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B-2017-0615CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0615 802 S BLANEY AVE CUPERTINO, CA 95014-4551 (369 27 014) F W H ACQUISITION CO LLC BOTHELL. WA 98011 OWNER'S NAME: SETH RUYBEN AND MEENU OWNER'S PHONE: 408-517-1493 LICENSED ONTRA TOR'S DECLARATION License Class C-36 Lic. #987398 Contractor F W H ACQUISITION CO LLC Date 10/31/2017 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. 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. 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. 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, V Date 04/19/2017 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). 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. 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 CFRTiFICATION 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 04/19/2017 ISSUED: 04/19/2017 PHONE NO: (425) 636-7078 BUILDING PERMIT INFO: X BLDG —ELECT X PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: (N) 50 GAL WATER HEATER - SAME LOCATION Sq. Ft Floor Area; I Valuation: $4086.74 APN Number: Occupancy Type: 369270 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 04/19/2017 All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 04/19/2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sec '0 25505, 25533, and 25534. t � Owner or authorized agen� Date: 04/19/2017 CONSTRUCTION LENDING= AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional 04/17/2017 MON 15:3$ FAX Fast water Heater Ijd00'L/016 89$'18 GENERAL PERMIT APPLICATION 13 rho 1-T -06XMEP IQ COMMUNITY DEVELOPMENT DI=PARTIJIENT • BUILDING DIVISION 10300 T4RRE AVENUE • CUPERTINO, CA €36094-3206 misc C U P ERTI N O (400) 777.3228 - PAX (406) 777.3333 • bltlld�QAOU RQ bo.,a V ILUM1i1N0 I._IklIrHANICAL 1- IFF-rw-rRli:,U, L I'Ailk 18-LA1Jnnur, MEN I''JtWHff A13DR %9 802 S 81 ANEY AVE APN P OWN11kNAMII SETH, RUYBEN 4085171493 Mf-PTADDR1Z-35 802 S BLANEY AVE CITY, sIATr aJr CUPERTINO CA 95014 PAX---�---- CONTACT NAME Katy Kehle FAST Water Heater PflONR 425-038-7084 "Au-KKehlewastwatera#er.com �he STRtiiii AC1t�it$ss 11715 N Creek pkwy S. C-106 C1TY,STA'rra 21P Bothell WA 98011 rAX 13 owmm 13 UWNIIRIsC=RAC11=AOENr 13 At1T11CT 0 UNUM -ER 0 DI:VEL.017:N Q IttldANI M OWNGRiGENT CWT[RACIOR ❑ RCI YurLULm CONTRACTORKAML FAST Ater Heater eater LICIENSENUMBER 987398 FLACENSEMW C36 r y 6llS.11C�1 99 100 01 COMPANYNAM6 FAST Water Heater � M''"' KKeblaf�ft7astwaterheater.com rAa 425-636-7085 sTtu.Irrnlrlal:>rss 11715 N Creak Pkwy S. C-106 Bothell WA 98011 Pl'(NE425-636-7064 11COtSCNUAI)iE 4/ P..Mh _ LVANYMA1.4 ITY,SIATH, ZIP TIAI\Z4R�9S 11 USE' Or risrrDupme'Y (] mull-jimLY PROJPCI'INW[I.ItLAA9? Q Yes nVILItrNO• ❑ CDMA51,WtAL (JWJAN rA71'RI'A(:t: AK1,A rj NA 11WIECI IN VON 11I4UJlzWir U NO ispictumAR E3 va 111011t.0 1{t1W [3 �tl DESCRIPMN OF WORK •. {ted J' {.d L JC � � ]ih'; L \ ! S V \ �//tJ��'i��;��,. ,_. •—._"_•�,!_ ��'� r ,1/ y 1.+/� ,�U TOTAL VALUATION: $40080,71By my slgnumv Wow. 1 ocrffl t to each of the fallowing; I !tilt 1110I)MIMNY awriCM imil1itrimil tiViil mm onthe property WVhM'b Ixh9lf. I ImoC rmd thiel npIxIIC0licu mid (IV lnfonRiadOg 1 hair Innrided is ca+necl• 1 have lead O,o new! iALian or Welk n+Id veri1}' It is Bccume. l agree to C0111ply vrltlt 9119pplicoble Imal 01dilmms and Slue lom m1m;a,a W Itil a osirpcli n. I Lit �1Ye ICptC9CrwiAti+es ofChpelliJJa to colo iheabole•identil7eJprdlleRy fur mSpee[iun InJrnoFas. 5lgn9tumorAppllcal+l/Agcnt: _�� I�IIt�: T _ T.4/'i 7/2017 -)y SUPPLEMENTAL INkO1RI WHON REQUIRED 0MCK USE ONLY _ o►'lili-i111u=ttlhrttJik EXPRESS STANDARD LAROP• ti11.1 �bfrsc:4p/I 2 t 1.r{ae rnWm.) 06/21/11 fI 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 • buildinq(a.cupertino.ora PURPOI'D r; 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 inspectionsare 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 ALAR_ M Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) — (Smoke alarms shall not be located within 3 feet of bathroom door) X X On every level of a dtivelling unit including basements and habitable attics X X Within each sleeping 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 commercial power supply, alarm(s) may be solely battery operated. In existing dwelling emits, 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 permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance tivith 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:- S y Permit No. V•�i' Specify Number of Alarms: G N Smoke Alarms:�1 #Carbon Monoxide Detectors 1 have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's)( Name: PWei ✓ t�° Signature .... .......................................................................................................... Date:FMo Contractor Name: Signature...................................................................... Lic.#....................................... Date:................... Smoke and CO for•m.doc revised 01/10,Q017 CUPERTINO 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 • buildingCa.cupertino.org Owner Name 90a ljs&w Siyi Permit No 6 -- 11_06�15, Address -2—� C 'L=ip �''�t} Pff/ Me A- q 5 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. " 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 110 1. 1 through 110 1. 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. X 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. P9 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: 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 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 improvements). ❑ My property 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-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'Califomia 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 followina Daee. Owner or Owner Agent's Signature: Date: 51361 Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB4072015.doc revised 01105117