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B-2017-1103
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1103 21063 CHRISTENSEN DR CUPERTINO, CA 95014-1652 (326 54 005) NOLASCO CONSTRUCTION GROUP MENLO PARK, CA 94025 OWNER'S NAME: PEARLMAN DALE LAND DARA B TRUSTEE DATE ISSUED: 07/11/2017 OWNER'S PHONE: 650-205-0412 1 I PHONE NO: (650) 289-6421 1 LICENSED CONTRACTOR'S DECLARATION License Class GENERAL BUILDING CONTRACTOR Lic. #526336 Contractor NOLASCO CONSTRUCTION GROUP Date 07/31/2018 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. I hereby affirm under penalty of perjury one of the following two declarations: 1. I have and will maintain a certificate of consent to self -insure for Worker's mpensation, as provided for by Section 3700 of the Labor Code, for the aA_performance of the work for which this permit is issued. z. 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. 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 Cupe Municipal Code, Section 9.18. Signature �—�--Date 07-11-2017 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 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: INSTALL 3 (N) SKYLIGHTS - LIVING ROOM Sq. Ft Floor Area: Valuation: $10000.00 APN Number: Occupancy Type: 32654 005 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 07/11/2017 RF ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without fust 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) 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: 07-11-2017 I hereby affirm under penalty of perjury one of the following three declarations: 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. 2. 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. 3. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 07-11-2017 YI%rsl A 7 0110 1sl 11 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 I 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: Date: 07-11-2017 CONSTRUCTION LENDING 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.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO I (408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino.org F1 NFW CONSTRUCTION ❑ ADDITION RQALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS % 3 C e� ri APN # 5 + 00C; ,21 o r J Ch,5 OWNERNAME /Q PHO 20 1,1 MAIL [ O I STREET ADDRESS CITY, STATE, ZIP FAX WZ CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER.BUn.DER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME /w Q LICENSE NUMBE 2 / LICENSE TYPE BUS. LIC # COMPANY NAME E-MAIL / L Con, dG7J 9n FAX X OI -ISS . h 1 STREET ADDRESS (2, 1I ^ V(2,1 1/LICENSE CITY, STATE, ZIP eh 1/0 .wk (24 [[ PHONE ARCHrrECT/ENGINEER NAME NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK / Z1 ( V 4L 7 G EXISTING USE PROPOSED USE CONSTR TYPE 1 # 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 ARE GARAGE AREA: DETACH I []ATTACH I # DWELLING UNITS: IS A SECOND UNIT ❑ YES BEING ADDED? SECOND STORY ❑ YES ADDITION? n /� []NO []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES WAL VAL TION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO R IC By my signature below, I certify to each of the following: I am the property owner or au orize agent to act on the property owner's behalf. I have readNhis application and the information I have provided is conn 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 to bw rdns orize repres tatives of Cupertino to enter the above -identified property for inspection purposes. 7 ` //—/ 7 Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUMD PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06/21/11 SMOKE I CARBON MONOXIDE ALARMS `.,s .IE :17-Vi a. OWNER CERTIFICATE OF COMPLIANCE zo1 ,,, SEP 0 .:.;31:3:k..''t COMMUN11Y t)I VLLOPi';I:141 D.1.1', I T1.tENT BUiLDING DIVISION CuPERTIr4 1')„'J`)TORISC AVENUE ('UPLRTINO CA 9'1011.1 .;,"l:t }„4011) i71- ?"'8 FAX+, E` ;.i t ' ti'r'y•t< .'4.j00,1.rsi orq iiy ___,) 1'FiZ\1I'I'( \\\OC HU I'1\ 111' i) t \ 1II rifts( i•RI11.1( 114 it 11RI-1'\ (()MPH' 1'1'I) si(t\i•1), \\I) RI 11 R\1'1) 1() rill- lit 11.1)I\(. 1)1\ 1`1()\ PURPOSE This att',davit is a elt-tt'•lint atittil ittr tilt in't ill iti.m t't ill It'ttulit'tl ``lrletl.t }alta (.. Irbon N Sono\ltit \.farms h r t.ampliantL' 11 illi 2011 C.RC 'section 1\ll I 2i ii+(.1i( (,, t"tit•n- -I-11'i, Ind tit)-.}.1 i2 k\11, rt tit} 1 ltt`rlttir atte,.• for I tnspoction;= are required GENT—Ci:\ I\roK 1''1 t TO\ _- _-___-- _ .a_ --1 1'4-1-11 -ln•_1-C 1Jilllli rrltl illliltt-E,lmd d‘.,71hi1..,, --11 i11 !h !'r, i Ittt'tl 'tt till<iTit'I.t ll'r T1 lrltl C�rhttll ----------=---- \Ionom& alarms \\hen tht t alt ltlt'll ttl Jtltlitit+lls ilk r ltR'ii ttl rt pair, t 1 t \Istifl d \t 11 '1: llIlli •t'\t.t't'ci- ] •.,1 li)1 t't) CRC `."t lion R'')1-: Ind CPA_ t t't it.tn-'`11'2.11 ` )titl 1211 ft rt'ttlllrt that `..-ill )kt \l ii ms and ttl Carbon \lona\ide Alarms be installed in tht Ittllarii in._lt't ihttlh 1R1 \ I ',11()1\1- \1 1R\1 CO 11 1R\1 <,itttsid' ;tit lit• - rbatt '-It fin art.l it t It r nta Ii. t t lt'rnitt i 1 \ N. igilt'tt't1T't�t'I'ri,-1 _ ,_ _ .__ — l.i[lt'klri 1...tel tt1 a cit\t•IinV unit IC1tilItlSlla ltl-•'rtlt'IS1, I \ _�, \ ',\ithln tach t-lt•eoit ,r,',tn1 1 \ Carbon \Iono\idt alarms art not required in tint llin.:', khith do nttt titlltain tud burnirnit appliai e' and that do not have an attached :.,aragt Carbon mono\kik alarm tttmhiilt'tl t\ilh '^nittht al }.rills shall tonlpI\ k..I'll CRC Set lion.1''0 t., and shall be arpprtneti h\ till Ottitt t't tilt L+t ttt 1 in \I rr,hal l'o\ker Suph1\ In ti\ttlli11units, \kith no tommt ictal Itttk\t r -iirp1t, alarm}--) max Is --oat IN, balk IA opt rated In e\istlilg kiklt'lling units alarms art pt!mined ttt ht sole'', hath rt hilt rated \k lit rt rt pair.,or alit rilions do not result in the renin‘al ill t all and t eIling 1lnisht'.or Ilii i't is no at tt" k nit an t't attic basement or t ra\k 1 _]_'ate Reier to CRC `'ettion R 71•I and C i•i(. L.t't 110 11!-+t111-.2 I I -I and -120.ft.2. \n t let ideal pi mitt is Required for alarms \t hich must hi t onilet'tt'tt to tht build int,„ik irin., ------T\s tTWile r of fit'-SEA i\'t'-i't fert'ill til`fTT irtrrie--1"1>i'1ch ----,-zi,H'irl• t-h:lt`t1ie—limn=*.H-rt-I- til-k-ed-all LIA—A=.11e1,-.1'1:1;2ke--bi-'t`•i -- ----- installed in ,ae ortlanet it ith tilt maantitat"ttirt r instructions and in compliant( 11101 tilt C alitornil B'ulldin , and California Residt ntlal Codes I he alarms spetitlt'ti ht lot\ Iia been It -it'd anti art operational, as tit tht date signed beim% 1t11ires+. o�-( ©�3 —_lr 1 s fel .$eo., J r, C,asper ( ((� o Permit \o. g-c20/7-/(Z 3 tinitlkt \t:lriil�. J r( :tlht}ii \lttiitl\lttt 1)ttt't:1ors: Specify Number of •1larms. _ _ I 7 . i 1 I!talq. rend oral iulree,t rcunitly with t!tX•'#t�rtu.rt I cotttlrhons of lits statement p.\•ner(or r�.ner/tytnl's)t•antc I � '4-- 7 Si;;rt:iluit: Clatc'51a.„,/,- Contractor Name. 3-21— / Siypature k.;,62633 halt' \tn LL aunl1 I)lotal,l'. tatt•sJ411 -lt, RECEIVED \\\ / WATER-CONSERVING PLUMBING FIXTURES • OWNER CERTIFICATE OF COMPLIANCESEP17 ,to, ,.z COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 BY (408)777-3228•FAX(408)777-3333•buildinq[a�cupertino.orq Owner Name Gi./'Ce.Teal 1a 'l skittle ✓�llyCCe Permit No. , a Address X1O .3 --LrvV�I Sl-ett sei iSr. ` e y'e -i !/je) ERl�'IIT,CANNOT BE.FINALEDYAND C(JN "-FATED DNTIL THIS CERTIFICATE = II EI�ON1N D it RFs-TTlR7�t�D O TFIE BUJLDTNGr D SIO T . ._. Please refer to the attached California Civil Code Sections 1101.1-1101.8 which are part of this Certification form. t 1. Is your real property a registered historical site? . ❑ Yes Civil Code Sections 1.1 through 1101.8 not apply. Sign below and skip the rest of the form. - / Owner'Signature: Date: g- .2-//i 7 5/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? i ❑ 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: E '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. Sign below and skip the rest of the form. Owner'Signature: Date: I4No 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. Sign below and skip the rest of the form. Owner' Signature: Date: Ga/Yes My real property is built and available for use or occupancy on or before January 1,.1994. Civil Code Sections-11=01.1 through 1101.8 apply.--Refer to the attached. l Q' 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). iscommercial real property. See Civil Code Section 1101.5. propertya ❑ My �Y p P 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. SB407 2014.doc revised 03/18/14 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). IIIUWe,the owner(s)of this property,certify under penalty of perjury that non-compliant plumbing fixtures have been replaced 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 fix comply with requir�-<dents as indicated in the table below. Owner's(or Owner Agent's) Signature: Ai : _ Date: fri/e2///7 Upon completing and signing this Certificate,please return it to the Building Division in order to final your permit. Non-Compliant I , � Water-Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) li 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_ Qmtbercial 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 - — _ -- psl - - 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. SB407 2014.doc revised 03/18/14