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B-2016-2386 CITY OF CUPERTINO BUILDING PERMIT BUH,DING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2386 21251 GARDENA DR CUPERTINO,CA 95014-1619(326 43 035) MOOMAU PLUMBING SAN JOSE,CA 95118 OWNER'S NAME: KRISHNAPRIYAN HAMPAPURAM K DATE ISSUED:07/26/2016 OWNER'S PHONE:408-829-6592 PHONE NO:(408)396-3837 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class PLUMBING Lic.#792821 Contractor MOOMAU PLUMBING Date 08/31/2016 X BLDG —ELECT X 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 40 GAL WATER HEATER 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 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. Sq.Ft Floor Area: Valuation:$2129.00 APPLICANT CERTIFICATION 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 326 43 035 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 of this permit. WITFIIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the app icant understands and will comply with all non-point source regulat. s r e_:C a ino Municipal Code,Section 9.18. 180 DAYS FROM LAST ED INSPECTION. Signatu Date 07/26/2016' Issued by: A N Date:07/26/2016 OWNER-BUILDER DECLA TION 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 being installed.If a roof is 1. 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) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec:7044,Business&Professions Code). Date:07/26/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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 performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I 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 25505,25533,and 25534. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or 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 Cuper'no Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions ofthe the Health&Safety Code rec ns 255 and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall _ be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:07/26/2016 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I 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,Civ C.) 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, 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 DECLARATION Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date 07/26/2016 Licensed g Professional CONSTRUCTION PERMIT-APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION p 10300 TORRE AVENUE•CUPERTINO, CA 9501.4-3255 Y �� (408)777-3228•FAX(408)777-3333•building(a�cupertino.orgCUPE2D /! . 26 _ ,D O NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 1'`' I.�,I rT/11 �Q y�� APN# OWNER NAME V' l-EV I 1�\ I. '1 �U 1 l Y�.�, PHONE({u 11/U517_ ✓1 _ _ l Y l A. u 1` E-MAIL STREET ADDRESS! �1 0 t (��p ,II / /A CITY, STATE,ZIPcvf�fb,no 1 �+„ �1� FAX CONTACT NAME /�,,,r77/V his,n�V/L PHO V .�'1-' E-MAIL ,JO STREET ADDRESS. Y� `-'-Y CITY,STATE,ZIP " FAX OWNER 11 OWNER-BUILDER ^ 11 OWNER AGENT .CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT 11 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME �a\`/�O 1/y. LICENSE NUMBER � r�. 1 LICENSE TYPE BUS.LIC# i COMPANYNAME D V UM V I l �M( A o, FAX STREET ADDRESS �,n 1 Lr�v1 ✓� CITY,STATE,ZIP n I ,vl O 4%1-ul- PHONE ��4 ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK oAttf CC EXISTING USE - PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR. DEMO TOTAL AREA AREA. AREA NET AREA BATHROOM _. KITCHEN - OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: EIDETACH . []ATTACH #DWELLING UNITS: IS A SECOND UNIT E]YES SECOND STORY E]YES -BEING ADDED? []NO ADDITION? F]NO - PRE-APPLICATION EJ YES IF YES,PROVIDE COPY OF IS THE BLDG AN YES `jZE VALUATION: PLANNING APPL# ANO PLANNING APPROVAL LETTER. EICHLERHOME? F]NO 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. L 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 t ilding cons ruction. I authorize representatives of Cupertino to enter the above-idemi fed property for inspection purposes. Signature of Applicant/Agent: Date: b SUPPLEMENTAL INFORMATION REQUIRED Q PLAN CHECI{T1PE A0,1uTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for Q' ov>x=i iE co IrtTEx ' C] $JILDIriG"PLANxI Y Ew existing building(s). Demolition permit is required prior to issuance of building permit for new building. Q,ExPl ss Cl 'PLANNING.PLANRE,VIEW, _Commercial Bldgs; Provide a completed Hazardous Materials Disclosure STANDARD . , :' l7" PUBLIC WOIZIcs , form if any Hazardous Materials are being used as part of this project. �=LA>GE „ ITRE DEP,i _Copy of Planning Approval Letter or Meeting with Planning prior to O MAJ012 D "sAr71TAxv"$EWER'DI5TLILCT . submittal of Building Permit application. 0`'EYVII20NMENTAliTiEALTII " BldgApp 2011.doc revised 06121111 F1 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION CLMPER 10300 TORRE AVENUE•CUPERTINO,CA 95014-3258 (408)777-3228•FAX(408)77771-3333•building651cmertino.oro Owner Name, r Permit NpL Address C I. Is your real property a registered historical site? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 15�-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? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. L7 j4 No Go to Question 3. 3. Is water service permanently disconnected for your building? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Gc to Question 4. 4. Is your:real property built and available for use or occupancy on or before January 1,1994? 0 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. Yes M real property is built and available for use or occupancy on or before January 1, 1994. Ci `l 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: _/0k My properly 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). 0 My properly 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 I ixtures 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). 0My properly 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 be re 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 1101.9,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements,and that the water- onserving plumbing fixtures comply with the requirements as indicated in the table on the following,page. _t Owner or Owner Agent's Signature, i DD a S xn/4 Upon completing and signing this Certifbate, ease return it to the Building Division in order to final your builds g permit. SB4072015.doe revised 08126115 f, t, UILD� PEILMIT C, OT.BE PINALED AND C!Oli�PLETED bN irl T I : ERTIEIC�TE BE �I. j�D AIi'D RTi TURNED TO THESOL- I SDI ST®l� Non-Compliant Water-Conserving Plumbing Fixture Pumbjnq Fixturel (Fixture Complying with Cwrrent'Code Applicable to New Construction) Fixture Type Maximum Water Us a a/Fiow Pate Water Usage 2013 CPC Ch.4 201:3 CPC Ch.4 2013 CPC Ch. 4 /Flow Pate 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, Urinals Exce average flush volume of two reduced flushes and one full flush ed 1.0 Gallons/flush 0.5 gallons/flush Showerheads Exceed 25 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 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 22 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 @ 50 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 si 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 (� s 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 08/26/15 P F LP SMOK-EINROOX�DEA RM OWNER ER FCATE ' COMPLIARG COMM'NITY DEVELOFIMENT'DEPARTMENT,GUILDING DIVISIONi 110300 TORRE AVENVAE m GUMERPNO,CA 95014-3255 (4408)777-3,228-F (4.08)777-3333 '}boj[diriyga pet'inn org E _ --=- . z��r�r6s '1 is affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for cofnpliance with 2 13 CTC Section 8314,2013 C$C Sections 420.6 and 9V.2.11.2 where no interior access.for inspections are required. Gt Ali kl'�6014,MA'I ION 'gXisting,single fa y and multi-family dwellings shall be provided with Sm, olke Alarms and Carbon MO tOd le alarms When the valuation of additions,alterations,Or repairs to existing dwelling units exceeds S1,000100',CAC Sec ion R314 and CBC Sections 907.2.1.1.5 and 420.6 require that Smoke Alarms acid/or Carbon Mo7uo-Aide Alaffns be installed in the following locations: Aft A AR, CO AI.A1 gtflsiae of eac:�separate sleeping area in the immediate vrcinrty of he bed�obmE�s Ong e've`r ,Ye�iel� f a ctwellin unit tneludn basernen,ts E � � s�VPfm�easl e int rooms Carb®n ManmoAdte afarzrts are,not re fired m dwellingwhich do,, not corttairn ; '.th it Wig. � fuel burnr�rtg appillatnces and; , a. dlc rtrotl'1a`ve a�ate clz�d garatge. Carlon morlo�rcle alarms cornbined wills s=ivzoile alarms sllatIl co�np�ly�rtlt CBC SeCtLorl420:6}and.shAl be appTcved by the Office of td�e State Fire Marshal. Pbwer SIXf .1.is�l i1we,1111ni ,lmits with,i 1 root c, erda`al 'i alarTTl s`1Tla�, be`SO eI s pp y g power s�upjp�y, '� ) y ' Ottery operated., In exist nig d vell'.'a t i1g urates,alarrnas are per, to be solely buffery operated eratedd where repairs or a�lferatrox s:cl not res:v mt the.r MOVatl oaf wall and ceiling fu islryes or there:is not a:.c - :;., , ,. cess,by „ e�.a� s o�attic;b ase�terltt OT, crawld space.,R-efer W,C .0 SectTon83=14 arzd C-OC Se:cfiarls 90117.2.31<.4 and 420.6.2.,An,elec t,icalpe= tk is.,relurred,for Alarms,which,,,mu,.-,.t be,co utiected toa the"buil,!ing,w rinrtg, As owner crI th.e a.ove-referenced pioperty,.I Hereby certify thtat the aElarm(s),referenced ahave has/hav,e b,eein, nstaflled rstl ac-cwci lance,with th mi, aizuFacturer s rnstructiows aifrdl zR cOmplf axtce with.the Ca}Yarn a,Builth-g, and Cath}fonitta Re 3i&Rtiail Codes,The Oar ms have beert tested aid arse}op:erationaaall,as;orf the daler s gyiedd b:elow., b Kjave=readiandza gee to+com,.G,wrf .fl fer=rtes>a;nd'corrdi6�ns,©f fhis sf temenf 1 _ Yve -w4 +ifs f . ... ....................... ....... ..................... # V 5t4-a(tre.:.a.. ....._... 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