15100168-OLCITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 19924 WHEATON DR CONTRACTOR: AFFORDABLE WATER PERMIT NO: 15100168
HEATERS&
OWNER'S NAME: PHILLIP & GRACIELA V PORRAS 28372 CONSTELLATION RD DATE ISSUED: 10/21/2015
OWNER'S PHONE: 4089108122 VALENCIA, CA 91355 PHONE NO: (661)259-7131
D LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑
REPLACE WATER HEATER SAME LOCATION
License Class Lie.#
Contractor
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.
I hereby affirm under penalty of perjury one of the following two declarations:
1. 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. 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
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
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
❑ OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of
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
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).
I hereby affirm under penalty of perjury one of the following three declarations:
1. 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. 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
permit is issued.
3. 1 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
1 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
Sq. Ft Floor Area: 0 ! Valuation: $1100
APN Number: 31621080.00 N Occupancy Type:
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by:
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.
Signature of Appl
Date:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
HAZARDOUS MATERIALS DISCLOSURE
I 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 I 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 or authorized agent:
Date:
CONSTRUCTION LENDING AGENCY
I 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
Lender's
ARCHITECT'S DECLARATION
I understand my plans shall be used as public records.
Licensed Professional
L 1LiLmuWATER-CONSERVINGPLUNIBING FIXTURES �0In
' OWNER-CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
ClJPERTI,N 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
8)777-3228. (408)777-3333•buildinc](a�cupertino.orq c-'
Owner Name �i� � ; F/ 0" Permit No. ` 51008`
Address /99Z j4, - v%v G) /.sem® e4-
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.
XNo 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?
O Yes .Civil Code Sections 1101.1 through'1101.8 do not apply. Skip the rest of the form and sign bottom of form.
IR No Go to Question,4. `'.
.4. Is your real property built and availablefor 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.
ogt.Yes My real,property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections'1101.1 through€1101.8apply. Check one of the three following statements and sign
bottom of form.. ..
5. 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 pluiiibing'frxtures throughout the building(regardless of whether property undergoes alterations or
improvements):'; j'..
El My property is a commercial real property:'See Civil Code Section 1101.5. -
On and after January. 1, 2.014,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'sagent of this property,certify underpenalty 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-co rving plumbing fixtures comply with the requirements as indicated in the
table on the following page. I �I
i
Owner or Owner Agent's'Signature: 11Wl Date: '
Upon completing and signing this Certif tate,p'ease return it'to the Building Division in order to final your building permit.
SB4072015.doc revised 08/26/15
•
BUILDING PERMIT T CANNOBE FINALED AND COMPLETED UNTIL THIS
CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION
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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. EPAWaterSense 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
'-i; 2.0 gallons per minute.@ 80 psi, or•the shower shall be'designed to
• allow only one shower outlet to be in o•eration ata 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 :iMaximum1.:5 gallons ,';°: psi . .
Faucets 0.8ygallons per.minute @ per minute`@•60 psi; .
20 psi .. minimumv0.8 gallons. '
• , . per minute @ 20 psi , 2.
, • ;Inrcommon.and public _ .
.'use areas 0:5{gallons ,: ,
: •per minute @60,psi i" ,
: ' .1.8 gallons per minute • • ,
• _ - ,('i . 60 esi
•
Faucets– 'Exceed 2.2 gallons 1:/8 gallons per minute @ i0.8;gallons,per minute ' :1.8 gallons per minute @•60
Kitchen per minute 60,,-,psi i@,•60 psi , psi §
FaucetsMay temporarily increase ,;May temporarily••...
up''to 2.2 gallon's per increase up to'2.2 -. '
minute @ 60 psi, and must gallons per minute @ •
default to maximum . , 160 psi, and must"i , . '
@
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 .1. ;unavailable, aerators or . '
` reduction.,• - 'othermeans maybe''. .• "
• •,,used toiachieve - ' -_ • -
reduction. ' . .—
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than'the figure: hown,itis not required to be upgraded
a.
5B407 2015.doc revised'O8/26/15
.Y