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B-2016-1910 CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS. CONTRACTOR: PERMIT NO:B-2016-1910 7473 ROLLINGDELL DR CUPERTINO,CA 95014-5812(359 32 010) ALLSTAR PLUMBING CORPORATION SAN JOSE,CA 95112 OWNER'S NAME: KOBAYASHI WILLIAM S AND CLAUDIA E DATE ISSUED:05/09/2016 OWNER'S PHONE:408-253-0371 PHONE O:(408)282-7020 ll LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-36 Lie.#732611 Contractor ALLSTAR PLUMBING CORPORATION Date 02/28/2017 X BLDG _ELECT X PLUM MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: GAS LINE REPLACEMENT TO FIRE PLACE;SINGLE LINE I hereby affirm under penalty of perjury one of the following two declarations: DIAGRAM REQUIRED FOR UILDING INSPECTOR 1. 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. 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:$4100.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupai icy Type: information is correct.I agree to comply with all city and county ordinances 359 32 010 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 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 u derstands and will comply with all non-point source regulations r t upertino Municipal Code,Section 9.18. 180 DAYS FROM L ST CALLED INSPECTION. Signature Date 5/9/2016 Issued by:ABBY AYENDE Date:05/09/2016 Z4,t, OWNS -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: following two reasons: All roofs shall be inspected prior t any roofing material being installed.If a roof is 1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an nspecfion,I agree to remove all new materials for inspection. 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 Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:5/9/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under a Chapter 34. 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 C pertino Municipal Code,Chapter 9.12 and the permit is issued. Health&Safety Code,Sectio 25532(a)should I store or handle hazardous 3. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I pse equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with tle Cupertino M cipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety C de,Sec' s 5,25533,and 25534.. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revolted. Owner or authorized agent: APPLICANT CERTIFICATION `Date:5/9/20116 CONSTR TION LADING AGENCY 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 of work's for which this permit i issued(Sec. ng Civ C.)I hereby affirm that there is a c instruc ion lending agency for the performance relating to building construction,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address judgments,costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands ARCH ECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 5/9/2016 professional i GENERAL PERMIT APPLICATION INVIAN E P COMMUNITY DEVELOPMENT DEPARTMENT,BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building(o-6upertino.Org Isc CUPERTINO P UMBING 0 MECHANICAL ❑ELECTRICAL [:11\41SCELLANFOUS PROJECT ADDRESS -7�/"J 2 /�`�� O� APN n 5q 2� �to P/ !�/l / J �I OWNER NAME Y `�. !\D �} QSI o PHT]IIE`/��3 6 7 7/ E-MAIL (A ��}f J STREET ADDRESS-,� n CITY, STATE,ZIP 2© FAX P rc " CONTACT NAME 1 _]� /� PHONE E-MAIL T STREET ADDRESS �� CITY,STATE,ZIP FAX J ��,� ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CQNTRACTORAGENT " ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME 1 r (J /`yam . LIC'E�NS� R/� ' , LICENSE TPE BUS.LIC � N •j�f �Q� COMPANY NAME ! ( /E-MAIL iG ` FAX STREET ADD CITY,ST��P J�sP PHONE ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS.LIC� COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROTECT IN'WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑ YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF NORK i ,y TOTAL VALUATION: I2ECELVED BY By my signature below,I certify to each of the following: I am the property owner or authorized agenttoact on the property owner's behalf. I have read this application and the information I have provi d 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 Taws relating to b construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: --SUPPI&MENTAL INFORMATION REQUIRED oI i Icy USE ol*L 1 ,�z� � O�ERTHE COI71�3'ER r £ ElFIPRESS „' '" BTl�D RD ' � DIAJOR? ME'MiscApp_2011.doc revised 06/21/11 WATER-CONSERVING PLUMBING FIXTURES VOL OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 ( (408} 7-3228•FAX(4 �8)7-17-3333• uildin cu ertino.or Owner Name Permit No. I I ' 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. $4,_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 110 1.1 through 11 10 1.8 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. o Go to Question 3. 3. Is water service permanently disconnected for our building? ❑ Yes Civil Code Sections 1101.1 through 11101.8 do not apply. Skip the rest of the form and sign bottom of form. �Z_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 properly 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 101.8 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 read 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 iimproveimepts). ❑ 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 thebuilding(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 propertyi 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 or Owner Agent's Signature: Date;6//Z/& Upon completing and signing this`Oertificate,pease return it to the Building Division in order to final your builcTing permit. SB4072015.doc revised 08126115 BUILDING PERMIT CANNOT BE FINALED AND COMPLETED.UNTIL THIS ` a CERTIFICATE HAS SEEN��IGNED AND RETURNED TO THE BUILDING DIVISION, Non-Compliant Water-Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage 2013 CALGreen Div.4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate Single-Family Multi-Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush) Urinals Exceed 1.0 0.5 gallons/flush Gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower,the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. _ Faucets— Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets— Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown,it is not required to be upgraded. SB4072015.doe revised 08/26/15 LoSMOKE / CARBON MONOXIDE ALARMS FILE OWNER CERTIFICATE OF COMPLIANCE &717 -F COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333• building (a7cupertino.org 1 / (?� Permit No. � (V'� I _ Address l � ?'� e-y� #of Alarms Smoke: _ Carbon Monoxide: oZ f PERMIT CANNOT BE FINALED AND COMPLETED,UNTIL THIS CERTIFICATE HAS BEEN ' + AND:HET 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, 013 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 follo(wing 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 dwellings which do not contain fuel-burning Carbon Monoxide alarms are not required,inappliances 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 CBCT Sections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected to the bullflding 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 manufac }rer,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 ag ee to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: wi gi 1�ovm. k Si nature...r,... 'r ......... / ,...................................Date: Contractor'Name: Sinatule...................................................................Lic.#......................................Date: ................... Smoke and CO fonn.doc revised 03118114