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15040058 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1272 PRIMROSE WAY CONTRACTOR:JEMICO LLC DBA PERMIT NO: 15040058 RENEWAL BY ANDERSEN OWNER'S NAME: LEV AMIR AND RONIT 30800 SANTANA ST DATE ISSUED:04/08/2015 OWNER'S PHONE: 4085075074 HAYWARD,CA 94544 PHONE NO:(510)263-3178 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL ❑ COMMERCIAL E] 'fy _ REPLACE 3(E)BEDROOM WINDOWS,LIKE FOR LIKE License Class / Lic.# D v (WILL !„f MEET EGRESS) Contractor -C ,.t W-1 "'Date l 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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$9818 o 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:36618015 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 ED INSPECTIO indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the g /f granting of this permit. Additionally,the applicant understands and will comply sue with all non-point source regulations per the Cupertino Municipal Code,Section 9 18. / l� RE-ROOFS: Signature Date All roofs shall be inspec a 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 I hereby affirm that I am exempt from the Contractor's License Law for one of Signature of Applicant: Date: 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 Cupert' unicipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections-M05,.255333,and 25 . Section 3700 of the Labor Code,for the performance of the work for which this w ls permit is issued. Owner or authorized agent: Date: f 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 l� V CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION O� 10300 TORRE AVENUE•CUPERTINO,CA 85014-3255 CUP�RTIPJ (408)777-3228•FAX(408)777-3333•building -cuaertino.oM NEW CONSTRUCTION ADDTLION ALTERATION/TI EJ REVISION/DEFERRED ORIGINAL kmTl PROTECT ADDRESS 1 ! ' Im AFN N � /,6' D ,� o/ OWNER NAME / r` ! w PHONE A - v^(, 2-MAIL o STREET ADDRESS CITY,STATE,ZIP`�(� / OI! ^ 11sol FAX CONTACT FA G�i� PHONE'70`2 I1 3 2 0 6(, r'�� �` J�/1r\S•�G..h ��llY W'�� Q L:.^2 (,Cut,, • STRBETADDRESS �i'�vC� nCl t CI'fY,STATfi,zrn L /` �'J<-..1�G! { FAX ❑OWNER ❑OWNEit BUILDER ❑ OWNERAGENT iIcoNTRACTOR ❑cONTRACTDA`AtoENr ❑(ARam-ECrT ❑ENGINEER ❑ DEVELOPER 171 TENANT CONTRACTOR NA:" 122 ^� a,�r-T',�� (CENSE NUMBER �j�.�}---�0� LICENSETYPE i BUS.LITH 1� COMPANYNAME lewx\ bi An�.7�-T w� AI `� FAX cb1U STRBBT ADDRESS ,STATE,ZIP L o�K PHONE 14 w&A PA AWFEITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC k COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK I 2 CLIKL O a t? 4 EXISTING USE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. SQFT. VALUATION(S) EXISTO NEW FLOOR DEMO TOTAL AREA AREA AREA NErAREA HATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA I DECK AREA TOTAL DECWORCH AREA I GARAGE AREA: HDETACH ATTACH #DWELLINGUNI'm ISASECONDUNrr IJ YES SECONDSTORY ❑YES BEING ADDED? []NO ADDITION? ❑NO PRE-APPLICATION p YES IF YES,PROVIDE COPY of IS THE BIAG AN [3 YES VED BY: TAL V A[�JATION: PLANNING APPL# ONO PLANNING APPROVAL LEITER RICHLERU0ME4 (ry ©a `f,--3 T By my signature below,l certify to each of the following. I am the property owner or aut zed age ct 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 and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relatin bund' construction authorize representatives of Cupertino to enter the ab en ed operty for inspection purposes. Signature ofApplicantlAgent: �l�t/u, ' ~~ _ Date; E b i SUPPLEMENTAL INFORMATION REQUIRED PLANCHECRTYPE ROiTFINGSLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER THE•COUFMR ❑ BUDAING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building, ❑ EXPRESS ❑ PLANMNG PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 11STANDARD ❑ PUBLICwOEtn £orm if any Hazardous Materials are being used as part ofthis project, ❑ LARGE ❑-FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWERDISTRICT submittal of Building Permit application. ❑ ENVIRONAIENTALHEALTH BldgApp 2011.doe revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 1272 PRIMROSE WAY DATE: 04/08/2015 REVIEWED BY: MELISSA APN: 366 18 015 BP#: *VALUATION: 1$9,818 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: 1GENRE WORK REPLACE 3 E BEDROOM WINDOWS LIKE FOR LIKE WILL MEET EGRESS SCOPE " :Lich. flan("heck Phimb.Plan Check Elec.Plan Check -feel. Perrllit Fee: Plumb.Permil hee: Elec. Permit Fee: Othea,leech.Insp. Oilier Plumb Insp. Li Other Ele(.Insp. Li ticch. Inch. Fe,., Plumb. Insp.Fee: Elec.Insp. Fee: 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 Dept-for addn'l info. FEE ITEMS (Fee Resolution 11-053 E . 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 = # Window/Sliding Glass Door Suppl. PC Fee: E) Reg. ® OT 0.0 fns $0.00 $431.00 IWINREP Replacement PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp.Feer Reg. ® OT 0,0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction Tax: Administrative Fee: Work Without Permit? ®Yes (F) No $0.00 E) Advanced Planning Fee: $0.00 Select a Non-Residential Building or Structure 0 Travel Documentation Fo : I A Strong Motion Fee: IBSEISMICR $1.28 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 $2.28 $431.00 TO FEEc $433.28 ham. _ , Revised: 04/01/2015 Project name: ReneW�E byAnderse Maim Backyard/Rear Setback 32 © l / r M�EDOM CEYE BED 3 BED 2 203' 202 SECOND FLOOR 201 Setback 12 BED 1 Setback 15 Garage BY DATE COMMUNITY Street/Front setback 26' PLANNING CUPERTINO T TY DEVELOPMENT DEPARTMENT BUILDING DIVISION CUPERTINO This set of plans aAED fob site Burin specifications MUST be kept at the g constrjction. It is,unlawful to make any changes or alterations on same, therefrom, without ,� or to deviate The St pproval from rhe Or Official amping of this pian and speeif,.,a ,�� be held to perSHALL NOT mi of n ai o'f the violation vi B - ,ce or State Law. N AT PERMIT# 8 5 bed 1 201- GL PA-of PA 945/8 49 3/8 941/4 49 bed 2 202., GL-AP_pf AP - - 945/8 493/8 941/4 49 bed 203 GL-PA of PA 95 433/8 945/8 43 Scope of work: CUPERTINO Building Department APR 0 8 2015 REVIEWED FOR CODE COMPLIANCE Reviewed By. G� �' `—' I Lg� SMOKE / CARBON MONOXIDE ALARMS P05 f Q, OWNER CERTIFICATE OF COMPLIANCE COMMUNITY 10DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORP.E AVENUE • CiJPERTINO, CA 95014-3255 ��� �` /5_0 y00 S� CUPERTINO (408)777-3228• FAX(408)777-3333• building cDcupertino.org Permit No. t_5--e'410 Q Address 12 12 H A ro #of Alarms Smoke: 4.Carbon Monoxide: r �,PERNIIT CANN�,02 BE FINAL, D AND COMPLETEll UNTIL THIS CERTIFICATE�� ���{ t�� a '�_��HAS BEEN��„A�D RT+FTUR1VEDaT�O�TFIE}BUILDING�bIYISION� ���,�,�{r c r .-n7-s.�rs:=��a•;^e��.s�c..,.....�._x?�:rrr_.r -a.aRs-,»�i,-v_s.:�..-.aac-=m�a�,+arane�+..�........T::-,�-i;._---^+.."`^_c.r.���.r—�r-,m,.rzr-�,--.a--- - ---- - 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 X X bedroom(s) 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 CSC 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 I have read and agree to comply with the terms and conditions of this statement Owner(orOwerAent' Name: .01 Signature.................. I1-4/V ..........................................................Date: o ts- . ..... Contractor Name: '4 '0 LLQ SBA iSignature...................................................................Lic.# ......................................Date: ................... W41/ Smoke and CO form.doc revised 03/18/14 : WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE F 1, L COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION !o CUPERTINO 10300 TORRE AVENUE- CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333 building(a)-cupertino.org Owner Name Le, i�, 1�" �. Permit No. 5-0 Y,90 6-Y Address CU-IAII-Ako 64 16 ` ��PERiyIITCANNOri'�BE�'INALEDr.A�.D CO�LET.ED�TII�THIS CEIZTIFICA'LE� F.s � 8�a. �",�- - " d4 '4-� �' '. a _J R•' -tta-" r a yf y.t.^.5 �- rc�: Y !y Please refer to the attached California Civil Code Sections 1101.1-1101.8 which-are partof this Certification forint: 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: nrm/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: Date- [/No ate: Q 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. —IN Owner' Signature: Date: I� No Go to Question 4. 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. Owner' Signature: Date: 1% 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. WRY property is a single fancily residential real property. See Civil Code Section 1101.4. On and afte January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixturesteplaced with water-conserving plumbing fixtures throughout the building. On or before January 1, 20 7, all�non-compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless f ,h'ethe property undergoes alterations or unprovements). 1Vlyproperty 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). 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 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 req ' ments as indicated in the table below. 1 Owner's (or Owner Agent's)Signature: 14 Date: Upon completing and signing this Certificate,please-return it to the Building Division in order to final your permit. Non—Co_ loan. W. Water-Conserving Plumbing Fixture_ (Fixture Com In - Plum m Fixture : (F. p y'ig with Current Code Applicable-to New..Construction) .. Water Usage/Flow W t Maximum a Rafe - Fixture Tr ype ' 2013 CPC Ch.4 2013 CPC Ch.4 2013 CPC Ch. 4 _ Water Usage /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 ?;1 Single flush toilets: 1.28 gallons/flush (Toilets) i 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 ; I Exceed 1.0 a` Gallons/flush - 0.5 gallons/flush Showerhe6ds Exceed 2.5 `:`I 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minutes_. 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 l ' 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 I allow only one shower outlet to be in operation at a time. .Faucets—4 Exceed 2.2 gallons : Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory �J, per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets = 0.8 gallons per minute @ per minute @ 60 psi; S1 20 psi minimum 0.8 gallons A 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 1, 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 @ F- default to maximum 60 psi, and must ' ` 1.8 gallons per minute @ default to maximum s� ! 60 psi 1.8 gallons per minute VN Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are 3 may be used to achieve unavailable, aerators or i reduction. other means may be r� used to achieve ' reduction. 1f4bexisting plumbing fixture water usage/flow rate is equal to or lower than the figureshow• ' zs_ of r qu ied5 to b'e upgraded , s . SB40 7 2014.doc revised 03/18/14