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Home My WebLink AboutB-2017-2195CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR. PERMIT NO- B-2017 2195 1211 BELKNAP CT CUPERTINO, CA 95014-4904 (362 10 020) F W H ACQUISITION CO LLC BOTHELL, WA 98011 OWNER'S NAME. WU ANDREW OWNER'S PHONE. 510-529-5977 LICENSED CONTRACTOR'S DECLARATION License Class C-36 Lic. #987398 Contractor F W H ACQUISITION CO LLC Date 10/31/2019 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. I 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 petfonuance 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 Date 12/21/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the stricture 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: 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. 2. 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 trust forthwith comply with such provisions or this permit shall be deemed revoked, ' 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 prdinances 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 12/21/2017 DATE ISSUED- 12/21/2017 PHONE NO: (425) 636-7084 BUILDING PERMIT INFO BLDG —ELECT X PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION REPLACE 50 GAL WATER HEATER (SAME LOCATION) Sq. Ft Floor Area. lVatuation. $1583.59 APN Number- Occupancy Type: 362 10 020 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION Issued by- Abby Avende Date: 12/21/2017 RE -ROOFS: 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: 12/21/2017 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, Sections 25505, 25533, and 25534. Owner or authorized agent: Date: 12/21/2017 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 Professio 12/05/2017 TUE 10, 53 FAX Fa.at Water He:ztpr 0007/019 A- 801032 GENERAL, PERMIT APPLICATION MEP 6044 ti1U14ITY DEVELOPMENT" DEPARTMENT - BUILDING DIVISION 10300 70RRE AVENUE + CUPERTINO, SCA 96(j14.32mi 'm1sc C U P E RT1 N0 (408) 777.3226 FAX (406) 777-3333or� �� &ful tINAMUn 1 1•f I A111f'11ANL 1 1—f 1Thm.r-1"TRti^m I.. 7 IAili:fMI3"A"ww)IJ5 P1LO]Pf AIJD0.I:49 12`11 13Et_KNAP WT. - -. - AIPN A WU, ANDRE KIWI 5105295977 STIt'RPT'ADDR-1-M 1211 BELKNAP CT CITY, s-JATIa ZIP CUPERTINO CA 95014 F+1R COMTAC( NAMGI\C � Kittle FA57. Water Heater I'/YIONLS ,IL5-636- 01 9'rRTEThDDRUs 11715 N Greek Pkwy S, C-106 r.ITY,arAYr,xu' Bothell WA 98011 FAQ 13 Q awNuyuuiujR ❑ OWWRAQ110 C'av'ywriCTt ❑GOmRACIORAGLINT ® AR01111JIC1- ❑1NiOD'IuCR 0 w-VULOPER 13 TEMAN) CIINYRAIC:'ItIR14AMri FAST Water Heater LICIENKNUNIDER 987398 lJC�FiSR'ii'P1S C36 V �p61PANYNAb+� FAST Water Heater e:,"'a", j��hle�fastwatarheater.cam ,: F"' 426-63.61-7006 s'r1lr,Isrnul>�Isc 11716 N Creek Pkwy S, C-106 CITY,sT,1,TILZIP Bothell WA 98014 P"ON;425-636.7084 Ak'iIPYt�t.'1�'I:N(i141tlik'Nh R -�.,� UctllsiiNLlninri -'-- � mr;5.1-1C1+ -'� Vf7 RANYHAIARP.•k7h 7� PAN --- - -- - 311ii 7ACp�J R:SS 4"1TP 37Ailii,1lT r ►i h Iltiet 01' 91g3rf'U4Bl,1;X AiU1;111'AMItY JIUILUINO• El COMMI CIhI. r7t)I�rfi 1NWILIN.AP+U YGH Vt1011t't iV ) YF5 1.Ik7JANIVIVIVAI!ItAikl`A NO IsYli[ ttilaulAN I'3 5'u bhisl 0.. 1' 1 ))I 9CRIIN)tDN UP MIRK 7'OT�+tI. YAI,UA7'1 3 Cl�_ � HuEKTun 11Y; . 13yIny i Ignululc bc1 Cnc9t ufiha folfo4Ving+ I hill 1ho prl;ixlty awncrarnudmif®d Will to 01 an (lie tlrulxli}' mvllur's WIRli_ I I m repel LI11R uR11HIPAIlDil And aw 11*11 orlon i Nov Illtiltf&Nt lStAlYcei, I IIA o Imid Ilio T)twiptign pr1 pIk lnd 5`Cijd} iL i8 ncculntc. 1 agree Cm1Mi)Y' 'ith fillnpliUtnUle Itrenl oldbrplte4s and s1 1c Ipw6 Rlntnry to 1%1i (1a onsim"1 I, I III 1IYC 1Ci11rAen{i11i147p t1l C illlUlyGup ftp Ut1L01'1ltep•i{Il'Rllfled �IDIl9HY rpp fll�poGUtalf pHFjtaStlK, r Date,. 121512017 51X- .if 'llHftll� 6f!`t111f11cdllVrtlj ilt;,_ _.,,,: - _ SIJI3E1I,L1v1LN7"AL INl'OItA4 t'1'IQiti REtZUI9tl i? t)€t,N;9b9f, ONLY 1� Ot'lrR•illp:Cllil�a`1{tl.' - STANDARD [] L:#1LfiE n. h1A,le11i� 1, 1. i.doe miffed 061201 q 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 • buildinaCa.cwertino.ora 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 mul aniiTy dwe�ings sh 1 be provided with Shi-We-Warms andrCarbon� Monoxide alarms. When the valuation of additions, alterations, or repairs to existing dwelling units exceeds $1000.00, CRC Section 8314, 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 907.2.11.4 and 420.6.2. An electrical permit is required for which_must be connctQd-to..the-buildirsg svir,—'1g - - 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: V1 '}' l C? A Permit No. � it 1. Specify Number of Alarms: # Smoke Alarms: 5 # Carbon Monoxide Detectors: 1 have read and a ree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: a t; tgnf Si natur. ........ Contractor Name: Signature...................................................................... Lic.#........................................ Date:................... Smoke and COform.doc revised 01/10/2017