14100072 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10596 JOHN WAY CONTRACTOR:TATS INC DBA MR PERMIT NO: 14100072
ROOTER PLUMBING
OWNER'S NAME: 1260 YARD CT UNIT C DATE ISSUED: 10/13/2014
OWNER'S PHONE: SAN JOSE,CA 95133 PHONE NO:(408)271-2822
❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑
REPAIR SEWER LINE AND INSTALL A PROPERTY LINE
License Class r 3 Lic.# �/� CLEANOUT.
Contractor /',l&ie- ' Date (10—/-?
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
performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$5000
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 APN Number:35918004 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 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 DAYS FROM LAST CALLED 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
granting of this permit. Additionally,the applicant understands and will comply Issued by: fV Date: /
with all non-point source regulations per the Cupertino Municipal Code,Section
9 18.
���� 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. 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 25505,25533,and 25534. /
Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent, `% Date:
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 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 per the Cupertino Municipal Code,Section Licensed Professional
9 18.
Signature Date
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVISION
ADDRESS: 10596 JOHN WAY DATE: 10/13/2014 REVIEWED BY: SEAN
APN: BP#: *VALUATION: $5,000
*PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY PENTAMATION 1 RPSS
USE: SFD or Duplex PERMIT TYPE:
WORK REPAIR SEWER LINE AND INSTALL A PROPERTY LINE CLEANOUT.
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Sewer, Sanitary 1PRSEWER 1 # $25
--------------------
TOTALS: $25.00
- IAOR
L1cc;t, l'Cc rrC fry c Plumb.Plan Check 0.0 hrs $0.00 I'lec�.
Fee Plumb.Permit Fee: IPPERMIT
Other Plumb Insp. 0.0 hrs $48.00 oill u ICc, .=�sp,
('?rtrnb. hisp. /ce:
NOTE: This estimate does not include fees due to other Departments(�.e.Planning,Public Works,Fire,Sanitary Sewer District,School
District,etc. . These ees are based on the relimina in ormation available and are onlyan estimate. Contact the Dept or addn'Z info.
FEE ITEMS (Fee Resolution 11-053 E . 711/13) FEE QTY/FEE MISC ITEMS
Plan Che(:4-
A5`uppl. 1'U Fce
PME Plan Check: $0.00
Perini! P'C< ::
srppl. Int?Fee
PME Unit Fee: $25.00
PME Permit Fee: $48.00
('cin ii-action Tax:
Administrative Fee: 1ADMIN $45.00
Work Without Permit? ®Yes (F) No $0.00
, �1b'�a7tccwl I'lunfling 1"ees:
Travel Documentation Fee: ITRAVDOC $48.00
Strom Motion Fee: IBSEISMICR $0.65 Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC $1.00
r w• $167.65 $0.00 TOTAL FEE: $167.65
--
Revised: 08/20/2014
•NEL PEE�R I t RPP f- � L cA i I o NMEP
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COMfViUN1Tl'DEVELOPMENT Di=PART1JENT• BUILDING DIVISION
10300 i ORRE AVENUE-CUPER i INO, CA 95014-3255
(408) r77-3228•r•;".X(403) i -3333•building ':ino.ora
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4�••y 7ny S;=_.i1rC 7Jel Ol6',I ce.; :=y to e=ch of t�-,e IOIIO\i :�: I am the?Soperrty ovmer 07•author ii 5d agtnt t0 act on tha proper iy mvnei s behalf I Iia-Te recd&-is
application and the info:r,aeon I have provided is correct I have read the Description_of work arid veaiv it is ne"r€te. 1 agree to comply With all applicable local
ordinances and State k its releffing to builking constT1.mCo ori_m-representaives of Cupt 7,o to enter the ab0ve-76er=L'. ed p,ro7e+i�'for LSpect:DZl pL,poses.
S ig iar re of ADplicar,l.�.gert: Date: ® � 01
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h�Z1�1417scfpp ?011.docrevised06/21/11
CUPERTINO
Address
1°[l -►Its
SMOKE / 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 • building(cDcupertino.org
FHLE
rII t,6 -
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 CSC 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 dwellin 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: Iii 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 California Building
and California Residential Codes. The alarms have been tested and are operational, as of the date signed
below.
l have read and agree to comply with the terms and conditions of this statement
Signature ...... 11 ..............................................................................................Date: t..�../S
Contractor Name:
Sinature...................................................................Lic.#...................................... Date: ...................
v
Smoke and CO form. doc revised 03/18/14
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 • buildingO cupertino.org
} ;*:
Owner Name � � Permit No./
Address
Please refer to the attached California Civil Code Sections 1101.1— 1101.8 which are part of this Certification form.
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Qrur�er' Srmnlatire��
o Go to Question 2.
y ate;�B`s
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.
Sign below and skip the rest of the form.
°_ a at
No
Go to Question 3. (J
Is water sei vice permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply.
06111WIT,
Sign below and skip the rest of the form.
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.
Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
� r ate: .40 �s
My real property is built and available for use or occupancy on or before January , 1994.
Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached.
lu"I' property is a single fa7nily 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
020
ures obe replaced with water -conserving plumbing fixtures throughout the building. On or before January 1,
all non-compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless
� Nether proper ty undergoes alterations or improvements).
❑ Myproperty is a multifanaily 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 co7ninercial 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.
SB40 7 2 015. doc revised 02/04/15
° ._ :Onoryb'efore January 1, 2019, all non-compliant plumbing fixtures shall be, replaced with water= conserving t'
plumbing fixtures throughout the building (regardless, of whether property, undergoes alterations or
improvements).
UWe, the owner(s) of this property, certify under penalty of perjury that non=compliant plumbing fixtures11 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
reouirements.'and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table below.
1 Earner's (or Owner Agent's) Signature: ""'' '/iL Date: 6�/ I
Upon completing and signing this Certificate, please return it to the Building Division in order to final your pen -nit.
1 If the existingumb`iig fixtnre�wa Ver usage/flow rate is equal to or lower than the figure shown,'jit is riot ire a to be.0 gid'.
40
SB4072015.doc revised 02/04/15
Non -Coir 11�a`n
Water -Conserving Plumbing Fixture
Plumbing Fixtur
(Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usage/Flow Rate
Fixture Typed
Water Usage ;
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
,
/Flow Rate t`'
2013 CALGreen Div. 4.3
2013 CALGreen Div. 4.3
2013 CALGreen Div. 5.3
�> Single -Family Multi -Family Commercial
•t,�;
Water Closet`s
(Toilets)
s,
' Exeeed=l' 1
Gallons/flush
' Residential Residential
Single flush toilets: 1.28 gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite,
,�
average flush volume of two reduced flushes and one full flush
Urinals
Exceed 1.0
0.5 gallons/flush
Gallons/flush''"':
Showerheads`.a
;Exceed 2.5 ''=2.0
gallons
gallons per minute @ 80 psi. Also certified to the performance criteria of
S. EPA WaterSense Specification for Showerheads.
per minute
Ai I':.�
hand-held shower is considered a showerhead.)
1;+:
-For multiple showerheads serving one shower, the combined flow rate of all
,s owerheads and/or other shower outlets controlled by a single valve shall not
'
e, ceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to
!
-4low only one shower outlet to be in operation at a time.
Faucets —
.,Exceed 2.2 gallons I
Maximum 1.5 gallons per
Within units:
0.5 gallons per minute @ 60
Lavatory
aper minute,
inute @ 60 psi; minimum
Maximum 1.5 gallons
psi
Faucets
!Gyg8
gallons per minute @
per minute @ 60 psi;
II
"20 psi
minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
i>. L
=
per minute @ 60 psi
1.8 minute
gallons per
t 1
60 psi
Faucets —
!Eeeed 2.2 gallons i,°=.8
gallons per minute @
1.8 gallons per minute
1.8 gallons per minute @ 60
Kitchen
per minute
60 psi
@ 60 psi
psi
Faucets
-.1 4ay temporarily increase
May temporarily
Y
,
l'
i p to 2.2 gallons per
increase up to 2.2
:mt�inute @ 60psi, and must
gallons per minute @
efault to maximum
60.:psi,.a171d must
gallons per minute @
default to maximum
Es
,60 psi
1.8 gallons per minute
-Where faucets meeting
@...6C. psi
t t
the above are unavailable,.
Where faucets meeting
' aerators, Oro means
the above are
I
may be used to -achieve
unavailable aerators or
reduction.
other means may be
used to`achieve
r'..-�_�._..•:.._
reduction.
1 If the existingumb`iig fixtnre�wa Ver usage/flow rate is equal to or lower than the figure shown,'jit is riot ire a to be.0 gid'.
40
SB4072015.doc revised 02/04/15