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15060102 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 1064 WESTLYNN WAY CONTRACTOR:PHILLIP D.BJURMAN PERMIT NO: 15060102 OWNER'S NAME: AROMAS,CA 95004 PHONE NO:(650)906-7533 -- LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL E] COMMERCIAL ❑ DEMO(E)SWIMMING POOL&FILL FOR FUTURE License Class�+: Lic.#' �52 �ZS � CONSTRUCTION(TO 90%CERTIFIED COMPACTION) ( Contractor - `J/ Date , I hereby affirm that I am licensed under the provision 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$11000 ave 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:35932062.00 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 DAYS SSUANCE 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 A LAST +D INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of th �S granting of this permit. Additionally,the applicant understands and wi o Is Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. S: Signature / r Date ;i3�^ . All roofs shall be inspected pri roofing material being installed.If a roof is s installed without first obtain 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 r 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 District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections C—A Date: permit is issued. r 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 918. Signature Date SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333•building(a)cupertino.org / 7 lJ PROJECT ADDRESS I O i APN# 3 �p 3 Z {j Z OWNERNAME L FAX CONTACT NAMEPHO LGs ` 'J '1.�(°Y'�ti Je CA OC C;�n STREET ADDRESS CITY,STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT C RNAM 13 ` LICENLICENTPE BUS.LIC#EnCBnR r� q-1 C014;ANY NAME E-MAIL ` FAX fl�(�►'i:a� i-� r �SS�I(s �'�Re1l� :�" fUir�.�rs� C STREET ADDRESS CITY,STATE,ZIP�pr(, Z (�'� P ONE ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK n � 7c, A, L:Jam. USE OF ❑ SFD or Duplex ❑ Multi-Family TYPE MATERIAL TYPE(CODE) AREA (SQ.FT.) VALUATION(S) STRUCTURE: ❑ Commercial POOL POOL JSPA MATERIAL TYPE CODES: SPA V - VINYL-LINED n ===L (� _ F - FIBERGLASS DEMO ��O 'UU G - GUNITE € - P - PREFABRICATED sRECEIVED BY ' y � a F '�Y ' �l ,' { TOT.}L�VALUA'O� By my signature below,I certify to each of the follo am the pro er or auth gent a pro owner's behalf. I have read this application and the information I have provided is correct. I hav ead to Descr' c and verify it is accurate. ree to comply with all applicable local ordinances and state laws relatin authoriz ... •••- °=- ---------ente -- ove-ide ified pr perry for inspection purposes. Signature of Applicant/Agent: Date: a f ti SUPPLEMENTAL INFORMATION REQUIRED u.c,�w oFF�cE,iSEONLY- "�,, :Roto�uvc'sLte� Commercial or Multi-Family g Buildings with Public Swimming Pools: , n Y " Department of Environmental Health approval required. ❑ OVER THE COUNTERY ' iBuu DnvcDEPTs�I y ' y ❑ EXPRESS zc ❑+P_WNINGDEPT + e i to 4 a t^,7 a xr r.) r +moi ❑" STANDARD ," ❑ PUBLIC'WORKS DEPT �C rper ❑� LARGE � .,r'i�s",� � yl� r❑�ENVIROA'MENTAL HEALTH w ❑,tIViA IOR v c ❑n SANITARY`SEWER•DISTRICT SwimPoolApp_201 Ldoc revised 03/16/11 CITY OF CUPERTINO D FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 1064 WESTLYNN WAY DATE: 06/15/2015 REVIEWED BY: MELISSA APN: 359 32 062 BP#: *VALUATION: 1$11,000 *PERMIT TYPE: Demolition Permit PL I<V CIIECK TTPF PRIMARY PENTAMATION USE: Swimming Pool, Res. PERMIT TYPE: 1 SFPOOLDEM WORK DEMO E SWIMMING POOL & FILL FOR FUTURE CONSTRUCTION TO 90% CERTIFIED SCOPE COMPACTION) FEE ID #POOLS 1DEMOPRES 1 Nfech. Plan Check I'hunb. E'lan Check Elec.Plan Check ;lleclr, Permit Fee: Plumh. Permit Fee: titer. Permit her: Other b/cch. Irish. Other Plumb Insp. Ocher Glee.Insp. J.Pech. Insp.Fee: 11I71rnb. Insp. Fee: filer.Imp.Fee: E iLd NOTE:This estimate does not include fees due to other Departments(Le.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). Theseees 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 Ef. 7f 11/13) FEE QTY/FEE MISC ITEMS Plan Check,Tee: Suppl. .PC Fee Plumb./illfec•h./Elec Permit Fee: $329.00 Suppl. Insp.Fee-.0 Reg. Q OT 0 01 hrs $0.00 PI?IMb.Ale ch./Elec Plunrh.iMec•h./Elec f ermil Fee: Construction Tax: Administrative Fee: bVork WYithout.Permit? Advanced Planning fees: Travel Documentation Tees: i Strong Motion.Fee: IBSEISMICR $1.43 Select an Administrative Item t Bldg Stds Commission Fee: 1BCBSC $1.00 e u Su`BTOTOTALs: $331.43$331.43 $0.00 FEE:a Revised: 05/07/2015 COPvtl�9(tNl iE Nr of s A .c PsRT fvO ANT Tc'i�`set �un1�r J ancfspP tW , ® Qg cOr,� oificati ti,;,rn,r' or ?ns ttonsn�f(I b n. ST kept Om, with -Qtion" - �s Llnlawf to pt at out n Som. {u/ n7al e th ^;;f �n,nn c Gppro'�af from ,.he,or Lo deviat%a any -Fis pi n e Builth ;pit Or to enc!spect �, n9 0rflcial �1 t oviclons Of a,l b, in`�p�'rov aeons SFiAL Y'Ci;, al o L�'pT urnanc A iation _._ SNS CHECKED BY 32 NING DEPT CUPERTINO . i CEjVED JUN 15 2015 vir OFPICE� b L 4 e T Lq C P ��21 - r T- r Address �ST3iysJ. 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(cDcupertino.org to 1V� FSI L [Zis FbS 615� 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 µ $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. ,r 1 have read and aoree to comply with the terms and conditions of this ........... "`"� _.....................-...e.............................................. Dat ..... ..C04..5... Contractor Name: Signature...................................................................Uc.#...................................... Date:................... Smoke and W form.doc revised 03/18/14 .R M1' r„ kv `a LM DUPE RTiHO IOwner Name Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ( 3333 • building (a)cupertino.or4 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 skip the rest of the form. ®wier�=-SXbiatui�n`� ,, ` ]Date-- 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. Y OwnerSrgnature At 6' , Date's �j 7 �d 14") -; Go to Question 3: ' 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 skip the rest of the forlA `O ffer 'Signa6u e Q��y (� f No Go to Question 4 4. Is your real properly 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 nota Sign Belo and skip the rest of the form. i'��iler�=Srgnafuie -�,� D►�ate��,�- v '.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. tet. Nlyproperty is a single fmiaily 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 tgbe replaced with water-conseiving plumbing fixtures throughout the building. On or before January 1, f2017, all non-compliant plumbing fixtures shall be replaced with water-conseiving plumbing fixtures (regardless ,�a Lo�ler property undergoes alterations or improvements). ❑ Myproperty 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). ❑ Myproperty 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 2 015. doc revised 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 improvements). I/\Ve, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixturessrwMlillbe 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 California Green Building Standards Code, and manufacturer's installation requirements, and that the water -'conserving plumbing_ _ -- Date: "V— Upon completing and signing this Certificate, please return it to the Buildlig Division in order to final your pen -nit. P? If the existing plumbing fxtufe°Waterausage/tlbW rate is equal. to or lower than the figure shown, it;is;not requited to b.e upgraded 24* SB4072015.doc revised 02/04/15 ," 1Non Complta'nt -opt" Water -Conserving Plumbing Fixture -Plumbing FixtureLl, (Fixture Complying with Current Code Applicable to New Construction) _• � - Maximum Water Usa a/Flow"Rate 9 Fixture Type.l r 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 i, l 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 'Gallons/flush 0.5 gallons/flush �`i Showerheads, 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of ,1=xceed gallons per minute 1 -U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) i ;<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 ;aper 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 `= k ,.: use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute + 9 60 psi Faucets – i :!Exceed 2.2 gallons '. a1.$gallons per minute @ 1:8. gallons per minute 1.8 gallons per minute @ 60 Kitchen Pper minute 60 psi; @ :60, psi psi Faucets 'May temporarily increase May fernporarily 'up. to 2:2 gallons per increase -up to 2.2..: . minute. @.166,0 ,rmmute:'@ default toimaximum r,60 pst, and must ',1-8 gallons per:mihute'@ 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 m{eans the above are ` ' ymaybe used'to achieve unavailable} aerators ,or reductionr other means may be -use tl to achieve .. . P? If the existing plumbing fxtufe°Waterausage/tlbW rate is equal. to or lower than the figure shown, it;is;not requited to b.e upgraded 24* SB4072015.doc revised 02/04/15