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15010111�f CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 20652 PARK CIR WAY CONTRACTOR: JON BARTZ PERMIT NO: 15010111 CONSTRUCTION OWNER'S NAME: CHENG CHUAN NIU 1901-A FELTON EMPIRE RD DATE ISSUED: 01/21/2015 OWNER'S PHONE: 4083987743 FELTON, CA 95018 PHONE NO: (831) 706-0228 L"ENSED ONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑COMMERCIALE] REPAIR WOOD PATIO ENCLOSURES AND UNITS 1 & 2 & License Class 6Lic. # 66!j27 REMODEL BATH IN UNIT 1 (48 S.F.) AND REPAIR J UPSTAIRS WOOD BALCONY FOR UNIT 4 Contractor ✓1 (7 Date 1 5 I hereby affirm that I am licensed under the provisions o 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: $12000 I have and will maintain Worker's Compensation Insurance, as provided for by APN Number: 32632016.20652 Occupancy Type: Section 3700 of the Labor Code, for the performance of the work for which this 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 " _ LED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of theIg Date: granting of this perm 'onally, the applicant understands and will comply with all non-po source re lations per the Cupertino Municipal Code, Section RE-ROOFS: If is 9 18. Signature Date All roofs shall be inspected prior to any roofing material being installed. a roof 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 hich emit hazardous ould I u quipme!agency material. Addimconstruction Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminand the B Area anagement District I performance of the work for which this permit is issued. will maintain cith the upertinode Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & SSecti s 25505 25 Section 3700 of the Labor Code, for the performance of the work for which this Owner or authh Dater 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 T UCTION LENCY 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 affirma construction lendihe 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building cDcupertino.org b CCUPERTINO I 1 1 I I I-TTTl1TT I I AT TCD AT7nNT/TT F-1 DCA1TCTnKT /T1T:T: T:DDT:TI OPT(:TMAT PPPARTT1i O/ C2 1�k / r PROTECT ADDRESS 20652 'M'N # 3 Z0 16 / // / lJle/ OWNER NAME Alk �� ( �// i Ji// In ( , o� / Y P V r/✓/6I � E-MAIL STREET ADDRESS /, /„ CITY, STAT P �O CI Jl� CONTACT NAMEP p 23�/ E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUDDER ❑ OWNER AGENT RLCONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME n 4- �- � LICENSE NUMBEq/V5_ 7 BUS./LICC iv 36 176 COMPANY NAME A fLICEN E-MAIL ' / � ` nll �(f FA7Q STREET ADDRESS C/ ' (P I CITY, ATE, ZIP 6 PH (1`93/15Ls W 1`3/15 ARCHITECT/ENGINEER NAME L1 SE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,, STATE, ZIP PHONE DESCRIPTION OF WORK - Vtel WIA—_ 6A 7 One EXISTING USE PROPOSED USE CONSTR TYPE # STaIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AR±A _. TOTAL NET AREA BATHROOM REMODEL AREA G 4I t 'SRI KITCHEN REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: EIDETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNrr ❑ YES SECOND STORY ❑ YES BEING. ADDED? []NO ADDITION? ❑ NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NOv RRECEIM., TOTAL VALUATION: ❑ (ICS i'. By my signature below, I certify to each of the folio g:a9he property owner or au n to act on the property owner's behalf. I 11ave read this application and the information I hav ovid d ' IT I e r the Description of Work and verify it is accurate. I a ree to comply with all applicable local ol�ordinances and state laws relatin o buildi st tion ze repre s of Cupertino to enter the abov -iden fled pro erty for inspection purposes. S Signature of Applicant/Agent: Date: SUPPLEMEN L INFORMATION REQUIRED' . � EL`A1�GHE 1'„YPE „ >.,- , k„ ROUTING SLIP New SFD or Mu ltif ily dwellings: Apply for demolition permit for �'1 O�ES�HE OUNTER � ❑ BUILDING PLAN REVIEI x . existing building(s). mOlitio, permit is required prior to issuance of building permit for new building.. EXPRESSa _ ��i�aRnQ ` ❑ LANNINGPLANREVIEW ❑ s _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure > 17BLIC NORi form if any Hazardous Materials are being used as part of this project. Copy of Planning Approval Letter or Meeting with Planning prior to BARGE �� ®o ❑IRE DEPT ❑ _ submittal of Building Permit application. �ANIxARY S�sWER DISTRICT ❑ ;�� `��. �, �k: -.� � . � '. = VIRO]VMENTAL HEALTH, ' BldgApp_201 1. doc revised 06/21/11 WE CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION 20652 PARK CIR DATE: 01/21/2015 REVIEWED BY: MELISSA jimlADDRESS: APN: 326 32 016 BP#: *VALUATION: 1$12,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY USE: Multi -Family Dwelling Buildina is >3 Stories 0 Yes Q No PENTAMATION PERMIT TYPE: 1GENRE i WORK REPAIR WOOD PATIO ENCLOSURES AND UNITS 1 & 2 & REMODEL BATH IN UNIT 1 48 S.F. SCOPE AND REPAIR UPSTAIRS WOOD BALCONY FOR UNIT 4 FATIs.f. $645.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E f.' 7/1/13,) FEE QTY/FEE A, cch' Flan Check P1,1110, Plan Check flee% P/,"i? ? helll TT L1e�;f3. Perin f C". Phunb. P'er?n;f 1't�C.' /-s.zrc. 0,1,(vr ;l cch, lrasP 0,/,er, P'lwnlf 1,up, 0iber Lk.'- Irsl?. 3l��cit fav). Phend), h1q). 1"ee: 1>ier:. Ins"' 1 ;-ca: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etc.). These fees are based on the nreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Resolution 11-053 E f.' 7/1/13,) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (j) No $0.00 0 hours $143.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: Q) Reg. 0 OT 0.0 1 firs $0.00 PME Plan Check: $0.00 FATIs.f. $645.00 Remodel, Bath (<=300 sf) IREMRESBAT Permit Fee: Hourly Only? 0 Yes (E) No $0.00 Suppl. Insp. Feer Reg. 0 OT F0,01 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ("Onstruction Tax: T AJinini,. Irative Fc>f?. Q E) Work Without Permit? ® Yes No $0.00 Advanced Planning Fee: $0.00 Select a Non -Residential Building Building or Structure 0 �1�f�c€v��l L�cxc°rrtn�tnfrxlifrvr Fees: Strong Motion Fee: IBSEISMICR $1.56 3.0 hrs $429.00 Inspections ISTINSP Inspection, Hourly Bldg Stds Commission Fee: IBCBSC $1.00 $2.56 $1,217.00 s TO FEE. 561 $1,219.56 Revised: 01/06/2015 IN I c.,4a �ol 3 CA BLDA/67 aDE,� A- rfLY OFFICE Copy PLOT PLANS CHECKED BY DAA �e�a'�"� o� p EPT. A qW.- piVEPT. DATE U-) f)FPT /I I JAN 21 2015 �i r5f FI -()61y— -By . --� 0 IN iv Jai» I& WUAMIT 1i �6'SZ per G`r Second F/a)r r ,11P CUPERTINO Owner Name 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(ftuoertino.org Address 2o&_4-2 )Ozr '` ct � PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION Please refer to the attached California Civil Code Sections 1101.1 — 110 1. 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. — / Owner' Signature: Date: W' No 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. Sign below and skip the rest of the form. Owner' Signature: No Go to Question 3. Date: 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Of/No Go to Question 4. Date: 4. Is fur real property built and available for use or occupancy on or before January 1, 1994? Q?' 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. Owner' Signature: Date: /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. Refer to the attached. ❑ 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, 17, 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. SB407 2015. doc revised 02/04/15 0 4 0 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). I/We, the owner(s) 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 below. Owner's (or Owner Agent's) Signature: Date: Upon completing andi g t s C ifte, pleas eturn it to the Building Division in order t rmit. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB40 7 2015. doc revised 02/04/15 Non -Compliant Water -Conserving Plumbing Fixture Fixture (Fixture Complying with Current Code Applicable to New Construction) -Plumbing Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) 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 Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets - Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB40 7 2015. doc revised 02/04/15 CUPERTINO Address m } Ae 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 - buildinaCa)-cupertino.org J/' Permit No. f'� J � # of Alarms Smoke: /.2 Carbon Monoxide: PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNEi2 AND RETURNED TO THE BUILDING DIVISION 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 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 907.2.11.4 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 belo � !LqnYtv�� I� F � 9 1 !;;;; rad and a ree tocom l with th t sand di6ons of this s wner Agent's) Name: Sinatu .............................................................................................................. D .................. EontractorCtName: f 01 / Signature.... Lica ... t! � ............... Date: 2.19_ yA Smoke and CO form.doe revised 03118114