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14080214 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10696 S TANTAU AVE CONTRACTOR:DRAIN DOCTOR PERMIT NO: 14080214 OWNER'S NAME: JOHN BLAKLAN 480 ALDO AVE DATE ISSUED:08/20/2014 OWNER'S PHONE: 9548303370 SANTA CLARA,CA 95054 PHONE NO:(408)370-3082 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ PROPERTY LINE CLEAN OUT,REPLACE SEWER LINE License Class Lic.# SANITARY SUNNYVALE JURISDICTION Contractor r«l tA a J" Date 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: 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. Sq.Ft Floor Area: Valuation:$5000 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 APN Number:37537004 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT E 7OFPE NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 1 0 DAT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enterupon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS OD INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments,costs,and expenses which may accrue against said City in consequence of the Issued bDate: S 20/ granting of this permit. ditionally,the applicant understands and will comply Y' with all non-points regulations per the Cupertino Municipal Code,Section 918. RE-ROOFS: Signature ate 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) 1,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 Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25 ,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: 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 CONSTRUCTION LENDING AGENCY 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 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 PERMi i RPPL[CA i ION Inv;a E P �� ,. ... COPJMUNITY DEVELOPMENT DEPAR T Idii=ttiT• BUILDING DIViSIG1: /� I 50300 TORRE AVENUE• CUPERTINO, CA°5014-3255 ( V� ('08) 777-3228•i=An(!OS)iii -3333•buildin�l�cu��ino.ora lT EU��i It.CO M I V'15 • l _ Tv,r :G nl, =�.�c�i ❑�L�ciRICAT ��:y4��c[[cV ?R07 cr ADDRESS I �? 75-3'7 6 Act 4- A'K ✓lam I oPHONE I _i✓E� n�.�R i�vs' � S::�Z ADDRESS I CITY,SIATc,ZiP � I F�•%, CJI ti �-T OH'!..-, •❑ OV,�_•3i T_D ❑ OV, AG=�i COT3RCOR ❑C01 �rORgACh? ❑ A?C sECI ❑ C—r. ❑ D1%�0?? ❑ c=N4NT OR 3,4 I LiCMNSE3Tu3ZnER / `-[� O I �iCE S-C�b I FUS.Lict sY COiJ Anal +?s / I 3✓AT I r t e STRci ADD?.ESS I Cl i Y,STA::,ZIP Co �! P 30h3 �C?u i=Ci/ GIh= ?t!1✓? I LICE SE hTI51 ut. I BUS.LIC COVDAY NAIL I E 1✓i9II I FAX STRz=7 ADDRESS I CITY,STATE,ZIP I PHON--- U'S8 OF ❑SFD or DUPLEX ❑ WLTLTI-F UZLY I PRO:BCT IR'WILDLAINM ❑ �tS ( PRO-ECT iT ❑Yrs I IS 2'I^BLDG kX ❑YES 3L'LT Dn:G: ❑CO}✓°�c'.CLSL URBAN 7T�FAC=AP. A ❑ NO ZOOD?02,=- ❑ No AO DFSC?.IPTION Orwo-Rx r � •�e��f- C l yr o Rv i:i4 Sim_i1rC i)elD\,�,I Ceitli) t0 CP�•h D'ti'i9 foll0 ii7ri�: I Zv tie.�I037C•'iy Oii•i?eI OI.L ihOilud fi�elli i0_i Oil tr:e rrOl7.e ei S bshalr �iaVe ie2d Lh'S aDplication and the infmn tion I have provided i5 c0i I have:ead the D c s c7!?tion Df W ork and vel.r it is a'..mz1 Gtr.. 1 F-2 7.P.. D CD:np y i"-:,t. Enn, .ab c:� D.�.G� O:dinance5 and S=te is s relat3nE i0 lJL1Id1rlE C^^ Cil0i1. I�utho" reDreSentGtiVeS Df Cupw in0 t0.`.a-I the a�JOVe-ideP_ti=�ed plo:)tT�f0r LSD`. On Du-'PCseS. S i c latare Of Apalic_t"Annt: 'DGte U�1 _ O-AF =os = . f 14�>;�11�w�C.�p _2OILGOC revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION W�PERMIT DDRESS: 10696 s tantau DATE: 08/20/2014 REVIEWED BY: Mendez PN: BP#: -VALUATION: $5,000 PE: Plumbing Permit PLAN CHECK TYPE: Alteration /Addition / Repair PRIMARY SFD or Duplex PENTAMATION 1 RPSS USE: p PERMIT TYPE: WORK ro ert line clean out replace sewer line SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Sewer, Sanitary 1PRSEWER 1 # $25 TOTALS: $25.00 rt r0 MV00ry 1'/Un t_het k Plumb.Plan Check 0.0 hrs $0.00 hien. Pia;-'t �a_>ctz Fee: Plumb.Permit Fee: 1PPERMIT r1 r> Ie r. irrv; Other Plumb Insp. 0.0 hrs $48.00 Omer 1 r insp, °e�rx't tr?,/�_ .e,E�: Tirtnti. Iirsp. FV".- NOTE: V".NOTE: This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). Theseees are based on the prelimina information available and are onl an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff. 7/1/13) FEE QTY/FEE MISC ITEMS PME Plan Check: $0.00 PME Unit Fee: $25.00 PME Permit Fee: $48.00 �.o� i:S 17`;;1"11 on 7(f,Y. Administrative Fee: (ADMIN $45.00 Work Without Permit? ® Yes 0 No $0.00 f.:es Travel Documentation Fee: ITRA VDOC $48.00 Stron_ Motion Fee: IBSEISMICR $0.65 0.0 hrs Inspections Bldg Stds Commission Fee: IBCBSC $1.00 $0.00 Inspection,Hourly '2 a" L� $167.65 $0.00 TOTAL FEE: $167.65 Y N Revised: 07/10/2014 RECEIVED SMOKE 1 CARBON MONOXIDE ALARMS SEP 15 2014 2 OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION BY CUPERTINO 10300 TORRE'AVE1.NUE-CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building O,cupertmo.ora Permit No. ll��o YO Z/a Address �'v�9e'i u- C C4av#of Alarms Smoke: Carbon Monoxide: PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.211.2 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 valuationof 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 X X bedroom(s) 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 attachedgarage".. : 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 8314 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. 1 have-read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Nam -j f I r ... .... .. .. L ... ..... .. ... ......... ........Date... . ..... ...... ... Contract Name: Si nature. Lic.#...... :.. .. ....� V.....Date: . . .:. law tl Smoke and COform.doc revised 03118/14