15090153 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 20889 FARGO DR CONTRACTOR:DRAIN DOCTOR PERMIT NO: 15090153
OWNER'S NAME: LIM ALEX DONG SEOP 480 ALDO AVE DATE ISSUED:09/23/2015
OW ER'S PHONE: 4089967988 SANTA CLARA,CA 95054 PHONE NO:(408)370-3082
LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
INSTALL(N)PROPERTY LINE CLEANOUT AND REPLACE 55'
License Class C Lic.tl (Q OF EXISTING SE E**CUP ER 06
TARY+•
Contractor DT-U.\%A �G�4� 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. RY
I hereby affirm under penalty of perjury one of the following two declarations: Sq. Ft Floor Area: Valuation:$7200
1 1 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 k 1'N N u in her:32630188.00 Occupancy Type:
performance of the work for which this permit is issued.
SAN-ITA
^ . I have and will maintain Worker's Compensation Insurance,as provided for b>
!� Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. PERMIT EXPIRES IF WORK IS NOT STARTED
APPLICANT CERTIFICATION WITHIN 180 DAYS OF PERMIT ISSUANCE OR
I certify that I have read this application and state that the above information is 180 D A YS FROM LAST CALLED INSPECT ON.
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 ,�Jq� a� j
upon the above mentioned property for inspection purposes. (We)agree to save Issued by: "� Date:
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply with
all non-point source regulations per the Cupertino Municipal Code,Section 9.18. ROOFS:
All roofs shall be inspected prior to anyy roofing material being installed.If a roof is
Signature Date installed 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 ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
the following two reasons:
1 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 HAZARDOUS MATERIALS DISCLOSURE
sale(Sec.7044,Business&Professions Code) I have read the hazardous materials requirements under Chapter 6.95 of the
z. I,as owner of the property,am exclusively contracting with licensed contractors to California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
construct the project(Sec.7044,Business&Professions Code). compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(x)should 1 store or handle hazardous material.
I hereby affirm under penalty of perjury one of the following three declarations: Additionally,should I use equipment or devices which emit hazardous air
r 1 have and will maintain a Certificate of Consent to self-insure for Worker's contaminants as defined by the Bay Area Air Quality Management District 1 will
Compensation,as provided for by Section 3700 of the Labor Code,for the maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Health&Safety Code,Sections 25505,25533,and 25534.
performance of the work for which this permit is issued.
z 1 have and will maintain Worker's Compensation Insurance,as provided for by Ow r rized agent:
Section 3700 of the Labor Code,for the performance of the work for which this Date: -Z
permit is issued.
3 1 certify that in the performance of the work for which this permit is issued,I shall CONSTRUCTION LENDING AGENCY
not employ any person in any manner so as to become subject to the Worker's
I hereby affirm that there is a construction lending agency for the performance of work's
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 for which this permit is issued(Sec.3097,Civ C.)
Lender's Name
must forthwith comply with such provisions or this permit shall be deemed
revoked. Lender's Address
APPLICANT CERTIFICATION ARCHITECT'S DECLARATION
1 certify that I have read this application and state that the above information is I understand my plans shall be used as public records.
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 Licensed Professional
upon the above mentioned property for inspection purposes.(We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the
granting of this permit.Additionally,the applicant understands and will comply with
all non-point source regulations per the Cupertino Municipal Code,Section 9.18.
Signature Date_
rE=zh
GENERAL PERMIT APPLICATION �J�QgQ�j3, MEV
WKCOMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333•buildina(�cuoertino.oro
CUPERTINO
PLU1vIDING MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS
P O r APN# 3 !
00
OWN'ERNAME PHON �,J�Q Aa/,��QJQ' E-1✓�a.IL
T T n DRESS �CI'TY/TATE,ZIP /y FAX
CONTACT NAME PHONE E mAII, t/09 -7/; 30
STREET ADDRESS �� C STATE,ZIP lIJJ A 814 ) Lrj Auto- ,
�, Claz
FAX
E3OPRda^It ❑ OANER-BUILDER 1:1OWNERAGENT WCO' ATRACTOR ❑CONTRACTORAGENT ❑ ARCHM ECT ❑ ENO EER ❑ DEVELOPER ❑ :-N.,',-
CONTRACTOR KkbM a ex LICENSE NUIvMER �� LICENSE TYPE , BUS.LIC#
CO1✓iP.4NY N.AI✓.E / r E-MAIL C FAX
STREET ADDRESS //fo CITY,STATE,ZIP PHONE
/� c ♦ c-,45052) - l
A RCHn=/ENGAEER NAME LICENSE NUMBER BUS.LIC"
COMPANY NAME E-MAIL
FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
USE OF FD or DUPLEX ❑ MULTI-FAIMY PROJECT IN Wn.DLAND ❑ YES PROJECT IN ❑ Y S IS THE BLDG AN ❑ }::5
B=NG: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO I EICIII.ER HOME? ❑ NO
DESCRIPTION OF WORK
4-ren,C I e'/! t? --
���� �w�/" G tie w ti tie w c :4
TOTAL VALUATION: VM( —
By my signature belo ,I certify to each of the ollowin;: I am the property owner or authorized agent to act on the prcperty 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 c struction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Sigpwure of Applicant/Agent: Date: `t Z3l
S L MENTAL II\FORMATION REQUIRED OFFICE USE ONLY
0VEF:-TFE-coy,rEr,
- ❑ EMT ES
❑ �T.'_ND.%. D
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AlfEPA,RSCApp_2 011.doc revised 06/21/11
CITY OF CUPERTINO )50g01 53
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 20889 Fargo Dr. DATE: 09/23/2015 REVIEWED BY: Paul
APN: 326 30 188 BP#: "VALUATION: 1$7,200
*PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration /Addition / Repair
PRIMARY PENTAMATION
USE: SFD or Duplex T I PERMIT TYPE: 1 RPS i
WORK Install N property line cleanout and Replace 55' of existing sewer line "Cupertino Sanitary"
SCOPE
APPLIANCE/EQUIP TYPE FEE ID QTY UNITS BP FEES
Sewer, Building 1PRSEWER 1 # $25
Sewer, Sanitary 1 PRSEWER 1 # $25
TOTALS: $50.00
Plumb. Plan Check 0.0 hrs $0.00
F- Plumb. Permit Fee: IPPERAUT
Other Plumb Insp. 0.0 hrs $48.00 Ll
NOTE: This estimate does not include fees due to other Departments(i.e. Planning, Public Works, Fire,Sanitary Sewer District,School
District,etc. . Thesefees are based on lite preliminarl information available and are only an estimate. Contact the De l or addn7 info.
FEE ITEMS (Fee Resolution 11-053 Eff 7/1113) FEE QTY/FEE MISC ITEMS
Plant Check Fcc.
PC Fee,
PME Plan Check: $0.00
ln.c/r 1 ,
PME Unit Fee: $50.00
PME Permit Fee: $48.00
rOW1,110ioll 10A.
Administrative Fee: (ADMIN $45.00
Work Without Permit? O Yes (E) No $0.00
A(tvance d Planning Fees:
Travel Documentation Fee: ITRA VDOC $48.00 A
Strong Motion Fee: IBSEISMICR $0.94 Select an Administrative Item
Bldg Stds Commission Fee: IRCBSC $1.001 7
SUBTOTALS: $192.94 $0.00 TOTAL FEE: $192.94
Revised: 07/02/2015
SMOKE / CARBON MONOXIDE ALARMS FILE
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
CUPERTINO
(408)777-3228• FAX(408) 777-3333• building(E-cupertino.org
pD Permit No. .�
Address 20 GCS D dr r�I ��°l #of Alarms Smoke: Carbon Monoxide:
PERMIT CANNOT BE FINXL.ED AND COMPLETED UNTIL. THIS CERTIFICATE
HAS BEEN SIGNED AND RETt_ 1RNED TO THE BUILDING DIVISION
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 X X
bedroom(s) j� I
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: h-i 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.
1 have read and agree to comply with the terms and conditions of this statement
Owner(or Owner Agent's)Name:
��^ Si nature..` Date:
Contractor Name:
Signature...................................................................Lic.#......................................Date: ...................
Smoke and CO form.doc remised 03/18114
WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ( Y/\ C
CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408)777-3228• FAX(408)777-3333• buildingCcDcupertino.org
Owner Name u1P�c Liw Pennit No. /SO yo 3
Address a(A9V-0,Va ,, Or nAQ012+lVln
1. Is your real property a registered historical site?
Yes Civil Code Sections 110 1.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
No 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.
Skip the rest of the form and sign bottom of form.
❑ No Go to Question 3.
3. Is water service permanently disconnected for your building?
Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
No Go to 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 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
❑ 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. Check one of the three following statements and sign
bottom of form..
5. lease check ONE of the following:
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.
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,as the owner or owner's agent 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 requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the
table on the following page.
Owner or Owner Agent's Signature: Date: Z
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
SB407 2015.doc revised 08/26/15
t axBUILDING PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS
CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION
Non-Compliant Water-Conserving 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
Gallons/flush 0.5 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 08/26/15