The URL can be used to link to this page

B-2017-0595CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0595 10185 PARKWOOD DR APT 5 CUPERTINO, CA 95014-1464 (326 27 037) THERMAL MECHANICAL SANTA CLARA, CA 95054 OWNER'S NAME: AVERY GLENBROOK LP OWNER'S PHONE: 650-961-8330 LICENSED CONTRACTOR'S DECLARATION License Class C-4. 10, 20, 36, 38 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: i. 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 hay 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 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. Z Date 4/19/2017 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). 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. 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. 1 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 4/19/2017 DATE ISSUED: 04/19/2017 PHONE NO: (408) 988-8744 BUILDING PERMIT INFO: X BLDG X ELECT X PLUMB X MECH X RESIDENTIAL ^ COMMERCIAL JOB DESCRIPTION: BLDG #34/UNIT #5; ADD (1) A/C; REPLACE FURNACE, SAME LOCATION; (N) WASHER AND DRYER HOOK UPS; (I) ELECTRICAL SERVICE (70 AMP); (1) GAS LINE FOR STOVE; (1) RECEPTACLE OUTLETS; (I) LIGHT; (1) BATHROOM EXHAUST FANS. 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: Abby ende Date: 04/19/2017 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 ofApplicant: Date: 4/19/2017 ALL ROOF COVERINGS TO BE CLASS "A" 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 25505, 25533, and 25534. Owner or authorized agent: ;bate: 4/19/2017 CONSTRUCTION LENDING AGENCY 1 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 Flym % CONSTRU%".`#TION PERMIT APPLICATION h�()R-M15 C{?MIMUNITY DEVELOPMENT DEPARTMENT a BUILDING DIVISION 10300 TORRE AVENUE c CUPERTINO, CA 95014-3255 (435) 77-1-3225 - FAX (403) 77 7-3333 ❑NEWCONSTRUCTION n ADDITION n ALTF,RATION/Ti n RFVIgrnN/nFFFRRPD ORTCgNAT P17RRQIT�9 PROJECT ADDRESS 10185 Parkwood DR, BLDG 34, Unit #5 APN# OWNERNAME Avery Glenbrook LLC PHONE 650-961-8330 E-MAIL avery@pacbell.net STREET ADDRESS 130 East Dana Street CITY, STATE, ZIP Mt. View, CA 94041 FAx 650-961-0571 CONTACT NAME Rob Moyer PHONE 408-593-8115 E-MAIL rmoyer@thermaimech.com STREET ADDRESS 425 Aldo ave. CITY, STATE, ZIPFAX Santa Clara, CA 95054 408-988-0233 ❑ OWNER ❑ OWNER-BunDER ❑ OWNER AGENT i� CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAMEThermalMechanical LICENSENUMBER 256057 LICENSE TYPE BUS. LIC# 299 C-4,10,20,36.38 cOMPANYNAME Thermal Mechanical E-MAIL rmoyer@thermalmech.com FAX 408-988-0233 STREET ADDRESS 425 Aldo ave. CITY, STATE, ZIP Santa Clara, CA 95054 PHONE 408-988-8744 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # 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 PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTALDECKNORCH AREA GARAGEAREA: DETACH ❑ ATTACH I # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEINGADDED? ONO ADDMON? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL# NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLERHOME? ONO D BY: TOTAL VALUATION: By my signature below, I certify to each ofthe following: I am the property owner or authorized agent to act on 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 to building c truction. authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date:_q/ /� / t Y SUPPLEMENTALAFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER THE -COUNTER VIlUELDING 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. ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure �❑�RESS V 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 EIMAdoR El SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doc revised 06121111 lam CUPERTINO PURPOSE 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 • building(a)cupertino.org PEIt11�I I "CANlv'U I' I3I♦;:..FINALED'UNTII, THIS CERTIFICATE HAS.i3EEN COIL' P .ETED 'SIS {D .A.NP'RF-T'UANF_D%TO THE BUILDING'DI-NTISION flus ittidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms I -or Compliance with 2013 CRC Section R314, 2013 CBC Sections 420 6 and 907.2.11.2 where no interior access tnr inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon i\/Ionoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000 00, CRC Section 8314 and CBC Sections 907.2.11.5 and 420 6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the folloviing locations. �— AREA _ — SMOKE ALARM_ CO ALARM i Outside of each separate sleeping area in the immediate vicinity of X X� the bedroom(s) _ On revery level of a dwelling unit including basements _ X I X - L Within each sleej : rClon1 _ - X T (=arbor Mono -vide alarms are not required in dwellings which do not contain fuel -burning appliances Lund that do riot have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with C'BC Section 420 6 and sh all be approved by the Office of the State Faire Marshal. Power Supply' 111 dwelling units with no commercial.poiver supply, alarm(s) may be solely battery operated. Ti 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 crave=1 space. Refer to CRC Section R314 and CBC Sections 907.2.114 and 420 6.2. An electrical permit is required for alarms which must be corulected to the building wiring As ojA7ner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed inn 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 sighed below Address ;?�&41&C'j00JP4 � �� P/' S� Permit 1\To.ff-201i-0T_?5 Specify Number of Alarms f Smoke Alarms 1 / ! t Carbon Monoxide Detectors I have read and agree to comply with the termaand conditions of this statement Owner (or Owner Agent's) Name• 1/1'4'o ale' �'%; _ -- Signature ,Y'' Date:7BS Contractor Name: `7 Signature t Lic.# 6&1 Dater 40/ c —7---4 r -n f 7-- ,.,,,r 1)nn7i; -1 )wner Name 1 dress WATER -(CONSERVING PLUMBING FIXTURES F OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 IanP%77z_q?')P . GaY IAOQN 777_-- I . Is your real property a registered historical site? i 1 Yes Civil Code Sections 1101.1 through 1101.8 do not apply: Skip the rest of the form and sign bottom of form. P 1. 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? 1 7 .Yes Civil Code Sections 110 1. 1 through 1 10 1.8 do not apply. i The licensed plumber's certification has been provided to the Building_ Division. Skip the rest of the form and sign bottom of fonn. 7 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. Yl No Go to Question 4. Is your real property kiilt and available for use or occupancy on or before January 1, 19949 F] 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 bottoin of form. I Yes My real property is built and available for use or occupancy on or before January 1, 1994. i \ 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: 17 Myproperty 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-coanpliant phunbing 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 777.ultifaMily residential real property. See Civil Code Section 1101.5. On and after: January 1, 2014, specified building alterations or irrrproveinents 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 Nvhether property undergoes alterations or improvements). My property is a c0777777ercial 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-conseiving 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-compliant 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-conseiving plumbing fixtures comply with the requirements as indicated in the table on the following page. '' 1 Owner or Owner ' A ents Signature- � 7_ ��-"-_f�� >�rt� 9 9 _ _ Dates c? Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SE407 2015. doe remised 0812611.5