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15110143a E CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 19831 LA MAR DR CONTRACTOR'. PERMIT NO: 15110143 U#1N il-P 031 . OWNER'S NAME: RAMANATHAN RAJIV AND ANANTHANARAYANDATE ISSUED: 11/20/2015 OWNER'S PHONE: 4086004302j�� =HONE N LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL E]COMMER IAL / � f / (� License Class (� Lie.# '7 b O REPAIR SEWER LINE (40') t"GQ61P 4k Contractzl WL Date (j 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: 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: Valuation: $1000 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: 36910030.00 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 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 granting of this permit. Additionally, the applicant understands and will comply Issued b ✓�" �"' Date: OlU V I� y' with all non -point source regulat' ns per the upertmo Municipal Code, Section RE -ROOFS: 9.18. [� Signature ate 7 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 LZ 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 I performance of the work for which this permit is issued. I have and will,maintain Worker's Compensation Insurance, as provided for by will maintain compliance with the Cuperting Municipal Code, Chapter 9.12 and the Health & Safety Code, cti nsr255 5, 33 nd 25 Section 3700 of the Labor Code, for the performance of the work for which this Owner or authorized a Date: 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 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 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 Cityof 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 4 CUPERTINO M-01 GENERAL PERMIT APPLICATION CC)MMUNITY DEVELOPMENT DEPARTMENT • BUILDING DI ISION "� 10300 T ORRE AVENUE • CUPERTINO, CA 55014-3255 (408) 777-3228 • FAX (408) 777-3333 - buildinCO)CUDerilnO.Orq PLUm=NG ❑MECIRkNTICAL ❑ELECTRICA ❑AiISCELLA"'EOUS PROJECT kDDRESS( r_q -�/'� `Of- i APN t Q COX OWTtR NA1�E ' �V � W �� I PHO>\� • D � �y „ j'� }� = I✓��.�Z STREET ADDRESSn� I l r W I CITY, S T?' n y n (,� ti V I F.- ACT KAIM C01\7y R 6x- �%-� �� E-hL •% I o 14, Jv0'CfM",_ STREET ADDRES� 7 D I FAX ❑ Oli'T=� ❑ OR \-,-1,-BUIID _R ❑ 0\+'?�t AG�+'T L� CO?'TP.4CTOR ❑ CONT kCTOR AGM? T ❑ ARCHT=T ❑ ? Gi wR ❑ DVLO? ❑ T=? a�� CONTRAa.Jy CO]J,P.ki\TY 3j.k4m • I E•N.AlT, i C � � I F k7- I L�vl � � Vl �• �� STREET / DDRES ' CITY, S-.:5", ZIP PT�" : W A RCMTE CTrnGnNEER XAME LICENSE NrnfBER BUS. LIC r C01JP/?vY ? E -NAS I FAX STREET ADDRESS CITY, STATE, ZIP i PHONE USE 0'r Sr -D, or DU-PLF X ❑ MULTI -FA) M_Y . PROJECT L'\ A'ILTTMAIND ❑ YFS PROMECT IN ❑ YES IS T?• = BLDG „N ❑ Y S BULTDNIG: ❑COI.GIERCLAL URBAN LI FACEA 5 ❑ I I\10 FLOOD ZONE ❑ I -O EICITSERFiO]J2? ❑ NO DESCRIPTION OF WORK r a TOTAL VALUATIO\: By my signatn-e below, I certify to each of the follow.•ing: I am the property owner or au'uorized agent to act on the property owner's behalf. I have read this a lication and the Lnformation I have r ded is correct. have -ead ` escri tion of Work and verify itis is accurate. I agree to comply with all z IcP PST � p �' � y applicable local ,D ord»ances and state laA-s relating to ilamQ c stru I rize epreseptatives upertino to enter the abonnve-idea ifi d p ity for inspection purposes. Si A... =atnre of Date: 1. SUPPL TEN l AL D\F•OR MATION REQULREDNT �� Yes _ OFFSCE T S1rD?�'Ll , a g.102 n • ',ti, �-755--w-75k } S �S g, i, 'S..Y�J.�M ' -,On ^X.. AIFPAJ73cX.pp_2011.doc remised 06121/11 CITY OF CUPERTINO 15110143 FF.F FIRTI]WATO-111 — HITILDING DIVISION Ph an Check ADDRESS 19831 LaMar Dr DATE: 11/20/2016 REVIEWED BY: Paul Permit Fee: 1PPERMIT I APN: 369 10 030 1 BP#: *VALUATION: 1$1,000 *PERMIT TYPE: Plumbing Permit PLAN CHECK TYPE: Alteration / Addition / Repair PRIMARY SFD or Duplex USE: hisp. Fff: PENTAMATION 1 RPSS PERMIT TYPE: A WORK Repair Sewer Line (40') SCOPE Ph an Check Plumb. Plan Check 1 0.0 1 hrs $0. 00 Ele(—Plon (. her k [Plumb. Afec .Pei ni F, Permit Fee: 1PPERMIT I F Insp. —L— Other Plumb Insp. hrs Fo-o .(??' 137,x, Inso, 0h -'LIech. lnq. 1.*,!,..,:f*,fec. Phviib. 1, T�, hisp. Fff: DOTE: This estimate, does not include fees due to other Departments (i.e. Planning, Public Works, tire, Nanitary Newer District, MU001 District, etc.). These fees are based on the preliminary information available and are only an estimate. contact the Dept -for aitan'tinfo. FEE ITEMS (Fee.Resolution].1-053.ff. 717113) FEE QTY/FEE MISC ITEMS Plan CYieck.Fee: supj.)L.P(714ee I PME Plan Check:' $0.00 Permit Pee: F PME Unit Fee: $25.00 PME Permit Fee: $48.00 (".1onstrilation Tak,: Administrative Fee: JADMIN $45.00 Work Without Permit? 0 Yes (F) No $0.00 Advance,d.Planning ,,.Fees: T Travel Documentation Fee: ITR.4VDOC $48.00 Strong Motion Fee: IBSEISMICR $0.50 Select an Administrative Item i Bldg Stds Commission Fee: IBCBSC $1.00 -S ALS TOTAL FEE; so00$167.50 ] Revised: 10/01/2015 COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 m FAX (408) 777-3333 o building(a.cupertino.org ref y� —3��e� Cid 1 q$ 31 L A 1M A R ID 911tI��d� 15' 1! D1 t} 3 PERMIT CANNOT DE FINAI,ED AND COMPLETED UNTIL THIS OERTWICATE MAS.BE' EN11GI JUD. AN13 '�, l�TED ' CO 'TSE Iii�.IEDrNG 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 Califon -da Residential Codes. The alarms have been tested and are operational, as of the date signed below. t have read and agree to comply with the terms and conditions of this statement Ov�;rto� OWnarAgen. Gs7 Name: 27 �D'� tRRTIV RAMANATHAN ............................................................... - - Cffffir44ama. yt e. l: c0 � Da:t Smoke and CO form. doe revised 03/1'8/1'4 WATER -CONSERVING PLUMBING F- XTURES F 2 L El E OWNER CERTIFICATE OF COMPiL�ANCE Ene ifs I COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION CUPS—RTINNO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 ^ building(a.cupertino.org Owner Namet R AIT R A M 410 TH A IV Permit No. Address V1101 LA 1M A R PA j GV PE RT 1 NO � GA 0i '04 1. O14- 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. X 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 forn and sign bottom of form. ;K 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. M 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. ix 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: Myproperty 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 plunmbing 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 irnprovernents 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 followinv nave_ . • 6 � Owner or Owner Agent's Signat2!= """� - DategL.. Z 71 ZO I Upon completing and signing this rti ate, please return it to the Building Division in order to final your building permit. SB407 2015.doc revised 08/26/15 BU]tl EqG PER),HT CA-ININOa'1'BE FllgA� AiND CO1VXP T9D i>l"ITT-IL THIS CER N T31; � TO T 3�IT I3IViS��f r' Non -Compliant Plumbin Fixture Water -Conserving Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) ` Maximum Water.Usa a/Flow Rate, Fixture Type Water Usage /Flow Rate 2013 CPC Ch. 4 2013 CALGreen Div. 4.32013 2013 CPC Ch. 4 CALGreen Div. 4.3 2013 CPC Ch. 4 2013 CALGreen Div. 5.3 Single -Family Residential Multi -Family Residential Commercial Exceed 1.6 Gallons/flush Single flush toilets: 1.28 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 Water Closets (Toilets) Exceed 1.0 0.5 gallons/flush Urinals Gallons/flush Exceed 2.5 gallons per minute Exceed 2.2 gallons per minute 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria"of 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. Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 minute @ 60 psi; minimum Maximum 1.5 gallons psi 0.8 gallons per minute @ per minute @ 50 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi Showerheads Faucets — Lavatory Faucets In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute Exceed 2.2 gallons per minute 60 psi 1.8 gallons per minute @ 60 psi May temporarily increase up to 2.2 gallons per minute @ 60 psi, and must default to maximum 1.8 gallons per minute @ 60 psi Where faucets meeting the above are unavailable, 1.8 gallons .per minute @ 60 psi May temporarily increase up to 2.2 gallons per minute @ 60 psi, and must default to maximum 1.8 gallons per minute @ 60 psi Where faucets meeting 1.8 gallons per minute @ 60 psi Faucets— Kitchen Faucets aerators or other means may be used to achieve reduction. the above are unavailable, aerators or other means may be used to achieve reduction. rate is equal to or lower than the figure shown, it is not required to be upgraded. 1. If the existing plumbing fixture water usage/flow SB4072015.doo revised 08/26/15