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Home My WebLink AboutB-2017-1989CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR:- PERMIT NO: B-2017-1989 21529 TERRACE DR CUPERTINO, CA 95014-4741 (356 20 012) WHEN QUALITY COUNTS INC MENLO PARK, CA 94026 OWNER'S NAME: SHASTRI SUBRAMANIAM S TRUSTEE & ET AL DATE ISSUED: 11/16/2017 OWNER'S PHONE: 650-714-5240 PHONE NO: (650) 323-6464 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-36 Lic. #979380 Contractor WHEN QUALITY COUNTS INC Date 08/31/2019 X BLDG —ELECT X 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 SEWER MAIN; PROPERTY LINE CLEAN OUT I hereby affirm under penalty of perjury one of the following two declarations: t. 1 haveandwill maintain a certificate of consent to self -insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the rformance 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: $7000.00 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 356 20 012 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 Cupertiinn`o�MMbnicipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 000 �. 'gnature / Date Issued by: Abby Ayende Date: 11/16/2017 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 (See.7044, Business'& Professions Code). Date: 1 hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 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 z. 1 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 a. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should 1 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 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. caner or authorized agent: APPLICANT CERTIFICATION Date: I certify that I have read this application and state that the above information is CONST IO ENDI G 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 expenseswhich 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. Signature Date Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION B. 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255Jim, (408) 777-3228 • building@cupertino.org PEMIT #B - l CUPERTINO REV# DEF# ❑ NEW CONSTRUCTION ❑ADDITION ❑ ALTERATION ❑ T.I. ❑ MEP ❑ RE -ROOF ❑ SWIMMING POOL/SPA PROJECT ADDRESS L ^ 1 r)A Tam c t D • ✓) APN # — ! 0 — O Z OWNERIT PHONE 020714 9240 E-MAIL &J4+.0e4- STREET AD RESS 212 T"r r. CITY, STATE, ZIP , C' CONTRACTORNAIWE ❑ OWNER -BUILDER COMPANY NAME LICENSE NUMBER LICENSE TYPE eta nrnv� �eDawhom Pluxe STRNRRESS .,r 7 CIT�,STAWD ed 04-u E-MAIL COVrfAGFuS e IOOI SYl DYQ IU,hI 1'S PHONE &5P 32TT''3 6 4 � 0 BUS. HLIC Vh'32 ❑ ARCHITECT' ' ❑ OWNER ❑ OWNERAGENT ffCONTRACTORAGENTE3 ENGINEER ❑ DEVELOPER ❑ TENANT CONTACTNA'— -&L ft , —e &J J �l v (! E-MAIL n l.u'Abe.r5. CC) hl STREET ADDRESS Same- 6S Cc�h itCbr CITY, STATE, ZIP PHONE DESCRIPTON reAft0t imx l ill e -4 4v y � Ind, e4 D I,L ❑SINGLE-FAMILY/DUPLEX ❑MULTI -FAMILY ❑ INDUSTRIAL ❑ COMMERCIAL USE TYPE OCC SQ.FT. VALUATION ($) EXISTING USE JEXIS7*G'SF .I NEW FLOOR SF PORCH SF DECK SF I DEMO SF I STORIES # TOTAL NET SF REMODEL REMODEL KITCHEN I REMODELOTHR GARAGE ❑ ATTACHED BATHROOM SF SF SF SF ❑ DETACHED EXISISP�KLE� ❑,NO FIREO IICHLER ❑❑ NO SECONDSTORYADDI7fON DWELLING []YES ❑ ATTACHED❑ DETACHED OTHER JsEcONbDwELLING UNITS # UNIT ADDITON: ❑ NO S F I POOLS ❑ FIBERGLASS ❑ VINYLLINED ❑ GUNITE ❑ PREFABRICATED POOL- SF ' "SPA - SF SPA ATTACHED ❑ YES ❑ NO TOTAL - SF RE BY: AL VALUATION: Commercial or Multi-Timtilu Buildings with Public Swimming Pools requires Department of Environmental Heath approval RE -ROOF EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ E OTHER (SPECIFY) REMOVE /REPLACE ❑ NO IF NO PLYWOOD ❑'h' E13/8- PLYWOOD TYPE: PITCH_ '12 ROOF CLASS []YES( #OFLAYERS THICKNESS❑5/8" OTHER Dom ❑CDX OTHER 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 signatureibelow 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. 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 construction. I authorize representatives of Cupertino to enter the above -'identified property for inspection purposes. I acknowledge and authorize all information contained on this application form. to be made available for public record. ;Signature of Applicant/Agent: - Date: r? 'SUPPLEMENTAL INFORMATION R UIR *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. WHOA-Provide-a,letter of approval from the Home Owner's Association BldgApp_201 7. doc revised 08/01/17 CUPERTINO SANITARY DISTRICT 20863 Stevens Creek Blvd #100, Cupertino, CA 95014 Tel (408) 253-7071 • Fax (408) 253-5173 w^ sr �rIs rQLr, I S 1t TD*' CUPERTINO SANITARY DISTRICT PERNHT I,'DI�R Cupertino Sanitary District has adopted Resolution No. 1263. Building Permit Request (Over -the -Counter) ❑ Single Family Project ❑ Multi -Family Project ❑ Commercial Project Project Address: 7 py-fan __e _ ut-, Permit Number: _ "��— ` q Scope of Work: Owner/Applicant Name: (k!Q <,-kccl bafes Phone: (&S(j) Z -4� V �tf Address: 215 b 1 Date: r WlV:�_ Prepared By: Authorized Representative 1, as property owner or authorized agent, acknowledge that all Cupertino Sanitary District requirements will be met and all'required fees will be paid. prior to the approval of final inspection for proposed project. Date: 1 Signature: Owner/ Authorized Agent c<' CUPERTINO SANITARY DISTRICT OFFICE USE ONLY kPre-inspection Required Final Inspection uired ( ate Scheduled: Date: �` 1 Conditional Approval By: Authorize Representative Cupertin6 Sanitary District District will notify.owner of the required fee within 5 days after Pre -Inspection has been completed and cc City of Cupertino. ❑ Inspection Fee Paid Date Paid: Inspection Fees: l $250/unit - Single Family Residential already connected, but new cleanout is required $150/unit - Single Family Residential already connected with existing cleanout in working order $350 Minimum — Commercial and Retail Actual Amount: $200/each — Disconnect and/or abandon lateral service Connection 'Permit Fees: $350/unit - Single Family Residential connecting to existing lateral D $650/unit — Single Family Residential connecting with new lateral $1 d0/unit — Multi, Hotel, Living Units, etc. Actual Amount: $500/connection - Commercial and Retail Actual Amount: Connection Use Fees (See Attached Calculation Sheet): D Area and Frontag'e Fees Amount: D. Residential Excess Fees over 3.5 unit/acre Amount: Commercial and Retail Connection Fees Amount: D Commercial and Retail Change in Use Fees Amount: Date: Final Approval By: Authorized Representative Cupertino Sanitary District 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 • build ina(a-)cupet no.ora I'ER1I�IIT CAIUN�T �E,F,I��AL��I. UNTI3s TSS CEi2TI�'I��TE �7A5-BEEN: CoLT% I NETt TI IETTEI) TO THE B1TGI�II�iGIVISIO . ... 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, R315, 2016 CSC 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, 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 ALARM 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 dwelling 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 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 P 2��7 Address- 2 � Jr2� Temate- Dr Permit No0 Specify Number of Alarms # Smoke Alarms =#Carbon Monoxide Detectors -- 1 have read and agree to comply with the termsrd co�of this statement -9wreF(a Owner Agent's) Name: VA 'I I"a�— Signature ................................ ...... ...... .... I .. .. ........... ....... ......... Date: .f..... ... Contractor Name: Samtei l Signature Lic,# 0171,39'0 Date: 17 Smoke and COforrn.doe remised 0111012017