The URL can be used to link to this page

15030127 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 23676 BLACK OAK WAY CONTRACTOR•-TRn_-TO BE PERMIT NO:15030127 DETERMINED OWNER'S NAME: PHONE NO: 14 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL ❑ INSTALL 240 VOLT,50 AMP BREAKER FOR FUTURE EV License Cl s �G(o Lic.#�S U� CHARGER Contractor f ate l I hereby affirm that I am l ed 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 pe ance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$950 I ave and will maintain Worker's Compensation Insurance,as provided for by SRction 3700 of the Labor Code,for the performance of the work for which this APN Number:34256014.00 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 DAY 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 F ST CALLED INSPE indemnify and keep harmless the City of Cupertino against liabilities,judgments, _ costs,and expenses which may accrue against said City in consequence of the Issued b Date granting of this permit. Additionally,the applicant understands and will comply y' with all non-point source regulations er the Cupertino Munici al Code,Section 918. 6 I 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) 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 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. 3 Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized 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 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 re s per the Cupertino Municipal C e,Section Licensed Professional 9.18. 3 Signatur Date GENERAL PERMIT APPLICATION MEP is COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228-FAX(408)777-3333-build ingt'a�cupertino.org l 5u J M ' sc ❑PLUMBING ❑MECHANICAL ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS 2 3 6 /1L �r iLti k�.y APN# 5to O 1-4-60--4,6 0 I OWNER NAME -7(v A-�C7 `' 0 n1< kOY CJT,Y,STTsg ZIP P_/ev 0/C,4 FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNEER,Tcyixr��❑ OWNER-BUILDER �❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT NUMBER CONT AC/' �✓��13/'�/ 667 11.5 LICEN �//�O C�E�NS�ETY/PE O BUS.LIC# ®p ? COMPANY NAME E-MAIL ZQ FA'r fJ7 TSTREET A�,D//D77RE!ESSCIITY,STATE,ZIP Tj7 ONE A 70 /6/i2 Jd 19- Z K- 2-07 2-17 P6 2-/- ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WI,DLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK �C/-1019 � ,/��!' n�/��, c1�x� IAIl57wtZ - 47yoI/L/T— o ,,( �/T�7 z > r�2 V TOTAL VALUATION: �!7 It1G�LY$U 13Y: „ 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 c ect. 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 buil . struction. I authorize representatives of Cupertino to enter the ab o^e-iidentif d property for inspection purposes. Signature of Applicant/Age Date: 3 li(J J SUP ENTAL INFORMATION REQUIRED ,OI4TCE;USE ONLY � ,� OS'�R,THE-COIINl'ER L'zI EXPRESS _ � STANDARD LARGE a `7yfAJOR MEPMiscApp_2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 23676 black oak way DATE: 03/20/2015 REVIEWED BY: Mendez MIAPN: BP#: *VALUATION: $950 *PERMIT TYPE: Electrical Permit PLAN CHECK TYPE: Alteration/Addition/Repair PRIMARY SFD or Du lex PENTAMATION 1 REAP2 USE: p PERMIT TYPE: WORK install 240 volt 50 amp breaker for future ev charger SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Services 1 ERT<200 50 Amps $48 � $48 00 itis TOTALS: w 3� Akch. Plan(.heck 1'l wlE Placa Check Elec.Plan Check 0.0 1 hrs $0.00 btech. Permit Fee: Plumb.I'ermil Fee: Elec.Permit Fee: IEPERMIT Other•Inch. 1rup. Other Plumb Insp. Other Elec.Insp. 0.0 hrs $48.00 Llech. hasp. Fe": Plumb. hasp.Fee: Ei6c.Imp. Nee: NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc). These-fees are based on the prelimina information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: suppl. P(."Fee PME Plan Check: $0.00 Permil Fee: suppl. Insp Fee PME Unit Fee: $48.00 PME Permit Fee: $48.00 (`onstruction Tar: Administrative Fee: IADMIN $45.00 Work Without Permit? ® Yes (E) No $0.00 Advanced Planning Nees: Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission.Fee: 1BCBSC $1.00 ` av $190.50 $0.00 �j $190.50 „�� Revised: 02/14/2015 ;dry'L"JN•I TY DEPARTMc.: 7 DI��C C''1%,/' .iON -CUPERTiNO APPROVED + c+ply s and specifications MUST be kept at the ;ob s.,' du,Mg construction. It is unlawful to make any c"a;,fes or alter atio;ls on same, or to deviate ti,erefrom, without apprCyal from the Building Official. G .tis p!an and specifications S,101L NOT A ' :~•' er to b/e+an�a}pproval of th,? violti�tion li it ��./ — C. .....1.._.,. .,.. Vl iiti a � or f,4:. a. u�nc,ate Lair. 0*6 o u�Le1 o P -� X0(3 10 R CUPERTINO ay►�C 1•. t 1441%R 0 201.E REVIEWED FOR CODE COMPLIANCE Reviewed By: � 4"1 9-f- PIAT PLANS CHS LL:: BY DATE �lZ7-- j PLANNING DEPT Lu� -� n CUPERTINO (0, 1 a E Rc k,)1✓) C W 4-1 �; {�Oe - REv1ttT'�`= (ear rAq4 ko 4 �,�w -s �Oc) Ma.�n re,� Sc'-cUiC�.. � t (v7C��tPa �ue v'Okk 5C"' r /- 22�1 ' l IC-'krcuL PZ"Al 23 G� G (S C,(l (,O\ � z CUPERTINO Address SMOKE 1 CARBON MONOXIDE ALARMS I � F ii OWNER CERTIFICATE OF COMPLIANC' j , I L COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building aC-cupertino.or4 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 below. I have road and aaree to comnly with the terms and conditions of this statement Signature.................................... ............................... Lic.# ....... ............................... Date: ................... Smoke and CO form.doc revised 03118114 l5 CUPERTINO Owner Name Address WATER - CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE M F COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION,✓�� 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 ( 3333 -* buildingCa.cupertino.oro _ 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 tegistered 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: PMo 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 110 1. 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: Date: �7 No Go to Question 3. 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: Date: No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? /DbNo 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, 2017, 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 2014. doc revised 03118114 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 have been replaced with water - conserving plumbing fixtures in accordance with Civil Code Sections 110 1. 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 fix ture comply wit -th equire is as indicated in the table below. Owner's (or Owner Agent's) Signature: Date: Upon completing and signing this Certificate, please return it to e Building Division in order to final your permit. 1. if the existing plumbing fixture water usage /tlow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2014. doc revised 03118114 J Non -Com liant P ._. .Water - Conserving Plumbing Fixture Plumbing Fixturel (Fixture Complying with Current Code Applicable -to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Wa Usage ter 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 maybe used to achieve reduction. 1. if the existing plumbing fixture water usage /tlow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2014. doc revised 03118114 J