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Home My WebLink AboutB-2017-1464CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1464 10383 COLBY AVE CUPERTINO, CA 95014-2421 (316 29 021) ON-TIME AIR CONDITIONING & HEATING INC . PLEASANTON,CA 94588 OWNER'S NAME: JENKINS DALE S AND FRANCESCA G TRUSTEE DATE ISSUED: 09/01/2017 OWNER'S PHONE: 408-973-1506 PHONE NO: (925) 872-7326 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-20 Lic. #817040 Contractor ON-TIME AIR CONDITIONING & HEATING INC Date 09/30/2019 X BLDG _ELECT ?C 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: REPLACE 40 GAL WATER HEATER - SAME LOCATION I hereby affirm under p ty of perjury one of the following two declarations: 1. I have an - dl maintain a certificate of consent to self -insure for Worker's Com sation, as provided for by Section 3700 of the Labor Code, for the p ormance of the work for which this permit is issued. 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: $2858.00 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 APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 316 29 021 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 o e granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and I comply with all non -point source regulations per the Cupertino M icipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 0gneture Date 911/2017 Issued by: AbbyAyende Date: 09/01/2017 OWNER -BUILDER DECLARATION 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 t. 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) z. 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: 9/1/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER r. 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 i. 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. 1 will permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the a. 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 material. Additionally, should I use equipment or devices which emit ardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Manage t District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Municipal Cod apter 9.12 and exemption„ I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Se ' 25505, 255 ,and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked, ner or authorized agent: :APPLICANT CERTIFICATION Date: 9/1/2017 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. I understand my plans shall be used as public records. Signature. Date 9/1/2017 Licensed CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 .12 (408) 777-3228 • building@cupertino.or; PEMIT #B - ZO I C? CUPERTINO REV# DEF# n XTRW C'(_)N1;TRTT('TI0N I—LAr)T)TTTnN 7 AT.TFRATTON 7 T T 7 MFP 7 RE -ROOF I—I SWIMMING POOL/SPA PROJECT ADDRESS ! a /s. • `�/CJs14- A'N I ' OWNER NA PHONE JE-MAIj STREET AD ESS CITY, STATE, ZIP ANTRACTOR NAME ❑ OWNER -BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE S EETADDRESS / Zo G' CITY,2 ZIP E (f� If e"d PHONE BUS: LIC # - SS.� ❑ ARCHITECT ❑ OWNER ❑ OWNER AGENT WZQNTRACTOR AGENT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTA � cru L E- � dC 4AAP STREET ADDRESS/ G CITY TATE, ZIP �( P �IGL��cG - DO 5 ONE �/ � Jam. DECRIPTON . co INGLE-FAMILY/DUPLEX ❑ MULTI -FAMILY ❑ INDUSTRIAL ❑ COMMERCIAL 'USE TYPE OCC SQ.FT. VALUATION ($) EXISTING USE I EXISTING SF NEW FLOOR SF PORCH SFDECK SF DEMO SF STORIES # TOTAL NET SF REMODEL BATHROOM SF REMODEL KITCHEN SF REMODEL OTHR GARAGE SF SF ❑ ATTACHED ❑ DETACHED EXISING [3 YES SPRINKLERS [3 NO FIRE YESNO EICHLER 0 YES SECOND STORY ADDITION NO DWELLING SECOND DWELLING ❑ YES [3 ATTACHED ❑ DETACHED I OTHER UNITS # UNIT ADDITON:, ❑ NO S F POOLS ❑ FIBERGLASS ❑ VINYL -LINED ❑ GUNITE ❑ PREFABRICATED POOL - SF SPA - SF SPA ATTACHED ❑ YES ® NO TOTAL - SF Commercial or Multi -Family Buildings with Public Swimming Pools requires Department of Environmental Heath avproval RE 12 ED BY: JT� AL)V t[ION: Cr RE-ROOF EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES❑ WOOD SHAKES ❑ WOOD SHINLES TILE OTHER (SPECIFY) REMOVE /REPLACE[:] NO EI ygg I IF NO # OF LAYERS PLYWOOD ❑ ,h„ ❑ 3/8" PLYWOOD THICKNESS ❑ 5/8- OTHER TYPE: ❑ OSB E]CDX OTHER PITCH: .12 ROOF CLASS A PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER *Provide a signed copy of the Cupertino's Tear -Off Policy SF #of SQUARES By my signature below I certify to each of the 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. T ave read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws rela ' jg,fo–building construction. I authorize representatives of Cupertino to enter the above -identified property for inspectiposes. I a owledge and authorize all information cont ' ed op this application form to be made available for public record. Signature of Applicant/Agent: Date: / SUPPLEMENTAL INFORMATION REQUIRED *New SFD/Second Dwelling Units/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new construction: *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. *HOA -Provide a letter of approval from the Home Owner's Association BldgApp 2017.doc Devised 08101117 CUPERTIN O 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 • buildinana.cupertino.org P RIIIIT C: N flT:V- 1I1 AIS UNTI :T S CERTIF C -ATE _HAS B El CO L�T�➢,-��N� ANI'.RF I'LTI2 n TD fiH�: $I7iIJIiIl�GiiIVISION: 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, 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 Monoxid&,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 907.2.114 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 specified below have been tested and are operational, as of the date signed below Address- UE- A \/L:: , u p zn),j ®} e Q 9'SO) � Permit No. - 2-0 Specify Number of Alarms: # Smoke Alanns. _:-Z�. 1 #_Carbon Monoxide Detectors 1 have read and agree to ca ply with t1ielerms and conditions of this statement Owner (or Owner Agent's) Name:�7 Signature ®/ 6�1 >J. �c 5 : v,'x-) V_ i .1S . �.. c� Date: Contractor Name: Signature Lic.# Date. Smoke and COfo»n.doc revised 12/15/16