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B-2016-1926CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR:' PERMIT NO: B-2016-1926 21433 SHANNON CT CUPERTINO, CA 950144970 (362 01 004) AFFORDABLE WATER HEATERS 28358 CONSTELLATION RD Cupertino, CA 95014 OWNER'S NAME: TAGAWA HEATHER L TRUSTEE DATE ISSUED: 05/10/2016 OWNER'S PHONE: 408 439 2169 PHONE NO: 855 349 9087 LICENSED CARATION BUILDING PERMIT INFO: License Class PLUMBING Lic. #627388 Contractor AFFORDABLE WATER HEATERS Date 09/30/2016 X BLDG ELECT _ PLUMB MECH X RESIDENTIAL— COMMERCIAL I >fereby affirm than 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. SOD DESCRIPTION: REPLACE 50 GALLON WATER HEATER 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 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: $2200.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above ApN Number: Occupancy T'pe: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 362 01 004 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. Additionally, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code; Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date Issued by: Patricia Garcia Date: 05/10/2016. OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one ofthe RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 1. L 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 to]- orcompensation, compensation,will do the work, and the structure is not intended or offered for - inspection. sale (Sce.7044, Business & Professions Code) 2. L as owner of the property, am exclusively contracting with licensed Signature of Applicant: _ contractors to construct the project (Sec.7044, Business & Professions Code). Date: 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 T 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 a. 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 shall not employ any person in any manner so as to become subject tothe material. Additionally, should I use equipment or devices which emit hazardous Worker's Compensation laws of Califomia. If, after making this certificate of - air contaminants as defined by the Bay Area Air Quality Management District I exemption, I become subject to the Worker's Compensation provisions of the will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. .Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 1 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 performance 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. 1understand my plans shall be used as public records. Signature Date Licensed 0511012016 13:31 MAY/10/2016/TUE 01:45 PM City of Cupertino u511URU16 I Ud (FAX) P.0041004 FAX No. 408 777 3333 P.002 (rax) F.UUZ1UUz GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 950-14-3255 CUP ERT NCO (408) 777-3228 - FAX (408) 777-3333 • buil int(a cuoer ino,oro PLUMBING nMSCHANICAI, rlry.nr RI -AL 7mixr-FLLANmus o ' MEP I C. Iff I S 01* PROJECTAZIMS6 AYNP tS O r OltT1e11NAAtL P110 E-MAIL C Awa STREETADDILESS t� I 1 1 cl n 01-1 CITY, STATE,ZIP Q. 5D fAX CONTACT NAME - - PHO fi E•NIA1L S"r;6 ADgtUisS fT I09 B' C .67ATL. 'LIP �%a Cf'C X11. FAX r o r a(3 t a b S S io ❑ owNeR ❑ owrMrc.aurLmaL ❑. Ow'NsnAumiT 0 CONTItAcmA CONrRA[TORAv---m ❑ AnCntrEcr ❑ CNOINnn, ❑ DEVELOPtlft ❑ -rm-xr CONTRACTORNAME LICENSENUMBER 1110w5�TYI'E� BUS. LIC IT d Ly Or C O, O U COPoQ; YONAMI: G-MAft. PAk STREET ADORHIS YA. A/ CCTV, STATE, ZIP FNONe ARCEIITEL-TiEN0INizan'NAM2 LICaNSC NUMBER BUS. Lir 9 Ca%IPANY NAME 1:•btAlL FAX STILEPT AOPRESS CITY. FrATEZIP 17I10NE USE of SFaapUPCEX ❑ MULT4FAMILY PROMCTINtV1LDLANO ❑ Y65 PRO72CrIN ❑ YHB ISTHEBLOGAN 0 ITS 131.1ftnING: ❑ COMMERCIAL URBANIN71=FACk AREA ❑ NO FLOOOZONE ❑ No HCISLER IIOPiP.'? ❑ NO DMILIFTION OF WORE. - a orl wn er er a e / O c 0 � -- ".. � ,(7 I ""---��:�;(sr� '=�—�`p•P_ TOTAL VALUATION; ID ID By my signature below, i ertify to each firths following 1 um the prnpClly owner ar aotltori2ed s Cnt to act an the property owner's behalf, I have rend thin application find the intlormation 1 have provided is Correct I have read Ula Description of Work and vCriCy it is accurate. I agree In comply with all applicable local ordinances and state laws relating to build' n on5tructl'orl- I AVIhDrila Mpimuhtatives efCuperdno to cntcr tha abovPadentified property for inspection purposod. Signature of ApplicanUAECnCCular rJ ► O SUPT' MENTAL INFO AT[ONRP,QUIRED , A, EP*xf:App 201 t aloe revised D6121/11 . Go r� 1601a :41b1i1:E01 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 • buitding(ftuaertino.on PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN COMPLETED, SIGNED. AND RETURNED TO THE BUILDING DIVISION 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 bedroom(s) X X 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 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 specified below have been tested and are operational, as of the date signed below. n Address: 2 1 C4-1,3 ��r�u^ C�� Permit No. /c� '2ot �►' / �z4 Specify Number of Alarms: # Smoke Alarms: Iy' 1 # Carbon Monoxide Detectors: t have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: Signature Date ems,,, ................. Contractor Name: Signature.................................................................. Lic.#...................................... Date: Smoke and COform.doc revised 09/27/16 CUPERTINO 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.cupertino.or4 Owner Name Permit No. 2, 2O t & Address ?,( y 93 5 �a vivo, 9t r �W� 9 3t)t I PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED AND RETITRNED TO THE BUILDING DIVISION Please refer to the attached California Civil Code Sections 1101.1 — 1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: A?"No Go to Question 2. /( n _ 2. Does your real property have a licens um er 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. Sign below and skip the rest of the form. - )�I"No Owner' Signature: Date: Go to Question 3./�t5 /� 3. Is water service permanently disc cted for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. No Owner' Signature: Date: Go to Question 4. (�(rn J 4. Is your real property built and avail 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:�l /0Yes My real property is b ' e for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. �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). ❑ 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. SB407 2014.doc revised 03118114 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). UWe, 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 fixtures comply with thPr4quirements as indicated in the table below. Owner's (or Owner Agent's) Signature: %' Date:�1?= Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit. 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 03118114 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate 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. SB407 2014. doc revised 03118114