B-2017-1065CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1065
11757 PINE BROOK CT CUPERTINO, CA 95014-5113 (366 04 055)
WAI YUEN CHAN
CONSTRUCTION CO
SAN JOSE, CA 95132
OWNER'S NAME: CHENG SIMON T AND ASHLEY L
DATE ISSUED: 07/03/2017
OWNER'S PHONE: 408-218-0070
PHONE NO: (408) 316-0366
LICENSED CONT A TOR'S DECLARATION
BUILDING PERMIT INFO:
License Class a Lic. #972817
Contractor WAI YUEN CHAN CONSTRUCTION CO Date 05/31/2018
X BLDG —ELECT —PLUMB
MECH X RESIDENTIAL COMMERCIAL
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.
JOB DESCRIPTION:
REMODEL 1 ST FLOOR AND 2ND FLOOR HALLWAY BATHROOMS
I hereby affirm under penalty of perjury one of the following two declarations:
(60 S.F.)
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.
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
Sq. Ft Floor Area:
Valuation: $16000.00
permit is issued.
APPLICANT CERTIFICATION
1 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
36604 055
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
may accrue against said City in consequence of the granting of this permit.
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally, the applicant understands and will comply with all non -point
source regulations Per the Cupertino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature '�eA Date 7/3/2017
Issued by: Abby Ayende
OWNER -BUILDER DECLARATION
Date: 07/03/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
1. I, as owner of the property, 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.
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 7/3/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
t. 1 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
2. 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 the
3. 1 certify that in the performance of the work for which this permit is 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
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the t upertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Coft,,Sections 25505, 25933, qd 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent:�F---
APPLICANT CERTIFICATION
Date: 7/3/2017
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a construction lending 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 7/3!2017
Professional
@-)-1.mT - totes
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (406) 777-3333 - buiidingagugertino.oro
❑ NEW CONSTRUCTION ❑ AMMON ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #
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13 OWNER ❑ OWNER-BBUURDER ' OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGIT'EER ❑ DEVELOPER ❑ TENAN'T
CONTRACTOR NAME Ai , q.� ,,) ^ _ I
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ARCHITECT/ENGINEER NA1viE✓`' LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK 2 6 f H jai ((x
EXISTING USE
PROPOSED USE CONSTR.TYPE
#STORIES
USE TYPE
OCC,
SQ.FT.
VALUATION (S)
EXISTG
NEW FLOOR
DEN,0
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN
OTHER
REMODEL AREA
REMODEL AREA
REMODEL AREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: DETACH
[]ATTACH
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# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY YES
BEING ADDED? []NO
ADDITION? []NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF '
IS THE BLDG AN ❑ YES
RE IVE BY s
TOTAL VAL AT70N:
PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
x Y'AWOUL
By my signature below, I certify to each of the following: I am the property owner or authorized agent to ct on Ae property owner's behalf. I have read this
application and the information I have vide is correct. av read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to b " g co�tructi orize representatives of Cupertino to enter the above-id�fiedproperty for inspection purposes.
Signature of Applicant/Agent: Date: 11 f 77
(
SUPPLEMENTAL INFORMATION REQ D
M _N cxc_ck 7- PE ROUTT-1,'G, SLIP
I �—\t
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
O\SLR rE-COL'��iFR Tl ,`i i 13 R'�
permit for new building.
,
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
_ r.,Ni:-
Form if any Hazardous Materials are being used as part of this project.
LiI:GE
_ Copy of Planning Approval Letter or Meeting with Planning prior to
r -,
submittal of Building Permit application.
BldgApp_2011.doc revised 06121111
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
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 alarni(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: 1 .�7 cPii1 16— bZav< C 7,uo CA Permit No. , / Z 0
Specify Number of Alarms: #Smoke Alarms: =# Carbon Monoxide Detectors: I 7 1
I have read and agree to comply with the, terms and conditions of this statement
p rnerf(orOwnerAgenrt_'s)Name:
Vd��l1�i� �r l�
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Signature.✓.....r.''--.................��:.............,............................................... Date:�'�(( I
.........................................................................................................................
Contractor Name:
/64M"
Signature... `/'L/ ... Lic.#�r ........ DateWC�,%
Smoke and CO form.doc revised 09127/16
G.UPERTINO
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT , BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
1 I (408) 777-3228 • FAX (408) 777-3333 • buildincl(Wcupertino.org p f
Owner Name u `1 �� C-6ay, Permit N6.6- 2,4(1 " (06 5-
Address
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:
VNo 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:
L9/No Go to Question 3.
Date:
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.
- Owner' Signature:
M No Go to Question 4.
Date:
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 of the form.
Owner' Signature: Date:
Lg Yes My real property is built and available for use or occupancy on or before January 1, 1994.
1 Civil Code Sections 110 1. 1 through 1101.8 apply. Refer to the attached.
M 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.
SB40 7 2014. doc revised 03/18/14
1. If the existing plumbing fixture water usage/flow rate is equal to or lower man the ngure snown, n is not requires io oe upgraueu.
SB4072015.doc revised 08/26/15
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.Zgallons
Maximum 1.5 gallons per
Within unit's:
0.5 gallons per minute @ 60
Lavatory
per minute
minute g60 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 pe`r
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 man the ngure snown, n is not requires io oe upgraueu.
SB4072015.doc revised 08/26/15