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15080147CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 7612 RAINBOW DR CONTRACTOR: MIKE COUNSIL PERMIT NO: 15080147 PLUMBING INC OWNER'S NAME: LEWIS HELEN L TRUSTEE 1915 O'TOOLE WAY DATE ISSUED: 08/19/2015 OWNER'S PHONE: 4082534443 SAN JOSE, CA 95131 PHONE NO: (408) 272-4900 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ )/ - � REPLACE (E) BUILDING SEWER (NO SANITARY) License Class � i0 Lic. 4—i63-1? Contractor ate lid 1.57 I hereby a rm tha I am licensed under the provisions of Chapter 9 (commen ng with ection 7000) of Division 3 of the Business & Professions Code and at my cense 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: $14741 performance of the work for which this permit is issued. lltrre 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: 36611036.00 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 AYS FRO LED INSPEC ION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the C Iss Da / granting of this permit. Additionally, the applicant understands and will comp y source regulations per the Cupertino Municipal Code, Sec with all no7�R 9.18. SignatureDate/ �j 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. ❑ O�E-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 1, 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. 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. 12 and will maintain compliance with the Cupertino Municipal Code, Chapter 9�jW I have and will maintain Worker's Compensation Insurance, as provided for by 25505, 25533, and 25534. the Health & Safety Code,PRUCT Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized agentDate: 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 CONSON LENDINGAGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is aonst ction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit i iss d (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 (408) 777-3228 •FAX (408) 777-3333 • build! na(a)cuoertino.org rh���� CUPERTENt� (J m I� OPLUIvIBING ❑ MECHANICAL ❑ ELECTRICAL ❑ 1,4ISCELLA2,1EOUS PROJECT ADDRESS f_ G► R.OL�Y1 d/ O �� • I APN n 0 3 6 ONTJNER NAME !/ /7 , j " E-NLAIL STREET ADDRESS CITY, STATE, ZIP FAX Lk CONTACT NAME � s PHONE O � � � � � � O E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ owmER-BuiLDER ❑ mNERAG•m\7 CO>*IRACTOR ❑ COhTRACTORAGENT ❑ ARCHITECT ❑ ENGAMER ❑ D--,,cLOPIIt ❑ T=? e]vP CONTRACTOR T ,hF + Q! I C LICENSE ' l / LICE TYPE �` 6 6 I BUS. LIC: , COMPANY N. i E-MAIL FAX 1 - STREET ADDRESS I S O e CITY, STSTB� ZIP !"T j�Ci 5-1-61 J PHONE n _ dO L ARCHITECT/ENGINEERNAME I LICENSE NUMBER BUS. LIC COMPANY NAME E-MAIL I FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF FD or DUPLEX ❑ MULTI-FANELY . I . PROJECT LN wIIALAND ❑ YES PROJECT IN ❑ YES BUIIDAG: ❑ COMMERCIAL URBAN'' L+QTERFACE AREA ❑ I'm FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK Lk,1 TOTAL VALUATION: / �:: By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the s behalf. I have read this application and the information I a rovided is correct. I have read the Description of \TJork and verify it is agree to comply with all applicable local ordinances and state la��'s relating o bu ing cons ction. I authorize representatives of Cupertino to enter abo 'e-identifi d property for inspection purposes. Signature ofA.pplicant/Agent: Date: 2 SPLEA NTAL WFOR-MATIONr REQUIRED r .,.. �OFFICEgLSE:OI�L1,� K.. IS 01 -IT AfEPA1iscA4pp_2011.doc remised 06121111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION APPLIANCE / EQUIP TYPE 7612 RAINBOW DR DATE: 08/19/2015 REVIEWED BY: MELISSA IlaADDRESS: APN: 36611036 BP#: *VALUATION: 1$14,741 *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: I PENTAMATION 1 RPSS I PERMIT TYPE: WORK REPLACE Q BUILDING SEWER NO SANITARY SCOPE suppl. Imp Fee APPLIANCE / EQUIP TYPE FEE ID 1-7ec. flan Check Nec. 1'ermif Fee QTY UNITS BP FEES Sewer, Building 1PRSEWER 1 # $25 Permit Fee: suppl. Imp Fee PME Unit Fee: $25.00 PME Permit Fee: $48.00 Construction :Tar: Administrative Fee: IADMIN $45.00 Work Without Permit? ® Yes (E) No $0.00 TOTALS: N* ; $25.00 Strong Motion Fee: 1BSEISMICR ;llech. !'tart (:'heck tlech. Permit Fee: Other .t tech. fru - Plumb. Plan Check 0.0 1 hrs $0.00 Plumb. Permit Fee: 1PPERMIT Other Plumb Insp. 0.0hrs $48.00 1-7ec. flan Check Nec. 1'ermif Fee ollter h lec. insp. Plan Check Fee: ;14ech. Insp. Fee: I /'/urnh. Irish Fee: I Flee. Insp. Fee: NOTE: This estimate does not include fees due to other Departments (Le. Planning, Public Works, Fire, Sanitary Sewer District, School rli.irini of, 1 Th— foo. pro hn.od nn fho nrolimiwanr infarmntinn avnilahlo and am nnly nn ostimato_ 1-a"tact tho Dont for addn'1 info - FEE ITEMS (Fee Resolution 11-053 E . 711/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: Suppl..PC:' Fee PME Plan Check: $0.00 Permit Fee: suppl. Imp Fee PME Unit Fee: $25.00 PME Permit Fee: $48.00 Construction :Tar: Administrative Fee: IADMIN $45.00 Work Without Permit? ® Yes (E) No $0.00 Advanced Planning Fees: Travel Documentation Fee: ITRAVDOC $48.00 Strong Motion Fee: 1BSEISMICR $1.92 Select an Administrative Item Bldg, Stds Commission. Fee: 1BCBSC $1.00 $168.92 $0.00© 4' $168.92 Revised: 07/02/2015 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 cDcuoertino.org a 15 5 LJ- � -4-1 Address # of 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 alarms) 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 read and agree to comply vrith the terms and conditions of this statement (or Owner Agent's) Name: Z nature........G................................... Date: .. ....... C tractor Name: Signature... ......... ........... Lic.#...................................... Dat e?/Jt, Puyvk 161 Y11 \\j Smoke and CO form.doc revised 03/18/I4 1 LU CUPERTINO Owner Name WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 77��7-pp3228 - FAX (408) 777-3333 • buildina(&cuaertino.org 117 JAC) IPV) Permit No. 1 S G Address �l� � 1r\ X1gA PERNUT CANNOT BE FINALED AND CONtPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED 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. 1. 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: INo Go to Question 2. Date: ql�a�� �s. FILE 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: No Go to Question 3. Date: 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: 11"'No Go to Question 4. Date: 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: /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 2015. doc remised 02/04/15 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 r improvements). UWe, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and alifomia Green Building Standards Code, and manufacturer's installation requirements, and that the water-conse lu ixtures compl ith the requirements as indicated in the table below. Owner's (or Owner Agent's) SignatureDate: Upon completing and signing this"�e, please returl'i it to the Building Division in order to final your permit. \j 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 2015.doc revised 02/04/15 Non -Compliant Wa ing Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate 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 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 2015.doc revised 02/04/15