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15110107t,t, CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10650 STOKES AVE CONTRACTOR: DI LI CONSTRUCTION PERMIT NO: 15110107 CO INC OWNER'S NAME: MCMULLIN RUTH S TRUSTEE 18533 COX AVE DATE ISSUED: 11/16/2015 OWNER'S PHONE:, 6508470779 SARATOGA, CA 95070 PHONE NO: (408) 316-8698 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL DEMOXILL (E) SWIMMING POOL FOR LANDSCAPE License Class ~, Lic. # PURPOSES Conttactor,�D : L�, t ct.4Q Int C1► 6 Date T ONLY I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with'$ection 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. t 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: $6000 performance of the work for which this permit is issued. I 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: 32649007.00 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 DAY ALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of - -- — -- --- A granting of this permit. Additionally, the applicant understands and will com sued by: Dade —� J with all non -point source regulations per the Cupertino Municipal Cod ion 9.18. ,.. RE -ROOFS: Signature Date 1 t 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. ❑ 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 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. 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 1 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 25505, 25533, and 25534. Section 3700 of the Labor Code, for the performance of the work for which this 11 )JIT permit isissued. Owner or authorized agent: � Date: 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 withsuch 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 CUPERTINO SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - building (a.cupertino. org / 5//0 `O 1 SP PROJECT ADDRESS — APN # 3 2-4 Aj Q 90 L/ © � ✓✓ OWNER NAME / PHONE E -MAIL -f c v +` � STREET ADDRESS r i � CITY, STATE, ZIP r Q FAX t f ^ J CONTACT NAME —A �n8s PHONE &/j— c) y C?� ��-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEA 1 LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY NAPI E-MAIL , q AL FAX STREET ADDRESS CITY, STATE, ZIP 0 PHONE ^ ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK ft7� ' A USE OF FD or Duplex El Multi -Family TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION (S) POOL STRUCTURE: ❑ Commercial POOLISPA MATERIAL TYPE CODES: SPA V - VINYL -LINED F - FIBERGLASS DEMO G - GUNITE- P - PREFABRICATED RECE " "" TOTAL VALUATION: r -- do L5 By my signature below, I certify to each of the f Ing: I am the operty owner or authorized agent to o property owner's behalf. read this application and the information I have provided is correct. I have read the Description of Work and v Is accurate. I agree to comply with all ap licable local ordinances and state laws relating to building -co traction. I authorize representatives of Cupertino to enter the above- identifed property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL rgFoRMATION REQUIRED OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP � BUILDING WEPT _ Commercial or Multi -Family Buildings with Public Swimming Pools: Department of Environmental Health approval required. OVER-THE-COUNTER EXPRESS ❑ PLAN -UNG DEPT ❑ STANDARD ❑ PUBLIC WORKS DEPT LARGE ❑ ENVIRONMENTAL HEALTH I%TAJOR ❑ SANITARY SEWER DISTRICT SwimPoolApp_2011.doc revised 03/16/11 & if CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: 10650 STOKES AVE Ifech. Plan ("h .k DATE: 11/16/2015 REVIEWED BY: MELISSA APN: 326 49 007 BP#: Suppl. N F( 'VALUATION: 1$6,000 *PERMIT TYPE: Demolition Permit PE`. /nsp. Fec, PRIMARY Swimming Pool, Res. USE: Permit Fee: $329.00 PENTAMATION PERMIT TYPE: 1SFP00LDEM 'A WORK DEMO/FILL (E) SWIMMING POOL FOR LANDSCAPE PURPOSES ONLY iSCOPE FEE ID #POOLS 1DEMOPRES 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 the preliminary information available and are only an estimate- Cnntart the Dont fnr addn'l infn FEE ITEMS (Fee Resolytion 11-053 Eff 7/1/13) Ifech. Plan ("h .k QTY/FEE MISC ITEMS J'Iun Check ]-,ee,, Suppl. N F( Oiher J'hfnib Oiber Elec, /nsp, 'Phm;b, /nsp. Fec, 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 the preliminary information available and are only an estimate- Cnntart the Dont fnr addn'l infn FEE ITEMS (Fee Resolytion 11-053 Eff 7/1/13) FEE QTY/FEE MISC ITEMS J'Iun Check ]-,ee,, Suppl. N F( Permit Fee: $329.00 Suppl. Insp. Feer Reg. 0 OT To—o I hrs $0.00 �Awl:.s f 'ruclion 7 �I.A -.1dininisli-Wive flee., 't,'() `k Withoul Permit" lwnced Phmning wi-el Document(Ition T'ees: Strong , Motion Fee: IBSEISMICR $0.78 Select an Administrative Item B ldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALS - $330.781 $0.00 TOTAL FEE: $330.78 Revised: 10/01/2015 i CUPERTINO wilding Department z 140V 16 2015 REVIEWED FOR CURE COMPLIANCE a Keviewed By, COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION - CUPERTINO APPROVED This set of plans and specifications MUST be kept at the job site during construction. It is unlawful to make any changes or alterations on same, or to deviate therefrom, without approval from the Building Official The stamping of this plan and specifications SHALL N be held to approval of the violation any City Ordinance or State Law. DATE.�....,��....�.. PERMIT NO.-S�l��l� �j 6-1 BY EIVED CUPERTINO Owner Name Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 9501473255 innsn -7-7-_a)oa . c: 1. 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. 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. l 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. IJ X 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. PI ase 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 followine page. n n r Owner or Owner Agent's Signatu Date,-__;Jl1 I23= Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB407 2015.doe revised 08/26/15 ltbIR3LItDINi G .�:E1r.TT^tNOT ..B.:E rL_N.�DrNP C'�WT��i�MTHIS U��TY� :117TTL S+�ce7TRNS0YHBITD 7T� LL�lt3L 1. If the existing plumbing fixture water usage/ itow rale 16 cquai LU U, IU ly rl I-- - —b...., .. - ._ _- ___ _ _ _- __ SB407 2015.doc revised 08/26/15 (yon-Compliant Water -Conserving Plumbing Fixture , (Fixture Complying with Current Code Applicable to New'Construction) Plumbing Fixturel Maximum Water Usa a/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 Showerheads Gallons/flush 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/ itow rale 16 cquai LU U, IU ly rl I-- - —b...., .. - ._ _- ___ _ _ _- __ SB407 2015.doc revised 08/26/15 CVFF,RT1N0 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT > BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 a FAX (408) 777-3333 o building(cDcupertino.orq lmw0NN i 5 i� 0 10� c➢: ft -s 10 650 STo✓VES AV 6, GA G_hA1mti,=gide 2-- P ERNUT CANNOT BE FINALED AND CGIMPLETED UNTIL TMS CERTIFICATE W,S B_EE :T�i� E AND 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 su-tgle-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 )( 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. G have read and agree to comply with the term and conditions of this statement �'�v�rr:�t°_ or�- VvnsrAger��sl-f�tarrre: ------------ _R —Pjj%l l T V,H I S 'si'nefifre. ..........................'Date: Conn{Facf'or Names Si4L�0A.............. ............ ............... ............... ........... Lis.9-:...... ................. ......... ..... Daft?: ................... Smoke and CO foam.doc revised 03/18/14