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B-2017-0168CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS 10253 PARKWOOD DR APT 5 CUPERTINO, CA (326 27 037) OWNER'S NAME: AVERY GLENBROOK LP OWNER'S PHONE: 650-961-8330 L I N D CONTRACTOR'S DECLARATION License Class C10, C20, C36, C38 Lic. #256057 Contractor THERMAL MECHANICAL Date 01/31/2018 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. 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. APPLICANT CERTI 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 DW the Cupertino Municipal Code, Section 9.18. Signature- v _ `—'Date 01/31/2017 O R -B TIL DER 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. s. 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 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 01/31/2017 CONTRACTOR: I PERMIT NO: B-2017-0168 SANTA CLARA, CA ISSUED: 01/31/2017 NO: (408) 988-8744 BUILDING PERNHT INFO: X BLDG X ELECT X PLUMB X MECH X RESIDENTLkL _ COMMERCIAL JOB DESCRIPTION: BLDG 43/UNIT 5; ADD N A/C; REPLACE FURNACE, SAME LOCATION; (N) WASHER AND DRYER HOOK UPS; (I) ELECTRICAL SERVICE (70 AMP); (N) GAS LINE FOR STOVE; (I) RECEPTACLE OUTLETS; (N) LIGHT; (I) BATHROOM EXHAUST FAN Sq. Ft Floor Area: I Valuation: $20000.00 APN Number: Occupancy Type: 326 27 037 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: MELISSA NAMES Date: 01/31/2017 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 ofAppl Date: 01/31/2017 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 Code, Sections 25,505, 25533, and 25534. Owner or authorized agent:,-,n��^� Date: 01131/2017 C ST'KO(CTION LENDING AGENCY 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 I CONSTRUCTION PERMIT APPLICATION COMMUNITY 13EVELOPMENT DEPARTMENT. BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 B (408) 777-3228 - FAX (408) 777-3333 - buildinq0-gipertino.org CUPERTINO Zo 01 -EINEW CONSTRUCTION [I ADDITION [@ ALTERATION /Ti n REVISION I DEFERRED ORIGINAL PERMIT ig PROJECT ADDRESS 10253 Parkwood DR, BLDG 43, Unit # 5 1 MIN 11 -3 OWNERNAME Avery Glenbrook LLC PHONE 650-961-8330 E-MAIL avery@pacbell.net STREETADDRESS 130 East Dana Street CITY, STATB,ZIP Mt. View, CA 94041 FAX 650-961-0571 CONTACT NAME Rob Moyer PHONE 408-593-8115 AIL rmoyer@thermalmech.com STR13CTADDRFSS 425 Aldo ave. CITY, STATE, ZIP Santa Clara, CA 95054 PAX 408-988-0233 ❑ OWNFR 11 OWNER -BUILDER DOWNERAGENT CK CONTRACTOR 0 CONTRACTOR AGENT 171 ARCHITECT 11 ENGINEER 0 DEVELOPER IJ TENANT CONTRACTOR NAME Thermal Mechanical LICENSENUMdER 256057 LICENSE TYPE C-4,10,20,36,38 BUS. LIC # 299 cOMPANY"'Am" Thermal Mechanical E-MAtLrmoyer@thermalmech.com FAX 408-988-0233 STREET ADDRESS 425 Aldo ave. CITY, STATE, ZIP Santa Clara, CA 95054 PHONE 408-988-8744 ARCHITECV13NGINUERNAME LICENSE NUMBER BUS, LIC 4 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK add new AC, replace furnace in same location, (N) washer/dryer hook ups, (N) electrical panel (70 AMP), (N) gas line for stove, (N) electrical outlets, (N) light, (N) bathroom exhaust fan EXISTING USE PROI'OSPD USE CONSTR. USE TYPE OCC. SQ.FT. VALUATION ($) RXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET ARLA BATHROOM KITCHEN =ELAREA REMODELAREA RIMODELARRA PORCEAR3A DECK AREA TOTAL DECKWORCH AREA GA UOF AREA. DIVIACIF DATTACHE#DW-LLtNGUNITS. ISASENONDUNIT YES BEING ADDED?0 []NO SECOND STORY ❑YES ADDITION? rINO pRE_AppLI(WfIoN OYES IF YES, PROVIDE COPY OF PLANNING APPROVAL LETTER. IS THE BLDG AN DYES EICHLER HOME? ]N TOTAL VALUAJION: PLANNING AWL P [:]No By my signature below, I certify to each of the following: I anilhe property Owner or autrofffled—agent to a �tlj�jeajr6i_ty owner's behalf have read this eilcuratc. application and the infortration I have provided is correct. I have read the Description of Work and verify i I agree to coinply with all applicable local *uIpectionpurposes. r tat s of Cupertino enter die above4dontifi4propcity f or u ordinances and state laws relating to building S e, I I, pe"'no .. M, �"e �iveo'"_ Signature of Applicant/Agent: /—"I'- Date: 7 SUPPLEMENTAL INVORMATION RE Qi35IRE5 O .,UTjNGSj;L1P k 0. '&VWTI]4 'R. _�COU TF KnFY12 New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for now building. 1W. S; Commercial Bldgs: Provide a completed Hazardous Materi als Disclosuro, Ton—n if any Hazardous Materials are being used as part of this project,—RIF. A.. ph& .... Copy of Planning Approval Letter or Meeting with Planning prior` to AW q"iTAR.Ysi')bisxRiqjr,- submittal of Building Permit application. ..mOidN '�i IIEALT BidgApp_2011,doc.revised 06121111 SMOKE / CARBON MONOXIDE ALARMS Otli(NER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 • buildinana cunPrHnn rim PURPOSE n -Lis 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 wheT^ no interior access for inspections are required. - GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke :and Carbon Monoxide alarms. When the valuation of additions, alterations, or .repairs to ex, Telling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require tha'- darms and/or Carbon Monoxide Alarms be installed in the following locations: AREA _ COKE ALARM _ CO ALARM _ Outside of each separate sleeping area in the immedia�_ X X' the bedroom(s) On every level of a dwelling unit includingbasements X Within each sleepin 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 con_- -—rc,ia' In existing dwelling units, alarms are pezautcea to be suic-, " not result in the removal of wall ana ceila� — space. Refer to CRC Section R314 and CBC Sections. 9w..,_ ., alarms which must be connected to the building wiring �(cl avbe solely battery operated. irs or alterations do ily ec, basement or crawl ermit is required for 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 Califon -Lia Residential Codes.. The alarms specified below have been tested and are operational, as of the date signed bolow. C),R�� y,2!�/W a �® Address: Permit No. o ~ -��oC Specify Number of Alarms: 4 Smoke Alarms: °2 # Carbon Monoxide Detectors: �1 nave read and agree to comply with the term.&and conditions of this statement Owner (or Owner Agent's) Name: _. �� Signature....... Dote. ......................... ........................................................................................... ..............�.��3®% Con/tractor Name: qq� jj_ S {�1G'j�'lgl.� ( t"lC'�i7ti�t.Lv Signature...... Lic.# ...........�!................... Date• Z GnnZ-v m7d ('n irn-nv drwl ravivoll W? 711'K CUPERTINO Owner Name Address 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 - buildin2@cuoertlno .or i97�►�,r�'-1� G L L Permit No. 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 foam 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 lambing, 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. ❑ No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 11.01.8 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 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. XYes 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:: 0 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 residehdal real properly. 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). ❑ Myproperty 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 plurnbing 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-cornpliant plurnbing.frxtures will be replaced priorto 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-conseiving plumbing fixtures comply with the requirements as indicated in the table on the following Daae. Owner or Owner Agent's Signature: ' Date: 'f3 - 1 Upon completing and signing this Certificate; Dlease return it to the Building Divicinn in ni-rjPr to final vnnr lhn;rf 4"n .”-;IF SE4072015.doc revised 08/26/15 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 2015.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 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 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 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 J 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 2015.doc revised 08/26/15