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B-2017-0535CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0535 10170 PHAR LAP DR CUPERTINO, CA 95014-1114 (326 39 009) FRANS CARTWRIGHT SAN JOSE, CA 95133 OWNER'S NAME: SRIDHAR THIRUMALAI AND SUJATHA TRUSTEE DATE ISSUED: 04/04/2017 OWNER'S PHONE: 408-252-2023 PHONE NO: (408) 250-6672 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-36 Lic. #828814 Contractor FRANS CARTWRIGHT Date 12/31/2017 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: (I� 50 GAL WATER HEATER - GARAGE I hereby affirm under penalty of perjury one of the following two declarations: i. 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 PIC Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $1400.00 APPLICANT CERTIFICATION certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 326 39 009 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. Additionally, the applicant understands and will comply with all non -point WITHIN 180' DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signaturrec �__._�—� i Date 4/4/2417 Issued by: Kim Dunbar Date: 04/04/2017 OWNER -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 to any roofing material being installed. If a roof is i. 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 properly, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 4/4/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER i. 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 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 2553 and- 41. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent:' i APPLICANT CERTIFICATION Date: 4/4/2017 / I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY 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 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 DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 4/4/2017 Professional COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION INU, �a I 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.or misc O g PLUMBING MECHANICAL F-1FT.FC'.TRTC,AT. I IMTCt':RT.T.ANFCITTC PROJECT ADDRESS 16 l q "7 0 ��� � � � � APN # e--- OWNER NAMr i p �[ � PHONE d 0• 2- (G' -2 3 E-MAIL STREET ADDRESS r7b V\or CIT STATE ZIP A FAX CONTACT NAME PHONE"VL po 9-,! !jr t Q 1 ( STREET ADDRESS 6 0 , II ^ _ lJ� �X� C STATE,, ZZIP 4 , C 0 r (J 10�� FAXw �(I ` 1 Y ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT <CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LIC YN LICEN1 BIDS. C COMPANY NAME EMAIL FAX STREETDREffSS cQ p �p ET K CITY, STA'TE�ZIPP �� /I 2 Sl PHONE ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIC COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF 91F7DUPLEX DUPLEX ❑ MULTI -FAMILY BUILDING: ❑ COMMERCIAL PROJECT IN WBALAND ❑ YES URBAN INTERFACE AREA ❑ NO PROJECT TN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN ❑ ITS EICHLER HOME? ❑ NO DESCRIPTION OF WORK TOTAL VALUATIONi —f By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I hav the scription of Work and verify it is accurate. I ab ee t comply with all applicable local ordinances and state laws re Q action. author n tives of Cupertino to enter the above -id tified roperty for inspection purposes. —14 e r Signature of Applicant/ C,.. �— - e: �-C SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE oniY_. " - -� ❑ OV ER THE COUNTER c, f" 0 EXPRESS.'.. .-- © STANDARD U_ Z 4 �.. _ E]ZARGE_" " 0 MAJOR MEPMiscApp 2011.doc revised 06/21/11 CUPERTINO PURI'O V L SMOKE I CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • hi iitriinn(nlri sncrtnn n.., This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section R314; R315, 2016 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, R315, 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) - (Smoke alarms shall not be located within 3 feet of bathroom door) X X -- On every level of a dwelling unit including basements and habitable attics X X Within each slee2ing 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 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 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 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 specified below have been tested and are operational, as of the date signed below. Address: i0 t ? a p Rte L -*f _ffy� ve Cv P ek IT > APO , e 4 9J -b /�t Permit No. B, 12,017 � -�- Specify Number of Alarms: #_S moke Alarms: t v [ i# Carbon Monoxide Detectors: = 1 have read and agree to comely with the tarm.c anrt rnnrlftlnnc of th« &nfnmonf Owner (or Owner Agent's) Name: A2vm /A'( sH sewn SU%,,--rhe Signature .............. ............}...... .................. .................... .............................. ................ Date:................... Contractor Name: Signature...................................................................... Lic.#........................................ Date: ........ ........... (911_11S[10_� L1 Smoke and COform.doc t•evised 01/10/2017 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 - building(&-cupertino.ora Owner Named / ,� �},�'� % f R v1 A110 �v� q lrv'r bee Permit No. 2-e t 7 0S 3 Address to 1 '? d p m mt CAP J 3'i v -e 6,or c o�?1,'v rD Com} 93� l Y- 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. gNo 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. 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. ,< 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. l P i `�' " l" " L, 1 y, 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). ❑ 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). 1, 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. Owner or Owner Agent's Signature: Date: 7 upon compienng ana signing tors uertincate, please return it to the Building Division in order to final your building permit. SB4072015.doc revised 01105117