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14060009m, CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 22997 CRICKET HILL RD CONTRACTOR: CONSOLIDATED PERMIT NO: 14060009 PLUMBING INC OWNER'S NAME: IN SOO KIM AND YUN SOOK 3732 CHARTER PARK DR STE D DATE ISSUED: 06/03/2014 OWNER'S PHONE: 4082212061 SAN JOSE, CA 95136 PHONE NO: (408)978 -3093 C� LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL EJ INSTALL (N) PROPERTY LINE CLEANOUT -7 License Class Lic. # J � �r��l � Z tyC'- Contractor \ L Date " 3 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 of the following two declarations: "+ r ? affirm under penalty of perjury one I have and will maintain a certificate of consent to self - insure for Worker's wr 4 P 4 u Compensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $17500 erfonnance 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 APN Number: 34241029 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WIHIN 180 DAYS ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 80 LAST CA INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, L�y.T costs, and expenses which may accrue against said City in consequence of the b Date: granting of this permit. Additionally, the applicant understands and will comply with all non -point so cc regulation per the Cupertino Municipal Code, Section 9 18. 3 _ , Lr RE- ROOFS: Signature Date 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. ❑ OWNER- BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self - insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cu tmo Muni ipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code S 25 05, 5533, nd 25534. Section 3700 of the Labor Code, for the performance of the work for which this /� ? Owner or authorized agent: Date: (=9 - J 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 CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9 18. Signature Date GENERAL PERMIT APPLICATION O M E P COMMUNITY: DEVELOPMENT DEPARTMENT • BUILDING DIVISION ( �O 1,0300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 �p CUoitAt o (40.8) 777 -322$ • FAX (408) 777 -3333 • building0cuDertino.orQ MISC LuNawo ❑MECHANICAL ❑ELECTRICAL MISCELLANEOUS PROJECT ADDRESS APN # j Ll ,j �( � 1 OWIQERi\AME p zZ, - ` TMAIL STREETADD 2 9 Of -7 C/�i° > Crrr, 7E,71p 9 a. I FAX CONTACT NAME PHONE 7- KAIL STREETADDRESS CM, STAT , ZIP FAX ❑ OWNER ❑ OFTff///1t•��BUII,DIIt ❑'OWNERAGEhT ❑ e0NmArroR ❑CoxJxACTORAaD r ❑ ARCHr= ❑ ENGINM ❑ Dfi'VFLOPER ❑ TENkNr CONTRACTOR NAMT t /�� LTCEN NUMBER LICENSE TYPE BUS. LIC k COMPANY NAME E.MpII P STREET ADDRESS 7-� CITY. STATE P PHONE ^ ARCH=MNG1NEER NAME LICENSE M MBER BUS. LIC 9 COMPANY NAME E-MAIL FAX STREET ADDREsS CITY, STATE, ZIP PHONE USE OF ❑ sFD or DUPLEx ❑ MULTI -FAMQY BtJILDINO: ❑ COMMERCIAL PROJECT IN V I DLAND ❑ YES URBAN D.'TRFACE AREA ❑ NO PROJECT IN FLOOD ZONE ❑ YES ❑ NO IS THE BLDG ADI ❑ YES EICHLER HOl M ❑ NO DESCRIPTION OF WORK p r TOTAL VALUATION: W� K . a< By my signature below , I certify to each of the following; I am the property oamer or authorized agent to act on the pro owner' half. I have read this application and the information I have, provided is correct. I have Description of Work and verify it is acc e. I a comply with all applicable local ordinances and state lams retatmg to bu' ' o ction. a esentatives of Cupertino to enter the abo,'. ' ntifi d property for inspection purposes. Signature of ApplicanUAgent: Date: '. .. OPWAnON REQUMD = r r is RESS�s; r WEPMiseApp_2011.doc revised 06121111 CITY OF CUPERTINO IRUIP IF 4QT'Fl%4 A TnR — R1 TYI.DING ]DIVISION LAADDRESS: 22997 CRICKET HILL RD E: 06103/2014 REVIEWED BY: MELISSA UNITS APN: 342 41 029 BP#: *VALUATION: 1$17,500 xPERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: I # PENTAMATION I RPSS � PERMIT TYPE: A WORK INSTALL (N) PROPERTY LINE CLEANOUT SCOPE kle"(. h7 Shy , APPLIANCE / EQUIP TYPE FEE ID $0 . — QTY UNITS BP FEES Plumb. Permit Fee: Sewer, Sanitary A 1PRSEWER /rrsP 1 # $24 Plwnb. hisp. Fee: kle"(. h7 Shy , PME Unit Fee: $24.00 PME Permit Fee: $47.00 F Administrative Fee: 1ADMIN $44.00 Work Without Permit? 0 Yes 0 No $0.00 TOTALS: Travel Documentation Fee: I TRA VDOC $24.00 Strong Motion Fee: lBSEISMICR NOTE: This estimate does not include fees due to other Departments (t e. FlannIng, FUNIC WOM, rtre, aamrary aewerutstrtct, 13c rium --- --- --- L---,z ..I:...,.:..........., I-antart tho Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E 711113) A- Plumb. Plan Check s; "00 hr00 $0 . — MISC ITEMS Pil m Plec' Ch'' O" F11111 71 llet'iriil Fee.. Plumb. Permit Fee: IPPERMIT /rrsP Other Plumb Insp. El hrs PME Plan Check: $0.00 Plwnb. hisp. Fee: kle"(. h7 Shy , NOTE: This estimate does not include fees due to other Departments (t e. FlannIng, FUNIC WOM, rtre, aamrary aewerutstrtct, 13c rium --- --- --- L---,z ..I:...,.:..........., I-antart tho Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: suppl. PC Fee PME Plan Check: $0.00 Perm if S�11!)./--71' Iris] Fv�' PME Unit Fee: $24.00 PME Permit Fee: $47.00 F Administrative Fee: 1ADMIN $44.00 Work Without Permit? 0 Yes 0 No $0.00 P '10, , h fr"w'ng F �es: Travel Documentation Fee: I TRA VDOC $47.00 Strong Motion Fee: lBSEISMICR $1.75 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.001 all sZ $1 64.75 $0.001 TOTAL FEE: Revised: 04/01/2014 To Whom It May Concern Re: De Anza Oaks Homeowners Association Dear Sirs: Consolidated Plumbing, "Inc. has the association's permission to seek permits for the repairs of any domestic water lines or sewer lines located within the De Anza Oaks community. Since W- # , nullity Managafnent Services, Inc. Bill kibbard'; Association Manager De Ana Oaks Homeowners Association BH /st cc: Board of Directors 1935 Dry Creek Road, Suite 203 m Campbell, CA 95008 -3631 • voice (408) 559 -1977 •fax (408) 559 -1970 CUPERTI "NO Address 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 i+9dx�rv" /,/s %� ®/' ii of Alnrms Smoke: 5 Carbon Monoxide: Z PURPOSE This affidavit is a self- certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CLZC 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 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 have been tested and are operational, as of the date signed below. I have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: -%Id re .............. lll C ra r NNaame: �....f...... i n Lic.# ........ Date: e. l V Smoke and CO form.doc revised 03 118114 po BIVII CARBON MONIOXFDE ALARMS .x OW NE R CERTWICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISI 10300 TOR'R'E- AVENUE • CUPERTINO, CA 95014 -3255 f C U P Ei2T1'N f (408) 777 -3228 • FAX (408) 777 -3333 • buildin cu or ...:.QT„ Ivr»li%9rs g . Address / L 7 7 / PURPOSE. t This affidavit is a self- certification for the iAstallation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section RR4,1013 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 insta#6d in the following locations: sj AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms 'a e 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 batter operated where repairs or alterations do not result in the removal of wall and ceiling finishes' or therc js 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 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 have been tested and are operational, as of the date signed below. I h:aa,& marl afnd anraa tn - aril»tlibwitn. arms and conditions of this statement " l (or 0 r A en 's) N e: e)(?_- / Si natur 4.....n ......................................................... ........I...................... Date: .).� ...... Co ntr ` r Name: j Si natur ....... ..... :.... ........ ................Lic.# .� /..•� —.... Date: ...... .'-� .. M Smoke and CO form.doc revised 03118114