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B-2017-1540 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1540 1122 SCOTLAND DR CUPERTINO,CA 95014-5051(362 28 019) VISIONARY HOME REMODELING INC SAN JOSE,CA 95126 OWNER'S NAME: MAN STEVEN SIU AND FEI YU DATE ISSUED:09/11/2017 OWNER'S PHONE:408-393-6863 PHONE NO:(866)990-8474 JJCENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class f3 Lic.#1001351 Contractor VISIONARY HOME REMODELING INC Date 02/28/2019 3X BLDG X ELECT PLUMB MECH YX 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 is full force and effect. JOB DESCRIPTION: KITCHEN REMODEL-(432 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: REV#1-INSTALL 10(N)LIGHT FIXTURES-ISSUED 10/4/2017 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 r'\.l )'-rformance 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:$35000.00 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 362 28 019 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 understands,'and will comply with all non-point source`regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 1' nature.' ' j .. .. bate 10/4/2017 Issued by:Jasmine Archbold Date:09/11/2017 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 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:10/4/2017 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 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall '' be deemed revoked. ,Owne ti •uthorized --a APPLICANT CERTIFICATION Da'Vie . I certify that I have read this application and state that the above information is CONSTRUCTION LENIIING-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. I understand my plans shall be used as public records. . Licensed Signature__- Date 10/4/2017 Professional . . CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION toN, 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255 e.,,,,, (408)777-3228 • buildin f�cuperti.no.prg PEMIT#B-,7--C7l1- - ISt-kb CUPERTINO REV# 1 DEF ❑NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. E MEP E RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS 1, ;', _s`v 6 kW /1� APN d 3 Co? 'Z ( 'U OWNER NAME }r-' "} `� PHONEvYE-MAIL E '"4 60,ah 1,n041 (-to -3J,SC c STREET a � 0J,,,e D)-- CITY,STATE,ZIP J/ f�p WON/TRACTOR NAME H fi �OMPANY NAMELICENSEE NUMBER LICENSE YPE 7 '\' Jn//Ij aY VII- %1 lie s ,tile, k'2 /35/ STREET ADDRESS/ ✓^ IO C'(,1/e h J ^ CITY,SfM� V r'o`i ` /0.7 s,0 E-MAIL � /�r PHONE BUS.LIC S l `I° .9.0 4i 0 ARCHITECT ❑OWNER ❑OWNER AGENT 0 CONTRACTOR AGENT❑ENGINEER 0 DEVELOPER 0 TENANT CONTACT NAME E-MAI cD11>i 0 o,v101,6 b STREET ADDRESS CITY,STATE,ZIP PHONE LI d 0 arc (A, /9V e 5o Wb (a. & LA-0s . 7 k G t,,,,a(/ ..i.TON / . kfg k t-cli,�� �ayrativ, �h-Br6 I& l /,li d` e h b l 6s- ,je, ft, G- L 1r I.Ai rt-IJip Q,, Intev1 1/ ' 'V' Vul/G Nodi' Ntai•t tS(OV( Citu . (/ 4-ii flufs// 11� is 57N� r L_I'j,. 1.'� � JI:"r! . W er ,,I,� ) !,ru v^,,,°i; . „ ,_ I SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY ❑ aD1 i ❑COMMER AL EXISTING USE EXISTING SF NEW FLOOR SF PORCH SP DECK SP DEMO SE STORIES I TOTAL NET SF USE TYPE OCC SQ.FT. 'VALUATION(5) REMODEL REMODEL KITCHEN IREMODELOTHR GARAGE 0 ATTACHED BATHROOM SF cD Ci p. SP SF 0 DETACHED EXISING ❑Y25 EICHLEIR ❑YES SECOND STORY ADDITION ❑YES FIRE SPRINKLERS 0 NO 0 NO 0 NO DWELLING SECOND DWELLING ❑YES ❑ATTACHED DETACHED OTHER UNITS d UNITADDITON: ❑NO S F POOLS.' 0 FIBERGLASS 0 VINYL-LINE) ❑GUNITE ❑PREFABRICATED POOL-SF - SPA-SF I 'SPA ATTACHED❑YES 0 NO I TOTAL-SF EEIIVEED‘BY: T'OTA'L VALUATION: Connnerriul uEMrrlfi-Fnn,fly BaIl$itig$with Public Sruiruuriue Puuls.reniiires DeparImeaI o/Env/owuteu4tl Han!ntnuuviI � c(JWV,..` �.f L 5!T 0 0 RE-12001 EXISTING ROOF TYPE: 0 BUILT-UP ROOF 0 ASPHALT SHINGLES❑WOOD SHAKES 0 WOOD SHINGLES 0 TILE OTHER(SPECIFY)^' !— REMOVE/REPLACE 0 NOI IF NO PLYWOOD ❑'A" ❑3/S" PLYWOOD TYPE: PITCH: ROOF'CLASS ❑YES I` d OP LAYERS THICKNESS❑S/e" OTHER ❑ose ❑CDX amiss •12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF DASPHALT SHINGLES❑WOOD'SHAKES❑WOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy - SP lot SQUARES 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 have read the Description of Work and verify It is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino io enter the above-identified property for inspection purposes. I acknowledge and authorize all information contained on this application form • to be made available for public record, //, / Signature of Applicant/Agent; Date:(.......0//1/(9- SUPPLEMENTAL ( ( 9— SUPPLEMENTAL INFORMATION REQUI ED l�� *New SPD/Second Dwelling Units/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. , *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. ' . *Copy of Planning Approval Letter or Meeting with Planning prior-to submittal of Building Permit application. *HOA-Provide a letter of approval from the Home Owner's Association BldgApp_2017.doc revised 08/01/17 Assessor's Parcel Number: ELECTRICAL: Name of Owner: Pj c.( CO3PC-7: • All instated lighting shall be high efficacy.[CEnerC 150.0(k)1A] t ,G �1 A��� '�tSIO(4 i • Under-cabinet lighting must be switched separately from other lighting.[CEnerC 150.0(k)2L] Contact Person: Sue- C Tl� t — IPhone: etC)g) � • (4 A minimum of two 20-amp small appliance branch circuits are required to serve countertop and wall receptacles in the kitchen,pantry and dining room[CEC 210.11A].No built-in appliances are allowed on these circuits(except an electric clock or the ignition of a gas range). . Project Address: t O (C 'Z -D U - rr—F tie- i • Individual(dedicated)circuits are required for garbage disposals,microwaves,compactors,and dishwashers.[CEC210.19A1 b] Scope of Work: —re,21 rr� I�)PI,l ) C' 3 t S CCh U N c�{Z • AFC!(arc-fault circuit interrupter)protection is required for all 120V 15-&20-amp kitchen circuits.[CEC210.12A] i i • Receptacles shall be installed at each countertop space t 12 in.in width[CEC 210.52C1].Receptacles shall be installed so that no point along the wall line is more Applicable Code: 2016 California Residential Code(CRC) KS71,'fki5t.( ` spa/ 24 inches horizontally from an outlet in that space[CEC 210.52C1].The maximum spacing between receptacles,measured on the wall-countertop line,is 48 T� inches. 2016 Califomia Plumbing Code(CPC) _ T 2016 Califomia Mechanical Code(CMC) t �t C /�' �G��( C� fi All receptacles serving kitchen countertop surfaces shall have GFCI protection[210.8A6]. 2016 California Electrical Code(CEC) >;( �4- .. PPLI,A-�C'. • Countertop receptacles shall not be installed in a face up position[CEC 406.5E].Listed"pop-up°receptacles are allowed[CEC 210.52C5].Receptacles or strip 2016 California Energy Code(CEnerC) outlets can be installed on the underside of the cabinet above the countertop if within 20 inches of the countertop. 2016 California Green Building Standards Code(GRN) • Dishwashers require GFCI protection,including 240-volt dishwashers.(new in 2016 codes) PLUMBING: • All GFCI device controls must be in readily accessible locations.Outlets behind a dishwasher are not readily accessible.GFCI protection can be provided by using a GFCI circuit breaker. • Dishwashers shall be connected with an approved drainage air gap devices located above the flood level rim of the sink[CPC 807.3]. • Newly installed kitchen faucets shall not exceed 1.8 gallons per minute[GRN 4.303.1.4.4]. • Ali general purpose and countertop receptacles must be tamper-resistant.[CEC 406.12k] • All piping'/,inch or more in diameter and all hot water pipes from the heating source to the kitchen fixtures must be insulated with min.1-inch thick insulation • Corner sinks separate the space on each side when the distance between the corner and the sink is<18 inches.If t 18 in.,the 2 ft./4 ft.rule continues behind the sink[CEC 210.52C4].tCEnerC 150.0(j)2].Existing inaccessible piping does not require insulation. • On islands and peninsulas only,receptacles are allowed on the side of the cabinet,not more than 12 inches below the countertop and with no overhanging MECHANICAL: countertop greater than 6 inches[CEC 210.52C5 exc.] • Bar-type counters are considered wall space.Wall spaces a 2 ft.require receptacles so that no portion of the wall is more than 6 ft.from a receptacle outlet, • A mechanical permit is required to replace a kitchen exhaust hood that includes an outside air vent The vent must terminate on the building exterior at least 3 ft. measured at the floor/wall line[CEC 210.52A1&2]. from other openings into the building[CMC502.2.1].Flexible(co- ugated)ducting is not allowed for exhaust hoods[CMC 504.3]. COMMUNITY DEVELOPMENT DEPARTMENT • A range hood/microwave combination can be cord-and-plug connected if the circuit is an individual(dedicated)branch circuit.The receptacle outlet shall be a single type,not a duplex receptacle that would accept two plugs[CEC 422.1664]. BUILDING DIVISION C U P E RTI NO • The 24-inch/48-inch rule does not apply to island or peninsular countertops.These require only one receptacle per countertop space,regardless of length[CEC APPROVED 210.52C2&3].An island or peninsula is considered divided into separate countertop spaces when a sink or range is installed and does not have 12 inches of space This set of plans and �peafications MUST be kept at the c UPERTINO behind it.See the diagram on page 2. job site during constriction It is unia,,,fLI to make any _ -, Building Department changes or alter^;tions on san,.e, or to deviateF `'I building Official. 0 1} 2011 therefrom,'without r royal f crr ' - �' •`a OCTU The Stamping of to aid . : SHALL NOT be to permit c ANCE — 3'-5 /2ii y - of any,I avisior �„-4 BY ajit6—;-- 4--tk).0"-Y--0- 2)\ — ,a.... ... - x,..--, . ••- ' ' . .. . , DATE 1 O (-{ i 2c2! I , . , YYr VVPAeL P O YV ----.. IIIP r 1^12142R 1^12142R 1^t2cl42R 1^136152SR I0%3 YVZ9=3 Ot 130 W2 3 OTC332b6lb B25LhefSeries Dishwasher_ - I DD D r a R a �_`3 L. — — — ��J�'J 1' I.,_ — — B9Lsndard SingkPishwasher(dratuers)HB23R I _ I- z --1-13. --11:1-----1-11— I c) - - _ _ * Im K I�" I N — n7 /Ar rcl, - c==- .- tn ii) 1 -----') o RB33� B24L V�Ov it /ma 1Ilia 11100 \ O � ,0 .. bte \ In I •=1RB o A v 1 • el p ss EXISTING KITCHEN FLOOR PLAN PROPOSED KITCHEN FLOOR PLAN CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1540 1122 SCOTLAND DR CUPERTINO,CA 95014-5051(362 28 019) VISIONARY HOME REMODELING INC SAN JOSE,CA 95126 OWNER'S NAME: MAN STEVEN SIU AND FEI YU DATE ISSUED:09/11/2017 OWNER'S PHONE:408-3936863 PHONE NO:(866)990-8474 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class)3 Lic.#1001351 Contractor VISIONARY HOME REMODELING INC Date 02/28/2019 X BLDG _ELECT _PLUMB 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: KITCHEN REMODEL-(432 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: /k0 I have and will maintain a certificate of consent to self-insure for Worker's I 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 Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$35000.00 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 362 28 019 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 understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. • Date 9/11/2017 Issued by:Jasmine Archbold Date:09/11/2017 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 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:9/11/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER '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. 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. 11 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 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 the Cupertino Municipal Code,Chapter 9.12.ancl 'exemption,I become subject to the Worker's Compensation provisions of the the,9 ealth&Safety Code,Sections 25505,25533,and 25534. Labor Code,1 must forthwith comply with such provisions or this permit shall y° be deemed revoked. 0 authorized agent: APPLICANT CERTIFICATION :te:9/11/2017 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. I understand my plans shall be used as public records. Licensed Signature Date 9/11/2017 Professional f CONSTRUCTION PERMIT APPLICATION \rile/ COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION V10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 .41.19,, s (408) 777-3228 • building@cupertino.org PEMIT#B-Z-Ct 1- - IS'kd CUPERTINO REV# DEF# ❑ NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.I. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS APN I 2 ca CD 19 OWNER NAME �., PHONE ' E-MAIL 61lrGti in °? --3f S &A - STREET ADDRESS if alk S� b D CITY, STATE,ZIP V / a " (CONTRACTOR NAME 0 OWNER-BUILDER COMPANY NAME C- //P � LICEI'ISEE NUMBER� LICENSE TYPE g I STREET ADDRESS f (CITY, T E, IP V I I, I 440/VW Ae I //y�S�S'� E-MAIL /�� e HONE JC BUS.LIC a"' 0 ARCHITECT 0 OWNER 0 OWNER AGENT 0 CONTRACTOR AGENT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTACT NAME ) M /C� E-MAILr `/ 0 lit�L /1I k n /��i � /���`r STREET AD RES$ 1/ CITY,STATE,ZIP / 1. 'Iq PHONE(J/C/ �LI o �l a►^^ 411 e 5 0 .. g 7-d, ,Tj( DECRIPTON S a cik-r g h-c oe,� ,fie ,,Q1,y, t c qt. L,/I1 c/` 6��► b.? S a G-4't) (F ! Rc(a/ ' „ic ri l , 7k�trii \AAA 140AL ©,t i- a, � (, tr- ti l Lls lLINGLEFAMILY/DUPLEX ❑MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL I I EXISTING USE EXISTING SF ,NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES I TOTAL NET SF USE TYPE OCC SQ.FT., VALUATION($) I.' , REMODEL' REMODEL,KITCHEN REMODELOTHR GARAGE 0 ATTACHED II _ BATHROOM SF. SF e// . ' SF SF El DETACHED I' ' rl e. EXISING ❑YES EICHLER� ti YES SECOND STORY ADDITION ❑YES .1 I FIRE SPRINKLERS 0 NO ❑ NO ❑NO DWELLING ISECONDDWELLING ❑YES ❑ATTACHED❑DETACHED OTHER UNITS# UNIT ADDITON: Er N6 SF POOLS'', 0 FIBERGLASS ❑VINYL-LINED ❑,GUNITE 0 PREFABRICATED POOL-SF, SPA-SF 'I I EPA ATTACHED El YES 0 NO I TOTAL-SF : ,I I • _EIVED BY:: ;,' ® I `TO AL VALUATION: .Comnrercial,or.Mult-Family Buildiu5s withiPablic Swinuuiuy Pools requires Department ofEnviro uvental Heath approval /r A. I ; ,� ] 0 0 RE-ROOF'EXISTING ROOF TYPE ❑BUILT-UP ROOF❑ASPHALT SHINGLES WOOD SHAKES❑WOOD SHINGLES❑TILE 'OTHER(SPECIFIY) REMOVE/REPLACE 0 NO IF NO' PLYWOOD El 1/2" ❑3/B" PLYWOOD TYPE: PITCH. I ROOF CLASS I I]YES OF LAYERS THICKNESS❑5/8" OTHER I:0513 ❑CDX OTHER I� �I, 12 A PROPOSED'ROOF TYPE❑BUILT-UP.ROOF DASPHALT SHINGLES 0 WOOD SHAKES:MOOD SHINGLES ❑OTHER t I ' *Provide a signed copy of the Cupertino s Tear-Off Policy SF ' t iof SQUARES 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 have read the Description of Work and versify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize:representatives of Cupertino to enter the above-identified property for inspection purposes. I acknowledge and authorize all information contained on.tlis application form to be made available for public record. �I Signature of Applicant/Agent:' :: Date:�(/ l SUPPLEMENTAL INFORMATION RE \--'---- I' . *New,SFD/Second Dwelling Unit's/Multifamily Dwellings:A Demolition permit is required prior to issuance of a building permit for`all new construction. *Commercial Buildings: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. . II' , *HOA-Provide a letter of approval from the Home Owner's Association I;: . ! . ,I;: I BldgApp_2017!•doc revised 08/01/17 IS ' 7 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO INO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333• buildinq(a cupertino.orq PERMI ::CANNOT BE FINAI ED UNTIL T IS::CERTIFICATE.PIAS BEEN. COMPLETED -S100:AND RFTUT NED TO THE.BU LDING-DIVISION. PURPOSE This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 20116 CRC Section R314,2016 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 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 X X the bedroom(s) On every level of a dwelling unit including 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 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 CBC Sections 907.2.114 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 belowAddress. /1 2• 7 (b f/a n d . cot . per tt n O CIA . c /Permit No. t5-e6/ -AS Specify Number of Alarms: #Smoke Alarms- ! I #Carbon Monoxide Detectors. ( / ' I have read and agree to comply with the terms and conditions of this statement - Owner(or Owner Agent's)Name. Signature Date: Contractor Name: /�✓l / Lic.# .i... Date: (e 1J Signature �� J Smoke and CO forrn.doc revised 12/15/16