B-2017-0631P4
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0631
21868 OAKVIEW IN CUPERTINO, CA 95014-1146 (326 19 107)
HOME DEPOT U S A
INC
ATLANTA, GA 30339
OWNER'S NAME: CASEY ALLENE H TRUSTEE
DATE ISSUED: 04/21/2017
9
OWNER'S PHONE: 406-250-8881
PHONE NO: (770) 443-8211
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO: j
License Class B:C39:C-13 Lic. #602331
1
Contractor HOME DEPOT U S A INC Date 09/30/2018
X BLDG —ELECT _ PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
I
— MECH X RESIDENTLAL — COMMERCIAL ;
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
REPLACE WINDOW (6) - LIKE TO LIKE TO MEET EGRESS,
I hereby affirm under penalty of perjury one of the following two declarations:
REPLACE PATIO DOOR (1)
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 fox 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.
Sq. Ft Floor Area:
Valuation: $5999.00
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
32619 107
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
PERMIT EXPIRES IF WORK IS NOT STARTED i
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR l
Additionally, the applicant understands and will comply with all non-point
-
source regulations per the Cupertino Municipal Code�D�
180 DAYS FROM LAST CALLED INSPECTION.
�gnature
Issued by: AbbyAyende
MAU
Date: 04/21/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
RE-ROOFS: j
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. L as owner of the propert3; or my employees with wages as their sole
installed without first obtaining an inspection, I agree to remove all new materials for
compensation, will do the work, and the structure is not intended or offered for
inspection. 9
sale (Sec.7044, Business & Professions Code)
z. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant: d
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 4/21/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
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.
HAZARDOUS MATERIALS DISCLOSURE
z. I have and will maintain Worker's Compensation Insurance, as provided for by
I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code, for the performance of the work for which this
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and thej
1
s. I certify that in the performance of the work for which this permit issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the
t
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District )
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
-
be deemed revoked.
,Ow en r or authorized agent: 9
APPLICANT CERTIFICATION <Aate:
4/21/2017
I certify that I have read this application and state that the above information is
CONSTRUCd
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a constr ending agency for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is issued (Sec. 3097, Civ C.)
to enter upon the above mentioned property for inspection purposes. (We) agree
Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments, costs, and expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
;
and will comply with all non-point source regulations per the Cupertino Municipal
ARCHITECT'S DECLARATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Licensed
Signature Date 4/21/2017
Si 9
Professional
CONSTRUCTION PERMIT APPLICATION
[a COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
CUPERTIlNO (408)777-3228 • FAX (408) 777-3333 • buildingggZcupertino.org
r-1 MPW(`nR
NCTTTr11
TrnXT 1 1 AT't"Tmr XT I -I . n -_-
BldgApp 2011.doc revised 06121111
PROJECT ADDRESS j % (� G C -- /�
t (J/�
APN # 6 2 o - �('I `s i 0-
cJ/�/w/ "I
OWNERNAME
1 -I6? g�Z (� 7C
PHONE .,Z -c0 4y�5i5 1
7 "b
EMAIL
AIL
S ET ACD+D7R/E(SS�' /`'�
1f R SS
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2�f Z�
FAX
CONTACTNAME JEFF RAINEY
r
PHONE 510-427-4260
F-MALJEFFREY.RAINEY@ATT. NET
STREETADDRESS 1069 EDGEMERE LANE
CITY, STATE, ZIP HAYWARD, CA 94545
FAX 510-783-1041
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR !L CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER
LICENSE TYPE
BUS. LLC #
602331
B,C39,C13
1
COMPANY NAME
E-MAIL
FAX
HOME DEPOT USA
510-357-3750 1{
STREET ADDRESS
CITY, STATE, ZIP
PHONE
2456 VERNA COURT
SAN LEANDRO,CA 94577
510-877-4550
ARCHITECT(ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL.
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK f
1 Aj� � f �1 IJ &J f®
`" A)o
EXISTINGUSE
PROPOSED USE
CONSTRTYPE
#STORIES
f�
USE
TYPE
OCC.
SQ.FT.
VALUATION($)
EXISTG
NEWFLOOR
DEMO
TOTAL
AREA
AREA
AREA
NETAREA
BATHROOM
KITCHEN OTHER
-
REMODELAREA
REMODELAREA REMODELAREA
PORCH AREA
DECK AREA
TOTALDECK/PORCHAREA
GARAGEAREA-DETACH
❑ ATTACH
I
#DWELLING UNITS:
IS A SECOND UNrr ❑ YES
SECOND STORY ❑ YES
BEING ADDED? ❑ NO
ADDITION? ❑ NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RECE '.BY ` -
TOA,L VAI UAT N:
PLANNINGAPPL# ONO PLANNING APPROVAL I ETTER.
EICHLERHOME? ❑NO
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the p?operty owner's behalf. I have read this
application and the information I have provided is correct. 1 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 constructio onze presentatives of Cupertino to enter the above -id tied property for inspection purposes.
Signature ofApplicant/Agent:l
SUPPL INFORMATION RE
pLA-cLct_YPoLzn�rst�_
QYERTH3 GOTTNTER
L� BUILDINGPLANRE'YiEw
New SFD or Multifamily dwellings: Ap)-p>1kf emolition permit for
existing building(s). Demolition permit is required prior to issuance of building
,
permit for new building.
CJ_'
p r ANNIrz rI A t ul>
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
1l sTAtvnnitn
C ruBLlc Fvtiztz
form if any Hazardous Materials are being used as part of this project.
-
_ Copy of Planning Approval Letter or Meeting with Planning prior to
C� AIAatlx;'ER
submittal of Building Permit application.
Q'.:�iS'4'IRQN1y�ICNTAL�BEALT$,.' -,,
BldgApp 2011.doc revised 06121111
LEGEND:
SCOPE OF WORK: REPLACE / INSTALL (6) RETROFIT
® = RETROFIT WINDOW / PATIO DOOR / ENTRY DOOR LOCATION
VINYL, DUAL GLAZED, LOW E, WINDOWS & (1) PATIO
(XOX) = 3 PANEL SLIDER WINDOW
DOOR. NO (N) CONSTRUCTION / REPLACEMENT ONLY,
c u-
(XO) = SLIDER WINDOWNOTE;
WINDOWS / PATIO / ENTRY DOORS;
r~
tet— w
C-)
U -FACTOR = 0.30
= m
DINING ROOM
BATHROOM
MASTER BEDROOM SHGC = 0.250
WINDOW (XOX)
"t
PATIO DOOR
KITCHEN
WINDOW (XO)
80"w x 38"h / (overall)
Imo_ Z CC
71"w x 82"h
WINDOW (XO)
39"w x 25"h
25"w x 34"h / (nt. cir.)
o w o
(TEMPERED)
40"w x 37"h
(TEMPERED)
5.9 sq ft. / (nt. cir.)
w > Q
(egress window)
LO -j
KITCHEN
C:)
BATHROOM
MASTER BEDROOM
DINING ROOM
r
GARAGE
LIVING ROOM BEDROOM 3 BEDROOM 2
U) z o
(egress window) I (egress window) j U
LIVING ROOM ENTRY BEDROOM 3 BEDROOM 2Q
w — V
WINDOW (XOX) WINDOW (XOX) WINDOW (XOX) = j o
721w x 50"h 80"w x 381h / (overall) 80"w x 38"h / (overall) p Z
25"w x 34"h / (nt. cir.) 25"w x 34"h / (nt. c1r.) � ►=
FIRST STORY (FRONT YARD) 5.9 sq ft. / (nt. cir.) 5.9 sq ft. / (nt. cir.) c000 uj
FLOOR PLANOAKVIEW LANE v I v
NOTE:
1). SMOKE DETECTORS: WHEN A BUILDING PERMIT IS REQUIRED, SMOKE DETECTORS SHALL BE INSTALLED; (a) IN EACH SLEEPING ROOM, (b) OUTSIDE EACH SEPARATE SLEEPING AREA IN THE IMMEDIATE VICINITY OF THE ah 04.18.17
BEDROOMS, (c) ON EACH ADDITIONAL STORY OF THE DWELLING, INCLUDING BASEMENTS AND HABITABLE ATTICS BUT NOT INCLUDING CRAWL SPACES AND UNINHABITABLE ATTICS. (CRC 314)
SC"'f NTS
2). CARBON MONOXIDE ALARMS: WHERE A PERMIT IS REQUIRED FOR ALTERATIONS, REPAIRS OR ADDITIONS EXCEEDING $1,000.00, EXISTING DWELLINGS 08 SLEEPING UNITS THAT HAVE ATTACHED GARAGES OR FUEL BURNING WAMY DKW
APPLIANCES SHALL BE PROVIDED WITH A CARBON MONOXIDE ALARM IN THE FOLLOWING LOCATIONS; (a) OUTSIDE OF EACH SEPARATE DWELLING UNIT SLEEPING AREA IN THE IMMEDIATE VICINITY OF THE BEDROOM(S), (b) ON
EVERY LEVEL OF A DWELLING UNIT INCLUDING BASEMENTS. (CBC 420.4, CRC R315). 10B 9983804
sx��r
(HOME OWNER TO PROVIDE BEFORE FINAL INSPECTION). A-1
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 • buildingPcupertino.org '?
Permit No. 20 1 07 _ l:
Address 2l � b'r 040&) &) i, N (,.wrm7 -Jo CA
PURPOSE
This 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 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 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 immediate vicinity of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
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 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 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 with the manufacturer's instructions and in compliance with the California Building
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
1 have read and aaree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
.:A'` ......... ............................................ Date: ...................
Si nature..... ... �
Contractor Name:
Signature. . .......................... Lic.# ...................................... Date: ...................
Smoke and CO form.doc revised 03/18/14
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 • building(a.cupertino.orp
Owner Name —8Ll C p E C 116 c q Permit No.
Address L 1 �6�r 08t -V iL � C 1�� C��� 21I� "ce i�- ��4 N
Please refer to the attached California Civil Code Sections 1101.1 — 1101.8 which are part of this Certification form.
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner' Signature:
lNo Go to Question 2.
Date:
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.
Sign below and skip the rest of the form.
Owner' Signature:
No Go to Question 3.
j __7
v
Date: , Y
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
le
Owner' Signature: L Date: j
VNo 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. Sign below and skip the rest
sof the form.
Owner' Signature: Date: 1� Z
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. Refer to the attached.
[ 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.
SB407 2015.doc revised 02/04/15
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/We, the owner(s) 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 Califo is Green Building Standards Code, and manufacturer's installation
requirements. and that the water-conservin�bing,�(ixj fres comply with the requirements as indicated in the table below.
[Owner's (or Owner Agent's) Signature: �. ``ti `acf' Date: U " 6 (3 -
Upon completing and signing this Certificate, please
it to the Building Division in order to final your permit.
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.
SB4072015.doe revised 02/04/15
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbing Fixture
(Fixture Complying with Current Code Applicable to New Construction)
Maximum
Water Usage/Flow Rate
Fixture Type
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
Water Usage
2013 CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
/Flow Rate
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
0.5 gallons/flush
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
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.
SB4072015.doe revised 02/04/15