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12120104 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19927 BEEKMAN PL CONTRACTOR:SHAH RAJESH PERMIT NO:12120100 OWNER'S NAME: SHAH RAJESH 19927 BEEKMAN PL DATE ISSUED: 12/19/2012 OWNER'S PHONE: 4082020299 CUPERTINO,CA 95014 PHONE NO: ❑ LICENSED CONTRACTOR'S DECLARATION I— F_ BUILDING PERMIT INFO: BLDG ELECT PLUMB License Class Lic.# MECH r- RESIDENTIAL J_ COMMERCIAL � Contractor Date I hereby affirm that I am licensed under the provisions of Chapter 9 JOB DESCRIPTION:REMODEL TWO BATHROOMS(100 SQFT);REMODEL (commencing with Section 7000)of Division 3 of the Business&Professions KITCHEN Code and that my license is in full force and effect. (180 SQFT),WATER HEATER AND ADD(1)SLIDING DOOR TO GARAGE-CLEAR CODE I hereby affirm under penalty of perjury one of the following two declarations: 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$15000 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is APN Number:31630137.00 Occupancy Type: 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, PERMIT EXPIRES IF WORK IS NOT STARTED costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION. 9.18. ^7 �y Signature Date Issued by: _/��/V J Date:w ❑ OWNER-BUILDER DEtQLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS: the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection. Business&Professions Code) 1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date: construct the project(Sec.7044,Business&Professions Code). I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER declarations: I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE 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 read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain [have and will maintain Worker's Compensation Insurance,as provided for by compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health& Section 3700 of the Labor Code,for the performance of the work for which this Safety Code,Section 25532(a)should I store or handle hazardous material. permit is issued. Additionally,should I use equipment or devices which emit hazardous air I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534. become subject to the Worker's Compensation provisions of the Labor Code,I must Owner or auffioKized forthwith comply with such provisions or this permit shall be deemed revoked. —Date: Z 2 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 I hereby affirm that there is a construction lending agency for the performance of"ork's to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.) upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the Lender's Address granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION 9.18. I understand my plans shall be used as public records. Signature Date UI�— Licensed Professional CONSTRUCTION PERMIT APPLICATION Is COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228• FAX(408)777-3333•buildinciAcupertino.org ❑NEW CONSTRUCTION ❑ ADDITION DALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# [PROJECT ADDRESS Ck J E7(fi APN# l9 �7 dee km�l1 �') g o� OWNER NAME Ku`e 5� S 1 L PHO O Ig E-MAIL 5 �` q ,I eco STREET ADDRESS119-),7 $ee kma►^ ��, CITY, STATE,ZIP C-, elr f,AV j C / FAX LJ D CONTACT NAME it G^l� PHON7 �5 7 —/ 7 / E-MAIL Y / STREET ADDRESS I CITY,STATE, ZIP O� C F� FAX ❑OWNER ❑ OWNER-BUDDER OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK 3 co-h-t o L a K f ch e_r\ fe-Ynv I. C j Z ,/ GG %G EXIST G USE PROPOSFp USE CONSTRE #STORIES J/�7 V USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA %D D REMODEL AREA/ REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: DETACH []ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YE SECOND STORY [-]YES BEING ADDED? ADDITION? �9Q6 PRE-APPLICATION ❑YES IFYES,PROVIDE COPY OF IS THE BLDG AN ❑YDS �ECEIYEA B TOTAL YALUATION. PLANNING APPL# PLANNING APPROVAL LETTER EICHLER HOME? O ,1 6 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. 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. Signature of Applicant/Agent: Date: L q-1 1!31 Zo 12,. SUPPLEMENTAL INFORMATION REQUIRED RolTuvc slP s r0. _New SFD or Multifamily dwellings: Apply for demolition permit for `OVER THE-COUNTER,' � BUILDING PLAN REVIEW �, existing building(s). Demolition permit is required prior to issuance of building 2 permit for new building. a❑ EXPRESS P3 �M!TING PLAN REVIEW'v €� ai yaw _Commercial Bldgs: Provide a completed Hazardous Materials DisclosureT"T QsTAIVDpRu ��PIrBLiCwoRxs w form if any Hazardous Materials are being used as part of this project. Q LARGE ti r _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. 0 1,rAJOR l' SANrrARY,SEWERDISTRICT� :.ENVIRONMENTAL HEAI TH:s B1dgApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR— BUILDING DIVISION ADDRESS: 19927 Beekman PI DATE: 12/19/2012 REVIEWED BY: Sean APN: BP#: *VALUATION: 1$15,000 ;�IPERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1 R3SFDREM USE: I PERMIT TYPE: WORK Remodel two bathrooms 100 sq ft); remodel kitchen 180 sq ft); Add 1 sliding door to gara. e. SCOPE 7-T 0,-".", A,, Lj r , NOTE. This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Thesefees are based on the preffinWdna information available and are only an estimate. Contact the De t or addn'1 info, FEE ITEMS (Fee Resolution /1-053 Lf. ?'1;/Q2 FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00F$600.001 0 s.f. Remodel,Bath(<=300 sf) Suppl. PC Fee: Reg. 0 OT 0.0 hrs $0.00 IREMRESBAT PME Plan Check: $0.00 180 s.f. Remodel,Kitchen(<=300 sf) Permit Fee: $0.00 $600.00 IREMRESKIT Suppl. Insp. Fee-C) Reg. 0 OT 0,0 hrs $0.00 = # Window/Sliding Glass Door PME Unit Fee: $0.00 $467.00 1 WINNEWNST New(Non-Structural) pPME Permit Fee: $0.00 Work Without Permit? Yes (F) No $0.00 0 Advanced Planning Fee: $0.00 Select a Non-Residential E) Building or Structure 0 Strong Motion Fee: IBSEISMICR $1.50 Select an Administr ,ive Ite�ri . Bldg Stds Commission Fee: 1BCBSC $1.00 SUBTOTALS; $2.501$1,667.001 TOTAL FEE- , 69.50 Revis d: 10/01/2012 OWNER-BUILDER DISCLOSURE FORM COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228- FAX(408)777-3333- building5cuoartino.org Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: SITE ADDRESS 1901�7 n APN BP# OWNER NAME ��; es OWNER ADDRESS 1 ✓q a 7 b e-e km un f 1. C kqCY Dino, nt y J JJ ( DESCRIPTION OF WORK: Cl om C.tyt i fcke h 9,eynodel. We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you,the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS:Please read and initial each statement below to signify you understand or verify this information.) p �J 1. 1 understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder'building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 2. 1 understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. o ' 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. pp 0'CS' 4. 1 understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. ` 5. 1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the Total value of my construction is at least five hundred dollars($500), including labor and materials, I may be considered an"employer' under state and federal law. °r 6. I understand if I am considered an"employer" under state and federal law, I must register with the state and federal government,withhold payroll taxes, provide workers'compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. `9s 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 1!�h8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s)that result from any latent construction defects in the workmanship or materials. OwnerBuilderForm 2010.doc revised 04114/10 i'J- 9. I understand I may obtain more information regarding my obligations as an"employer"from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board(CS LB)at 1-800-321-CSLB (2752)or www.cslb.ca.gov for more information about licensed contractors. 04. '10. 1 am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. -V�J'11. 1 agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. 2. 1 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint.Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers'compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS:Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued,this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date:Tcf --------------------------------------------------------------------------------------------------------------------------------------------- (NOTE. The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner,the execution of which I understand is my personal responsibility, I hereby authorize the following person(s)to act as my agent(s)to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Name of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OwnerBuilderForm 2010.doc revised 04/14/10 SCOPE OF WORK: Kitchen and Bathroom Remodels; add door to garagef-,,..,1 9 ?IJ1r Project shall comply with the 2010 California Building (Base code 2009 IBC), 2010 R �ential (2009 IRC), Plumbing (2009 UPC), Mechanical (2009 UMC), Electrical (2008 NEC), Fire (2009 IFC}an9-� Codes (2008 Building Energy Efficiency Standards) Energy code mandatory lighting measures: 1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy luminaires. (150(k)(7)) 2. Permanently installed lighting in Kitchens shall be high efficacy luminaires. Up to 50% of the wattage of permanently installed lighting in kitchens may be in lights that are not high efficacy. (150(k)(8)) 3. Permanently installed luminaires in bathrooms, garages, laundry rooms and utility rooms shall be high efficacy luminaires OR are controlled by an occupant sensor(s)certified to comply with Section 119 that does not turn on automatically or have an always on option. (150(k)(10)) Plumbing plan notes: 4. Water closets shall have an average water consumption of not more than 1.28 gallons per flush. (CPC 402.2) 5. Shower heads shall have a water flow not to exceed 2.5 gallons per minute. (CPC 402.1.1) 6. Faucets in kitchens, wet bars, lavatories, laundry sinks, etc shall have a water flow not to exceed 2.2 gallons per minute. (CPC 402.1.2) 7. Shower stalls shall have a clear interior finish area of 7.1 sq. ft. and be able to accommodate a minimum 30 inch circle at the threshold level. These clearances shall be maintained up to a height of 70 inches above shower drain. (CPC 411.7) 8. Shower compartments and walls above bathtubs with installed shower heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches (6 ft). (CRC R307.2) 9. The maximum hot water temperature discharging from the-bathtub, shower and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit. The water heater thermostat shall not be considered a control for meeting this provision. (CPC 414.5 &418.0) 10. A 30-inch clear width for water closet compartment and 24 inch clearance in front of water closet. (CPC 407.5) Electrical Plan Notes: 11. The installation of smoke alarms in all of the following areas shall be provided: (R314.3) a. On the ceiling or wall outside of each separate sleepi g area in tl-y /Iyhdiate vicinity of bedrooms. i9/!N f� b. In each room used for sleeping purposes. / •f 9 �" �a 12. The installation of carbon monoxide alarms in the following ateas shall be provided: (R315.1) a. Approved carbon monoxide alarms shall bet nstalled,6utsi'de of each separate sleeping area in the immediate vicinity of the bedrooms and on every level including basements in dwelling units that have fuel-fired appliances or attached garages. 13. A minimum of two 20 amp small appliance branch circuits shall be provided for all receptacle outlets in the kitchen, dining room, pantry, or other similar areas. (CEC 210.11(C)(1)) 14. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such circuits shall have no other outlets. (CEC 210.11(C)(3)) 15. In every dwelling unit, fixed appliances such as food waste grinders, dishwashers, washing machines, dryers, laundry tray locations, built-in refrigerators or freezers, furnaces, AC units, built-in heaters or any other fixed appliance with a motor of'/ h.p. or larger shall be on a separate 20 amp. branch circuit. 16. All receptacles in bathrooms, garages, accessory buildings, outdoors, crawl spaces, unfinished basements, kitchens (where receptacles serve counter top surfaces), laundry, utility, wet bar sinks (within 6 feet of the edge of the sink), shall have ground-fault circuit interrupter(GFCI) protection. (CEC 210.8) 17. In all areas specified in 210.52, all 125-volt, 15-and 20-ampere receptacles shall be listed tamper-resistant receptacles. (CEC 406.11) A. L ;' k Braced Wall Panel Requirements: 18. For bearing wall construction, the following shall be provided as plan notes: a. Foundation sills shall be naturally durable wood or preservative-treated wood (R317.1) b. Anchor bolts shall be minimum 1/2-inch diameter(R403.1.6). c. Anchor bolts shall be embedded at least 7 inches into the foundation (R403.1.6). d. Anchor bolt shall be spaced not more than 6 feet apart(R403.1.6). Maximum anchor bolt spacing shall be 4 feet for buildings over two stories in height(R403.1.6.1). e. There shall be a minimum of two bolts per sill piece with one bolt located not more that 12 inches or less than seven bolt diameters from each end of the plate section (R403.1.6). f. Indicate on Foundation Plan plate washers for the anchor bolts, minimum 3 inch by 3 inch by 0.229 inch thick. Plate washer may be diagonally slotted with a width of up to 3/16 inch larger than the bolt diameter and a slot length not to exceed 1 3/ inches, provided a standard cut washer is placed between the plate washer and the nut(R602.11.1). g. Interior braced wall plates shall have anchor bolts spaced at not more than 6 feet on center and located within 12 inches of the ends of each plate section when supported on a continuous foundation (R403.1.6.1). �( �( .3 _�� ���/ l �� -- �` ........�_.�...�.�.....e.........._........_._._....,._....._..._.I 4�.. �� ��� 6©�� �► � a � � � INC, 16 eR I Fly 4 G-F o s All TG1V � E '30. 4 co LLi l ,,lle W N ,✓/ sod s 1 02 „ �r 30" 36" z 111 ---36"- --- ---3 "---- - 36"-- z ........................... —_ ---------' ,i ............ .......... 1240 W3022 W3640N,Xk „j N 04 CV) CO \ 0-GAS-RANGE LS36 f 1 -. _— ` --�� iI N i O O 00 --- N � - o � co — -- chi _ ..... ------N 00 D .-IN dI o (V) r M e— N04 m N (NO (� M 1 M SIN cl - _