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14070119CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 868 CANDLEWOOD DR CONTRACTOR: WATER QUALITY PERMIT NO: 14070119 PLUMBING OWNER'S NAME: LAURA BRUNTON TRUSTEE 1860 ALMADEN RD DATE ISSUED: 07/28/2014 OWNER'S PHONE: 8314239740 SAN JOSE, CA 95123 PHONE NO: (408)267-9330 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ COPPER RE -PIPE ENTIRE SFD, RUN TWO (2) DEDICATED License Class Lic. # GAS LINES, ONE TO STOVE AND ONE TO DRYER `2� l� Contractor 'ik�! Date I hereby affirm that I am licensed unde 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: $10195 erformance of the work for which this permit is issued. have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 36919026.00 Occupancy Type: tion 3700 of the Labor Code, for the performance of the work for which this rtis 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 OF PERMIT 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 DAY AS D INSPECTION. 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 comply with all non -point source reg Municipal Code, Section NCuperti 9 18. hWy RE-ROOFS: SignatuA to Allroofs 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) I, 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. 1 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 Cupertin Municipal Co Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, 5 uj 255 4. Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized 'e ate: 2 41 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 CONSTRUCTION LENDING AGENCY Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions 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 perthe Cupertino Municipal Code, Section Licensed Professional 9 18. Signature Date V CUPERTINO GENERAL PERMIT APPLICATION \ �(o"MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION ` \ 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 i XO (408) 777-3228 • FAX (408) 777-3333 • buildino(aD-cur ertino.org \ ` MISC LUMBING UNIECHANICAL ❑ OWNERAGENT LJELECTRICAL MISCCE�LLANEOUS PROJECT ADDRESS /� � — APN # 3 6 �j — /5 02-9 +)— 9 OWNER NAME f r� LICENSE TYPE if BUS. LIC #� PHONE 2,2,1 q23s ��� E MAIL, I STREET ADDRESS lcwood E-MAIL CITY, STATE, FAX CONTACT NAb1Ebll STREET ADDRESSCITY, 1,716 SAvrLe- E STATE, ZIP PHONE 9 9s/ PHONE d STREET ADDRESS ARCHITECTA NGINEER NAME CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT WCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMI' LICEN©NUMBER so I f5 LICENSE TYPE if BUS. LIC #� COMPANY NAME I AA E-MAIL FAX STREET ADDRESSCITY, 1,716 SAvrLe- E STATE, ZIP crus 9s/ PHONE d ARCHITECTA NGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX BUILDING: ❑ COMMERCIAL ❑ MULTI -FAMILY PROJECT IN WIIALAND ❑ YES URBAN INTERFACE AREA ❑ NO PROJECT IN FLOOD ZONE ❑ YES ❑ NO IS THE BLDG AN EICHLER HOME? ❑ YES ❑ NO DESCRIPTION OF WORK 11^ _ _ _ 1 1. \ 1 % , \ 1 TOTAL VALUATION: / By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the rty owner's behalf. I have read this application and the information I have provided is correct. I have read th9jescription of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to bu uthorize r ntatives of Cupertino to enter thea-iden d property for inspection purposes. Signature of Applicant/Ager f --_._.._ Date: )1� file MEPMiscApp 2011.doc revised 06/21/11 CITY OF CUPERTINO FFF FSTIMATOR - BUILDING DIVISION kalADDRESS: 868 candlewood dr FEE ID DATE: 07/28/2014 REVIEWED BY: MELISSA APN: 369 19 026 BP#: *VALUATION: 1$10,195 xPERMIT TYPE: Plumbing Permit 1PREPPIPE PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: # PENTAMATION PERMIT TYPE: 1 RPD WORK COPPER RE -PIPE ENTIRE SFD RUN TWO 2 DEDICATED GAS LINES ONE TO STOVE AND SCOPE I ONE TO DRYER # APPLIANCE / EQUIP TYPE FEE ID QTY/FEE QTY UNITS BP FEES Piping, Area 1PREPPIPE 1 # $48 Piping, Gas <=4 Outlets 1PGASRES 2 # $140 PME Unit Fee: $188.00 PME Permit Fee: $48.00 Administrative Fee: IADMIN $45.00 Work Without Permit? 0 Yes C) No $0.00 TOTALS: Travel Documentation Fee: ITRA VDOC $188.00 Stronp- Motion Fee: IBSEISMICR s=1TO 1 W 4Plumb. Plan Check 0.0 1 hrs $0.00 Plumb. Permit Fee: IPPERMIT f' riile r,". r r, ., , Other Plumb Insp. 0.0 hrs $48.00 0f_ _c! r< = 1?,;"' llhwib. /;asp. f;ee NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, tire, Nanitary sewer District, scnooi L 17 rnntn/'t tha nont far addn'l infer_ FEE ITEMS (Fee Resolution 11-053 Ef. 7/1113) FEE QTY/FEE MISC ITEMS iflfif. /J c' PME Plan Check: $0.00 PME Unit Fee: $188.00 PME Permit Fee: $48.00 Administrative Fee: IADMIN $45.00 Work Without Permit? 0 Yes C) No $0.00 Travel Documentation Fee: ITRA VDOC $48.00 Stronp- Motion Fee: IBSEISMICR $1.33 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC $1.00 II gO�LS. $331.33 $0.00 TOTAL FEE: $331.33 Revised: 07/10/2014 Address SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 G (408) 777-3228 • FAX (408) 777-3333 • buildina(a"cuoertino.ora 7 Q P r (� PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section 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 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 the bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -burning appliances andthat 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 907.2.11.4 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 Falifornia Building and California Residential Codes. The alarms have been tested and argbperational, as of the date signed below. 1 have read and agree to corpply with the terms and conditions of this statement Owner (or Owner Agent's) Name: LuSi �.... nature...J...... ............................... Date:... Contractor Name: Signature................................................................... Lic.#...................................... Date:................... Smoke and COform.doc revised 03/18/14