B-2016-2813ITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-2813
923 BROOKGROVE LN CUPERTINO, CA 95014-4667
(375 39 026)
DAVILA PLUMBING
COMPANY INC
SAN JOSE, CA 95151
OWNER'S NAME: Daniel Helmick
DATE ISSUED: 09/27/2016
OWNER'S PHONE: 408-828-8985
PHONE NO: (408) 449-0030
LICENSED CONT4ACJOR'S CONTRACTOR'SDECLARATION
BUILDING PERMIT INFO:
License Class C-361 Lic. x#934263
Contractor DAVILA PLUMBING COMPANY INC ate 02/28/2018
X BLDG —ELECT X PLUMB
I hereby affirm that i am licensed under the provisions of Chapter 9 (commencing
MECH X RESIDENTLAL COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
REPLACE SEWER MAIN AND PROPERTY CLEAN OUT
I hereby affirm under penalty of perjury one of the following two declarations:
r. I have and will maintain a certificate of co ant to self -insure for Worker's
Compensation, asprovided for by Section: 700 of the Labor Code, for the
J
erformanee of the work for which this permit is issued.
have
I and will maintain Worker's Compensation Insurance, as provided for by
Section3700 of the Labor Code, for the performance of the work for which this
Sq. Ft Floor Area:
Valuation: $4090.00
permit is issued.
1 certify that I have read this application and state that the above
information is correct. I agree to comply with all c ty and county ordinances
APN Number:
Occupancy Type:
and state laws relating to building construction, a id hereby authorize
375 39 026
representatives of this city to enter upon the aboi a mentioned property for
inspection purposes. (We) agree to save indemr ify and keep harmless the
City of Cupertino against liabilities, judgments, cc sts, 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 comply with all non -point
source regulations per the Cu ertino Municipal C de, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
-Signature Date 9127/2016
Issued by: Abby A e� nde
OWNER DECLARATION
Date: 09/27/2016
-BUILDER
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
RE -ROOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
i. I, as owner of the property, or my employes 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 st, ucture is not intended or offered for
inspection.
sale (Sec.7044, Business & Professions Code)
2. 1, as owner of the.property, am exclusively contracting with licensed
Signature ofApplicant:
contractors to construct the project (Scc.70 ; Business & Professions Code).
Date: 9/27/2016
I hereby affirm under penalty of perjury one of th following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A'1 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 pei mit is issued.
HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Comp e ation 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
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any mann so as to become subject to the
air contaminants as defined by the Bay Area Air Quality Management District Iwill
Worker's Compensation laws of Californi . If, after making this certificate of
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 255505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
G /
Owner or authorized agent:
APDL ICANT CERTIFICATION
Date: 9/27/2016
I certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city, and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
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,
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
ARC'HITECT'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 9/27/2016
Professional
r GENERAL. PERMIT APPLICATION MEP
CONidiUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 buildingecuDeririo.org
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y Iny si na ure beloi3', I ce, pry to each of the following: I ain t_ne property owner or authorrized agent to act on the prop ,!-,-,\,
application and the inionnation I have provided is correct. I have read the Descrption of \Fork and verify it is accurate. I
ordinances and state laws relating 4o buiidffiZ construction. I authorize representatives of Cupertino to tnterthe above-ide
Signature of: pplican ` o nt: [ V� Date:
owner's b half. I have read this
agree to comply with all applicable local
tined property for inspection purposes.
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?SEP?�/i_rc.�pp_201 Ldoc rerised 06./2.7/11
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
V
l 10300 TORRE AVENUE , CUPERTINO, CA 95014-3255
(408) 777-3228 - FAX (408) 777-3333 - building(ftupertinomg
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section 8314, 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
-vicinity
SMOKE AILARl4
CO ALARM
Outside of each separate sleeping area in the immediate of the
bedroom(s)
X
X
On every level of a dwelling unit including basements
X
X
Within each slee2ing room
X
Carbon Monoxide alarms are not required, ffi' dwellings which do not contain fuel -burning appliances and that
donot leave ci-nattached ga,rage., 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, ceili-nig, fihishe& or there is no access by means of attic, basement or, crawl.
space,. Refer toCRC SectionR344and CBCSectaio'ns 907.2.11.4 and 420.6.2. An electrical permit is re.aired for
alarms whicla, must be connected to, the buil41ng, wiring.
As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above
installed',, in accordance with the m --artuf a c tur er's in's tr uc tions and in compliance with the C alif', o
and Califon a Residential Codes. The alarims, have been tested and areoperational, as of the da ned
below. V I L_ L
il Glave ."read and, a area foen m, n1v with thp; tarmac nnr1,'rv)nrHf1'nnC of f. I"; c P 1- I,
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CUPERTINO
Owner Name
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 FAX (408) 777-3333 • buildingcupertino.oro�
y e V V Z,-,, Permit No 0)
Address 7 z
1. Is your real property a registered historical siteT
❑ Yes Civil Code Sections 1101.1 -through 1101.8 do not apply.
%(No Go to Question 2.
Skip the rest of the form and sign bottom of form.
2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its
pl bing, 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,
❑ No Go to Question 3.
3. Is water service permanently disconnected for your building?
11YYesCivil 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.
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,l, 1994.
Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
1Yes My real property is built and available for use or occupancy on or before 7anuary 1, 1994.
Civil Code Sections 1101.1 through i 101.8 apply. Check one of the three following statements and sign
bottom of form..
j�acheck ONE of the following:y 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).
❑ 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- corn i nt
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
plumbing fixtures throughout the building (regardless of whether.property undergoes alterations or p e s
1, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliantrumbing fixtui s ✓ill be
replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
through 110 1.8, 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 followine naee.
I Owner or Owner Agent's Signature: T.-i�"- .-' —� Date: ( c f
Upon completing and signing this ISeAfflicate, please return it to the Building Division in order to final your building permit.
SE -407 2015.doc revised 08126115
SB407 2015.doc revised 08126115
Non-Compliant
l
Water-Conserving Plumbing Fixture
PlumbingFixture
(Fixture Complying with Current Code Applicable to New Construction)
Fixture Type
Maximum 1Nater Usa a/Flow Rate
Water visage
/Flow Rate
2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPG Ch. 4
2013 CALGreen Div. 4;3 2013 CALGreen Div. 4.3 2013 CA Green Div. 5.3
Water Closets
Single -Family Multi-Family Commercial
Residential Residential
(Toilets)
Exceed .6
gallons/flush
� � Single flush toilets: 128 gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite,
Urinals
exceed 1,0
€ average flush volume of two reduced flushes and one full flush
0.5 gallons/flush
gallons/flush
Showerheads
Exceed 2.5
gallons minute
2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
per
C.S. EPA WaterSerise 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
Faucets —
Exceed 2.2 gallons (
allow only one shower outlet to be in operation at a time.
Maximum 1.5 gallons per Within units:
Lavatory
Faucets
per minute (
0.5 gallons per minute @ 60
minute @ 60 psi; minimum Maximum 1.5 gallons psi
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
Faucets —
Kitchen
Exceed 2.2 gallons
per minute g
60 psi
1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60
Faucets
a
60 psi p psi
@ 60si May temporarily increase May temporarily
up to 2.2 gallons per increase up to 2,2
!
minute @ 60 psi, and must gallons per minute
I
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
1
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 maybe
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.
SB407 2015.doc revised 08126115