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15060108 (2) CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10171 LOCKWOOD DR CONTRACTOR:SBL ENTERPRISES,INC. PERMIT NO: 15060108 OWNER'S NAME: SARATOGA,CA 95071 PHONE NO:( LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL COMMERCIAL ❑ REPLACE(E)40 GAL WATER HEATER,SAME LOCATION License Class C : _ Lie.# � ��� Contractor SA4 F.��Date � �6/ 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 performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$1200 1 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:34214032.00 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 1 ERMIT 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 AY ALLED INSPECT ON. indemnify and keep harmless the City of Cupertino against liabilities,jud costs,and expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply Date: with all non-point source regulations per the Cupertino Municipal Code,Section 9 18. RE-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. ElOWNER-BUILDERDECLARATION 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) 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 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,Section 505,25533,anp 25534. Section 3700 of the Labor Code,for the performance of the work for which this Owner or authorized agent: /f 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 (408)777-3228 • FAX(408)777-3333 -building(c cupertino.org CuPERTINQ PLUMBING MECHANICAL []ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS / / © DO� At, APN n OWNER NAME / l STREET ADDRESSo 17 ®G`c G� �� A CE TATE,ZIP I FAX olr l_ CONTACT NAME PHOT D �f�. E-MAIL F67-66) D i n C ` v U STREETADDRESS CITY,STATE, ZIP FAX C� ❑ OW ER ❑ 01AINER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑COATRACTORAGENT ❑.ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENA-Mr CONTRACTOR NA1 �7 wM&ER / D LICENSE TYPE BUS.LIC' � -/ COMPANYNAME,T {� / /// E-MAIL FAX 0 NNl r/ /L1 //J/!1 STREET ADDRESS C�r CITLED Y,STATE, P ' 7 ARCHITECTIENGINED-RNAME LICENSE NUMBER BUS.LIC COMPANY NAME E-MAIL FAX STREETADDRESS CITY,STATE,ZIP PHONTE USE OF ❑SFD or DUPLEX ❑ MULTI-FAnffi.Y PROJECT IN WILDLAND ❑ YES PROJECT IN ❑ ITS IS THE BLDG AN ❑YES BT=ING: ❑COMNID2CLAL URBAN INTERFACE AREA El NO FLOOD ZONE ElNO EICHLERHOME? E3 No DESCRIPTION OF WORK17 a e TOTAL VALUATION: /)©! '#tECEI. BY By my signature below,I ertify to each of the following: I am the property owner or authorized age act on ner S e al, ave �.ad this ry application and the information I have provided is correct. I have read the Description of Work I p y with all applicable ocah� ordinances and state laws relating to uildmg constructs n. I authorize representatives of Cup I mo to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: �1/-t°iYl� Date: SUPPLEMENTAL INFORMATION REQUIREDarLN A1EPA1iscApp_2011.doc revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR-BUILDING DIVISION ADDRESS: 10171 LOCKWOOD DR DATE: 06/16/2015 REVIEWED BY: MELISSA APN: 342 14 032 BP#: *VALUATION: 1$1,200 *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration/Addition/ Repair PRIMARY PENTAMATION USE: SFD or Duplex PERMIT TYPE: PRWHEATR WORK REPLACE E 40 GAL WATER HEATER SAME LOCATION SCOPE APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES Water Heater 1 PRWHEATR 1 # $29 TOTALS: $29.00 K k ;Yeah. Nart Check Plumb.Plan Check 0.0 hrs $0.00 F,lec.Plan Check ibleclr. 11errrai1 Fele Plumb.Permit Fee: IPPERMIT Ilea Permit Fee: Other Alech.Insp. Other Plumb Insp. 0.0 hrs $48.00 Oilier Elec.Imp. Li A1ech. hup.Fee: Phirnb, hasp. Tec:: Flee.Imp.Fee: NOTE:This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc.). These -f -fees are based on the relimina information available and are onlyan estimate. Contact the Detor addn'1 info. FEE ITEMS (Fee Resolution 11-053 Eff.' 711113) FEE QTY/FEE MISC ITEMS Plan Check Fee: Supp/,X, Fee PME Plan Check: $0.00 Permit Fee: Suppl, I.rtsr)Fee PME Unit Fee: $29.00 PME Permit Fee: 7-1 $48.00 Construction Tax: Administrative Fee: IADMIN $45.00 Work Without Permit? 0 Yes (j) No $0.00 Advanced Planning Nees: Travel Documentation Fee: ITR,4VDOC $48.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 w . =`SUBTOTALS'1$ 171.50 $0.00 TOTAL°FEE: $171.50 Revised: 05/07/2015 MATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingOa cupertino.org Owner Name � Permit No. 0 � O Address Please refer to the attached California Civil Code Sections 1101.1— 1101.8 which are part of this Certification form. 1. Is your real properly 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. ®��=riS�ignature ".,,�� _ --`-.. 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. L No Go to Question 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. O� Triter.•''#Signature �" _ - Date r,L�' � ��� �� a;;- Goto 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 throu h 1101.8 do not apply. Sign below and skip the rest of the form. OO wnez'Sg�iatuieDa j— 'esr My real property is - a�able for use or occupancy on or before Jin ual;'1994. y Civil Code Sections 110 1. 1 through 110 1. 8 apply. Refer to the attached. �� y' _property is a single fancily residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or inmprovements shall require all non-compliant plumbing yfixtuiestbe replaced with water-conseiving plumbing fixtures throughout the building. On or before January 1, ,%1017, allnon-cornpliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of =l et1Y6 propel ty undergoes alterations or improvements). ❑ Myproperty is a multifancily 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 concncercial 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.docrevised 02/04/15 C On or before January1, 2019, all non-coinpliant plumbing fixtures, shall be replaced with water-, conserving '• plumbing fixtures throughout the building (regardless- of whether property undergoes alterations or improvements). 1/We, 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 110 1.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation reauirements. and that the:water.=conserving ulumbiriz.%xtures complv.with the requirements as indicated in the table below. ?11=�'s (or Owner Agent's) Signature: Date: AN—11— J/, Upon completing and signing this Certificate, please return it to the Building Division in order to final your pen -nit. ,',1*N66-Complia7htA�"Og Water-Conserving Plumbing Fixture I' 4, '. -t PlumbingFixtured= Fixture Complyingwith Current CodeApplicable licable to New Construction ( PP ) • -' Maximum Water Usage/Flow Rate Fixture Type., 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 . ;d Water Usage " r 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate g Single -Family Multi -Family Commercial ;t Residential Residential Water Closets:; Exceed 1.6 j; Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, ,.,j 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 T.-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 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 ''d ,Maximum 1.5 gallons per . Withiri 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 I 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 @ 18. gallons per minute 1.8' gallons per minute @ 60 Kitchen ,-per minute p; .:: 60 psi. @ 60; psi psi Faucets May temporarily increase May femporanly up,to 2:2 gallons per increase up to 2.2:. . minute: 60 si, arid..must @ P allons erminute g P @ - default to maximum 60 psi,Tand , -, k > 1-8 gallons per -;minute;@ defaulfto maximum � .. � " 60 psi ;+ 1 8 gallons per minute p s11 Where faucets meeting @Y60 psi the above are unavailable, 1Nhere faucets meeting aerators or other means the above are- + r ;}n.+ i',� '. ,�ti ,d, maybe used to; achieve t -.__, unavailable, aerators:or . reduction'b otFier nie}ans may bej - usetl to -achieve -_. h. Ifthe"exrstmg plumbing fixture water usage/flow rate is equal to or lower than' the figure shown, jt is not required to lie upgraded SB4072015.doc revised 02/04//5 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 • buildino(a)cupertino.org afz� Address 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. I have read and agree to Owner (or Owner Agent's) Name: Contractor Name: ,( SignatureS-� with the terms and conditions of this statement .................................................................................. Date: q3� 903 �11�1 .........Lic.#...................................... Date: ... Smoke and CO form.doc revised 03118114 I'm