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B-2016-1809 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1809 7859 CREEKLINE DR CUPERTINO,CA 95014-4155(362 17 046) PACIFIC CONSTRUCTION& DESIGN CALABASAS,CA 91302 OWNER'S NAME: LEE KATHERINE I AND DENNIS DATE ISSUED:04/21/2016 OWNER'S PHONE:650-773-4601 PHONE NO:(818)880-1466 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#1008104 Contractor PACIFIC CONSTRUCTION&DESIGN Date 10/31/2017 X BLDG —ELECT —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: MASTER BATHROOM REMODEL(90 S.F.);REPLACE EVERYTHING I hereby affirm under penalty of perjury one of the following two declarations: LIKE FOR LIKE i. 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. A-11V 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:90 Valuation:$14500.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 362 17 046 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. WITHIN 18O DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1$0 DAYS FROM LAS CALLED INSPECTION. 9"ar19a,I;a,r Date 4/21/2016 Issued by:Alex Vallelunea / Date:04/21/2016 ' OWNER-BUILDER DECLARATION 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 i. 1,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(See.7044,Business&Professions Code) z. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(See.7044,Business&Professions Code). Date:4/21/2016 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 s. 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 material. Additionally,should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the 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 Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall i be deemed revoked. O s q .,y„ tU__tl.re ..a. APPLICANT CERTIFICATION Date:4/21/2016 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 pe ce 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 4/21/2016 Licensed CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 FUPERTI N0 (408)777-3228•FAX(408)777-3333•building0-cupertino.org 11609 ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESSr nd o CA0 I APN# 'S /UD-- I Of r /I OWNERNAME T 'S PHONE E-MAIL v dS©-773-4,0 I STREET ADDRESS , CITY,STATE,ZH' �� ® 1 FAX ir CIV"-011 ,hCO c( CONTACT NAMEt PHONE E=MATT CL�29. \ LIQ1;,?-f56-62 •o`�v�� t� C STREET AD^0 LIDRESS CI ,STATE,ZIP FAX ' SrJ1� •� CA a bl ❑OWNER ❑ OWNERBUIIAER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CO CTO&N n LICENSE NUMBER LICENSE TYPE BUS.LIC# ore_' to �c h� © © 3 D 11 COMPANY NAI U.A � � 1 E-MAII, FAX STREET AD SS A CITY,STATE,ZIP PHONE v1 o nn 5 2 vr�o�� SSS ARCHITECT/ENGINEER NAME LICENSE NUMBER \ BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK q o (CIO s' MO S-f er 'bCSI Y00yY1 EXISTING USE PROPOSED USE CONST&TYPET7 USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA I GARAGE AREA: EIDETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? []NO ADDITION? []NO PRE APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES ..•RECEIVED BN. TOTAL V UATION: PLANNING APPI,# ❑NO PLANNING APPROVAL LETTER EICHI"HOME? ❑NOV By my signature below,I certify to each of the following: I am the property owner or authorized agen to act on the property 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 authorize presentatives of Cupertino to enter the above-identified pro erty for inspection purposes. Signature of Applicant/Agent: 1�7JL r Date: f 2 0 SUPPLEMENTAL INFORMATION RE UIRED7- 11 - Q PLAN CHECIf TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for I existing building(s). Demolition permit is required prior to issuance of building �ovER TaE coUNTER �►B nvG P REVIEW permit for new building. ❑ ExPREss 'Ell"PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTANDAxD ❑ PUBLIc woxxs 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 0..MAd�R ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. CI: ENVIRONMENTAL HEALTH BldgApp 2011.doc revised 06/21/11 Assessor's Parcel Number: 3 c9c 1 Plumbing Notes: � i} N!S r 1. Water closets shall have an average water consumption of not more than 1.28 gallons per effective flush.(CPC 403.2) Marne of Owner: E N Lc ie 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 sci t.and be a i circle a th Id se arances shall be Contact Person: /� Phone:_ 0� 7�]�.. 1j� — �j maintained up to a height of 70 inches able the shower drain.(CPC 4 ,6) o•' w 5. Shower compartments and walls above bathtubs with installed showe s II be ishevi o nab b ac ght t less than 72 Inches 91 - 7i (6ft).(CRC 8307.2) Project Address: reek, A e. Dr` 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) Scope Of Work: )eo AA 61n ®,P& L 6) S-F. 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) Code Editions: 2013 California Residentiala. On the ceiling or wall outside of each separate sleeping area in the Immediate vicinity of bedrooms. (�6UIMUNITY DEVELOPMENT DEPARTMENT ��� j b. In each room used for sleeping purposes. 2013 California Plumbing Code` BUILDING DIVISION - CUPERTINO C. In each story within a dwelling unit,including basements but not including crawl spaces and uninhabitable attics, 2013 California Mechanical Code 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 APPROVED basements in dwelling units that have fuel-fired appliances or attached garages.(CRC R315,1) 2016 California Electrical C set of plans and specifications MUST be kept at thl A (I r� 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)) 2013 California Energy Codj�b site during construction. Itis unlawful to make any ,, 4. All receptacles In bathrooms,garages,accessory buildings,outdoors,crawl spaces,unfinished basements,kitchens(where receptacles serve countertop surfaces), Itundry,utility,wet bar sinks(within 6 feet of the edge of the sink) shall have ground-fault circuit interrupter(GFCI)protection. (CEO 210.8) Mechanical Notes: changes or alterations on same, or to deviate 13Y 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) therefrom, without approv?l fromm R,�ildin ' Official. 1. Bathroom vents shall terminate not less than tl ev lean nal�nd Pp?- rpsert I es.(Ch7 504. g e ° p�n n�ja ed 4, . SHALL NOT EnerayCode iVlanda[oryMeasures: be held t0 P.frTllf Ort P p o by ,a ,.. l ��94% 1, All german tly installed high efficacy lumina�r ,dell pe switcched se arate7 fr 6"iiri�es�2. Permanent) installed luminaires in bafhroorris s a'�I b fi h!e w atc� lumi'rialre Ian-�688t)Iarat dbnsors(s)certified to comply with Section 119 that does not turn on automatically or have an always ono tion, 150(k)(10)) � a I DI U I 9' —7� oo ol9' Cmc VANITY VANITY — _ _ 0 0 ' t; 3 fx l OUPC: TINO o 0 �rnrtment I EVIEWED `1 !..j[ COMPLIAN TUB Revievr:d E' TUB 10' T 10' O SHOWER ( r C] SHOWER LJ 0 Li ar=c( EXISTING BATHROOM FLOOR PLAN PROPOSED BATHROOM FLOOR PLAN FILc SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION Ct-MERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333• building(a,cupertino.org c dam. 0 sn q- CA-ddr-els # s b D ION 1 PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 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 R314 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 SMOKE ALARM CO ALARM Outside,of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X Within each sleeping room X 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 tol CRC Section R314 and CBC Sections 907.2.11.4 and 420}.6.2.An electrical permit is,required for alarms wllicll must be co riected to the building wiring. As owner of the above-referenced property,I hereby certify that the alarms)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 belo-w. have read'and agree to comp!y with the terms and conditions of this statement ' 11+.x+ 1 rlL L< :SP naictra ......... ..... ........................... .................... .................. r.Si natu€e ............... .... ....................................�Dafe .............. LE WATER-CONSERVING PLUMBING FIXTURES F OWNER CERTIFICATE OF COMPLIANCE COMMUNITYDEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTIiNO 10300 TORRE AVENUE a CUPERTINO,CA 95014-3255 (408)777- 228-FAX(408)777-3333 buildingCa�cupertlno.ora Owner Name,( to Permit Noel Address - (vV, V , 6il -ll t.') eA `7 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? El 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? Q Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. l'�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 check ONE of the following: t—_,l k My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014,building alterations or improvementsshall 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). El 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). 1,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. Owner or Owner Agent's Signature f ~/ Date- Upon completing and signing this Gert' icate,please return it to the Building Division in order to final your building permit' SB40 7 2015.doc revised 08126115 j