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15100055CITY OF CUPERTINO BUILDING PERMIT It ILDING ADDRESS: 952 CANDLEWOOD DR I CONTRACTOR: ONT ACTO SER )CES OF CA I ERICAN PERMIT NO: 15100055 OWNER'S NAME: DUNN KENNETH M AND THELMA R 4&e *, ,I/ 1965 RIDGE LAKE BLVD STE 201 1 DATE ISSUED: 10/07/2015 I OWNER'S PHONE: 4082570213 11FIF X— I MEMPHIS, TN 38120 I PHONE NO: (408) 982-0405 I © LICENSED CONTRACTOR'S DECLARATION License Class 4f_ Lic. # 7�r, 5:1 S5' Contractor 4 Date 4/,- f 1 hereby affirm that I am l censed un 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: t 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. I—r, 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 permit is issued. APPLICANT CERTIFICATION 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 li 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 r I tions per the Cupertino Municipal Code, Section 9.18. Si_nature Date�Q"7_1 S ❑ OWNER -BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for one of the following two reasons: 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) 2 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). 1 hereby affirm under penalty of perjury one of the following three declarations: t. 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. 2. 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 permit is issued. a. 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 become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION 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, 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 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ REPLACE PORTIONS OF (E) BUILDING DRAIN (SEWER) LINES BENEATH SFD f r+� ® Nk W Sq. Ft Floor Area: I Valuation: $3000 APN Number: 36919019.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180�AYS'RO LED INSPECTION. RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, 1 agree to remove all new materials for inspection. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. 1 will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should 1 store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner r ized Date: CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name ender's ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO GENERAL PER1MiI i APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinCO)CUoertino.oro l S0 61 05 -s m H) dPLU BNr' F7I'ECHA.1"ICAL 7ELECTRICAL F7' KTSCFT.T.A?JFnTII PROJcCT ADDRESS ONVNERNAMB v l\J STREET ?.DDRES� ^ • O 1 � CONTACT N.4i✓,E r. n_ _) LC.V(iY! I AFN PHONE 408-��)l �I✓LZ "1 , (1 YA/�'/. Y- �/� �I -1. � �� � --- P. '�z�' `�v�- � l [/� E-?✓��II. STREETADDRESS�D Pa Mftn CITY,STATE, c 5, rad{ -- ❑ OAN-M ❑ 014.'ER-BUMMER ❑ OWNER AGMIT ❑ CONTRACTOR IN CO\7TRACTOR AGENT ❑ ARCITIMECT ❑ ENGn:_n ❑ D_� _�O; ❑ - :. _*T CONTRACTORN?h LIMSE.SER LICENSEnTE IBUS.LIC'n COMPANY N?J✓E n � E-MAIL FAX STREE7 ADDRESS��ny N J�J� I t CITY, S -NIP n/ -)Lf p- ARCHITECTM�GA'F.ER NATE LICENSE NUMBER BUS. LIC n _! COMP?.hYNAl✓,E E-MAIL STREET ADDRESS CITY, ST.STE, ZIP I PHOXF I USE OF ❑ SFD or DUPLEX ❑ MULTI-F.AKILY I PROJECT LN WIIALAND ❑ YES PROJECT LN ❑ YES B=M: ❑ COMMERCIAL URBAN R.TERF?.CE AREA ❑ NO FLOOD ZONE ❑ NO I IS TRE BLDG AN ❑ EICHLE[R HOME? t] v0 DESCRffTION OF WORK CSLJw _ -—�- -- TOTA.LV.A-UATION: bdo---- By my signature below, I certify to each of the following: application and the information I have provided is correct. ordinances and state lags relating to buildons ction. SigneLreofApplicant/AEent: I air the property owner or authorized agent to act o eperty owner's behalf. I have read this I have read the Description of Work and verify it is accurate. I agree to comply with all applicable loc-1 I autho ' e representatives of Cupertino to enter the abov-iden�tiJSed prop-, r inspection purposes Date: - ( - STJPP EMENTXXF0 D `i r ... _ MEPMisc.4pp_?OlI.doc remised 06/21/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION APPLIANCE / EQUIP TYPE ADDRESS: 952 CANDLEWOOD DR DATE: 10/07/2015 REVIEWED BY: MELISSA UNITS APN: 36919 019BP#: 'VALUATION: 1$3,000 PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: $25 PENTAMATION 1 RPSS PERMIT TYPE: A WORK REPLACE PORTIONS OF E BUILDING DRAIN SEWER LINES BENEATH SFD SCOPE APPLIANCE / EQUIP TYPE FEE ID Plumb. Plan Check0.0 hrs $0.00 Plumb. Permit Fee: IPPERMIT Other Plumb Insp.0.0 hrs $48.00 QTY UNITS BP FEES Sewer, Building 1PRSEWER 1 # $25 Supp/. PME Unit Fee: $25.00 PME Permit Fee: $48.00 Constructiurt lux: Administrative Fee: IADMIN $45.00 Work Without Permit? O Yes 0 No $0.00 TOTALS: Travel Documentation Fee: 1TRAVD0C $25.00 Strong Motion Fee: IBSEISMICR NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on die Dreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Rcsolution 11-053 /jI ? 1 13) / Plumb. Plan Check0.0 hrs $0.00 Plumb. Permit Fee: IPPERMIT Other Plumb Insp.0.0 hrs $48.00 , NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc). These fees are based on die Dreliminary information available and are only an estimate Contact the Dent for addn'l info. FEE ITEMS (Fee Rcsolution 11-053 /jI ? 1 13) FEE QTY/FEE MISC ITEMS i 'lure 0/t '11ppl. PME Plan Check: $0.00 Supp/. PME Unit Fee: $25.00 PME Permit Fee: $48.00 Constructiurt lux: Administrative Fee: IADMIN $45.00 Work Without Permit? O Yes 0 No $0.00 Travel Documentation Fee: 1TRAVD0C $48.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item Bldp- Stds Commission Fee: IBCBSC $1.00 SUBTOTALS: $167.50 $0.00 TOTAL FEE: F $167.50 Revised: 10/01/2015 CUPERTINO Address 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 • buildingAcupertino.org PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED AND RETURNED 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 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. 1 have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: Signature.................................................................................................................. Date:................... Contractor Name: /10�01ta 4411 7,44....q Signature ................ uc.# ....Ivl ........ Date: Gv Smoke and CO form.doc revised 03/18/14 CUPERTINO Owner N Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 POLE Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. XNo Go to Question 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. '"C 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 110 1. 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.. Please 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 1101.8, 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 pace. I Owner or Owner Agent's Signature: ,�C(�}��� Date: A) " 1,15 I Upon completing and signing this Certificate, please retum it to th-e&31ding Division in order to final your building permit. SB407 2015.doc revised 08/26/15 BUILDING PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED .D AND RETURNED TO THE BUILDING DIVISION 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 Non -Compliant Water -Conserving Plumbing Fixture PlumbingFixture (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 si 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