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B-2016-1596 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS. CONTRACTOR: PERMIT NO:B-2016-1596 10895 SWEET OAK ST CUPERTINO,CA 95014-0122(326 51 041) RELIABLE APPLIANCE SERVICE INC EL CAJON,CA 92020 OWNER'S NAME: FORD RICHARD L II TRUSTEE&ET AL DATE ISSUED:03/23/2016 OWNER'S PHONE:408-736-7475 PHONE NO:(800)767-4040 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class DOORS,GATES AND ACTIVATING DEVICES Lic.#96 C,2 a2 X BLDG ELECT _PLUMB Contractor RELIABLE APPLIANCE SERVICE INC Date 06/30/2017 — — I hereby affirm that I am licensed under the provisions of Chapter 9(commencing X MECH X RESIDENTIAL—COMMERCIAL— with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: REMOVE AND REPLACE(E)FORCED AIR.AND A/C SYSTEM IN I hereby affirm under penalty of perjury one of the following two declarations: SAME LOCATION r. 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 "I performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance,as provided for by NSection 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$5437.00 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 ATN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 326 51 041 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 mply with all non-point source regulations per the Cupertino nicip Code, with 9.18. 180 DAYS FROM LAST CALLED INSP ION. Signature Date 03/23/2016 Issued by:ALEX VALLELIL GA Date:03/23/2016 WNER-& 1LDE ECL TIONt I hereby a rim t at exempt from the Contractor's License Law for one of the RE-ROOFS: following two ons All roofs shall be inspected prior to any roofing material being installed.If a roof is r, 1,as owner ofthe properly,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. 1,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:03/23/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER r. 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 2. 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 maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Section 25532(x)should I store or handle hazardous a. 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 material.Additionally,should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Qualianagement District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertim apter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Secti5534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Ow'ner.or_authonzed.agent APPLICANTCERTIFICATION Date:03/23/2016 I certify that I have read this application and state that the above information is CONST I LENDING AGEN Y correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is :c struction 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 expenses which 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 I understand my plans shall be used as public records. Code,Section 9.18, Licensed Signature Date 03/23/2016 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10$00 TORRE AVENUE•CUPERTINO,CA 95014-3255' tlPlrEtTEEw[Q (408) 777-3226•FAX(408)777-3333-building cD--cupertino,org 1 l - 1 ❑NEW COATSTRucTION ❑ ADDITIOAt 0 AI TERATION/TI ❑ REVISION 1 DE);EPMED 0PJCiINAr-PEKWT--r PRoaEcTADDREss 10895 Sweet Oak pi I APNR i �-- 0 I ORWTERNAME Richard L. Ford Jr FI.ONE 408-736-7475 E-MAIL STREETADDRESS 10895 Sweet Oak pl CITY, STATE,ZIP Cupertino CA 95014 FAY. CONTACTNAME Sergey Mirolyants FHONE 650-771-6472 Srnirolyants@gmaii.com STREETADDRESS 1841 Northwest cir CITY,STATE,ZIP San Jose CA 95131 FAX ❑OWNER ❑ 0%WTER-BUILDER M OYRiERAGENT ❑ CONTRACTOR 16 CONTRACTORAGENT I❑ ARCHITECT ❑ENGBMFp ❑ DEVELOPER ❑ TENAirr CONTRACTORNAME Ariel Mavashev LICENSENUMBER 962632 LICHNSETYPE C-20 BUS.LICR 40255 co1,4PANYNAh" Reliable Appliance Service, Inc. E-MAIL Smirolyants@gmail.com FAX (619)447-1622 STREET ADDRESS 324 Coogan Way CITY,STATE,ZIP- EI Cajon CA 92020 PHONE (800)767-4040 ARCHITECT,'ENG,R,TERNAME LICEY SE NUMBER BUS.LIC COMPANY NAME E•h3AIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK Replacing HVAC system . EUSTINO USE PROPOSED USE CONSTR.TYPE r STORIES USE ( TYPE OCC. SQ:FT. VALUATION(S) EXISTG NEW FLOOR DEMO TOTAL AREA. AREA AREA NET AREA BATHROOM KITCHEN OTHER REMOT)EI AREA REMODELAREA REMODEL AREA PORC14AREA DECK AREA TOT.hL DECIUPORCH AREA GAI AGE AREA: LJ DETACH W LI ATTACH DWELLING UNITS: 1S A SECOND UNIT ❑YES SECOND STORY YES - BEINGADDEW nNO ADDITION? E]NO PRE_APPLIGA710?? OYES If YES,PROVIDE COPY OF ISTREBLDGAN ❑YES gRECEI�r.ED$Z �f : �y TOT.ALVALUATIONi PLANT11UNGAPPLR [:]NO PLANNING APPROVAL LETTER EICHLERHOMt� EJNO 5,437.00 By my signature below,I certify to eaclr of the folloxving: 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 lass relating to building constluctic a Drize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: - / Date: 03/23/201.6 SUPPLEMENTAL n1FOR11ATION REQUIRED s `:' `�' CILECI:;T] °,ROU;l I1G_SLIP-1_ New SFD or Multifamily d-wellings: Apply for demolition permit for ©x BUILDING PLA REVIE\3 ` emting building(s). Demolition permit is required prior to issuance of building ' r 5A N permit for new building. +'D�E�REsS ���— �' � PT��i�c P��:IiEv $ _Commercial Bklgs: Provide a completed Hazardous Materials Disclosure D sTA��ARD M }DrPUBLtcsiolu s form if any Hazardous Materials are being used as part of this project. ' _Copy of Planning Approval Letter or hiteetin,with Planning prior to x %��DLA34R Y � �E��,s-��iT�R�s>:1a ER DISTRIcr submittal of Building Permit application. r at B1d&4pp_20JLdoe.revised 06/21111 N��' ► GLEWOAKS PARK VILLAS ASSOCIATION 10902 Sweet Oak Street . Cupemno,California 95014 IVSD, EXTERIOR MODIFICA'T'ION PERMIT Applicant(homeowner)Name Address / Nature of modification 37j j r� o The Architectural Committee and.Board have reviewed your application received on APPROVED DENIED PERMIT NO. _l Conditions of Approval(where boxes checked): QZ Full maintenance of modification will now and ever after remain at your expense or that of any future owner of this property. 056- You or a future owner may not alter this modification without prior approval of the Architectural Committee. You must submit this permit to obtain a building permit from the City of Cupertino. You must submit a copy of the drawing as approved by the City of Cupertino. Upon completion of the modification you must notify the Architectural Committee so it may inspect for its final approval- C3 Additions/repairs must be painted to match original structure. Wood trim: Kelly-Moore 1245 Acry-Shield Wood Moss 4197 Stucco: Felly-Moore 1240 Acry-Shield,Oyster#26 - `(r tf u Q Al i a AJ© Approved b5= hitectural Committee Date Board of Directors Date Owner agrees to conditions of approval r Date !f Final Approval—Architectural Committee/Board Date GlenoAsl xtMo&ainit rev 0316 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION CUPRTINp 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buiIdingQ)cupertino.orq (Permit o. f , ress O �� t W—ofa�Smo i. ar FCon_W- -noxi-da -----_. _ PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE ' 3 HAS BEEN SIGNED AND RF,TURIVFD TO THE BUILDING DIVISION 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 907.2.11.2 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 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 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 thL statement Owner or O��'�-Name: (Si natwr..... ......... .... ...._........(Date`. (Con r�acfor Name: (Sib-ma-167r-e?.................................................................rLic.#)......................................(Da e.. ............. ...... Smoke and COform.doe revised 03/18/14 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)7777-3Z28•FAX-008)77773333•building(a_cupertino.org (Owner N (Permit l 7o �- dress _. CC Is your real property a registered historical site? Y Civil Code Sections 1101.1 through`1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question-2. Does your real property have a licensed plumber certifying that,due to the age or configuration of the property or its plumbing,installation of water-conserving plumbing fixtures is not technically feasible? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. Jb_<O� Go to Question 3. Is water service permanently disconnected for your building? : ❑ Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. No Go to Question 4. 44) Is your real property built and available for use or occupancy on or before January 1 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. [5] ease check ONE of the following: My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 11 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing -fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2019,all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1,2014,specified building alterations or improvements shaUrequire non-compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or improvements). I,as the owner or owner's agent of this property,certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the table on the following page. (Owner orw,ner Agenf ii Si na ure: a e: Upon completing and signing this Certificate,please retain it to the Building Division in order to final your building permit. SB407 2015.doe revised 08126115