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B-2016-1472CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1472 10221 STERN AVE CUPERTINO, CA 95014-3666 (375 I1 069) ( ROOTER HERO PLUMBING INC) MISSION HILLS, CA 91346 OWNER'S NAME: LEE MENG-KUN AND LIU SHIH-YU DATE ISSUED: 03/04/2016 OWNER'S PHONE: PHONE NO: 408-469-6209 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class CC-36 Lie. #9,�7 214_ Contractor (ROOTER HERO PLUMBING INC) Date 03/04/2016 X BLDG _ELECT X PLUMB ` MECH X RESIDENTIAL— COMMERCIAL 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. JOB DESCRIPTION: SEWER CLEAN OUT * SUNNYVALE SANITARY I hereby affirm under penalty of perjury one of the following two declarations: r. 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. 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. Sq. Ft Floor Area: Valuation: $5000.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above Number: Occupancy Type: information is correct. I agree to comply with all city and county 375 11 069 3 75 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 PERMIT EXPIRES IF WORK IS NOT STARTED expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR granting of this permit. Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION. Code, Section 9.18. rl, Issued by: ABBYAYENDE � n Signature /� Date 03/04/2016 Date: 03/04/2016 4�C OWNER-BU LDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the 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 following two reasons: 1. I; as owner of the property, or my employees with wages as their sole inspection. compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) Signature of Applicant: z. I, as owner of the property, am exclusively contracting with licensed Date: 03/04/2016 contractors to construct the project (Sec.7044, Business & Professions Code). ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: r. 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will 2. 1 have and will maintain Worker's Compensation Insurance, as provided for maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the by Section 3700 of the Labor Code, for the performance of the work for which Health & Safety Code, Section 25532(a) should I store or handle hazardous this permit is issued. material. Additionally, should I use equipment or devices which emit hazardous 3. - I certify that in the performance of the work for which this permit is issued', I air contaminants as defined by the Bay Area Air Quality Management District I shall not employ any person in any manner so as to become subject to the will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and Worker's Compensation laws of California. If, after making this certificate of the Health & Safety Code, Sections 25505, 25533, and 25534. 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 Owner or authorized agent: be deemed revoked, t-:Date: 03/04/2016 CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance I certify that I have read this application and state that the above information is of work's for which this permit is issued (Sec. 3097, Civ C.) correct.. I agree to comply with all city and county ordinances and state laws Lender's Name relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree Lender's Address to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in of the of this permit. Additionally, the applicant ARCHITECT'S DECLARATION consequence granting understands and will comply with all non-point source regulations per the I understand my plans shall be used as public records. Cupertino Municipal Code, Section 9.18. Licensed Professional Signature Date 03/04/2016 CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino.org A1EPA1iscApp_011.doc revised 06121/11 PLUMBING ❑ MECHANICAL ❑ ELECTRICAL ❑ MISCELLANEOUS 1 PRUCT ADDRESS y' 7N x � �- t O 4,-e- OWNER NAl g Lee- tl ! if � � r i A bo t► l vl -�PHONE E -M kM L4 I STREET ADDRESS CrY, STATE, ZIP FAX CONTA J32P4T �TAME5'tr6x�o �H�©� � / j�_ 6 Z E-MAIL STREET ADDRESS CIT , STATE; ZIP FAX 2� e� urnb t C4, r(r 1:1OR'NER ElOANEK-BUII.DER' j 1 OwNEKAGENf CONTRACTOR ❑ COA'TRACTORAGEAT 1:1 ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TE: NANT CONTRACTOR NAME LIC SE JE'R LICENSE TYP� COMPANTY NAME / E-MAIL FAX rLeel-c" STREET ADDRESS (� CIT STATE; ZIP PHONE 2 Z� �7 0.4 r Iry I --L- ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC N CO-MPAN'Y NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PYONE s �� -7® USE OF ❑ SFD or DUPLEX ❑ muui-FAMILY PROJECT L'v WILDLAND ❑ PES PROJECT A' ❑ PES IS THE BLDG AN ❑ YES BL'ILDLNG: ❑ COMMERCLAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO I EICHLER HOME? ❑ NO DESCRIPTION OF WORK/'i ( if c l � nm�^ / )^ sf r --e , /6'I� Y` W a\4 QrowlOy me- r.., TOTAL VALUATION: �v 4:� RECEIVEDB� ' By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owne 's beha 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 relating to building struction. I authorize representatives of Cupertino to enter the above identified property for inspection purposes. Date: Signature of Applicant/Agent: SUPPLEMENTAL INFORMATION REQUIRED Q � " � OFFICE USE ONLryI Ef ERTHE-COiJ1�TER .a C j ST iI33ARD4 c A1EPA1iscApp_011.doc revised 06121/11 CITY OF CUPERTINO WN FEE ESTIMATOR - BUILDING DIVISION ialADDRESS: 10221 STERN AVE DATE: 03/0412016 REVIEWED BY: ABBY APN: BP#: VALUATION: 1$5,000 *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: PENTAMATION 1 RPSS PERMIT TYPE: WORK SEWER CLEAN OUT * SUNNYVALE SANITARY SCOPE APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES Sewer, Building 1PRSEWER 1 # $25 TOTALS: $25.00 Plumb. Plan 0.0 Check hrs $0.00 x E DIEL I f..S ."`Y A£,, 1s :a . Plumb. Permit Fee: IPPERMIT Other Plumb Insp. 0.0 hrs $48.00 o f NOTE. This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School District etc These ees are based on the nrelimina information available and are only an estimate. Contact the Dept for addn'l in o. ITEMS (Cee Resolution 11-053 Elf.' 7/1/13) FEE QTY/FEE MISC ITEMS }FEE s= PME Plan Check: $0.00 PME Unit Fee: $25.00 PME Permit Fee: $48.00 Administrative Fee: IADMIN $45.00 Work Without Permit? 0 Yes (E) No $0.00 i Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $0.65 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS, $167.65 $0.00 TOTAL FEE; $167.65 Revised: 01/01/2016 ANCE OWNER',DERTIFIC -ATE OF U COMMUNITY DEVELOPMENT DEPARTMENT* BUILDING DIVIS'11 rCa1�i Ott 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building(@cupertino.org PF'R1Vt1T CANN OT RIF, F"INAIII D MD COMPLETJEj) UNTIL IT PURMSE This affidavit is a self -certification for the installation of all required Smoke and 1 compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 ins eCtinn(zare rp wired U, Monoxide Alarms for no interior access for GM, tHAL INFORMATION Existing single-family and multi -family dwellings shall be provided with SmokeAlarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repair's to existing dwelling units exceeds $1000.09, CRC Section 8314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Mon -oxide, Alarms, be installed in the following locations: ARBA SMOKEIALARM CGAIARRM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s,) X X On, every level of a dwelling unit including basements X X 314/0 X ............ . .... ............. I ................ Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances andthat der not leave an- attached garage. Carbon monoxide alarms combined with smoke alarms shall comuFly with CBC Section 429,6,, an, d shall be approved by the Office of the State Fire Marshall. Fuwer Sup units no ca mmm ercial power sup m(s), may be solely battery oprerated. , p : In, &wel, g, t s with supply, alax hh, existktg, dwehIffig., ma -its,, alarms i are permitted to be solely battery operated w, here repairs or alterations, do, not resift, int the removal of wall and ceiling. firdshes; or, there is, nog access by mnean& , of attic, baser—ent or, crawl space.. Refer to CRC Section: R314 and CB"C Sections 907.2.11.1 and 420.6.2. An electrical perHat is req, piredi for alaran,,s; wktch m u -,&t be coa.m-,ected to, the building, wiring. As, owner. 4 fke ab-ove-referenced property, I hereby certify flruakt, the alar m referenced above hasihaLve, beer, installed inaceoTmdimc e with, the ma n4act ur er's ins timcoons: awnid� in Eem. olime e With,N the Callifimnia %,fldhng, arty Caififon6a, Reesi4fenA410ydes:. T he allairms, have been tested an id! are operafio nal, as-, of, the datesjgAe(j1 off thh§, sh9femweat 69 0M NW0,15 4 '7 �9 � V� L stofbr.......................... ..................... ...._....Ciafs 314/0 ............ . .... ............. I ................ Smoke and-l"C0fornit dbcrevised 03-1p81 Owner WATE&R-CONSERVING",PLIUMMN(:x�,",,FIX�TU,,RES 16W"" ER CE jjjj7 1C, ATE OF COMPUARM COMM',UjNi,TYID'E-VELOP,ME,N,T',,DE,�P,A,R-TUC-NT-',B�ILID,ING',Dl'-V,I$,low 10300 TTQRR"E,A'ViEfW-LX -'CjJPERT-jN �M) TI'7-32-2-8 •',FAX *OWF�7-3�33 a buildi - k)fti- Address 1'-j t I Is your real propertya registered historical site? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip, the rest of the form 'i -and sign bottom of form. B No Go to Question 2. 2. Does your real property have a licensed pluifnbercerfifying 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. 59 No Go to Question 3. 3. Is water service permanently 6n.tly digeofinected for your building? 0 Yes Civil Code Soctiorig 1101.1 through 1101.8 do not apply. Skip the rest of the form andtsign bottom of form. 0 No Go to Question 4, 4. Is your real property built and available for use or occupancy on or before January 1, 1994? 93 No My real property is, built and available: for use or occupancy Aftq January 1, 1954. Civil Code Sections 110-1.1 through, 1101.8 da not apply. Skip the rest of the forrn and sign bottom of form,. ffil El Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1191.1 through 11q1..8apply. Check one of the three following statements and sign bottom of form.. Please check ONE of the following: 0 1AY Pr"E)POItVig aS10 O r&1deniccrl real properly. See Civil Code Section 110'1.4. On md', alfter, lantiaty 1, 2014k, building- alterations dr, i ftuprovenients shall require all n611 -compliant pltmbing, fixtures tcyberop,lacedwith wa,te'r�conserviftg,pt,umbifi,gfi,x, -tu r, e& throughout the buil&kg.. Un or before January 1, 2017, all non- compliant ptamliing fixtures, shall be tepIdeed'with water -conserving Pftinibir4 fixtures (regaTdless of whether property undergaes, alterations or im-pf(avernent-s). 0 MyPfoperWis amvffifamfiy reAdenfialrwIptoperty. See Civil, Code Section 1101.5 On and after, January I,- MIA, speGifiedbtilrdligg, alterations or it nptovernefaits Shall reqiftire non- compliant plumbing factures to) be repl9ced, with water conceiving plumbing fixtures. On, or, before January 1, 2019,t alt non-compliantplum Wittig, fixtures, shall be mplacedi vvithi- water- Wrdergoesalterations or 0! See Cade Section 1101.5. On and after, Jlawmy 1, 2014„ alterations or improvements shall riequi I T -e non- compliant. plumbing fixtures: to, b e replaced with, water conserving plumbing fixtures. On, or before: Tanury It, 2%9,, all nor-Legrayliamt plumbing fixtures shall be replaced with water- conserving pluinMkg Extatesi &oughhuat tht buffiivg, (Fegardlless of whether property undergoes afteFatibm& or improvements)� as the, owner, or' owner`& agent of this!, property.; certify ify un, der penalty of perjury that non compl, plumbing. fixtures, will. be regf,acedlipr,iortudate speciihe,&ab-,iDivewith;,water�co-nservin,g/.plumbing f,xtures in accordance with Civil Code Sections.1101.1 Code and; Calffomia Green:BuiIdingSitan&.rdsCode„ and manufacturer's imsteVation requirements„ ts,,, and' that they water -conserving plumbing fixtures comply wi, the req, F, th Iirements as indicated in, the table on the fdffbwing. page,. -6Zt Upon eompfetffig and, signing this, Ceit fieA-e,. please return, it, to, the Building Division iii: order to, final" your: building; peninit. S-B-40,720Vt1doc revised,0812-6115