,,�,>,� , .;,.y,...:;;< ;,�,�.�.. RrEPhlisc,4pp_2011.doc remised 06/�l/11 CITY OF CUPERTINO 1+ 0 0 [ 31 FEE ESTIMATOR - BUILDING DIVISION APPLIANCE / EQUIP TYPE ADDRESS: 10698 Larry Way DATE: 11/18/2015 REVIEWED BY: PAUL QTY APN: 316 02 036 BP#: *VALUATION: 1$9,885 *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: SFD or Duplex Insp. . PENTAMATION PERMIT TYPE: 1 RPSS WORK Install N connection to sanitary "Cupertino Sanita ** SCOPE APPLIANCE / EQUIP TYPE FEE ID 1'.'er,. Ulan Cf,ct>k QTY/FEE QTY UNITS BP FEES Other Plumb Insp. 0.0 hrs $48.00 Sewer, Sanitary 1 PRSEWER 1'.71Yrdl7..,.It:Y J. 1 £-F Insp. . 1 # $25 $0.00 Ilerinil Pee: �ifZi/3 J1. Insp .Fe PME Unit Fee: $25.00 PME Permit Fee: $48.00 t:"Ons/ruc:/ion lit. : Administrative Fee: IADMIN $45.00 Work Without Permit? 0 Yes (E) No $0.00 i Travel Documentation Fee: 1TRAVD6C $48.00 Strong Motion Fee: IBSEISMICR TOTALS: Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 $25.00 $168.29 tech. 1'ic,rz t:`iief:l Plumb. Plan Check 0.0 hrs $0.00 1'.'er,. Ulan Cf,ct>k QTY/FEE Plumb. Permit Fee: I PPERMI7' _ f 1�af,e. I ear•. r: i Fee: .11an (."heck 1' ee. Other Plumb Insp. 0.0 hrs $48.00 0 tree ,i7e . lt,:;p. 1'.71Yrdl7..,.It:Y J. 1 £-F Insp. . 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 prelinddna information available and are only an estimate. Contact the De t or addn'l info, FEE ITEMS (Fee Resolution 11-053 E . 7/1/13 FEE QTY/FEE MISC ITEMS .11an (."heck 1' ee. su j/J) , l .Y . ew PME Plan Check: $0.00 Ilerinil Pee: �ifZi/3 J1. Insp .Fe PME Unit Fee: $25.00 PME Permit Fee: $48.00 t:"Ons/ruc:/ion lit. : Administrative Fee: IADMIN $45.00 Work Without Permit? 0 Yes (E) No $0.00 i Travel Documentation Fee: 1TRAVD6C $48.00 Strong Motion Fee: IBSEISMICR $1.29 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS $168.29 $0.00 TOTAL FEE:; , Revised: 10/01/2015 CUPERTINO Owner Name WATER -CONSERVING PLUMBING MXTURES OWNER CERTIFICATE OF C®MPUANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 ^ FAX (408) 777.3333 o building(cDcupertino.org ZLEZ> r Permit No. I 0 131 Address i o 6q E L .AZ? 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 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. Skip the rest of the form and sign bottom of form. i No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 4. 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. G-1 r4 Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Yes My real. property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1. 1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. Please check ONE of the following: My property is a single family residential real property. See Civil Code Section 1101.4. On and after 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. 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 improvernents). I, as the owner or owner's agent 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 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water -conserving pjumbing fixtures comply with the requirements as indicated in the table on the followine nage. Owner or Owner Agent's Signatu�e,_.-..lDateI— Z Z Z� 1J Upon completing and signing this Certificate, plea r turn 't to the Building Division in order to final your building permit. SB407 2015.doc revised 08/26/15 !BUILDING LDING PEA R -BUT CNTiN"o�_ ' 1Sll ,-iL-I�,LL kND Cfli�fPTE:D U"'�.� �I�T 3 ATE, HAS BE, El N SI �N'� RV,T�IIR^_ri D 0TEE�3�1L1i�)L�'S+� �T�3SIflI�a 1. If the existing plumbing fixture water usage/Vow rate is equal to or iuwci wail «1Q i1 U1 U J11V _' 1 . I— -j-- j»" .- __ -"' SB407 2015. doe revised 08/26/15 Non -Compliant Water -Conserving Plumbing Fixture Complying with Current Code Applicable to New Construction) Plumbin Fixture (Fixture Maximum Water Us a a/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate 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 Gallons/flush Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria'of Showerheads 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 not 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 Osi Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons•.per minute 1.8 gallons per minute @ 60 Faucets- Kitchen Faucets per minute 60 psi May temporarily increase @ 60 psi May temporarily psi 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_ _ :+ : 1 1 ref n!i fn IlP llTl Rl•a 11P� 1. If the existing plumbing fixture water usage/Vow rate is equal to or iuwci wail «1Q i1 U1 U J11V _' 1 . I— -j-- j»" .- __ -"' SB407 2015. doe revised 08/26/15 fCV[PER.TINO �4l�ilOp't, CARBON 0OXIDALARMSOWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE o CUPERTINO, CA 95014-3255 (408) 777-3228 o FAX (408) 777-3333 o building(a)cupertino.org G / �-1MWVN-TQ 15110 1-S W ` 6 /-.P�"+Z2�� NA � M1,69 1 A =iii `ke: � ,Gah?�s�tu rMypm de: i PERMIT CANNOT BE 1FINALED AND COMPLETED UNTIL TINS CERTIFICATE PIAS B EEN&LQl'W'F' D AND � 1,12 TO THE, BUILDYNG D1171SION 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: ha 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. I have read and agree to comply with the terms and conditions of this statement -��i+�n�t; o:: ��:erAger�E=s1•,Narrre: ' e, t } `Dates • Z Z .G��► IJ CbnfFacfor Name: Signafu7e....................................................................Lic:t'.................................... Daft:` .................... Smoke and CO form.doc remised 03/18/14