15070147W,
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10255 MIRA VISTA AVE
CONTRACTOR: AMIR ELECTRIC
PERMIT NO: 15070147
OWNER'S NAME: VENKATAPATHY RAMANATI -IAN N AND PRASA
344 LASSENPARK CIR
DATE ISSUED: 07/21/2015
OWNER'S PHONE: 4252330884
SAN JOSE, CA 95136
PHONE NO: (408)234 -9903
49 LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL ❑
UPGRADE 100 AMP PANEL TO 200 AMP PANEL, SAME
License Class` Lie. # ?_3 ` - (' `
LOCATION
Contractor Akij ' en� 1Sg Date
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
Sq. Ft Floor Area:
Valuation: $700
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
ection 3700 of the Labor Code, for the performance of the work for which this
APN Number: 35702034.00
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 F CA INSPECT N.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue ainst said City in consequence of the
2/
granting of this permit. Addition a applicant understands and will comply
sue a e:
with all non -point source gu s per the Cupertino Municipal Code, Section
9.18.
- 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:
1 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 ' es which emit hazardous
Compensation, as provided for by Section 3700 of the Labor Code, for the
air contaminants as defined by the Bay Area u ' Management District I
performance of the work for which this permit is issued.
will maintain compliance with the Cupe t. Mu . rpal Code, Chapter 9.12 and
I have and will maintain Worker's Compensation Insurance, as provided for by
the Health & Safety Code, Sections 25 , 255 , 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
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
ARCHITECT'S DECLARATION
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
........................._ ....
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
CUPERT[N0
(408) 777 -3228 • FAX (408) 777 -3333 • buildina(a)cupertino.orq m l!"Sk C
❑ PLUMBING ❑ MECHANICAL (Y ELECTRICAL 7 MISCELLANEOUS
PROJECT ADDRESS
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O�a✓NER NA1�fE 5 a u vA al r el5 Q PI.. K� X 33 68 8 l E -NLAIL I'Y) y '� ®YI
STREET ADDRESS ' 1
CITY, STATE, ZIP ^ G e,,,� 1; o FAX
�Oj
CONTACT NAME rn
PHONE( A' / E -MAIL
STREET ADDRESS
CITY, STATE, ZIP
FAX
❑ OWNER ❑ O)AINER- BUILDER ❑ OWNER AGENT
i CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGUMR ❑ DEVELOPER ❑ TENANT
CONTRACTORN ?) � V
LICENSE?\LTIDER ��J LICENSETYPEc
BUS.LIC# D
COMPANY N.ANE ' J �/ , e
E- M.4IL r- �i /// 7/ Q� a (
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FAX
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STREET ADDRESS
CITY, STATE, ZIP r-+
s �Ta s� 0 P,
PHONE
L�a� >�-g�6
ARCHITECT/ENGINEER NAME
I LICENSE NUMBER
BUS. LIC R
COMPANY NAME
E -MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or DTTPLFX ❑ MULTI -FAI M Y
PROJECT IN WILDLAND ❑ YES PROJECT IN ❑ YES
IS THE BLDG AN ❑ YES
BLIIIDING: ❑ COMMERCIAL
URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO
EICHLER HOME? ❑ NO
DESCRIPTION OF WORK
r
TOTA1 VALUATION:'
D
.,
By Iny signature be] , I certify to each of the following'
e property owner or authorized agent to act on wner's behalf. I have read this
application and the infonnation I have provided i orre
I e rea e Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building s ct'
utho ' representatives of Cupertino to enter the above - identified property for inspection purposes.
Signature of Applicant/Agent:
Date:
SUP LEMENTAL I TFORMATION REQUIRED
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AIEPAliscrlpp_2011.doc remised 06121111
� CITY OF CUPERTINO
Fw-- �I FEE ESTIMATOR — BUILDING DIVISION
APPLIANCE / EQUIP TYPE
ADDRESS: 10255 MIRA VISTA RD
DATE: 07/21/2015
REVIEWED BY: MELISSA
1w,
APN: 357 02 034
BP #:
"VALUATION:
$700
*PERMIT TYPE: Electrical Permit
PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY
USE: SFD or Duplex
$48
PENTAMATION
PERMIT TYPE: 1 REAP
WORK
UPGRADE 100 AMP PANEL TO 200 AMP PANEL SAME LOCATION
SCOPE
APPLIANCE / EQUIP TYPE
FEE ID
lun,h. Plan Check
QTY
UNITS
BP FEES
Elec. Permit Fee: IEPERMIT
Services
1 ERT <200
Other Elec. Insp. 0.0 hrs $48.00
200
Amps
$48
)ermil F'ee:
' 71 1 ,, F'ee
PME Unit Fee:
$48.00
PME Permit Fee:
$48.00
_771 Construction Tar:
Administrative Fee: 1ADIfIX
$45.00
Work Without Permit? O Yes Q No
$0.00
TOTALS:
Travel Documentation Fee: ITRAYDOC
$48.00
Strong Motion Fee: IRSEISMICR
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Ptre, ,'anitary hewer vistrtct, acnoot
lliu /:iM n/n 1 Th... foot — Ane—1 aN A? Oroliminaru infarmatinn awailahle and are nn1v an ewimate. Contact the Dent for addn7 info.
FEE ITEMS (Fee Resolution 11 -053 Eff.' 711113)
Mech. Plan Check
lun,h. Plan Check
Elec. Plan Check 0.0 1 hrs $0.00
Plan Check F'ee:
Plumb. Permit Fire:
Elec. Permit Fee: IEPERMIT
Other ,tlerh. Insj
Oilier Plumb Insp-
Other Elec. Insp. 0.0 hrs $48.00
',. Irsp. Fee
Plumb. b,sp. Fee:
f lec. InsEz F
NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Ptre, ,'anitary hewer vistrtct, acnoot
lliu /:iM n/n 1 Th... foot — Ane—1 aN A? Oroliminaru infarmatinn awailahle and are nn1v an ewimate. Contact the Dent for addn7 info.
FEE ITEMS (Fee Resolution 11 -053 Eff.' 711113)
FEE
QTY/FEE
MISC ITEMS
Plan Check F'ee:
5'gppl. P(:' Fire
PME Plan Check:
$0.00
)ermil F'ee:
' 71 1 ,, F'ee
PME Unit Fee:
$48.00
PME Permit Fee:
$48.00
_771 Construction Tar:
Administrative Fee: 1ADIfIX
$45.00
Work Without Permit? O Yes Q No
$0.00
ldvanced Planning F'ees:
Travel Documentation Fee: ITRAYDOC
$48.00
Strong Motion Fee: IRSEISMICR
$0.50
Select an Administrative Item
Bldg Stds Commission Fee: 1BCBSC
$1.00
SUBTOTALS:
$190.50
$0.00 TOTAL FEE:
F $190.50
Revised: 07/02/2015
Address
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•
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(a.cuigertino.org
FILE
77-7-
(1ti,
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.
t have read and agree to comply with the terms and conditions of this statement
Owne or Owner Agent's) Na e:
, 0 S'
ov r��04
J
Signature .................... .............. .................................... ............................... Date:...................
Contractor Name:
Signature......................................... ..........................Lic.# ....... ............................... Date: ...................
Smoke and CO form.doc revised 03118114
M
WATER- CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
CUPI`Rl°!NO 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255
(408) 777- 322(8-FFAX (408) 777 -3333 • buildina(akugertino.org
Owner Name �,c� l5�,� Permit
Address A) 2 S� A-1—mac.
FILE
.L , / ,
9�.
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 ship the rest of the form.
Owner' Signature: A-1-- Date: c C _k-
1\1
o Go to Question 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:
l No Go to Question 3.
L�
Date:
l
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 she form.
Owner' Signature: Date: 1
,-"[Z No Go to Question 4. G
4. Is your real property built and available for use or occupancy on or before January 1, 1994?
2 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.
AC- Yes
El
Owner' Signature:
Date:
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 fmnily 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 it Troverments 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.
SB40 7 2015. doc revised 02104115
On .or before January 1, 2019, all non - compliant plumbing fixtures shall be replaced with water- conserving
pluxnbing' fixtures throughout - the building (regardless of whether property undergoes alterations or
. improvemehfs).
1A Ve, the owner(s) of this property, certify under penalty of perjury that non - compliant phumbing fixtures will be replaced
prior to date specified above with water - conserving plumbing fixtures in accordance with Civil Code Sections 110 1. 1 through
1101.8, the current California Plumbing Code and �,�ajifornia Green Building Standards Code, and manufacturer's installation
requirements, and that the water - conserving pl g fixtures comply with the requirements as indicated in the table below.
Owner's (or Owner Agent's) Signature: Date: o I y
Upon completing and signing this Certificate, please 'Lfetum 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.
SB4072015.doc revised 02104115
Non- Compliant
Water- Conserving Plumbing Fixture
Plumbing Fixture
(Fixture Complying with Current Code Applicable to New Construction)
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 i
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 riot
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 i
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 psis and must
1.8 gallons per minute @
default to maximum
60 psi
1.8 gallons per minute
Where faucets meeting
@.160 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.
SB4072015.doc revised 02104115