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B-2016-2732CITY OF CUPERTINO BUILDING PERMIT HARTMAN DR CUPERTINO, CA 95014-1020 (326 13 087) WMITM OWNER'S PHONE: 656-969-1994 License Class ]a Lie. #24= Contractor S 0 D BUILDERS INC Date 11/3MO17 hereby affirm that I am licensed under the provisions of Chapter 9 (commenchig 4th Section 7000) of Division 3 of the Business & Professions Code and that my cense is in full force and effect hereby affirm under penalty of perjury one of the following two declarations: 1. 1 have and will maintain a certificate of consent to self -insure for Worker's ONTRACTOR- 1 PRRMrr NO- B-2016-2732 0 D BUILDERS INC NCINO,CA91316 DATE ISSUED, 09115i2ffiti PRONE NO. (818) 616-8377 CULDING PERAHT INFO: BLDG ELECT —PLUMB MECH RESIDENTIAL — COMMERCIAL )B DESCRIPTION: iD FLOOR BATT ROOM REMODEL (100 SF); CLOSET REMODEL 10 SF); (N) VAULTED CEILING -CLOSET, (N) W51DOW (5 FT) Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. z 1 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. FtFloor Areae IVhurtl... $75000.00 AULICANTCERTMCAMM 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 un ds and will comply with all non -point source regulations per te-eui- 'no MunisileeFeedei, Section 9-18. hereby affirm that am exempt from the Contractor's License Law for one of the two reasons: 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 (See.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sce.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three declarations: 1. 1 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. 2. 1 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. 3. 1 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 become subject to the Worker's Compensation provisions ofthe, Labor Code, I must forthwith comply with such provisions or this permit shall be deemed rp-voke& certify that I have read this application and state that the above Information is orrect. I agree to comply with all city and county ordinances and state laws elating to building construction, and hereby authorize representatives of this city D enter upon the above mentioned property for inspection purposes. (We) agree 3 save indemnify and keep harmless the City of Cupertino against liabifilies, idgments, costs, and expenses which may accrue against said City in onsequence of the granting of this permit, Additionally, the applicant understands tnd will comply with all non -point source regulations per the Cupertino Municipal 'ode. Section 9.18. APNNumber- Occupancy Ti pe: 32613087 1 1 120411,11 ',,1 - �.WIGWSKAR I W, 111, 411011 V A ==., 11: 111 IY4%w's J 2, ( I ri a W, N'.1 I K W, - I Ble-MM: Ali 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 ofApplicant: Date: It A it HAMRQQ119!MATERJALS DISCLONURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 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 Day Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sectip Owner or authorized agent: LZ Date: 9-15-2016 CQNSIMCTION LENMG AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lenders'Name Lender's Address I understand my plans shall 4#�e !R� ,d�s public re Licensed COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228. FAX (408) 777-3333 - bulIdinaC=upertIno.orcL DNEW CONSTRUCTION n AnT)MnW FXAITPP&-rfn`J;T1 F1 PR4C)JECT ADDRESS � os OV11% ER NAME a, PRON E-MAIL it STREETADDRESS CITY, ��ES FAX ' CONTACT NAME TPHONE oSe &Ma9Ak!t IYO&I-57TI E -.%LAI LF STREETADDPESS > C] Ty� F Ax. El GUNTR 0 OU'MM-BURDFR MINER AGaT CONTRACTOR 11 CO\MZACTOR,&GF_\'r 0 AaMrrECT Id M;GLLEER 0 DIAzELOPER IJ TEXAi\T CONTPU%CTORN.AXE LICENSENNUMBER got. ink LICENSE TYPE 6. COMPANY NA -ME E-MAM FAX STRE- El ADDRESS3 1* CITY. STATE, ZIP n ClrV � 0 PHONM 9 UAL YURCPJTECTIENGMEER NAME LICENSE _%UMBER BUS. LTC 4' COMPANY NAME A E -M LAIL FAX CM sit � STREET ADDRESSI � k-q�y//: 7 �dl j �jt CITY, MTE. ZIP jf DESCRIPTION OF �'vORK Balr"M C'j(7jW �E� add, -ONONOPL -d Lh 'n am -a' &D EXISTING USE a I PROP OSED USE #ST0FJES I USE TYPE OM T SQ.F� N( VALUATIONS) l V & j EdSTL NEW FLOOR DEN -10 TOTAL AREA AREA I Iki I NET AREA BATHROOM KITCHEN OTHER REMODEL AREA 1 REMODELAREA MNIODELAREA PORCH AREA DEC AREA TOTAI DECKPORCHARFA GAYACEAPEA- [I DETACH I 1 [3 ATTACH iDNtTLLEtiGURITS.' ISASECONDUNIT AYES SECONDSTORY 0 BELNGADDED? [3NO AUDITION? rINO PRE -APPLICATION C]NFS IF YM PROVIDE COPY OF ISTHE BLDG ANN 0 YESTOTAL VALUATION' PL ASS ;fi A?PLw []NO PLANNING -APPROVALL MEP EICHLER ITOME? El?"O By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the properry owmer% behalf --...this application and the information I have aided is correct. I have read the Description of Work and verify it is accurate. I agree to comply %�ithalt applicable local ' ordinances and State la,.�%-s relating to ui in. -construction, I authorize representatives ofCupertino to enter the above-iden f] d m ug I. Ui e pro fl sp-mtionpurpose& Signature ofApplicaaWkgent: Date: SUPPLENI� rAL INFORMATION REQUIREDX T� PLIUN of C PE RGUILN SUP 0 0%.-ER-TIM-COLNTT.R mv New SFD or Multifarnily dwellings: Apply for demolition permit for existing build ing(s). Demolition permit is required prior to issuance ofbuilding permit for new building. 0 EXPRESS 1 PLAN R — Commercial Bldgs: Provide a completed Hazardous Materials Disclosure f7 M, PE -"::1C: ORI�s form if any Hazardous Materials are being used as part of this project. 'RE DEPT Cory of Planning :approval Letter or Meeting with Planning prior to submittal of Building Pennit application. E, . E*,N1P10N',!EN_YALUF_%LT!f BIdg,4pp.2011.doc revised 061'21;11 Address PURPOSE 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 • building &CUpertlno.ora � ars j ,�� ,s �+ Permit No. -2 c C _2 93 2 \ ti� ` '�' i �'` of Alarms Smoke: Carbon Monoxide: to PERMIT CANNOT BE FINALED AND, COMPLETED UNTIL THIS CERTIFICATE .` . HAS BEEN { AND UJ RNI♦ D I Ii THE BUILDING DIVISION 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 8314 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 Outside h in the immediate the SMOKE ALARM X CO ALARM X of of ea; separate sleeping area vicinity of Contractor Name:Si �C"e.. bedroom(s) nature......... ...�T On every level of a dwelling unit including basements Within each sleeping room ' X X � X�v� 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. I have read and aoree to comoly with the terms and conditions of this statement j�O,w,n�e�r (or Owner Agent's) Name: v &AAO-Vlgj �'. 1.�'t'e� icy� Signature .................. ......................................................................._.................... Date: ...... Contractor Name:Si �C"e.. nature......... ...�T Smoke and CO fort?. doe revised 03/18/14 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERT NO,.,, ( 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 {40 77 -3228 • FAX (408) 777-3333 • building(a)cupertino.ora Owner Name & te) 6-1-N Permit No ' 2.0 1- : 2 �73 2 - Address Address 7/1; 1111 " " 1. 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. 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. 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 chock ONE of the following: My property is a single-family residential real properly. 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-conseiving 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 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 1101.8, 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. I r`» Owner or Owner Agent's Signature: Dated11- l t T Upon completing and signing this Certificlate, please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08126115 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. SB40 7 2015.doc revised 08126/15 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 Rafe 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 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 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 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. SB40 7 2015.doc revised 08126/15