B-2016-1831CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1831
21739 BEAVEN DR CUPERTINO, CA 95014-1220 (326 47 058) SOSA GRANITE &
MARBLE INC
LIVERMORE, CA 94550
OWNER'S NAME: CHEN FRANK T AND ANNE S TRUSTEE
OWNER'S PHONE: 408-271-2842
LICENSED CONTRACTOR'S DECLARATION
License Class GENERAL BUILDING CONTRACTOR Lic. # 15 2183
Contractor SOSA GRANITE & MARBLE INC Date 06/30/2017
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:
1. 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
pIerformance 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
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 re
s rhe Cupertino Municipal Code, Section 9.18.
,Signature\ Date 4/26/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. 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)
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:
1. 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.
3. 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 must 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 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 4/26/2016
DATE ISSUED: 04/26/2016
PHONE NO: (925) 373-7675
BUILDING PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
KITCHEN REMODEL 360 SQ FT, BATHROOM REMODEL, REPLACE
(E) TUB TO SHOWER- FIRST FLOOR
Sq. Ft Floor Area: Valuation: $35000.00
APN Number: Occupancy Type:
326 47 058
PERMIT EXPIRES IF WORK IS .NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Abby A, e� p���� 1
'1
Date: 04/26/2016 `�+�skielvoiL
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: 4/26/2016
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 &
afe a tion,L"5,21113, and 25534.
.gy� Avner or authorized agent:
ate: 4/26/2016
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
Professional
CUPERTIN O
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 o building(E)cupertino.org
1�-2m P n't
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT #
PROJECT ADDRESS a APN #
OWNER NAME ra l`, C4-rt:f-n PHONE JkW�n` E-MAIL
STREET ADDRESS , I I�n �e; L r CITY, STATE, ZIP I ) � 0 L l FAX
I CONTACT NAME
STREET ADDRESS
PHONE
CITY, STATE, ZIP
E-MAIL
FAX
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME 0G�,-�� jl i ` LICENSE NUMBER y -a J ], LICENSE TYPE C I� L� BUS. LIC # 3 j
COMPANY NAME Y LL✓ilii l V 5 ���� E MAI I> �."i SC �e�l r) I FAX
STREET ADDRESS -7-) O ��t U ' 1-A'1'"►1,(,lV 1 CITY, STATE, ZIP
a 1 �✓ ✓ l PHONE61.7 JJ(16CI
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC #
I COMPANY NAME I E-MAIL I FAX
I STREET ADDRESS I CITY, STATE, ZIP I PHONE
DESCRIPTION OF WORK f `'i+C/ I 44%. /I r {)
f'k' -YB <v�, �� o�-I-h ruwn .�, n urea- "i e l U4 ^-fe)f\ -H ' 1 aG-1 /,,1(a -LL.
EXISTING USE PROOOSED USE CONSTR. TYPE # STORIES
USE TYPE I OCC. I SQ.FT. I VALUATION ($)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM _KJTCHENOTHER
REMODEL AREA REMODEL AREA i bc) REMODEL AREA
PORCH AREA I DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA: LJDETACH
FI ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? []NO
ADDITION? []NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
PLANNING APPL # [-]NO PLANNING APPROVAL LETTER
1S THE BLDG AN ❑ YES
EICHLER HOME? []NO
RECED BYTOTAL
VALUATION:
me
1
By my signature below, I certify to each of the following: I am the property owner or authorized agent totact on Aie property owner's behalf. I havereadthis
application and the informat ave rect. I have read the Description of Work and verify it is accurate. I agree
to comply with all applicable local
ordinances and state laws r ating to bution. I authorize representatives of Cupertino
&ions
to enter the ab ova -filen ifie�l
property for inspection purposes.
Signature of Applicant/Agent: -"
Date:
SUPPLEMENTAL INFORMATION REQUIRED
PL"Aiv cilEcx TYPE
ROUTING SLIP
❑'; OVER -THE COUNTER
BUILDING PLAN REVIEW
_ New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ ;EXPRESS
Eli PLANNING PLAN. REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
❑"'sTANDARD,
❑ PUBLIC woRlis
form if any Hazardous Materials are being used as part of this project.
D LARGE
FIRE DEPT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
M iro>z :
D sniv>TAtzy SEWER DISTRICT
submittal of Building Permit application.
Q ENVIRONMENTAL HEALTH
B1d,-App_2011.doc revised 06/21/11
Assessor's Parcel Number: Plumbing Notes:
1. Faucets in kitchens, wet bars, lavatories, laundry sinks, etc shall have a water flow not to exceed 1.8 gallons per minute @ 60 psi. (C�Q 40opy r1�
Name of Owner:- l [r� Y Electrical Notes:
2. The installation of smoke alarms in all of the following areas shall be provided. (R314.3) t
COMMUNITY DEVE OPM g ' i ✓au outside of each separate sleeping area in the immediate vicinityo;,.b,.droom �r
Contact Person: I' h� ` ((i c>U� Phone: ��j—�NT �'� ne.fi't7sd for sleeping purposes.
BUILDING DIVISION - Ct_p E
R ..IN'bry within a dwelling unit, including basements but not including crawl spaces and uninhabitable attics.
e EP r• ved carbon monoxide alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on eve
Project Address: 2� �✓� ���yL� �+ 1 f �d �f `I �����'�/ 4=r� Ap t" p g "d� y � every level including
This, set of plans ands pecific tlonbe��fnants in dwelling units, that have fuel -fired appliances or attached garages. (CRC R315.1)
r A hii'nii�N'Ytye$ Ernol�nall appliance branch circuits shall be provided for all receptacle outlets in the kitchen, dining room, pantry, or other similar areas. (CEC
Scope of work: ( � G �' lC� 4r a v— CJD si e during construction. It isZ1012IMPtb make any
h �es or Iterations �n sIn ver ° g ijg unit- �� circuit shall be provided to supply bathroom receptacle outlets. Such circuits shall have no other outlets. (CEC 210.11(C)(3)).
�tilei o s.or al t a rOV' T' p,,,In��ver �we mg unit x§appliances such as food waste grinders, dishwashers, washing machines, dryers, laundry tray locations, built-in refrigerators or freezers,
Code Editions: 2013 California Residential Code I `'�� �T > <le �a �n PP f "f�ht'eca L ) s u��lrla�)neaters or any other fixed appliance with a motor of Y h.p. or larger shall be on a se,P,grate 20 amp. branch circuit.
R g is plan and�speaffil�rlsh}L�h�, garages, accessory buildings, outdoors, crawl spaces, unr"mishea b�s6mat} s, kifYbnrs,�w, J cpta le serve countertop suraces),
2013 California Plumbing Code �� trs,,rt.,r�.,v;F_..,
be held to permit or to be an apob�f del [>S�'� $�a��}I (within 6 feet of the edge of the sink), shall have ground -fault arcult`intErrup`�er (�UFIC�iPrpfee�io�n��.�� �1 21 B(A))
2013 California Mechanical Code a I� all areas sp 1 1 52, all non-locking type 12o -volt, 15 -and 20- ampere receptaclessh�ll be fisted tamper-resistanWF'e cPI'
of pX ✓isior, of any City Ordinance or SUE
favi. e$• (CEC 406.12)
2013 California Electrical Code BY- (,�,
2013 California Energy Code DATE: <<< �s c �s Z�l'I
PERMfT #
EneroyCode mandatory liahtina measures: REVIEWED FOR CODE COMPLIANCE
1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy luminaires. (150(k)(7)) Reviewed By:
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 -98
I
are not high efficacy. (150(k)(8))---I'----
__- 50
_50 31,
is
r
-- - 105
EXISTING KITCHEN FLOOR PLAN
iiilliilue
C
PROPOSED KITCHEN FLOOR PLAN
-i•
0
Assessor's Parcel Number:
Name of Owner:
Contact Person:
Project Address:
Scope of Work:
Code Editions: 2013 California Residential Code
2013 California Plumbing Code
2013 California Mechanical Code
2013 California Electrical Code
2013 California Energy Code
Mechanical Notes:
Phone:
1. Bathroom vents shall terminate not less than 3 feet from openings and property lines. (CMC 504.1)
Energy Code Mandatory Measures:
1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy luminaires (150(k)(7))
2, Permanently installed luminaires in bathrooms shall be high efficacy luminaires OR are controlled by an. occupantsensors(s) certified to complywith Section 119 that
does not turn on automatically or have an always on option. (150(k)(10))
34.5"
To 132 33;1
Wideried
i
57.5"
10.5"
Toilet
Tiles, same
as kitchen's
18 %2 "
d
Va n ity 24"
57.5"
EXISTING BATHROOM FLOOR PLAN
Plumbing Notes:
1. Water closets shall have an average water consumption of not more than 1.28 gallons per effective flush. (CPC 403.2)
2. Shower heads shall have a water flow not exceed 2.0 gallons per minutes @ 80 psi. (CPC 408.2)
3. Faucets -in lavatories shall have a water flow not exceed 1.5 gallons per minutes @ 60 psi and shall not be less than .8 gallons per minutes at 20 psi. (CPC -403.6)
4. 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 able the shower draln. (,CPC 408.6)
5. Shower compartments and walls above bathtubs with Installed shover heads shall be finished with a smooth, nonabsorbent surface to a height not less than 72 inches
(0). (CRC 8307.2)
6, 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 409,4 & 408,3)
7. Water closet shall be set minimum 15 Inches from Its center to a side wall or obstruction and 24 Inch clearance In front of water closet. (CPC 402.5)
Electrical Notes:
1, 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 sleeping area in the Immedlate vicinity of bedrooms.
b. In each room used for sleeping purposes.
C. In each story within a dwelling unit, Including basements but not including crawl spaces and uninhabitable attics.
2. Approved carbon monoxide alarms shall be installed outside 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. (CRC R315,1)
3. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such circuits shall have no other outlets. (CEO 210.11(0)(3))
4. 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)
5. In all areas specified in 210.52, all 125 -volt, 15- and 20- ampere receptacles shall be listed tamper-resistant stant receptacles. (CEO 406.11)
;UPERTWO
Department
t 4U 2 i 4� O
34.5"
I Me. =
✓ideated
New SHOWER AREA
33"x57.5"
57.5"
10.5"
Toilet
Tiles, same
as kitchen's
18 %2 11
Va n ity 124"
REVIEWED FOR CODE COMPLIANCE
Reviewed By:
33"
hower
I:[-■
57.5"
J St FL, PROPOSED BATHROOM FLOOR PLAN
SMOKE I CARBON MO-NOXIDE ALARMS
0-WHER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING 'DIVISION
CUPE TING, 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - building(a.cupertino.org
PFR-IVUT CA[NINOT BF EIN,k'l,FD ,1 -D COMptF TED UNTIL THIS 'CFItT ICA I
HAS BM SWW AND WP , .r `DCIS "Y #U"ING 1C1:iV'i$1?C%
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.
GEN, ,RAL 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 complywitln
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) maybe 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 brat the alarms) referenced above has/have been
installed in. accordance with the manufacturers instructions and in compliance with the California Building,
and California Residential Codes. The alarms have been tested and are aperational, as of the date signed
below.,
t hava read and agree, to cornply with, they terms and condition& of this statement
Smoke aatd!CO fornv.dbc neuised 031181li4�
....
........... .... ... ® ..... . Dfe®
� ��
Confracfor�Nam`e:
Signature:_.. ...... ...... .... ..... L c # ....... Dafe'`
Smoke aatd!CO fornv.dbc neuised 031181li4�
OF LE
WATER -CONSERVING PLUMBING FIXTURES L
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
CUPERTINO 10300 TORRE AVENUE CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 building(a)_cupertino.org i(�c
Owner Name(�� t s s Permit Noel I (JJ
Address "
1 Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
V No Go to Question 2.
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?
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.
I to No Go to Question 3.
3. Is water service permanently disconnected for your building?
Yes Civil Code Sections 1101.1 through 1101.8 do not apply.- Skip the rest of the form and sign bottom of form.
OR� R No Go to Question 4.
4. 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. Please check ONE of the following:
My property is a single-family residential real property. See Civil Code Section 1101.4.
On and after January 1, 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).
El 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 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).
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. �_ s
Owner or Owner Agent's
Upon completing and signing this �Ceficate, please return it to the Building Division in order to
permit.
SB40 7 2015. doe revised 08126115