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15030156CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7535 KIRWIN LN CONTRACTOR: THD AT-HOME PERMIT NO: 15030156 SERVICES, INC. OWNER'S NAME: ROSENTHAL JANE L AND JACK A 2690 CUMBERLAND PKWY STE 300 DATE ISSUED: 03/25/2015 OWNER'S PHONE: 4085960944 ATLANTA, GA 30339-3913 PHONE NO: (510) 731-1004 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑ REMOVE AND REPLACE 1 PATIO DOOR / License Class C% Lic. # g 3 6 o Z l Contractor TfAi) /R'f A:q#1 f' 56!12. Date "7 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 o ensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $2176 rmance of the work for which this permit is issued. e and will maintain Worker's Compensation Insurance, as provided for by cc ion 3700 of the Labor Code, for the performance of the work for which this APN Number: 35919033.00 Occupancy Type: pe it 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 FRO ST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence f the Issued by: Date: l� granting of this permit. Additionally, the applicant understands ill comply with all non -point source regulations per the Cupertino Mu ' ' al Code, Section 9 18. RE -ROOFS: Signature Date f 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-BUIM4DECLARATION Signature of Applicant: Date: I hereby affirm that I am xempt 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 DJstrict I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code, Cha 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: Dater S 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 CONSTRUCTIO ENDING 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 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 GUPEIi>r lNO (408) 777-3228 • FAX (408) 777-3333 • build inclCa�cupertino.org 1 ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / Ti F- REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESSS153 5 r 1 iz. W ,,j 1— c APN # ) C O23, d.�i [E g '� OWNER NAME ./ 1,•1�� .^^O� � \ � PH 1� �^ 7 -(MAIL STREET ADD SFAX 23 7ROW t,,+ J C CITY, STATE, ZIP w c-�-7t�J o ��+ 9Sai � CONTACTNAME JEFF RAINEY PHONE 510-427-4260 E-MAILJEFFREY.RAINEY@ATT. NET STREET ADDRESS 1069 EDGEMERE LANE CITY, STATEZIP HAYWARD, CA 94545 FAx 510-783-1041 El OWNER 1:1 OWNER -BUILDER 11 OWNER AGENT ❑ CONTRACTOR 43 CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE �^❑ BUS. LIC 836021 B,C39,C13,C17 COMPANYNAME THD AT HOME SERVICES E-MAIL FAX 510-783-1041 STREETADDRESS 2456 VERNA COURT CITY, STATE, ZIP SAN LEANDRO,CA 94577 PHONES10-785-6340 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK i tj `' ©� pL 4' C A)� /C9 � � A EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES /V 0A)6_ USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHIN OTHER REMODEL AREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? ONO ADDITION? []NO PRE -APPLICATION []YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES TO AL VALUATION: 3. PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO / (ri 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 correct. I have read the Description of Work !Sdx&=fy it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I autbmize representatives ertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLE L INFORMATION P ROUTINGSLIP THE ❑ DING New SFD or Multifamily dwellings: Apply molition permit for existing building(s). Demolition permit is required prior to issuance of building OVER COUNTER BUII PLAN REVIEW permit for new building. ❑ EXPRESS ❑ PLANNING PLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure f- Q STAFTDA1W, El PIF BLlc WORKS form if any Hazardous Materials are being used as part of this project. ❑ FRtE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to 0>� ❑ submittal of Building Permit application. siviTnizY SEWER DiszcT BldgApp_2011.doc revised 06121111 CITY OF CUPERTINO wo FEE ESTIMATOR - BUILDING DIVISION ialADDRESS: 7535 kirwin In DATE: 03/25/2015 REVIEWED BY: Mendez APN: BP#: *VALUATION: 1$2,176 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: p 0.0 PENTAMATION 1GENRE PERMIT TYPE: i WORK remove and replace 1 patio door SCOPE $0.00 p m r ilech. flan Check Phimb. Plan Check Elec, Plan Check ,Meeh. Permit Ece: Plumb. Penni? Fee: /,, le Permit fie: Orher- aferh. Insp. (then Plumb Insp. Li Other L>lec. Insp. ,Tech. bask, Fee: Pharrtb, lisp. Fee: Insp, Fee: NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public works, tire, sanitary sewer utstrict, scnoot District etc . These fees are based on the prefintina information available and are only an estimate. Contact the De t or addn7 info. FEE ITEMS (Fee Resolution 11-053 E . 7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window / Sliding Glass Door $431.00 1 WINREP Replacement Suppl. PC Fee: 0 Reg. ® OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee -.C) Reg. ® OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 ConsfrLich.on 7'a -y: ,ldininistrative Fee: G Work Without Permit? ® Yes ID No $0.00 Advanced Planning Fee. $0.00 Select a Non -Residential Building or Structure G 0 7rUvel Doc°utne>ntation Fees: Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: 1BCBSC $1.00 �"MOM I now$1.50 $431.00 , T(17�LE: $432.50 Revised: 02/14/2015 DATE CUPERTINO LEGEND' SCOPE OF WORK: INSTALL (1) RETROFIT VINYL, DUAL = ® = RETROFIT WINDOW/ PATIO DOOR LOCATION GLAZED, LOW E PATIO DOOR. NO (N) CONSTRUCTION, ~ DINING ROOM FRAMES WILL NOT BE DISTURBED. o PATIO DOOR z 95"w x 81"hNOTE; WINDOWS / PATIO DOORS; w � r1Arn U -FACTOR = 0.30 v p rP SHGC = 0.25 > U U �t,lT C. TtN oC �4ft�. G �� DINING ROOM Lu ¢ o N cn � T ept at the LL1 Lu > S'be 2i > ions M� make any t a and sp kjon alit is unia`�f t t eviate = I- 2, c, wy' e tuct�on. oe to tflox- Q N z 'ft1s s co,�St m he gull ,n9 � ej d'3 t 1xt&�R yes a,t. 4�i it �ypT cn SCh v ,a",.� ILGJt aY'tC'` tl0� 55� t afi O gyp`. �1,1C� r, m, s tyir..t rd aln tcl"u b� �''e bp x t 03 m ENTRY .r =%CJP »� yi p RTIN� Iilr e�aftent ri 2015 Lu R VIEVv i 1,"i'-�li � rn eviewcaa C.O MANCE z v r�o CD 15;;Lcc: FIRST STORY (FRONT YARD) < L0 � FLOOR PLAN KIRWIN LANE NOTE: U 1). SMOKE DETECTORS: WHEN A BUILDING PERMIT IS REQUIRED, SMOKE DETECTORS SHALL BE INSTALLED; (a) IN EACH SLEEPING ROOM, (b) OUTSIDE EACH SEPARATE SLEEPING AREA IN THE IMMEDIATE VICINITY OF THE BATE 03.24.15 BEDROOMS, (c) ON EACH ADDITIONAL STORY OF THE DWELLING, INCLUDING BASEMENTS AND HABITABLE ATTICS BUT NOT INCLUDING CRAWL SPACES AND UNINHABITABLE ATTICS. (CRC 314) SCALE NTS 2). CARBON MONOXIDE ALARMS: WHERE A PERMIT IS REQUIRED FOR ALTERATIONS, REPAIRS OR ADDITIONS EXCEEDING $1,000.00, EXISTING DWELLINGS OR SLEEPING UNITS THAT HAVE ATTACHED GARAGES OR FUEL BURNING DnAMBY DKW APPLIANCES SHALL BE PROVIDED WITH A CARBON MONOXIDE ALARM IN THE FOLLOWING LOCATIONS; (a) OUTSIDE OF EACH SEPARATE DWELLING UNIT SLEEPING AREA IN THE IMMEDIATE VICINITY OF THE BEDROOM(S), (b) ON EVERY LEVEL OF A DWELLING UNIT INCLUDING BASEMENTS. (CBC 420.4, CRC R315). 108 8022516 SHEET (HOME OWNER TO PROVIDE BEFORE FINAL INSPECTION). A_1 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE 12 COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION C U P E RTI N © 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingP-cupertino.org PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN COMPLETED, SIGNED. AND RETURNED TO THE BUILDING 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 specified below have been tested and are operational, as of the date signed below. Address: % .�c3 � f ' Permit No. 2-)o' J� Specify Number of Alarms: # Smoke Alarms: F77 # Carbon Monoxide Detectors: ro2� 1 have read and agree to comply with the terms and conditions of this statement Owner -(or Owner Agent's) Name: QSignature Date:7� ........ ............................................................................. ............................................................................................................................... Contractor Name: Signature.................................................................. Lic.# ......................................Date: Smoke and COform.doc revised 09/27/16 CUPERTINO Owner Name Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (4 ) 777-3228 • FAX (408) 777-3333 - building aacupertino.ora Permit No. O / j �SAr; c�1 LoL,7� PFIRA11T CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE ' If AS BFENISE �'tFI) ;4ND R TI_R1;F D TO TIFF BUILDING, DI- ISION Please refer to the attached California Civil Code Sections 1101.1— 1101.8 which are part of this Certification form. 1. Is ur 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: ❑ No Go to Question 2. Date: 2. Does y ur real property have a licensed plumber certifying that, due to the age or configuration of the property or its pl mg, installation of water -conserving plumbing fixtures is not technically feasible? es 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: ❑ No Go to Question 3. 3. Is wer 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: ❑ No Go to Question 4. Date: 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. Ell /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 110 1. 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 03/18/14 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). 1/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 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and jhatthe IAI�Lter-conserving plumbing fixtures comply with the requirements as indicated in the table below. FOwner's (or Owner Agent's) Signature: ,I Date: �z/ ±ZZA Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit. 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. SB407 2014.doc revised 03/18/14 Non -Compliant Water -Conserving Plumbing Fixture Fixturel (Fixture Complying with Current Code Applicable to New Construction) —Plumbing Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPG 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 on-] y one shower o u_tl et to be in oeration 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. SB407 2014.doc revised 03/18/14