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15110036CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS::'10295 CALVERT DR CONTRACTOR: GOGO ROOTER PERMIT NO: 15110036 OWNER'S NAME 'TRASK RICHARD D AND MARSHA K 2530 BERRYESSA RD STE 509 DATE ISSUED: 11/06/2015 OWNER'S PHONE: 4087258886. SAN JOSE, CA 95132 PHONE NO: (408) 282-7026 LICENSED CONTRACTOR'S DECLARATION RESIDENTIAL COMMERCIAL JOB DESCRIPTION: ❑ ❑ -. License Class C Lic.'#g ob 3 (N) foundation cleanout and to tunnel 3' under foundation. Contractor "p �ev - Date's I hereby affirm4haf I am licensed under the provisions of Chapter 9 (commencing with Section 7'000) of Division 3 of the Business & Professions Code and that' jiicense is,in full force and effect. I hereby affirm under penalty.•of perjury one of the following two declarations: I have and;will linaintain a certificate of consent to self -insure for Worker's Compepsati.diij as provided for by Section 3700 of the Labor Code, for the Sq. Ft Floor Area: Valuation: $4000 performance' of the _work for Which this permit is issued. have an&will'uiaintain Worker's Compensation Insurance, as provided for by Secii6ri,3700of tt a I:aboi'Code,ifor the performance of the work for which this permit is`issuedr:::., APN Number 37517018.00 ' Occupancy Type: APPLICANT CERTIFICATION .. I certify that I have'reaa thisapplication and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree;t6 comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter 1.2 WITHIN 180 DAYS OF PERMIT ISSUANCE OR upon'the„above ii}enttoned , , . ty, for inspection purposes. (We) agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnifylanalkeepliarmless`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 Issued by: Date: with all non pontt:source regulations per the Cupertino Municipal Code, Section 9.18. I 6 RE -ROOFS: Signa 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. ❑ ^;; i.,OWPIER-BUILDER DECLARATION Signature of Applicant: Date: I hereby, affirmthat am, exempt from the Contractor's License Law for one of the -following two reasons: ;' I, as"owner of the;property; or:my employees with wages as their sole compensation, ALL ROOF COVERINGS TO BE CLASS "A” OR BETTER Will do; ft 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 I construct the project (Seb.7044, 'Business .& Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the ;:;:, • ;:. ,' `. I hereby affirm'; under penalty of perjury one of the following three California Health & Safety Code, Sections 25505, 25533, and 25534. I will r ; ,,: i maintain compliance with the Cupertino Municipal Code Chapter 9.12 and the P P P � P declarations: it ;:... .; ; I have ill! iriainfain a;Certificate of Consent to self -insure for Worker's Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous i, Compensation 1as;piovided 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 ygork`for yvhigli this permit is issued. will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and I have andlwdl'maintaih Workeiis Compensation Insurance, as provided for by the Health & Safety Code, Sections 25505, 25533, and 25534. Secti 11ion. 3700'of the tabor C1.ode for the performance of the work for which this ``, Owner or authorize"gent Date: permit is issued q t' I cert► y,tfigt m!the perforrr ance'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 `iaw i of Californias If, after making this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subjectiio tfie• Woik'6f 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.) - til �i(�l �I'yl iillt�i � ..i Lender's Name ilISIIIII (�IF� li I •, APPLICANT CERTIFICATION Lender's Address I certify tli' `I'haveireadithis`application andatate that the above information is ..w:ith ..., correct., I agrdelto,'comply,all"city and county ordinances and state laws relating to buildin ,construction; ,and hereby authorize representatives of this city to enter I, c 1, upon,the; 'ode' for inspection menhoned'property purposes. (We) agree to save `"'"' ''I '' ' ify and keep harm'tli ndemniless'e City of Cupertino against liabilities, judgments, ARCHITECT'S DECLARATION costs, arid expenses,, , ich may.accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this p' eimit; . dd}tionaily; the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18 n Sig nature�l'-.ys;, f, r,i.�;�. i{;i<iw ..:' Date -^e CUPERTIt-10 GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildln0(O CUDertinO.Org /21kum'BINCT ❑ lJ1BCHk1'TlC.kL ❑ ELECTRICAL ❑ I,1121CELLA-KE0US 1CDIIdo3� PROJECT ADDRESS APN - C) O%VTERNA3,6 PRONE,,. I - \ A a q �/ q0 �� a 0 BF+ STREETADDRESS .DDRESS I CITY, STATE, ZIP FAX �t CONTACT NA IJE PH01\- oC� STP—EETADDP.ESS CITY, STATE, ZIP FA,X G e- Q -f ❑ OY,h=R ❑ 01WNFR-BUIMEP, ❑ OWNERAGIENT 1C! C0 M-kCTOR ❑ C0\ --i ,CTORAG`N-f ❑ ARMUTECT ❑ ENG R ❑ D�r_LOpc ❑ -,\c � THXuj%D' CONTRACTORNAJ\r(: ,C� ILICV�;, BE ILICENSE 1-M.: IBUS. LIC C COIJ,PANYNAJ,�EI E -NAIL I FAX V7D6�C% e STREET ADDRESS CITY, STATE, ZIP PHONE S ez ARCFITECTrt; -GDZ'RNAs4E LICENSE NTLNBER BUS. LIC CON,PA?.Y NAME E -I- ;IL I FA STREET ADDRESSI CITY, STATE, ZIP I PHONE U-SE OF ❑ Sr -D- or DUP1.X ❑ 1JULT I -F 4I.M-Y I . PROJECT LN WIT DI -4 -ND ❑ M PROTECT LN ❑ YFs ------------- IS Tri BLDG AN ❑ m BU-MDLNG:❑COhO. PCL URBArNLN*P—ACEAREA ❑ 1.'O FL.00DZOMB ❑ NO EICFTLERHOI✓.E7 E) NO DESCPPTION OF WORK � t. I TOTALVALU.-.TION: 000,00 \$ ` ti, By my signature below, I ce ti fy to each of the f0ll0V.'ing: I zm the property owner or authorized agent to act on the property owner's behal I zve rend this application and the L-iformation I have provided is correct. I have read the Description of Work and veru itis zccurzte. I zgree to comply with all applicable local crdiznces and state laws relating to building cons I authorize representatives of Cuuertino to enter he above -identified propeitty for inspection purposes. SignatureofAi)licant/Agent: Date: SUPPLEMENTAL L\TORvIATION REQUIREDpg OVER TiiF COU ITER h _N ❑ k r El�RE�S h a } K � A,IEPA�,7sC/vp_201].doe revised 06121/11 CITY OF CUPERTINO FEE ESTIMATOR — BUILDING DIVISION APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES Sewer;, Sanitary 1PRSEWER 1 # $25 Sewer, Building' 1 PRSEWER 1 # $25 TOTALS: $50.00 o _ t e a Ga 10295 Calvert Dr DATE: 11/06/2015 REVIEWED BY: Phuong JimADDRESS: APN: , 375-17-018 BP#: *VALUATION:$4,000 Other Plumb Insp. 0.0 hrs $48.00 *PERMIT.TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration /Addition/ Repair PRIMARY SFD or Duplex USE:. Elec. Insp. 1,ee: PENTAMATION 1 RPSS PERMIT TYPE: WORK; N foundation cleanout and to tunnel 3' under foundation. SCOPE . . . APPLIANCE / EQUIP TYPE FEE ID QTY UNITS BP FEES Sewer;, Sanitary 1PRSEWER 1 # $25 Sewer, Building' 1 PRSEWER 1 # $25 TOTALS: $50.00 o _ t e a Ga Mech-T',lan Check, ' Plumb. Plan Check 0.0 hrs $0.00 Flee. flan Check Perwil Fee:Plumb. Permit Fee: IPPERMIT faec. Permit Fee: Other Aleck. Insp: Other Plumb Insp. 0.0 hrs $48.00 Other lilee. Insp. Li ,.Vlech, Insp. ]fee: Phurib. hasp. Fee: Elec. Insp. 1,ee: NUM T has, estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School Distriet_ etc J. These fens are havod an the nrolisninanr infnrmalinn availahlo and aro nnhy nn actim wo i'nnfanf fha Hoof for ndilar �l ssfi� FEE ITEMS (Fee Resolution 11-053 M. 711/13,) FEE QTY/FEE MISC ITEMS Plan Check Fee:' S'uppl. P'C'T'ee PME Plan Check: $0.00 Permit Fee: . Sulyl. 1qv Fee PME:Unit Fee: , $50.00 PME'Permit Feer $48.00 ,C'�rzstructi�n�Taas' Administrative Eee: ]ADMIN $45.00 Work Without Pehnit? 0 Yes (j) No $0.00 Advaned,P:.lar nz fik Fees.: Travel,;Documentation Fee: ITRA VDOC $48.00 Str6n2'Moti6n Fee: • IBSEISMICR $0.52 Select an Administrative Item Bl'dg'Stds'.'C'ommission Fee: 1BCBSC $1.00 y' it r tip �k3 r' !V ; ,'s� i . ; � "' SUBTOTALS: $192.52 $0 .00 TOTAL,FEE: $ 192.52 Revised: 10/01/2015 Owner Name OWNER CERTIMATE OF COMPUANCE COMMUNITY DEVELOPMENT DEPARTMENT a BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 [ (408)7,77-3228 ^ FAX (408) 777=3333 ^ building (a cupertino.org G � W /L Permit No fr qq Address li (7 tl q 5- e—' �L % e f� M10 4� 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. i�. 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 110 1. 1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Skip the rest of the fonn and sign bottom of form. 9. 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. -�r �, q 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. iq 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: 14 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;_'.%% ill -15, �t,,,,l t Ulllp1UL 118 alio a,giiuig uus k..ci uiiL;dLc, picasc rciurn a io ine isuuaing ijivision in oraer to tinal your building permit. SB407 2015.doc revised 08/26/15 ' -T �SED CBU71LDhGPER-1�TCA1N �TBE�NALEDY ✓CTi� �+�+q'yry^�q•;q �-}�,� �+ -{pq; �� g=,I\,. ;� "` ` 7��g ^� r�+�g�+ g��7y� 7�yp�, �,�v 7q p��+T,p+� L:L'.R•1:1.i'3C_-k E, Ml� ,.J L"iL'TKLl �.1 ,IA f INT RI71H _i71 TO 1'�r. .ANLL-UJDll9GD 0r][SI N7 .} 1. If the existing plumbing fixture water usage/tlow rate is equal to or lower than u1c Ugu1 c J11U will 11 13 uUL , -i-', "Nb SB407 2015.doo revised 08/76/15 Non -Compliant Water -Conserving Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Plumbing FixtureI Maximum Water Usa a/Plow Rate 4. 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, avers e 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 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/tlow rate is equal to or lower than u1c Ugu1 c J11U will 11 13 uUL , -i-', "Nb SB407 2015.doo revised 08/76/15 '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 buildingftcupertino.org r;laOS�� 0 3 G 0 A 5 %"e, �d�� t'� a s isl e: SC iibngrMQnc i e 1/ PERMIT CANNOT BE FINALED AND COMPLETED UNT11, THIS CERTIFICATE HAS R.E.lyI0 I.. ,. Iii , I t7 `PIEIF BI DIIvT ]DIVIS.IC). F 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 sh-igle-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 a ree to comolv with the terms and conditions of this statement 60k��' orOwnerAgenfs) Name: - Z' J.V,_td ................. - -# ................. ....... . ................................ .'Dater .........../..5 CoFfFaefor=Nrarne: Siq.��...0.7.q. Smoke and. CO form.doc revised 03118/14