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140600071Z CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10079 RIDGEWAY DR CONTRACTOR: CONSOLIDATED PERMIT NO: 14060007 PLUMBING INC OWNER'S NAME: CAROL WATSON 3732 CHARTER PARK DR STE D DATE ISSUED: 06/03/2014 OWNER'S PHONE: 4082524420 SAN JOSE, CA 95136 PHONE NO: (408)978 -3093 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL INSTALL (N) PROPERTY LINE CLEANOUT License Class �' 6 Lic. # .�� S'' /6"Z Contractor e ?R4(J l— g Date & — S7' IV SANIOTARY 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. I hereby affirm under penalty of perjury one of the following two declarations: 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 Sq. Ft Floor Area: Valuation: $17500 performance of the work for which this permit is issued. ave and will maintain Worker's Compensation Insurance, as provided for by ction 3700 of the Labor Code, for the performance of the work for which this APN Number: 34241020 00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS ISSUANCE OR to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save 180 D LED INSPEC ION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the ssued by: Date: granting of this permit. Additionally, the applicant understands and will compl with all non -point source lations per a Cupertino Municipal Code, Section 9 18. RE- ROOFS: Signature Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER- BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(a) should I store or handle hazardous I have and will maintain a Certificate of Consent to self - insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2 25533, a d 25534. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agent: permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation iprovisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9 18. Signature Date • GENERAL PERMIT APPLICATION 'w " COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION MEP 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 CUE��t`i IhtO (408) 777 =3228 • FAX (408) 777 -3333 - buildinga- cuDertino.oro MISIC LUIvMB1NG I 1 -N ECHANICAL 7P1.Ff'TR1r AT ni.,rrcr -T T T ewrtnrrc PROJECT ADDRESS 1&9 71 APN # 3(f , n [l / `� L OWNERNAME 4 PHO. a- E•M4II/ STREEET ADDRESS CITY, TE, ZIP FAX CONTACT NAME JI PHONE E•MSII STREET.4DDRESS CITY, STATE, ZIP FAX ❑ OV,"�ER '❑ OIXI'MR•BUIIMER CI 'O1;`N R AGEI.T ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TErtRNl' CO: TRACTOR N LICENSE NUMBER I LICENSE TYPE �... BUS. LAC # COMPANY N.A1 reow-a/ 0 `` EMAIL n f I FAX STREET AD� RESS CITY, STAY E ZIP ff/j l O P O B _ ^ AR.CHIiECT/ENGWEER NAME LICENSE NUMBER. BUS. LIC # COMPANY NAME EMAIL FAX STREET ADDRESS Cr1Y, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX' Q MUI 77•FAMILY BUILDwa ❑ COhOaRCIA'L PROJECT N L t WLAND ❑ YES URBAN DIRT; RFACE AREA ❑ NO PROJECT IN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YES EICHLER HO1,M ❑ NO DESCRIPTIONOFWORK mez m TOTAL VALUATION: By my signature b -low Icerfif to each of the following: I am the property Owner or authorized agent to act on the perry oumer's behalf I have read this application and the information T have provided is correct. Lh e Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bur co ctio orize representatives Of Cupertino to enter the above -i entified joperty for inspection purposes. S i ¢nature of Applieant/A¢ent: Date: PL N dATION REQUIRED E7 i MEPA,fiscApp_2011.doc revised 06121111 WE CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION imADDRESS: 10079 RIDGEWAY DR DATE: 06/03/2014 REVIEWED BY: MELISSA APN: 342 41 020 BP #: *VALUATION: 1$17,500 *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY USE: SFD or Duplex PENTAMATION PERMIT TYPE: 1 RPS WORK INSTALL N PROPERTY LINE CLEANOUT SCOPE T'<lvn,it 11,< APPLIANCE / EQUIP TYPE FEE ID QTY/FEE QTY UNITS BP FEES Sewer, Sanitary 1PRSEWER 1 # $24 T'<lvn,it 11,< sZ {pPl, 17"71/"? PME Unit Fee: $24.00 PME Permit Fee: $47.00 Consirtiction 7ir:r: Administrative Fee: 1ADMIN $44.00 Work Without Permit? 0 Yes 0 No $0.00 TOTALS: Travel Documentation Fee: ITRAVDOC $24.00 Strong Motion. Fee: IBSEISMICR ,Lech. /Flan (. beck h-ch. 1'etrttil Fee: {?titer ;E.t'%r. 7rts;r3 14c, h. F,-1c Plumb. Plan Check 0.0 1 hrs $0.00 1�Ie��. 1'l�an Chk'C/s Plumb. Permit Fee: 1PPERMIT Petro,ih h<e Other Plumb Insp. 1 0.0 1 hrs 1 $47.001 oilier t�iec. Irsl:. TPirtrtab. Tars} . Fee: hlce.lt NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School nictrirt. otr )_ Thaw foov aro haaod an tho nroliminary infarmatinn availahle and are only an estimate. Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11 -053 Eff. 711113) FEE QTY/FEE MISC ITEMS PC Fcc PME Plan Check: $0.00 T'<lvn,it 11,< sZ {pPl, 17"71/"? PME Unit Fee: $24.00 PME Permit Fee: $47.00 Consirtiction 7ir:r: Administrative Fee: 1ADMIN $44.00 Work Without Permit? 0 Yes 0 No $0.00 A61volICCG / hlrlftt 7 Travel Documentation Fee: ITRAVDOC $47.00 Strong Motion. Fee: IBSEISMICR $1.75 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 e` $164.75 $0.00 TOTAL FEE:, $164.75 Revised: 04/01/2014 1,cl COMMUNITY MANAGEMENT SERVICES March 18, 2014 To Whom It MayConcern Re: De Anza Oaks Homeowners Association Dear Sirs. Consolidated Plumbing, Inc, has the association's permission to seek permits for the repairs of any domestic water lines or sew- er lines located within the De Anza Oaks communiev. Sineer: Cuttrnuni!ty Maa a%dnent Services, Inc. Bill I ubbard,`,Association Manager De An Oaks Homeowners Association BH /st cc: Board of Directors 1935 Dry Creek Road, Suite 203 a Campbell, CA a 95008.3631 • voice (408) 559 -1977 ■ fax (408) 559 -1970 �0,,d I�Wlwrrfrl SMO KE /CARBON MONOXIDE ALARMS Address V� # of Alarms Smoke: Carbon Monoxide: PURPOSE This affidavit is a self- certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section "314; 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. OWN °ER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT •BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 CUP'ERTII�iO (408) 777 -3228 FAX (408) 777 -3333 • buildin o.or Smoke and CO form.doe revised 031181 GENERAL INFORMATION Existing single- family and multi- family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When tl� 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: 1 AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) ` X X On ever level of a dwelling unit basements X X Within each slee in 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 walland ceiling finishes or'there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 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 have been tested and are operational, as of the date signed below. I have read and a ree to comply with the terms and conditions of this statement Owner (or Owner Agent's) ia 1...1(/./.......... �NIa Col Qi I Si nature .................. ................ ................ ............................... e: Con ct Nam : ♦ /� Si nature .... ....... ...... ... r,66 -------------- _-- -Lic.# ....�� /..�.�... Date: J 14