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B-2017-0120CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0120 7611 SQUIREWOOD WAY CUPERTINO, CA 95014-5054 (362 27 008) TOP CONSTRUCTION EDGEWATER, FL 32132 OWNER'S NAME: LEE DI ET AL DATE ISSUED: 01/24/2017 OWNER'S PHONE: 408-996-1694 PHONE NO: (408) 892-3449 LICENSED ONT TOR' DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic. #680832 Contractor TOP CONSTRUCTION Date 11/30/2017 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. 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 -,,,E% Section 3700 of the Labor Code, for the performance of the work for which this 1 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. Sig_naiun % Date 1/24/2017 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. T 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 revoked. 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 11241207 X BLDG —ELECT _PLUMB X MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REPLACE WOOD FIREPLACE TO GAS; INSTALL GAS LINE Sq. Ft Floor Area: I Valuation: $9500.00 APN Number: Occupancy Type: 362 27 008 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby A e� tide Date: 01/24/2017 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 Applicant: Date: 1/24/2017 . ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE 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 ;C/o�de�, Sections 25505, 25533, and 25534. Owner or authorized agentf !'7' Date: 1/2412017 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 T'S D . RATION I understand my plans shall be used as public records. Licensed Professional • b- IT ®12o CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333.• building(ftupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT G ADDRESS "7 f/ S Gt:.r L'1N���9 I.✓� i APN # 21— o /y o l'ilXl OWNER NAME PHONE E-MAIL STREET ADDRESS ?(I>f S(Si i �l���� kV4'r CITY, STATE, ZIP 1P(51� • &0 Gf FX CONTACT NAME M (r f =Z--I-C 7`f rdV�.i S PHONE E-MAIL STREET ADDRESSCITY, I <n c, 6�� -oAo ✓� STATE, ZIP ��Gt ks�l-�h Fi- 32/32 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ACIL r�6�.f(�/z-i (�s�r, LIC SE NUMBER LICENSE TYPE BUS. LIC # 31.5-r8 ."ll(C © 2_ ii c 1 COMPANY NAME E-MAILFAX G/ omQ4,11 Gv / ST ET ADDRESS © fLAO CITY STATE, ZIP ' C w4/-Z�h C L 3.)-1 3 2 PHONE 2©?- 2 � f 9 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK 7-0 GX S . %� r''i 10 U C-4-( S I'L. 13 /L i W ,i, " M- C a4,I[-� `_.0 c -am -L 4- rI jVFLL VL -t-, f"f YFL �t/E"Z. EXISTING USE PROPOSED USE CONSTR TYPE # STORIES I USE TYPE; OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCHAREA DECKAREA TOTAL DECK/PORCHAREA GARAGE AREA: DETACH ❑ ATTACH I # DWELLING UNITS: IS A SECOND UNIP ❑ YES SECOND STORY ❑ YES BEING ADDED? []NO ADDITION? []NO - PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RgUIVED BY- TOjFAL VALUATION: PLANNING APPL # F]NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO + AL By my signature below, I certify to each of the following: I am the property owner or authorized agent to act o 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, v)bb�uilding 0 ction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applieant/Agent: // / ff` � Date: 2--y / -7 SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER El BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS 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 11 MAJOR El SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 06/21/11 CUPERTINO SMOKE CARBON MONOXIDE ALARMS OWNER, CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORR8 AVENUE • CUPERTINO, CA 95014-3255 (408) 777-32 • FAX (408) 777-3333 • buildinga-cupertino.ord PURPOSE This affidavit is a self -certification for f ae installation of all required Smoke and Carbon Monoxide Alarms for compliance with. 2016 CRC Section R314, R315, 2016 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, R315, 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 bedroom(s) - (Smoke alarms shall not be located immediate vicinity of the within 3 feet of bathroom door) X X On every level of a dwelling unit includin4 basements and habitable attics X X Within each sleeping room I X _ J Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances and that do not have an attached garage. Carb n monoxide alarms combined with. smoke alarms shall comply with CBC Section 420.6 and shall be approv d by the Office of the State Fire Marshal. Power Supply: In dwelling units with ' o commercial power supply, alarm(s) maybe 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 fetishes 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 th 6 building wiring. As owner of the above -referenced pro erty, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the man acturer'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. Address: i b t/ S f t�t�t��G1 /, WYNY C, i°C '7,*'6'4��9 r O Permit No.6-2 0/? ^ d712�J Specify Number of Alarms: # Smoke Alarms: # Carbon Monoxide Detectors: l have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: 6 P7?Yi- L•15' c ame: .............. Lic.# ... Rd- ...................... Date: ........•... �.. 1� Smoke and OOform.doc revised 0111012017 Owner Name WATER -C NSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE A`YI,ENUE • CUPERTINO, CA 95014-3255 777-3228 > rAX (44Q8) 777-3333 • building(ftupertino.org Address 7 C f( S O.c-f 1. Is your real property a registered historical ite? ❑ Yes Civil Code Sections 1101.1 thro gh 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Z No Go to Question 2. 2. Does your real property have a licensed ph ber 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 thro gh 1101.8 do not apply. ❑ The licensed plumber's certi kation has been provided to the Building Division. Skip the rest of the form and sig bottom of form. [Z No Go to Question 3. 3. Is water service permanently disconnected tor your building? ❑ Yes Civil Code Sections 1101.1 thro gh 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 4. 4. Is your real property built and available for luse or occupancy on or before January 1, 1994? ❑ No My real property is built and ava Jable for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 thro gh 1101.8 do not apply. Skip the rest of the form and sign bottom of form. R(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.. Please check ONE of the following: 1� My property is a single-family residenti, On and after January 1, 2014, building to be replaced -with water -conserving pli compliant plumbing fixtures shall be property undergoes alterations or impro, ❑ My property is a multifamily residential On and after January 1, 2014, specified plumbing fixtures to be replaced with w On or before January 1, 2019, all non -c( conserving plumbing fixtures throughou improvements). ❑ My property is a commercial real propel On and after January 1, 2014, specified 1 plumbing fixtures to be replaced with w On or before January 1, 2019, all no plumbing fixtures throughout the buildir real property. See Civil Code Section 1101.4. terations or improvements shall require all non-compliant plumbing fixtures ibing fixtures throughout the building. On or before January 1, 2017, all non- eplaced with water -conserving plumbing fixtures (regardless of whether -ments). eal properly. See Civil Code Section 1101.5. ailding alterations or improvements shall require non- compliant ter -conserving plumbing fixtures. npliant plumbing fixtures shall be replaced with water - the building (regardless of whether property undergoes alterations or See Civil Code Section 1101.5. ilding alterations or improvements shall require non- compliant ;r -conserving plumbing fixtures. -ompliant plumbing fixtures shall be replaced with water- conserving (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 ater-conserving plumbing fixtures in accordance with Civil Code Sections 110 1. 1 through 1101.8, the current California Plum ing 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 DaLye. Owner or Owner Agent's Signature: Date:.: 4Z Upon completing and signing this Certific te, please return /to the Building Division in order to final your building permit. SB4072015.doc revised 08126115 1. If the existing plumbing fixture water rate is equal to or lower than the figure sho-,gni, it is not required to be upgraded. SB4072015.doc revised 08/26/15 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Water Usage/Flow Rate • 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage /Flow Rate 2 13 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 Gallons/flush 0.5 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 and -held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all sho erheads and/or other shower outlets controlled by a single valve shall not exc ed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allo onl 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 min to @ 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 tD 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 maybe used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water rate is equal to or lower than the figure sho-,gni, it is not required to be upgraded. SB4072015.doc revised 08/26/15 HOME O%IVNL®rz� C-ONTkACTOR CA ' COMMUNITY DEVELOi'hO:ENT DEPARTMENT 1 AFIFIROVED r This set of p(ans and sfru~dficati2ans f 4DIST be karat at ifrs jcfa - — —" c ' changes or. �itaa an�asrrnv„ ccrir,[ri.+r tirrir. It i m�.irrin�9`rr f�.irrrtlaa, any ch nlfmaaflons on same, or to deviate tlra irlrcrrrr, Without approval from the Buil*tr** C Mcia*I. "- m starnpling of this frlarr and sporlIuzfarns SI-Al�-I-�qOT Itc - held to taa.rm4 or in f rc all Qapp[,Vsl oa theviolation er si iy provision rr of any Lily 01 it �ariItate Law 'Bytaxa? ia,� ._� .. .......... . ............ ......... I°)?iTE 010Vel' 4 PERM PER V � I NO .....I�.r 20 17 '1�� 120 4 r5. ; CU 3 4� t5 e i h 4 e _ ID E 11 11141 IP3 u lii un paift runeun't k"vVt',;" ey J ByAbby Ayeinde Date, 0tl/Zllr°tl7 13ACKER.OVER RX5.1S7` 1 . R N,5'4LAif 00 r r ---->J!t'- 13e -o"