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15070080CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10341 TONITA WAY CONTRACTOR: CALIFORNIA HOME PERMIT NO: 15070080 BUILDERS & DESIGN OWNER'S NAME: SAMADDAR SUMITRO AND SEN SUPARNA 1775 JUNCTION AVE DATE ISSUED: 08/19/2015 OWNER'S PHONE: 4082539042 SAN JOSE, CA 95112 PHONE NO: (408) 392-8200 Zr LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ License Class 1�� Lic. # CONSTRUCT ONE STORY ADDITION (471 SQ FT); REROOF WITH COMPOSITION SHINGLES (2177 SQ FT); REMOVE rl / Contractor L- . UNPERMITTED PATIO COVER (290 SQ FT). _ ,Dtp I hereby affirm th�t I am licensed under the provisions of Chap /r9' (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 Copensation, as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $70000 erCo, of the work for which this permit is issued. Ifh�ve and will maintain Worker's Compensation Insurance, as provided for by Se11ction 3700 of the Labor Code, for the performance of the work for which this APN Number: 35914003.00 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 LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the $ 1� granting of this permit. Additionally, the applicant deptands and will comply with all non -point source regulations per oeff ertind Municipal Code, Section Is Date: 9.18. fr —� Signatu/- i ate C RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is , '� I, Iinstalled 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) 1, 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 Quali management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertin�uni'crp�l Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, Sections 2 505, 25533 ,an $'3,4. /Owner Section 3700 of the Labor Code, for the performance of the work for which this or authorized agDate: ���---! 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 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) 777-3226 - FAX (408) 777-3333 - buildingCcDcupetno.org El NEW CONSTRUCTION n ADDITION 7 ALTERATION / TI 7 REVISION / DEFERRED ORIGINAL PFRMTT;� PROJECfADDRESS APN # - 35-41 C)"ArNER NAME C7 0 PHONE 0 r3 MAIL - STREET ADDRESS CITY, STATE, ZIP - FAX CONTACT NAME e, f PHON] E-MAIL Rs) — 12— STREET ADDRESS y JpRo-q Arorrm I- CITY, STATE, ZIP <)e-� FAX E:I OIANER 11. OWNER -BUILDER❑ mAqIER AGEw ❑ CONTRACTOR ❑ CONTRACTOR AGENT El ARCHITECT 1-1 ENGINEER El DEVELOPER El TENANT CONTRACTORNAlvM LIC SENIA-LBER LICENSETYPE BUS. LIC f COMPANY NAME E-MAILFAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECVENGINEERN,42113 LICENSENIUMBFR BUS. LIC I COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK q 1 F Ue, i 1/eV 7 ' 5' - Ex(STX USE PROPOSED U E TYPE STORIES CONSTR 05 USE TYPE OCC. SQ.FT-7 VALUATION (S) at* EXISTG AREA 'L I, - r 7-( N7 FLOOR AREA 1 -1 -;�41 DEMO - AREA TOTAL NET AREA Z 1 BATHROOM KITCHE7.4 OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH ARE GARAGE AREA: LJDETACH I ❑ ATTACH 9 DIATLLINGUN�ITS: IS A UNIT ELYS SECOND STORY E] YES E G ADDED? E]NO BEING ADDITION? QN0 PRE -APPLICATION [-I 'iTS IF YEES. PROVIDE COPY OF IS THE BLDG AN [D.YES -- 'Jt -.F, -F .1y,1 -- g,, 7 �IE-5212N-1. M N TOTAL VALUATIO PLANNINIGAPPL4 MNO PLANNING APPROVAL LETTER ETCHLERHONIF? [] NO J-0 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 and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature ofApplicantJA,-ent: Date: SUPPLEMENTAL R\1FORMATIONREQUIREDBURDEN New SFD or Multifamily d%Nellincrs: Apply for demolition permit for W 1]E 1-3170 & 00- existing building(s). Demolition permit is required prior to issuance of building 04 Mus- M —5.0 R-nff-AUJL-'JWQ:F!?lWa—E permit for new buildinla . 4 S -� SO , Commercial Bldgs: Provide a completed Hazardous Materials Disclosure RM - V -40 form if any Hazardous Materials are being used as part ofthis project. Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. Eldg,(pp.2011.doc revised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION OCCUPANCY TYPE: 10341 Tonita Way DATE: 07/13/2015 REVIEWED BY: Sean liaADDRESS: . APN: BP#: *VALUATION: 1$70,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY USE: SFD or Duplex 2nd Unit? Yes '' No OTC? 0 Yes E No PENTAMATION PERMIT TYPE: 1 R3SFDADD i WORK Construct one story addition 471 sq ft); Reroof with composition shingles 2177 sq ft); Remove SCOPE unpermitted patio cover (290 sq ft). OCCUPANCY TYPE: TYPE OF CONSTR. FLR AREA s.f. PC FEES PC FEE ID BP FEES BP FEE ID R-3 (Custom) II-B,111-B,IV,V-B 471 $1,626.00 IADDPLCK $1,323.00 IADDINSP Elec. Ins}.r. h'ee: $1,323.00 Suppl. Insp. Fee -(j) Reg. 0 OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction 1 err: Administrative Fee: 0 E) Work Without Permit? 0 Yes (j) No $0.00 TOTALS: 471 $1,626.00 ` . $1,323.00 Strong Motion Fee: IBSEISMICR MECH,._HOURLY `` Yes "„O No' PLUMB, HOURLY , ` � Yes � No;:. ELEC; HOURLY ;19ech. Plan C:'Feek 1'larnrb. Pkin Chc:cl, Elec. Plan C'hecic tfech. Pernrii Fee: Ptrrmb. Pcrnzit Fee: IUe Pet unif heir: (:)tiler :11ec•h. Insp. other Plumb Insp.Li Other Elec. Insp. Li ldech. hasp. Fee: Plunib. hap. Fee: Elec. Ins}.r. h'ee: NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Dhtrirf etc )_ Thece fees are hated an the nreliminary information available and are only an estimate. Contact the Dept for addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff. 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: $1,626.00 2,177 s.f. Re -roof $374.00 IREROOFRES Suppl. PC Fee: (j) Reg. 0 OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $1,323.00 Suppl. Insp. Fee -(j) Reg. 0 OT 0,0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 Construction 1 err: Administrative Fee: 0 E) Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Fee: IPLLONGR $65.94 Select a Non -Residential G Building or Structure 0 I i Travel Doc uinentation Fees: Strong Motion Fee: IBSEISMICR $9.10 Select an Administrative Item Bldg Stds Commission .Fee: IBCBSC $3.00 _ SUBTOTALS: $3,027.04 $374.00 TOTAL FEE:,: $3,401.04 Revised: 07/02/2015 CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB ADDRESS: jD -7cil o v% JA w PERMIT # 20 OWNER'S NAME: 5 A, � d A ar '71 r"' PHONE # H 49— _ Z — 0 Lk 7 -- GENERAL CONTRACTOR: C-ot i ; 0rV4a *e f3u,'YeW BUSINESS LICENSE # L-ko y 3 ADDRESS: \—('(S AVC CITY/ZIPCODE: 560 p S z 9 C A g S j j 'Z - *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the following information: / Contractor Signature Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork C""14 v(v� c1 (40.4AC- R'J <I c� t" " \ L-\3 Cement Finishing ,� ,� '; Electrical r r L� �1 1-1 'r, Excavation f- r y a t1 ``t Fencing Flooring / Carpeting Linoleum / Wood Glass/ Glazing Heating r-' ,irA t D!+At- . „'j d ed (� Insulation .� j vk; o A S o1,, 1j Q „A 6° Landscaping Lathing C✓ v.A !Vie vc7 rte'" 1114 3 Masonry Painting / Wallpaper >✓ L (© j +-t 3 Paving ` Plastering ,� �- Plumbing r Lt 3 Roofing Ca we' ��� �, 5 2_ Septic Tank Sheet Metal rat 1":' 4eo ri vex I�L'0.44 e f?7 c it � 3 Sheet Rock /- ►'\ `t Tile / Contractor Signature Date SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO 10300TOR REAVENUE__.CUF�ERTINOi,:CA9'5l)14-3255:."=: '(408) r?7 3228 • FAX (408) 777-3333 • buildina(c cuoertino.Drg Permit No. L S D -- Address _ =i M I 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 4220.6 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 I SMOKE ALARM_j 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 I X Within each sleeping room _ I 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 hasihave 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. _ l have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: S:u.M ITALO Std M A�OaA Q ... Signature............................................................. ................................................... Date:G...56' ontractor Name: `Cs is9 9,e,, n Signature.........LIC.# ... .. Date: Sn2oke and COforni.doc revised 03/1811 �4 CUPERTINO WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE e CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(c)-cupertino.org w*umza, �,—na. 5 U ry)I7 A v 5A f`'1A bDA P -MEI. O. I5o-7006P wMEM 10941 on I'tA InIr,U PERINfIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN S (T ED AND RETURNED TO THE BUILDING DIVISION Please refer to the attached California Civil Code Sections 1101.1- 1101.8 which are part of this Certification form. Is your real property a registered historical site? ❑ Yes Civil Code Sections 110 1. 1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Q No Go to Question 2. Date: 6--7v—1 -7 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: �b- f(� No Go to Question 3. Date: 6'-3C_'-_ /7 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: , �L?4 No Go to Question 4. Date: 00 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 110 1. 1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: � , Date: 0/.- _�Y` - / 7 � [Z Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1. 1 through 1101.8 apply. Refer to the attached. ❑ y 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 2015.doc revised 02/04115 On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures thmughout the building (regardless of whether property undergoes alterations or improvements). I/We, the owner(s) of this pro erty, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above , vith water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current CaliforniaPlumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the wa er-conserving plumbing fixtures comply with the requirements as indicated in the table below. Qwner':s.(or_Owner,Agent's) S -afore: Date.: �� Upon completing and sigr4g this Certificate, please return it to the Building Division in order to final your permit. Faucets — Exceed 2.2 Kitchen per minute Faucets 1. If the existing plumbing Rion -Comp iant Water -Conserving Plumbing Fixture Ions 1.8 gallons per minute @ 60 psi @ 60 psi (Fixture Complying with Current Code Applicable to New Construction) May temporarily increase Plumbing Fi Ktures up to 2.2 gallons per increase up to 2.2 Maximum Water Usage/Flow Rate Fixture Type Water Us ge 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 1.8 gallons per minute @ /Flow Rae Multi -Family Commercial Single -Family y 1.8 gallons per minute Where faucets meeting Residential Residential the above are unavailable, Where faucets meeting Single flush toilets: 1.28 gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, Water Closets Exceed 1.6 (Toilets) Gallons/flus flush volume of two reduced flushes and one full flush other means may be average 0.5 gallons/flush Urinals Exceed 1.0 reduction. than the figure shown, it is not required to be upgraded. Gallons/flus 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of Showerheads Exceed 2.5 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 controlled by a single valve shall not showerheads and/or other shower outlets 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.0.5 gallons per minute @ 60 Maximum 1.5 gallons per Within units: g P minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets— Exceed 2.2 allons Lavatory per minute 0.8 gallons per minute @ per minute @ 60 psi; Faucets 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 Kitchen per minute Faucets 1. If the existing plumbing SB40 7 2 015. doc revised 02104115 1.8 gallons per minute 1.8 gallons per minute @ 60 Ions 1.8 gallons per minute @ 60 psi @ 60 psi psi 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. than the figure shown, it is not required to be upgraded. zre water usage/flow rate is equal to or lower SB40 7 2 015. doc revised 02104115