B-2016-2682 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2682
20065 CEDAR TREE IN CUPERTINO,CA 95014-2004(316 34 003) OVERMILLER INC
CONCORD,CA 94520
OWNER'S NAME: PANCHANATHAM SIVAAND MUTHIAH RANJANI DATE ISSUED:09/08/2016
OWNER'S PHONE:408-203-5032 PHONE NO:(925)798-2122
LICENSED ONT TOR' DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#323839
Contractor OVERM ILLER INC Date 07/31/2018 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:
PROPERTY LINE CLEAN OUT
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 Am DV
Compensation,as provided for by Section 3700 of the Labor Code,for the
/) performance of the work for which this permit is issued. SAN ITAA,EK,- I
v z. 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:$3875.00
APPLICANT CERTIFICATION
I certify that l 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 316 34 003
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. WITIIIN 180 DAYS OF PERMIT ISSUANCE OR
Additionally,the applicant understands and will comply with all non-point
source regulations per the Ciapertin cipaI Code,Section 9.18• 180 DAYS FROM LAST CALLED INSPECTION.
Si tures Date 09/8/20116 Issued by:Kim Dunbar
Date:09/08/2016
OWNER-B RDECLARATION
I hereby of m 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)
z. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Dater /09 8/2016
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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. HAZARDOUS MATERIALS DISCLOSURE
z. 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
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
3. 1 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 Man eme District I
Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Co e,C ter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,S tions 25505,25533,a 25334,
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. Owner or author' -age
APPLICANT CERTIFICATION Date:09/8/2016
certify that 1 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 I hereby affirm that there is a const ction 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 DECL4JUUON
Code,Section 9.18. 1 understand my plans shall be used as publ rds.
Signature Date 09/8/2016 Pr -
r -
GENERAL PERMIT APPLICATION M E P
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
9 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
(408)777-3228 FAX(408)777-3333• building5cuoerino.org
CUPERTINO
[ALiJI11]3IING ❑3vMCPLkhIC.AL ❑ELECTRICAL /
❑1`iISCELL?11'EOUS
PROTECT ADDRESS �- r-� .�.FAr� ��/ 5 ( J 003
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O%VNERNAA 'e-7711A E-h/i y
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STP'tETsTJORESS I CITY, STATE,ZIP FAX
a/aI
CONTACT NAME PH I E-A/TAIL
STREETADDRESS CITY,ST:TE ZIP FAX
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❑ OVQIER ❑ OW-la-BUIL DER ❑ O'WKER AGENT Rft-0,,TRACTOR ❑CO\ZRACTOR AGE\T ❑ AiZCHITECT ❑ENGA=ER ❑ DE\ELOPIER ❑ TELA-T
CONT,ACTORNAMEI LICENSE NUA,BER TSE it PE I BUS.LTC 1
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COMPANY NAME E-NHAIL FAXPei
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STREET ADDRESSI CITY,ST. ZIP PHONE
ARCHITECT/ENGINEERNAn;E LICENSE NUMBER BL'S.LTC
COIMPA?Y NAME E-FLAIL FAX
STREET ADDRESS I CITY,STATE,ZIP PHONE
USE OF SF,-,.DLPLEX ❑ 1,4ULTI-r'AMILY I PROJECT P.NILDLANM ❑ YES PROJECT Ih ❑YES 1S TI-M BLDG AN ❑ 1 Es
BLaDP.G:. ❑COKKERCIAL URBAN INTERFACEAREA ❑ NO FLOOD ZONE ❑NO EICHLERHOME? ❑ NOS
DESCRIPTIO':OF SV%ORK
TOTAL V%ALUATIOY:
By my Signature below;I cer i�,o
the follo�iing: the proper) o«ner or authorized aa_ t to a^ on th propem oxmers behalf. I have read his
application and the informatioided is co�;ect. scaciptio f N?,eork.uld veri) it is accurate. I agree to comply with all applicable local
ordinances and state laws relg cd�" ctI -. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Si nature of Applicant .ni Date:
i\TAL IINFORb6ATION REQUIRED
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4 EP-ViscApp_2011.doo revised 06121/11
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SMOKE / CARBON MONOXIDE ALARMS FIL
[OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•'BUILDING DIVISION
I. 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
CUIPERTINNIII(408)777-3228•FAX(40$)777-3333* buildingCcr�,cupertino.arg
�,� Per�x$tNo. Ivy
Address 4f-�`�' t,_ b'C ,f #of Alarms Smoke: jS Carbon Monoxide:
PERMIT CAIVNt)T BE E ;zLED ANAv C()MPLUETI✓D fTIII CHIS GERTI��CATE n'
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PURPOSE
` .This affidavit is.a self-certification for the installation of all required Smoke and CarbnrrMonoxide Alarms for
compliance with 2013 CRCSection 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 multifamily 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 8314 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 induding 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 attache.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.
l
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
notresult in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl
spaee.'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-reforenced 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
I have._read and agree to comply with the terms and conditions of this statement
Owner(or Owner Agent's}Name;
,�ah 14 r i e
c r";' G►1 �'1 Signature........ ....... :. ......... ..... 2 .................................... ..............Date: Pff/.....
Contract r Name:
Signature ........................_.......................................Uc.#................... ..............Date: ...................
Smoke and CO form.doc revised 0;118/14
i
I
WATER-CONSERVING PLUMBING FIXTURES art
OWNER CERTIFICATE OF COMPLIANCE - "
COMMUNITY DEVELOPMENT DEPARTMENT.BUILDING DIVISION
UP F2T1� Q 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 r
(408)777-3228•FAX(408)777-3333• building cu ertino.or31 � /�
Owner Name 1C est h � , r` �o
Permit No. V J
�h
Address �ta
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.
R-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 Section's 1101,1 through 1101.8 do not apply.
❑ The licensed pl}nnber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
E;�`No Go to Question 3.
J
3.. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sectiones 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
PNo Go to Question 4. r!
4. Is your real property built andavailable 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.
tom'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. Ple se 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
properly undergoes alterations or improvements).
My property is a mult family 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-
conseiving plumbing fixtures throughout the building(regardless of whether property undergoes alterations or
improvements).
My property is a connnercial 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.
g
Owner or Owner Agent's Signature: -- , h Date: 0 1 f�- .
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
SB4072015.doc revised 08/26/15
I
BIDING PAWW 19AMM,XRON9 .
y'-t
Non-Comb .p
�I�ant 'Mater-Conserving Plumbing Fixture
Plumbin ixture1 (Fixture Complying with Current Code Applicable to New Construction)
Fixture Type {{ Maximum Water Usage/Flow Rate
WaterUsage 2013 CPC Ch.4 2013 CPC Ch.4 2013 CPC Ch.4
/Flow Date 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3
Single-Family Multi=Family Commercial
Residential residential
Water Closets Exceed 1.61 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 1 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
l (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
liexceed 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`g allons 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 psis 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
n
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.
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07 2015.doc revised 08126/15
SB4 ,