15110089Ew
01
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10157 S FOOTHILL BLVD
CONTRACTOR:* .I.
PERMIT NO: 15110089
OWNER'S NAME: KALYANTHAYA MURALIDHARA AND NAIK SR
DATE ISSUED: 11/13/2015
OWNER'S PHONE:
PHONE NO:
LICENSED CONTRACTOR'S DECLARATION
JOB DESCRIPTION: RESIDENTIAL COMMERCIAL
REPLACING SEWER LINE BETWEEN FOUNDATION AND
License Class S G G 12 P Lic. # Z Z 5
PROPERTY (40 FT); INSTALL (N) PROPERTY LINE
Contractor L(,' 1 E UI / ,DJJd/AAte ((— t 3 -Z G (S
CLEANOUT.
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:
AgN
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:V ua 280
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: 34214116.00
cc ane ype:
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 DAYS FROM LAST CALLED INSPECTION.
indemnify and keep harmless the City of Cupertino against liabilities, judgments,
costs, and expenses which may accrue against said City in consequence of the
Issued by: Date: ; I
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 -ROOFS:
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)
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. 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 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, Se ions 25505, 25533, and 25534.
Section 3700 of the Labor Code, for the performance of the work for which this
Owner or authorized agent: Date: — 13 Zo
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
CONSTRUCTION LENDING AGENCY
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
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
9.18.
Signature Date
GENERAL PERMIT APPLICATION
COMMIUNI TY DEVELOPIJiENT DEPARTMENT - BUILDING DIVISION
10300 T ORRE AVENUE - CUPERTINO, CA 5301 ",-3235
(4'r08) 777-'3228 - FAX (1408) 777-3333 - buildinana cuoerino.ora
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By my siQaa-e below, I certify to
each of the followi,:g: I the property owner or authorized zQent to act on the pro -. o ner's behalf. I have rend this
appliUtion and the information I h -we provided is co*:ect. I have read the Desorption of'Work and verify it is accurate. I agree to comply with all applicable local
crdiriances and sate lays's relating
1ding construction. I authorize representatives of Cupertino
to enter the above-identii ed propeliy for inspection purposes.
Signature of. pplicant/Agent:
Date:// -13- ZQIS
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hIFP_A!isc�'pp_2011.doc revised 06121/11
CITY OF CUPERTINO
FEE ESTIMATOR — BUILDING DIVISION
ADDRESS: 10157 S Foothill Blvd DATE: 11/13/2015 REVIEWED BY: Phuong
APN: 342-14-116 BP#: 'EVALUATION: $2,800
*PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair
PRIMARY SFD or Duplex PENTAMATION 1 RPSS
USE: PERMIT TYPE:
WORK replacing sewer line between foundation and property (40 FT); Install N property line cleanout.
SCOPE
APPLIANCE / EQUIP TYPE
FEE ID
Plumb. Plan Check 0.0 1 hrs $0.00
QTY
UNITS
BP FEES
1 ler.. 1'erniii i <:
Sewer, Sanitary
1 PRSEWER
{:?t , I:;f'& . insp.
1
#
$25
Sewer, Building
1 PRSEWER
SuppL
1
#
$25
PME Unit Fee:
$50.00
PME Permit Fee:
$48.00
: `r��t>strttc°tir�a� :l`c�t:
Administrative Fee: IADMIN
$45.00
Work Without Permit? Yes No
$0.00
TOTALS:
Travel Documentation Fee: ITRA VDOC
$50.00
Strom Motion Fee: 1 BSEISMICR
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Fuhtic Works, tire, unitary Sewer District, 3cnoot
n;cfr;nf ofn 1 Thoco fooc oro hncad nn tho nro/imhi"ry infnrmatinn avaitah/o rind aro nn/v an Pvtimato_ rawart the I)Pnt fnr addn'1 info.
FEE ITEMS fee Resolution 11-053 Fff. 7'1113)
Alt'ch /'1:an Check
Plumb. Plan Check 0.0 1 hrs $0.00
1s ec, .Pl an
Plumb. Permit Fee: IPPERMIT
1 ler.. 1'erniii i <:
Other Plumb Insp. 0.0 hrs $48.00
{:?t , I:;f'& . insp.
:rer;la. Irasr. I f
I i€tatr3. AN- J<.s..:
$0.00
NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Fuhtic Works, tire, unitary Sewer District, 3cnoot
n;cfr;nf ofn 1 Thoco fooc oro hncad nn tho nro/imhi"ry infnrmatinn avaitah/o rind aro nn/v an Pvtimato_ rawart the I)Pnt fnr addn'1 info.
FEE ITEMS fee Resolution 11-053 Fff. 7'1113)
FEE
QTY/FEE
MISC ITEMS
PME Plan Check:
$0.00
Permit If
SuppL
F
PME Unit Fee:
$50.00
PME Permit Fee:
$48.00
: `r��t>strttc°tir�a� :l`c�t:
Administrative Fee: IADMIN
$45.00
Work Without Permit? Yes No
$0.00
Travel Documentation Fee: ITRA VDOC
$48.00
Strom Motion Fee: 1 BSEISMICR
$0.50
Select an Administrative Item
i I
Bldg Stds Commission Fee: IBCBSC
$1.00
SUBTOTALS:
$192.50
$0.00 TOTAL FEE: 1
$192.50
Revised: 10/01/2015
CUPEG?:TINO
Owner Name 5 M U
WATER -CONSERVING PLUMBING FBXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 o FAX (408) 777-3333 o building(cDcupertino.org
L) D "95,2 V A L V A N -r u A Y A Permit No.
Address 6 10 { S - F a 0? N P L r
LY0 e U p96? T iyV 0, (� l
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 fonn.
V 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.
g 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.
1 &� 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.
W 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. Please check ONE of the following:
Cvy 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 image.
Owner or Owner Agent's SignatuFq,,;_.-1 MMDate:::(( f 9 ti
T i 4 a _r__
"Y"•' "•'•••r •"'•••b """ "'b""'b v, },Ill•U 1-U111 it LU L11t+J_)U11U1116L/1V1J1V11111 MUM LU nnal your Duriaing permit.
SB407 201 S.doc revised 08126115
d kl lld lOi J db 11��,' d' t rat ', 'i Ilj r ALEArNM COBIXP Td'+.II7► 'l MS
X23 If��' II��S Iii' Sd �l E� IT'I>'i'D '3' d�+liia➢°;iG�"�'Sddl`
,t
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the ngure siiowil, 1L La noL LL.quLieu LV ue urs —C.
SB407 2015.doc revised 08/76115
Non -Compliant
Water -Conserving Plumbing Fixture
(Fixture Complying with Current Code Applicable to New Construction)
PlumbingFixturel
Maximurn
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.
I_ _1- _ .a
..4 .- ori 4- 1, oA-1
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the ngure siiowil, 1L La noL LL.quLieu LV ue urs —C.
SB407 2015.doc revised 08/76115
fCVPERTINO
PURPOSE
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPUANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 o FAX (408) 777-3333 • buildingCa.cupertino.org
0
PERMIT CANNOT BE IFINALED AND CO.iAI'LETED UNTIL TATS CERTIFICATE
HAS BEEN S 91_IE AND RF,,'r�l�'�°� I3YJILDrNG DIVISION
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 suzgle-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 comply with the terms and conditions of this statement
MU13AL1014A1C U4LYasro , nfare........... ...................................... .......................................................
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Smoke and. CO form.doc revised 03/18/14