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B-2016-1625CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
10225 PARKSIDE LN CUPERTINO, CA 95014-6600 (369 04 048)
OWNER'S NAME: CAMPBELL BRIAN AND FLOY TRUSTEE
OWNER'S PHONE: 4088330900
LICENSED CONTRACTOR'S DECLARATION
License Class GENERAL BUILDING CONTRACTOR Lic. #991840
Contractor FUTURE VISION REMODELING INC Date 04/30/2016
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. 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. I bav"e 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 Cupertino Municipal Code, Section 9.18.
Signature Date 03/24/2016
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. I, 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 (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
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.
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 revolted.
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.
Date 03/24/2016
CONTRACTOR: PERMIT NO: B-2016-1625
FUTURE VISION
REMODELING INC
VAN NUYS, CA 91406
DATE ISSUED: 03/24/2016
PHONE NO: (818) 284-9890
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
REMODEL GUEST, HALL AND MASTER BATHROOMS (250 S.F.)
Sq. Ft Floor Area: Valuation: $20000.00
APN Number: Occupancy Type:
369 04 048
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED TINCTION.
Issued by: ALEX VALLELUNGA
RE -ROOFS:
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
inspection.
Signature of App]
Date: 03/24/2016
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUSMATERIALSDISCLOSURE
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.
l�
Owner or authorized agent:
Date: 03/24/2016
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
Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • build! ng.(a,cupert! no, org
❑ NEW CONSTRUCTION ❑ ADDITION ALTERATION / TI
❑ REVISION / DEFERRED ORIGINAL D-111.'
PROJECTADDRESS Q �� 1 1 / / / _ I APN r �- y` ,,, 9 04, o
!//�jJrl �S!-
OWNER NAME � / �^n j I /'
PHONE �dg- ��(.��,1 E-MAIL
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STREETADDRESS }' 1
/+/S!�
if Oma- /� 4i v - (� � V � l � � FAX
Vt�! CITY, STATE,ZIPP ///t f�
CONTACT NAME PHONE L 0� E-IvLAIL
STREET ADDRESS �j fA U C'
/ 1_
CITY, STATE, ZIP ' C'k
FAX
❑ OWNER ❑ OININER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR OICIOXTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
I LICENSENU1,11BER �j�jj / LICENSE TYPE
CONTRACTOR NAMEFq
BUS. LIC
COMPANY NAA /
E-MAIL e A
Il'
FAX
STREET ADDRES G / /
CITY, STATE, ZIP
PHOX&`vjI
r
ARCHITECTENGINEERNAMELICENSE NUMB
BUS. LIC'
COMPANTY NAME
E-NIIAIL
FAX
STREETADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WOItIi � }� � (S ' ( ^y - I ®/ � �� ✓ V �
!gin' �•� rr'l, k ems(
EXISTING USE ---j PPPOSEDL'SE CONSTR. TSTE _ STORIES
USE I
TYPE
OCC.
SQ.FT.
VALUATION (S)
EMSTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NETAREA
BATHROOM � /J
KITCHEN
OTHER
REMODELAREA '/�(ss
REMODEL AREA I
REMODELAREA
7-
PORCH AREA.
DECK AREA
TOTLAL DECKPORCH .AREA
GARAGE AREA: Lj DETACH
-
-
E] ATTACH
D\�%ELLiNG L,1\4TS: ,
IS A SECOND UNIT []YES
SECON-D STORY ❑ YES
BELNGADDED? El NO
ADDITION? []NO
l
PRE -APPLICATION ❑ YES IFYES. ES. PROVIDE COPY OF
IS THE BLDG AN ❑YES
TOTAL VALUATION:
PLANNING ADPL m I] NO PLANNING APPROVAL LETTER
EICHLER HOME? []NO
�`/`]
JVL—)
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on theroperty 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 relating to building construction. I auth 'ze entatives of Cupertino to enter the above-identined property for inspection purposes.
Signature of Applicant/Agent: Date:
SUPPLEI (ENTAL FNTFORIA_aT�YON REQUIRED
�s
,, PLA'�CHECI>TIPE
I � �; ROUTI'tiGSLIP� E '�
/
I\Tew SFD or Multifamily dwellings: Apply for demolition permit for
',,'-EON-ERTxE coU�TER
BUILD(\G Pa �� 7tEt IE1� �,
existing building(s). Demolition permit is required prior to issuance of buildings
g
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permit for new building.
x
31� E�REss❑
PLA�inQ L�G PL�n 72E� IEi '
Commercial BIdas: Provide a completed Hazardous Materials Disclosure
L sT� D�RD
❑E PusliCiNoRI '
_
form if any Hazardous Materials are being used as part of this project.
3 I
ry
LARGE s aPIREDEPT
ss
s a'
_Copy of Planning A pproVal Letter or Meeting with Planning prior to
©� JOR ' x
❑'s��Ir.
submittal of Building Permit application.
Az
uu sEi� ER�IsrlucT
E\�ZRO\14ENT`AL HEALTH
Bldo jpp_Z011.doe revised 06/21/11
c'
l A sensor's Parcel Number:
6L 0q9
Narne of Owner:
i
Contact Person: ���� Phone:
Project Address: �A fb'k je— /G4 rw_ �f4
Scope of Work:
Code Editions: 2013 California Residential Code
2013 California Plumbing Code
2013 California Mechanical Code
2013 California Electrical Code
2013 California Energy Code
_ifo � ___ P _� — 0 9 J
COI _4� '��O(bf
Mechanical Notes: OFFICE CO'P�Y
1. bathroom vents shall terminate not less than 3 feet from openings p fngs and property lines. (CIVIC 504.1)
Energy Code Mandatory Measures:
1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy luminaires (150(k)(7))
2, Permanently installed luminaires in bathrooms shall be high efficacy luminaires OR are controlled by an occupant-sensors(s) certified to comply with Section 119 that
does not turn on automatically or have an always on option. (150(k)(10))
COMMUNITY DEVELOPMENT DEPARTMENT
BUILDING DIVISION - CUPERTINO
This s�Dt of plans and specifications %,JUST be kept at the
job iSz:s c3tlring colIstruction. It is unlawful to make any
cl langss or alterations on Safe, or to deviate
therefrom, without approval from the Building CafflCial.
Tho starnping of this plan and specifications SHALL NOT
bre 'hold to permit 0 F a anaryl-roval of the violation
of any provision r rn Cit e u'e,^rice or State Law.
BY 31;vq
DATE
PERMIT NO.
L�:
Plumbing Notes:
1. Water closets shall have an average water consumption of not more than 1.28 gallons per effective flush, (CPC 403.2)
2. Shower heads shall have a water flow not exceed 2.0 gallons per minutes @ 80 psi. (CPC 408,2)
3. Faucets -in lavatories shall have. a water flow not exceed 1.5 gallons per minutes C 60 psi and shall not be less than :8 gallons per minutes at 20 psi. (CPC -403.6)
4. Shower stalls shall have a clear interior finish area of 7.1 sq.ft. and be able to accommodate a minimum 30 inch circle at the threshold level. These clearances shall:be
maintained up to a height of 70 inches able the shower drain. (CPC 408.6)
5, Shower compartments and walls above bathtubs with Installed shouter heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches
(6ft). (CRC 8307.2)
6, The maximum hot water temperature discharging from the bathtub, shouter and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit. The water heater
thermostat shall not be considered a control for meeting this provision. (CPC 409,4 & 408.3)
7. Water closet shall be set minimum 15 Inches from its center to a side wall or obstruction and 24 inch clearance in front of water closet. (CPC 402.5)
Electrical Notes:
1. The installation of smoke alarms in all of the following areas shall be provided: (R314.3)
a. On the ceiling or wall outside of each separate sleeping area in the Immediate vicinity of bedrooms.
b. In each room used for sleeping purposes,
C. In each story within a dwelling unit, including basements but not including crawl spaces and uninhabitable attics.
2. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in the Immediate vicinity of the bedrooms and on every level including
basements in dwelling units that have fuel -fired appliances or attached garages. (CRC R315.1)
3. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such circuits shall have no other outlets. (CEC 210.11(C)(3))
4. All receptacles in bathrooms, garages, accessory buildings, outdoors, crawl spaces, unfinished basements, kitchens (where receptacles serve counter top- surfaces),
laundry, utility, wet bar sinks (within 6 feet of the edge of the sink), shall have ground -fault circuit interrupter (GFCi) protection. (CEC 210.8)
5. In all areas specified in 210.52, all 125 -volt, 15- and 20- ampere receptacles shall be listed tamper-resistant receptacles. (CEC 406.11)
7 y f
Y -
E?C1STING BATHROOM FLOOR PLAN
�LnwI, r-ru/m�i
4r �� i2b Av;,,r sU'r
REVIEWED FOR CODE COMPLIANCE
Reviewed By: Tkv'o�mvw
PROPOSED BATHROOM FLOOR PLAN/
to
Building DePartment
, s,
NAR 2 4 2016
REVIEWED FOR CODE COMPLIANCE
Reviewed By: Tkv'o�mvw
PROPOSED BATHROOM FLOOR PLAN/
Assessor's Parcel Number: 36q 04 046.
Name of Owner:
Contact Person; V4
Project Address:
Scope of Work:
Code Editions: 2013 California Residential Code
2013 California Plumbing Code
2013 California Mechanical Code
2013 California Rlectrical Code
2013 California Energy Code
Mechanical Notes:
9/3b� ��vo
Phone;
— C-tl�
Gf I4bIL�
Bathroom vents shall terminate not less than 3 feet from openings and property Imes. (CIVIC 504.1)
Energy Code Mandatory Measures:
I. All permanently installed high efficacy luminaires shall be switched separately from lour efficacy luminaires (150(k)(7))
2, Permanently installed luminaires in bathrooms shall be high efficacy luminaires OR are controlled by an occupantsensors(s) certified to complywith Section 119 that
does not turn on automatically or have an always on option. (150(k)(10))
=F7
EXISTING BATHROOM FLOOR PLAN
3z �
Plumbing Notes:
1. Water closets shall have an average water consumption of not more than 1.28 gallons per effective flush. (CPC 403.2)
2. Shower heads shall have a water flow not exceed 2.0 gallons per minutes @ 80 psi. (CPC 408.2)
3. Faucets -in lavatories shall have a water flow not exceed 1.5 gallons per minutes @ 60 psi and shall not be less than :8 gallons per minutes at 20 psi, (CPC -403,6)
4. Shower stalls shall have a clear interior finish area of 7.1 sq.ft. and be able to accommodate a minimum 30 inch circle at the threshold level. These clearances shall:be
maintained up to a height of 70 inches able the shower drain. (CPC 408.6)
5. Shower compartments and walls above bathtubs with Installed shower heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches
(6ft). (CRC R307.2).
6, The maximum hot water temperature discharging from the bathtub, shower and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit, The water heater
thermostat shall not be considered a control for meeting this provision. (CPC 409,4 & 408.3)
7. Water closet shall be set minimum 15 Inches from its center to a side wall or obstruction and 24 inch clearance in front of water closet. (CPC 402,5)
Electrical Notes:
1, The installation of smoke alarms in all of the following areas shall be provided: (R314.3)
a. On the ceiling or wall outside of each separate sleeping area in the Immediate vicinity of bedrooms.
b. In each room used for sleeping purposes,
C. In each story within a dwelling unit, including basements but not including crawl spaces and uninhabitable attics,
2. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area In the Immediate vicinity of the bedrooms and on every level including
basements in dwelling units that have fuel -fired appliances or attached garages. (CRC R315,1)
3. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such circuits shall have no other outlets. (CEO 210.11(C)(3))
4. All receptacles In bathrooms, garages, accessory buildings, outdoors, crawl spaces, unfinished basements, kltchens'(where receptacles serve counter top- surfaces),
IGundry, utility, wet bar sinks (within 6 feet of the edge of the sink), shall have ground -fault circuit interrupter (GFCi) protection. (CEC 210.8)
5. In all areas specified in 210.52, all 125 -volt, 15- and 20- ampere receptacles shall be listed tamper-resistant receptacles. (CEO 406.11)
------------
OvI)l�v /--z G-�
Building epartmet t
2616
REVIEWED FOR CODE COMPLIANCE
Reviewed By: T&Kp��Old
PROPOSED BATHROOM FLOOR PLAN
4
(' Assessors Parcel Number;_3M C04-0
Name of Owner:
i
Contact Person: I)AVi 6 �G
Project Address:
Scope of Work:
Code Editions: 2013 California Residential Code
2013 California Plumbing Code
2013 -California Mechanical Code
2013 California Electrical Code
2013 California Energy Code
Mechanical Notes:
Bathroom vents shall terminate not less than 3 feet from openings and property lines. (CIVIC 504.1)
Energy Code Mandatory Measures:
I. All permanently installed high efficacy luminaires shall be switched separately from lour efficacy luminaires (150(k)(7))
2, Permanently installed luminaires in bathrooms shall be high efficacy luminaires OR are controlled by an occupantsensors(s) certified to complywith Section 119 that
does not turn on automatically or have an always on option, (150(k)(10))
2, d
EXISTING BATHROOM FLOOR PLAN
Plumbing Notes:
1. Neater closets shall have an average water consumption of not more than 1.28 gallons per effective flush, (CPC 403.2)
2. Shower heads shall have a water flow not exceed 2.0 gallons per minutes @ 80 psi. (CPC 408.2)
3. Faucets•in lavatories shall have a water flow not exceed 1,5 gallons per minutes @ 60 psi and shall not be less than .8 gallons per minutes at 20 psi. (CPC -403,6)
4. Shower stalls shall have a clear interior finish area of 7.1 sq.ft. and be able to accommodate a minimum 30 inch circle at the threshold level. These clearances shall be
maintained up to a height of 70 inches able the shower drain. (CAC 408.6)
5. Shouter compartments and walls above bathtubs with Installed shower heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches
(6ft). (CRC R307.2)
6. The maximum hot water temperature discharging from the bathtub, shouter and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit The water heater
thermostat shall not be oonsidered a control for meeting this provision. (CPC 400,4 & 408,3)
7. Water closet shall be set minimum 15 Inches from its center to a side wall or obstruction and 24 inch clearance in front of water closet, (CPC 402.5)
Electrical Notes:
1, The installation of smoke alarms -in all of the following areas shall be provided: (R314.3)
a, On the ceiling or wall outside of each separate sleeping area in the Immediate vicinity of bedrooms,
b. In each room used for sleeping purposes,
C. In each story within a dwelling unit, including basements but not including crawl spaces and uninhabitable attics.
2. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in the Immediate vicinity of the bedrooms and on every level including
basements in dwelling units that have fuel -fired appliances or attached garages. (CRC R315.1)
3. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such circuits shall have no other outlets. (CEO 210.11(C)(3))
4. All receptacles In bathrooms, garages, accessory buildings, outdoors, crawl spaces, unfinished basements, kitchens (where receptacles serve counter top- surfaces),
laundry, utility, wet bar sinks (within 6 feet of the edge of the sink), shall have ground -fault circuit interrupter (GFCI) protection. (CEC 210.8)
5. In all areas specified in 210.52, all 125 -volt, 15- and 20- ampere receptacles shall be listed tamper-resistant receptacles. (CEC 406.11)
Bu'Iding Department
�VWV�= E 40C ANCE
Reviewed By: Tpw ku �
PROPOSED BATHROOM FLOOR PLAN
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT , BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building a(Dcupertino org
Owner Name Perin
21()t6 -j6
Address lJ� ®�? 5 �'�nr�c S i Q - i^ �+rr Ck l
1. Is your real property a registered historical site?
4 C71 Yes Civil Code Sections 110 1. 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.
_1 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.
Li
i6o 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.
%j)�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 ease check ONE of the following:
1� 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).
❑ 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 nage.
Owner or Owner Agent's
Upon completing and signing this Certificate, please return it to the Building Division in order to final vnnr bn;lrhna „Pr mit
SB407 2015. doe revised 08/26/15