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B-2016-2201
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2201 851 S TANTAU AVE CUPERTINO,CA 950144648(375 38 039) CUPERTINO PLUMBING INC SAN JOSE,CA 95124 OWNER'S NAME: WU JAMES LAND AIMEE DATE ISSUED:06/23/2016 OWNER'S PHONE:48-252-0191 PHONE NO:(408)253-0618 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class PLUMBING Lie.#6249 Contractor CUPERTINO PLUMBING INC Date 04/30/2018 X BLDG —ELECT X PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing 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: COOPER REPIPE I hereby affirm under penalty of perjury one of the following two declarations: t. 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. ve 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:$4000.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 375 38 039 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 and stands and will comply with all non-point source regulations per ert u ' ' al Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signat Date 6/23/2016 Issued by:Abby Ayende Date:06/23/2016 OWNER- DER 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 to 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 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) 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;6/23/2016 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 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 permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous 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 Quality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505 3,and 25 4. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:6/23/2016 1 certify that I have read this application and state that the above i�lformation is CONSTRUC LE G GENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction 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 againt 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 Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 6123!2016 Professional GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 misc CUPERTINO (408)777-3228•FAX(408)777-3333•buildings D_cupertino.org 9D-2-0t(0 - no d UMBING ❑MECHANICAL []ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS APN# OWNERNAMEHONE ©I O I UVE-MAIL STREET ADDRESS fZ y j,� dw X CIT STATE,ZIP"0 CA Cp@bIg � FFAX CONTACT NAME IVI 41 �j PHONE (/ "( V �•� E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENTCLQ'ONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRAC OR N ME LICENSE NUMBER LIC ENS TYPE BUS.LIC# ! ^� (> (� C.. CO PANYNAME ��r I E-MAIL FAX STREET DRE S �Y►Y b CITY,STATE P f PHONE GljG6k. � � 9 d9--3�l 2Q 2 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or Duplex ❑ Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA ❑ Yes ❑ No FLOOD ZONE ❑ Yes ❑ NO DESCRIPTION OF WORK I TOTAL VALUATION: RECEIVED BY-. e owner or authorized agent to act on the roe owner's behalf. I have read this B m signature below,I certify to each of the following: I am the property 0 Y Y g � �' g P P rtY g property rtY application and the information I have provided is co av5 aRd cripti f Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relaf to buil a nstruction. orize Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: 23 S MENTAL INPORMATION REQUIRED OFFICE osE ONLY w ❑ OVER-THE COUNTER,. , 0'_ EXPRESS U - USTANDARD .❑ LARGE ,MAJOR MEPMiscApp_201 Ldoc revised 03/16111 FILE SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE � f COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333• buildingC@-cupertino.org Permit No. h3 Z /L- _2-0 Address -7 l o-_t L- #of Alarms Smoke: Carbon Monoxide: PERMIT CAOT BE FINALED AND �OMPLETED UNTIL THIS CERTIFICAT AS SEES SCCI\TEg AN1 RFTTR3D TO THE BUILINGAISIQN u � 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 Carb Dn 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) _ WOOn every level of a dwellingunit including basements v X X ithin earl-i 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 con 1ply 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 batter 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 CSC 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 CaliforniaBuilding 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 AgenfsF)Name: Signature..,.... .. /h !! .... _ ........ ........ ....... ......... .... ....................... .ate: ................... Contractor Name: r�/- t�iadt'!® Signature...................................................... .........Lic.#...................................... ate: Smoke and CO formdoc revised 03118114 WATER-CONSERVING PLUMBING FIXTURES FILE OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-32 8•FAX(408)777-3333 building(a)cupertino.org Owner Name O-a M( S Permit No. 2 D2,2�, Address T670'7 f_C.,r° e— 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. [9 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 oi its plumbing,installation of water-conserving plumbing fixtures isnot 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. R0 No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101A through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. CST No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1,1994? El No My real property is built and available for use or occupancy affer'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: f P 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 plumb' fixtures to be replaced with water-conseiving plumbing fixtures throughout the building.On or before January 1,200,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My properly 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 o 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 frctures 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: Upon completing and signing this ertificate,please return it to the Building Division in order to final your building permit. SB407 2015.dol revised 08126115