B-2016-2548 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2548
21870 SAN FERNANDO AVE CUPERTINO,CA 95014-2837(357 15 055) BLOSSOM VALLEY
PLUMBING
SAN JOSE,CA 95120
OWNER'S NAME: WANG FAZ]IENG AND LI FENGYAN DATE ISSUED:08/18/2016
OWNER'S PHONE:626-698-5528 rNE NO:(408)997-1970
LICENSED CONTRACTOR'S DECLARATION BUILDING;PERMIT INFO:
License Class C-36 Lic.#7 4 24
Contractor BLOSSOM VALLEY PLUMBING Date 09/30/2016 X BLDG _ELECT X 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:
INCREASE GAS LINE FROM 1"TO 1 1/4"SIZE TO ACCOMMODATE
I hereby affirm under penalty of perjury one of the following two declarations: DEMAND;REPLACE LINE TO FURNACE,RANGE,FP&WATER"
i. I have and will maintain a certificate of consent to self-insure for Worker's HEATER
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
n I have and will maintain Worker's Compensation Insurance,as provided for by
,Pection 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$3200.00
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 357 15 055
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 the granting this permit. THIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and willl comply with all ll non-point
source reg s per th Cupe ' o Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
Signature Date /8 18/2016 Issued by:A13BYAYENDE
Date:08/18/2016
WNE - _ DER 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
1. I,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)
2. 1,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:8/18/2016
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. 1 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 MunicipalCode,Chapter 9.12 and the
3. 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 to the material. Additionally,should I use equipment or devices which emit hazardous
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 t Cuper' o Munl Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safe Cod Sect* s 2550171;533.and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or authorized agen .
APPLICANT CERTIFICATION Date:8118/2016
I certify that I have read this application and state that the above information is N T T ENDING 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. 1 understand my plans shall be used as public records.
Licensed
Signature Date 8/18/2016
Professional
r3 ice` l c. 3'e 317-6,0 u16
_.. ...._ GENERAL PERUMI T APPLICATION
C0Mfk/lUNiIY DEVELOPMiENT DEPARTMENT•BUILDING DIVISION MEv
10300 TORRE AVENUE• CUPERTINO, CA 9501'-3255
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SMOKE / CARBON,MONOXIDE ALARMS _
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, GA 95014-3255
CUPERTINO
(408)777-3228•FAX(408)777-3333,a building(a)-cupertino.org
i
Permit No.ZO If
Address #of Alarms Smoke: Carbon Monoxide:
PE x, OT SE EINALED AND COMPLETED UNTIL THIS IFICAT
CERTE
!1XIN ,`
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PURPOSE
This affidavit is a self-c rtification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 QRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for
inspections are required.
GENERAL INFORM TION
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 314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon
Monoxide Alarms be if stalled 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) i.
On every level of a d ivellin unit including basements X X
Within each Slee in room X
Carbon Monoxide alar are not required in dwellings which do not contain fuel-burning appliances and that
do not have an attache i 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.
i
Power Supply:In dwelling units with no commercial power supply, alarm(s)may be solely battery operated.
In existing dwelling a its,'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 8314 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.
t_ 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 have been tested and are operational, as of the date signed
below.
1 have read and agree to comply with the terms and conditions of this statement
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Owner(or Owner Agent s)Nome:
reSi natu .......®..�1
. . .. .................... ........,...Date. .
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Contracto a e�:r
8/ �4b Signature................ ..... Lic.#......................................Date.
Smoke and C'O fonn.doe revised 03118114
WATER-CONSERVING G PLU BING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
CUP RTINO 10300TORRE AVENUE CUPERTINO, CA 95014-3255
(408)777r32�8• FAX(408)777-3333•buildingo_cupertino.org
Owner Name Permit No.
Address L
1. Is your real property a re istered historical site?
❑ YY s Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of rm.
ILf'No Go to Questio 2, j
2. Does your real property hEive a licensed plumber certifying that, due to the age or configuration of the property or its `.
plumbing, installation of ater-conserving plumbing fixtures is not technically feasible? ✓.
J'Yes Civil Code Sec tions 1101.1 through 1101.8 do not apply.
❑ The licens id plumber's certification has been provided to the Building Division.
Skip the rest o�the form and sign bottom of form.
El No Go to Questio 3.
3. Is water service permane tly 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 forin.
�No Go to Questioil 4.
4. Is your real property built and,available for use or occupancy on or before January 1, 1994?
❑ No, , My real proper.-y is built and available for use or occupancy after January_l, 1994.
Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.`'
-Y-e5' My real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Se 'tions 1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of fora..
5. Please check ONE of the f llowiig:
y property is a single family residential real property. See Civil Code Section 1101.4.
Ori and after January 1, 2014;building alterations or improvements shall require all non-compliant plumbing fixtures
to be replaced with wa er-conserving plumbing fixtures throughout the building. On or before January 1,2017,all non-
compliant plumbing 'xtures shall be replaced with water-conserving plumbing- fixtures (regardless of whether
L -property undergoes alt rations or improvements).
-0 "My property is a multi milt'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-compliaht plumbing fixtures shall be replaced with water-
conserving plumbing f�xtures throughout the building(regardless of whether property undergoes alterations or
improvements).
❑. My property is a,comniercial real property. See Civil Code Section 1101.5.-
On
101.5.On and after January 1 2014, specified building alterations or improvements shall require non-compliant
-- plumbing fixtures to bc replaced.w th water-conserving plumbin-g fixtures.
On or before January 1, 2019, all non-compliant plumbing fixtures shall be'replaced with water- conserving!,_.
:plumbing fixtures throt ghaut 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 spegified above with water-conserving plumbing fixtures in accordance with Civil Code-Sections 1101,1
through 1101.8,the curiet California Plumbing Code and California Green Building Standards Code, and manufacturer's
installation requirements, nd that the water-copse �mbing�fies comply with the requirements as indicated in the
table on the following page.
Owner or Owner Agent's Signature: Dater � D
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
j SB407 2015.doc revised 08/26/15
74
i
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
!Nater: sage
/Flow Rate 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3
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. 0.5 gallons/flush
Gallons/flush
Showerheads Exceed 2. : 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. 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 2.21 gallons 1.8 gallons per minute @ 1.8 gallons per minute .1.8 gallons per minute @ 60
Kitchen per minuted 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 maybe
used to achieve
reduction.
1. If the existing plumbing fixt re water usage/flow rate is equal to or lower than the figure shown,it is not required to be upgraded.
SB407 201 S.doc revised 08126115