B-2016-1311 CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-1311
10641 N STELLING RD CUPERTINO,CA 95014-1647(326 08 050) (TOPSTAR BUILDERS
&CONSTRUCTION
INC)
CONCORD,CA 94518
OWNER'S NAME: SIVILLI FLORENCE J TRUSTEE DATE ISSUED:02/04/2016
OWNER'S PHONE:925-969-7873 PHONE NO:925-969-7873
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class Lic.# t Ps
Contractor(TOPSTAR UIL CONSTRUCTION_INC 1 Date�' —BLDG X ELECT _PLUMB
MECH X RESIDENTIAL COMMERCIAL
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. JOB DESCRIPTION:
KITCHEN REMODEL(120 SF);2 BATHROOMS REMODEL(100 SF);
I hereby affirm under penalty of perjury one of the following two declarations: REPLACE 100 AMP PANEL.
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.
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. Sq.Ft Floor Area: Valuation:$30000.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above APN
information is correct.I agree to comply with all city and county 2608 050
Number: Occupancy Type:
3
ordinances and state laws relating to building construction,and hereby 326
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 PERMIT EXPIRES IF WORK IS NOT STARTED
expenses which may accrue against said City in consequence of the WITHIN 180 DAYS OF PERMIT ISSUANCE OR
granting of tA9.11
onall pptfcant understands and will
comply with rrc�g ations per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION.
Code,Sectio
I sued by: 1979
Signature Date /_ �� ate:
OWNER-BUILDER DECLARATION % RE-ROOFS:
I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is
following two reasons: installed without first obtaining an inspection,I agree to remove all new materials for
t. I,as owner of the property,or my employees with wages as their sole inspection.
compensation,will do the work,and the structure is not intended or offered
for sale(Sec.7044,Business&Professions Code) Signature of Applicant:
2. I,as owner of the property,am exclusively contracting with licensed Date:
contractors to construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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 HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
2. I have and will maintain Worker's Compensation Insurance,as provided for California Health&Safety Code,Sections 25505,25533,and 25534. I will
by Section 3700 of the Labor Code,for the performance of the work for which maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
this permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous
s. I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipmen devices which emit hazardous
air contaminants as defined by the Bay Area anagement District I
shall not employ any person in any manner so as to become subject to the will maintain compliance with the Cuper,' o mcipal Code,Chapter 9.12 and
Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code,1S do s 5505,25533,and 25534.
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 Owner or authori71NTRUCTION
nt-
be deemed revoked. Dater �f
pV�l LENDING AGENC
APPLICANT CERTIFICATIONY
I certify that I have read this application and state that the above information is I hereby affirm that there is a construction lending agency for the performance
correct.I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued(Sec.3097,Civ C.)
relating to building construction,and hereby authorize representatives of this city Lender's Name
to enter upon the above mentioned property for inspection purposes. (We)agree
to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address
judgments,costs,and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally,the applicant ARCHITECT'S DECLARATION
understands and will comply with all non-point source regulations per the I understand my plans shall be used as public records.
Cupertino Municipal Code,Section 9.18.
Licensed
Professional
Signature Date
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTCCVO
(408) 777-3228• FAX(408)777-3333• building(cbcupert!no.org j —2016—
1� 45//
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT 4
PROJECT ADDRESSr �� 1 APN# o —�s, P,
b pV �n /�,
O��TIERNAME ' 11 J i P EMAIL
STREET ADDRESS 1 r K I CITY, ST TE,ZIP / FAX
I/ Q t
CONTACT NAME � � PHONE
STREET ADDRESS CITY,STATE, ZIP e45M C e;✓ FAX
❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME �// LICENSE NUMBERX LICE TYPE BUS.LIC#
COMPANY NAMEc 1104� ll (//It--
�`� E-MAIL FAX
STREET ADDRESS / �f / CITY,STATE,ZIP PHONE
ARCHITECTIENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
hi�CJ
EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES
USE TYPE OCC. SQ.FT. VALUATION(S)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET AREA
BATHROOM KITCHEN OTHER
REMODEL AREA REMODEL AREA REMODEL AREA
1� /-70k
PORCH AREA DECK AREA TOTAL DECK/POR AREA GARAGE AREA: LJDETACH
❑ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES
BEING ADDED? ❑NO ADDITION? ❑NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YESRECEIVED` TOTAL VALUATION:
PLANT'rNG APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO
✓�/ 000
By my signature below,Icertify to ach o the I-am the property owner or authorized age�to ct o th property owner's behalf. I have read this
application and the informatio ovided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state la e ati to ilding construction. I authorize representatives of Cupertino to enter the abovq-identified drop for inspection purposes.
Signature of Applica Date-I 4 /J
SUPPLER NTAL II\IFORMATION REQUIRED
..
Q PLa)\CHECI.TI PE. ROUTING SLIP
New SFD or Multifamily dwellings: Apply for demolition permit for Q OVER THE COU\TER ❑ BUILDI\G PLA\REQ IEVF' '
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑ ❑
EGRESS PLA\\L\G PLAl�REQ IE�i
Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STS\D�RD ❑ PUBLIC\�'ORI�S
form if any Hazardous Materials are being used as part of this project. �] LARG$ ❑ FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning prior to
NL4dOR ❑ S�\ITARI SE�iERDISTRICT
submittal of Building Permit application.
`^ ❑,E\MRO\MEATAL HEALTH
B1dg.4pp_2011.doc revised 06/21/11
i
Assessor's Parcel Number: Plumbing notes:
lr 1. Faucets in kitchens,wet bars,lavatories,laundry sinks,etc shall have a water flow not to exceed 1.8 gallons per minute @ 60 psi.(CPC 403.6)
Narne of Owner:
V P( Electrical Notes:
/ 2. The installation of smoke alarms in all of the following areas shall be provided: (R314.3)
�� I ` I / a. on the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedrooms.
Contact Person: CJI l/l� Phone: b. In each room used for sleeping purposes.
C. In each story within a dwelling unit,including basements but not including crawl spaces and uninhabitable attics.
Project Address: . � .la ��/ C/ ��'/ ��- 3. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on every level including
basements in dwelling units that have fuel-fired appliances or attached garages.(CRC R315.1)
�A 4. A minimum of two 20 amp small appliance.branch circuits shall be provided for all receptacle outlets in the kitchen,dining room,pantry,or other similar areas,(CEC
Scope of Work: J20 CZ �Wl OLid (09210.11(C)(1))
J 5. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets.Such circuits shall have no other outlets,(CEC 210.11(C)(3)).
\(Q 'O ^ �� i 6. In every dwelling unit,fixed appliances such as food waste grinders,dishwashers,washing machines,dryers,laundry tray locations,built-in refrigerators or freezers,
Code Editions: 2013 California Residential Code tJ furnaces,AC units,built-in heaters or any other fixed appliance with a motor of'/h.p.or larger shall be on a separate 20 amp,branch circuit.
2013 California Plumbing Code 7. All receptacles in bathrooms,garages,accessory buildings,outdoors,crawl spaces,unfinished basements,kitchens(where receptacles serve countertop surfaces),
laundry,utility,wet bar sinks(within 6 feet of the edge of the sink),shall have ground-fault circuit interrupter(GFCI)protection.(CEC 210.8(A))
2013 California Mechanical Code 8. In all areas specified in 210.52,all non-locking type 125-volt,15-and 20-ampere receptacles shall be listed tamper-resistant receptacles.(CEC 406.12)
2013 California Electrical Code t�----
IIP TING
PLOT, CKED BY
C'`� ER
2013 California Energy Code %... i EUf d ng Department
Enerov Code mandatory lichtina measures: /��- 1 ?` .,',
1. All permanently installed high efficacy luminaires shall be switched separately from low e ficacy fume f I"--- - i 4 2016
1'1C �- i
2. Permanently installed lighting in Kitchens shall be high efficacy luminaires.Up to 50%of the v✓zttage o� i aLl�i In kitchens may bedn;ligh� t-
are not high efficacy.(1 50(k)(8)) CUPERTINO �r_D
FOR CODE COMPLIANCE
I
Reviewe�, By:
t
(N)Cad
C.tJ .
DVI /-
0
COlVIty11,%TYDDjF-LO"y ENT Dc RTMENT
LD1iVsa DIVlSIOPJ-CU„EI INO
hi 0�,1 D �I�� (N)
This set of plr.ns and sp v ecificaions M T be ke c pt at theonstruction.ci-�;:. _ Itisur,'• es r alterations on same, r tc evi�make any
i ti :r0, •rn, 11 ithout a'
n peroral from the inn jv
( 1 Thr r'I' noin g Official.
A of this plan and specificat ^
f icic �o pS nit or to be an approval ”.SHALL NOT 1 J
o'anv r vis i c violation '
of a- City Ordinanc l
BY r Stage Law,
DAT
O
O I ERMIT NO. � ® 1 � z _
mak!' 79
y � 0 Jn
.� CkL
ff iCopy ;
�Y
EXISTING KITCHEN FLOOR PLAN PROPOSED KITCHEN FLOOR PLAN
j
Asse'ssor's Parcel Number: ! Plumbing Notes:
1. Water closets shall have an average water consumption of not more than 1.28 gallons per effective flush.(CPC 403.2)
Name of Owner: i 2. Shower heads shall have a water flow not exceed 2.0 gallons per minutes @ 80 psi.(CPC 408.2)
3. Faucets in lavatories shall have a water flow not exceed 1.5 gallons per minutes @ 60 psi and shall not be less than.8 gallons per minutes at 20 psi.(CPC 403.6)
4. Shower stalls shall have a clear interior finish area of 7.1 sq.ft.and be able to accommodate a minimum 30 inch circle at the threshold level.These clearances shall be
Contact Person: Phone: maintained up to a height of 70 inches able the shower drain.(CPC 408.6)
/�. �� 5. Shower compartments and walls above bathtubs with installed shower heads shall be finished with a smooth,nonabsorbent surface to a height not less than 72 inches
` (6ft).(CRC R307.2)
Project Address: rZ - a � { 6. The maximum hot water temperature discharging from the bathtub,shower and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit.The water heater
thermostat shall not be considered a control for meeting this provision.(CPC 409.4&408.3)
Scope of Work: 7. Water closet shall be set minimum 15 inches from its center to a side wall or obstruction and 24 inch clearance in front of water closet.(CPC 402.5)
Electrical Notes:
1. The installation of smoke alarms in all of the following areas shall be provided: (R314.3)
Code Editions: 2013 California Residential Code + a. On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedrooms.
I b. In each room used for sleeping purposes.
2013 California Plumbing Code {
C. In each story within a dwelling unit,including basements but not including crawl spaces and uninhabitable attics.
2013 California Mechanical Code 1 2. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area in the immediate vicinity of the bedrooms and on every level including
2013 California Electrical Code basements in dwelling units that have fuel-fired appliances or attached garages.(CRC R315.1)
! 3. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets.Such circuits shall have no other outlets.(CEC 210.11(C)(3))
2013 California Energy Code 4. All receptacles in bathrooms,garages,accessory buildings,outdoors,crawl spaces,unfinished basements,kitchens(where receptacles serve countertop surfaces),
laundry,utility,wet bar sinks(within 6 feet of the edge of the sink),shall have ground-fault circuit interrupter(GFCI)protection. (CEC 210.8)
Mechanical Notes; 5. In all areas specified in 210.52,all 125-volt, 15-and 20-ampere receptacles shall be listed tamper-resistant receptacles. (CEC 406.11)
1. Bathroom vents shall terminate not less than 3 feet from openings and property lines.(CMC 504.1)
Energy Code Mandatory Measures:
1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy luminaires(150(k)(7))
2. Permanently installed luminaires in bathrooms shall be high efficacy luminaires OR are controlled by an occupant sensors(s)certified to comply with Section 119 that
does not turn on automatically or have an always on option.(150(k)(10))
CUPERTINO
BijjDepartment
�m 0 4 2016
REVIEWED FOR CODE COMPLIANCE
Reviewed By:
�r
C�
C�.�.
-sk �OGt�h Y-0UVIl P� 2��� �� `roo r"l,
P�wi 6_4 1
EXISTING BATHROOM FLOOR PLAN PROPOSED BATHROOM FLOOR PLAN
SMOKE / CARBON MONOXIDE ALARMS -
OWNER CERTIFICATE OF COMPLIANCE �t ,
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUIIE1N4 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228 • FAX(408)777-3333.building(a)cu perti no.org
(� I� 3` Permit No.
�
Address � r n - #of Alarms Smoke: Carbon Monoxide: 2—
PERMIT CANNOT B. INALED AND COMPLETED.UNTIL THIS CERTIFICATE
HAS BEEN SI M-,AND RETURNED TO THE`BUILDING=DTVI ON
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 X X
bedroom(s)
On every level of a dwelling unit including basements X X
Within each sleeping room Xr
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 comp),with the terms and conditions of this statement
Owner(or owner Agenfs Name:
S .... ............ .. ........Date}tsY' naure . . .........f..
..
Contractor Name:
Signature. .................................................. .........'Lie.#..... .._......................Date: ...................
Smoke and CO form.doe revised 03/18/14
WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE ,
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
�lYPI5Ft71rI4 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255
(408 777Jjf 8•FAX(408)777-3333•buildinq(a)cupertino.org _ p
Owner Name r',/ i U� Permit No.
ff99
Address `l� b_ e
real property a registered historical site?
El Yes Civil Code Sectioni-1-1 tTl through 1101;8-dc not apply,—Skip-the.-rest ofthe 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.
El The licensed plumber's certification has been provided to the Building Division.
�'` Skip the rest of the form and sign bottom of form;
if No Go to Question 3.
3. Is water service permanently disconnected for your building?
El 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 4.
4, Is your real property built and available for use or occupancy on or before January 1, 1994?
El 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, 1`994,- -
Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign
bottom of form..
5. Ple e check ONE of the following:
{ My property is a single-family residential real property. See Civil Code Section 1101.4.
On and after January-J, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures
to be replaced with water-conserving phunbing 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).
0 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 uridergoes alterations or improvements).
I,as the owner or owner's agent of this property,certify under penalty of penury 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: Dater
Upon completing and signing this Ceftificate,please return it to the Building Division in order to final your building permit.
SB407 2015.doe revised 08126115