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HomeMy WebLinkAboutB-2017-0333CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0333 23500 CRISTO REY DRUNIT •511H CUPERTINO, CA 95014-6535 (342 53 250) �BAYAREA SAN JOSE, CA 95148 IOWNER'SNAME: MOI -IR JHENRY TRUSTEE &ET AL I (DATE ISSUED: 03/02/2017 OWNER'S PHONE: 650-537-1523 I I PHONE NO: (408) 238-5043 License Class GENERAL BUILDING CONTRACTOR Lie. # 18 7817 Contractor BAY AREA ENTERPRI Date 03/31/2017 I hereby affirm that I am 13eensed Eder 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: t. 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. rz ` 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 11 ` permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agrge 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 perVe Cupertino—Municipal Code, Section 9.18. Date 3/2/2017 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) z. . 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: r. 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. z. 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. 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/23 /2017 BUILDING PERMIT INFO: BLDG X ELECT _PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: UNIT 511H - INSTALL (I) LED RECESSED LIGHTS (7); REPLACE BATHROOM FANS (2); REPLACE OUTLETS (23); REPLACE LIGHT SWITCHES (14) Sq. Ft Floor Area: Valuation: $3000.00 APN Number: Occupancy Type: 342 53 250 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby A, en de Date: 03/02/2017 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 3/2/2017 11 A 11 HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health &Safety Code eJcf ns 255 33, and 25534. Owner or authorized agent: Date: 3/2/2017 - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional t CONSTRUCTION PERMIT APPUCATIk*-= . COMMUNITY DEVELOPMENT DEPARTMENT a BUILDING DIVISION 90300 TORRE AVENUE o CUPERTINO, CA 95014-3255 CLlElt-'El.T1$+f0 1 (408) 777-3228 • FAX (408) 777-3338 - building &cuDertino.orct ❑ -Nmv CONSTRUCTION ❑ ADDTFION TERATION / TI Q REVISION f DEFERRED ORIGINAL PERMIT # PROJECT ADDRES$,— ® n�6 e - - APN A " OIVNER N ME PHONE til ►E E-MAIL � � f;k- IA c, o_53r?_ tS'2.3 g a� sc •c6c4 STREETADDRESS CITY, STATE, ZIP FAX t CONTACT NA141ETr e S T P D a� $ i! E-hSAIII' `� �b-Z`f 4, c O in STREET ADDRESS(? rV CM. STATE, ZIP FAX 7-110 }� GVt cT 0 OWNER D OXVNER BUILDER 0 OWNERAGENT ice+ CONTRACTOR D CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER © DEVELOPER 0 TENANT CONMAC'TORiVAME 5r t'a.e UNI LICENSENBER LICENSETYPE BUS.LIC C01,iP,kNY N1V,'IE `5 £-hLAU f� r FAY r a A e cs� n e e U��I .0 o STREETADDR[*ESS/y CITY, STATE, ZIP 0 p #1 M C ARCHI'rECT/ENGtNEER NHME LICENSE NUMBER BUS. LIC n CONIPANY NAME E -.LIAR.. FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF8 tV iuc L ,- ct'�'k Roots v'1%0o le S W kT --- -� C W s Et iS SE PROPOSED USE CONSTK TIM ST USE TYPE OCC_ SQ.FT_ VALUATION(S) EXISCG NEW FLOOR -DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODELAREA i PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGEAREA:DETACH O ATTACH, #DWELLING UNITS: ISASECONOUNrr OYES SECONDSTORY OYES BEINGADDED? ONO ADDITION? ONO PRE-APPLICATfON OYES IF YES, PROVIDE COPY OF ISTHEBLDGAN OYES RECEIVED BY:UAATOTALVALUATIONj-- PLANNINGAPPL# ONO PL-,1Mi NGAPPROVAL LETTER EICHLER HO&IE? ONO. eQ n 3 irin �ry By my signature below, I certify to each of the follow g: I am the property owner or -authorized agent to kt on the property owner's behalf I bane read this application and the information I have provided is co . I ha d the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building cons etion- I a 0tIZe representatives ofCupertino to enter the above -identified property for inspection purposes_ Signature of ApplicantiAgenr SUPPLEMENT INFORMATIONREQIIIRED PLANCHECKTYPE ROUTINGSLIP [ OVER-TH&COUNTER BUILDING PLAN REVIEW New SFD or Multifamily dwellings: Apply for demolition peYn2it for _ existing building(s). Demolition permit is required prior to issuance of building permit for nein building. ❑ rxpRESS Q PLANNING PLAN REVI4V Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 0 STANDARD ❑ PUBLIC WOM _ form if any Hazardous Materials are being used as part of this project O LARGE 0 FIRE DEPT _Copyo€Planning Approval Letter or Meeting with Planning prior to © TWAJOR © SANITARY SEWERDISTRICT submittal of Building Permit application. D Etv'VIRONMENTALHEALTH Bld&4pF 201 Ldoc revised 06121111 CUPERTINO 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 • build ing(a)cupertino.org PURPOSE This affidavit is a self -certification for the 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 OFof each separate sleeping area in the immediate vicinity of the bedroom(s) - (Smoke alarms shall not be located withiva 3 feet of bathroom door) X X On every level of a dwelling unit including basements and habitable attics X X—_j jvWithin each slee ing room. _ _ X Carbon Monoxide alarms are not required in dwea-igs wlai.ch 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: Ira 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 pen -nit is required for alarms which must be connected to the building wiruag. 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. Address: `e 'j '` r 1—Te 1Z r 11 Permit No. 2- 011 r g w Specify Number of Alarms: " Smoke Alanlns: :E Carbon Monoxide Detectors: 1 have read and agree to comply with the terms and conditions of this statement O r Owner Agent' Name: �f ............................................................. Date ./.......... Si...:................. ....... nat ..........�� Contractor Name: Signature.. ................................................................ Lic.#...................................... Date:.................. Smoke and COform.doc rerised 01/1012017 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT; BUILDING DIVISION CUPE NO I 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408 777-3228 • FAX (408) 777-3333 • buildingocupertino.org Owner Name,� Permit No "`'0 (7 C)- ✓f Address i� 1 -5, , a A e�'� � *311 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. 4P 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? ❑ 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 1101.8 do not apply. Skip the rest of the form and sign bottom of form. tR 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 Januaiy 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: I - My property is a single family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or iinprovements 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 iinprovements). ❑ 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 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). I, as the owner or owner's agent of this property, certify under penalty of perjury that non-coinpliant 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 imae. ., Owner or Owner Agent's Signature: ,�/d a_ ! Date: Upon completing and signing this Certif e&4t 'please return it to the Building Division in order to final your building permit. SB4072015.doc7•evised 08/26/15