B-2016-2280 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2280
11663 VINEYARD SPRING CT CUPERTINO,CA 95014-5135(366 54 004) HIB M
CONSTRUCTION
SAN JOSE,CA 95136
OWNER'S NAME: PAI NAI H AND AI C DATE ISSUED:07/08/2016
OWNER'S PHONE:408-348-5005 :����PHONEN�O:(408)3�15-44663
LICENSED CONTRACTOR'S DF RATI N BUILDING PERMIT INFO:
License Class$ Lic.#642852
Contractor H I B M CONSTRUCTION Date 04/30/2018 X BLDG —ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing- —MECH X RESIDENTIAL_COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
I hereby affirm under penalty of perjury one of the following two declarations: REPLACE EXTERIOR SIDING(2000 S.F.) LIKE I OR LIKE
1. 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
X performance of the work for which this permit is issued.
z' have and will maintain Worker's Compensation Insurance,as provided for by
.Se�,t'on 3700 of the Labor Code,for the performance of the work.for which this
permit is issued. Sq.Ft Floor Area: Valuation:$2400.00
APPLICANT CERTIFI ATION
certify that I have read this application and state that the above
information is correct.I agree to comply with all city and county ordinances APN Number: Occupancy Type:
and state laws relating to building construction,and hereby authorize 366 54 004
representatives of this city to enter upon the above mentioned property for
inspection purposes. (We)agree to save indemnify and keep harmless the
City of Cupertino against liabilities,judgments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against.said City in consequence of the granting ll this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signatur Date 7/7/x$ Issued by:Abbyyende
Date:07/08/2016
OWNER-BUIELD R D A ATION
I hereby�affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material be' g installed.If a roof is
t. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
z. I,as owner of the property,am exclusively contracting with licensed Signature ofApplicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:7n12016
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A" R BETTER
t. 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. HAZARDOUS TER AL DISCLOSURE
i. I have and will maintain Worker's Compensation Insurance,as provided for by have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,2553 ,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code Chapter 9.12 and the
a. 1 certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store r handle hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California, If,after making this certificate of will maintain compliance with the Cupertino Municipal C0
de,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall '
be deemed revoked. ( '
Owner or authorized ager .
APPLICANT CERTIFICATION Date:7/7/2016
I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY
correct.l agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,CivC.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities, r'
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATIQN
Code,Section 9.18. l understand my plans shall be used as public records.
Licensed
Signature Date 7/7/2016
Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228 FAX(408)777-3333•building(akupertino.org
CUPERTINO
-W ® 2
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS APN# h
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STREET ADDRESS CInnTY,STATE,ZI FAX
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STREET ADDRESS CITY,STATE ZIP e
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❑OWNER ❑ OwNER-BUIIAER ❑ OWNER AGENT K'l CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEvFLC PER ❑ TENANT
NTRACTOR NAME LI NSE ER LICENSE TYPE BUS.LIC#
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COMPANY NAME E-MAIL M1 r FAX
STREET ADDRESS C ,STATE _ PHONE
ARCHITECTIENGINEER AME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK g ' j
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CUIC04 fl)
EXLS GUSEPROPOSED USE. CONSTR.TYPE #STORIES - -
USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL -
AREA AREA AREA NETAREA
BATHROOM KITCHEN - OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH
J.A-TACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY E]YES - ---
BEING ADDED? Q-NO ADDITION? ®PIE)--
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS.THE BLDG AN ❑YES RECE $ - TO ALGAL ATION:
PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO ")�fY(
°.'
By my signature below,I certify to each of the following: I am the property owner or authorized agent to acLon thd 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 relatWg to buildMg-constrntion. I authorize representatives of Cupertino to enter the a71e-*bovn fled property for inspectionpurposes.
Signature of Applicant/Agent: :f � a. Date: ®' l / -
SUPPLEMENTAL INFORMATION REQUIRED �
TY 1NCHECKTYkE I2OJIT.IN P SY� x<.: ."
_New SFD or Multifamily dwellings: Apply for demolition permit for
OVER THE COIIryTER ❑ BL7ILDING PLAN REVIEW
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. EXPAESS ❑ PLANNINGIP xiD iEw
_ ❑ ruBLIcwOizxs
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure II STAIIDAAD �� `
form if any Hazardous Materials are being used as part of this project. ❑F;p DEPT
❑v LARGE „
_Copy of Planning Approval Letter or Meeting With Planning prior to ❑.'mA�oR �k ❑ SANrTARY SExY R DISTRICT ..
submittal of Building Permit application.
ENVIRONME T L HEALTH
BldgApp_2011.doc revised 06121/11
F I
SMOKE 1 CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE vftk�
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
GUPERTlIw O 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333 buildin-gO-cuoertino ora
C
j,73 tPfRlz ) S�'�'-� a � P� ' Permit NJ 2,0/�
Address #of Alarms Smoke: Carbon Monoxide i
1'ERMT CANNOT BE FINALED ANI)COMPLETED�;t,NTIL TRIS Gf�RTIFICATI� '.
PURPOSE Rl Va7y�r(�c
E
This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide.Alarms for
compliance with 2013 CRC Section 8314,2013 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:
ARRA SMOKE ALARM CO ALARM
Outside of each separate sleeping area in the immediate;vicinity X X
bedrooms)
On eve level.of a dwellin unit including basements X X
Within each slee ing room
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 8314 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 comp/ with the terms and cortdrfions of this statement
Qwneror�Owner r)Name;
Signature ................................... Date: .
p actor Name:
��� Signa t , . Lic# 7 +....Date: ."
Smoke and W foimn doc revised 03118114
- WATER-CONSERVING PLUMBING FIXTURESIF
I L EfE,
GINNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPERTI1' O 10300 TORRE AVENUE•,CUPERTINO, CA 95044-3255
40 )7A71• FAX(408)777-3333•bWldinq{C17cupertlno.Orq
Owner NameZPermit No l
Address �� V�IZ-`/�,�P SPRIA14 Cr, ` -
�'"
P
1. Is your real property a registered historical site
El 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?.
j Yes Civil Code Sections 1101.1 through 1101.8 do not apply.
YY ��
El The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
❑ 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.
Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
C °Yes My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 1101.1 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).
11 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).
El 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 improvements).
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 110 1.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's
installation requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the
table on the following page.
Owner or Owner Agent's Signature: ``- Date:, 2
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
SB407 2015.doc revised 08126115
' BT7ILDI:I�,G I' �T CANN�'�'BE,>±'IN;�LED SND C411tPLE�Eb-[�1�I�'IL THIS _
y �. n,
-
Non-Compliant
Water-Conserving Plumbing Fixture I
Plumbing Fixture1 (Fixture Complying with Current Code Applicable to New Construction) i
Maximum Water Usage/Flow Rate
Water Usage
Fixture Type 201'3 CPC Ch.4 2013 CPC Ch.4 2013 CPC Ch,4/Flaw Rate 2013 CALGreen Div.4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3
5
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,
Urinals Exceed 1.0
average flush volume of two reduced flushes and one full flush)
--
Gallons/flush 0.5 gallons/flush
Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to theperformance criterla of i
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. J
Faucets— Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 I
Lavatory per minute / minute @ 60 psi; minimum Maximum 1.5 gallons psi I
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
j 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 08126115