B-2016-1389 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1389
10896 LINDA VISTA DR CUPERTINO,CA 95014-4749(356 14 045) (WONDER HOMES
INC)
CUPERTINO CA 95014
OWNER'S NAME: PRADHAN FIROZ AND ZUBEDA DATE ISSUED:02/17/2016
OWNER'S PHONE:408-821-2052 PHONE NO:408-821-2052
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lia#a99346
Contractor(WONDER HOMES INC)Date 92/17/2016, X BLDG ELECT —PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTIAL—COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
I hereby affirm under penalty of perjury one of the following two declarations: REMODEL(E)HALL/GUEST BATH(38 S.F.),LIKE FOR LIKE
17'1 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:$8000.00
APPLICANT CERTIFI ATION
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 APN Number;: Occupancy Type:
ordinances and state laws relating to building construction,and hereby 356 14 045
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 this permit. Additionally,the applicant understands and will
comply with all non-point ource regulations per the Cupertino Municipal 180 DAYS FROM LAST C NSPECTION.
Code,Section 9.18.
�',, Issued by:MELISSA
Signature Date 02/17/2016 Date:02/17/2016
OWNER-B L 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
1. 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:02/17/2016
contractors to construct the project(Sce.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
z. 1 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
3. I certify that in the performance of the work for which this permit is issued,I material.Additionally,should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
shall not employ any person in any manner so as to become subject to the will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and
Worker's Compensation laws of California, If,after making this certificate of the Health&Safety Code,Sections 25505,25533,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 authorized age ty
be deemed revolted. Date:02/17/2016
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that 1 have read this application and state that the above information is l 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 02/17/2016
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUPERTI NO (408)777-3228 FAX(408)777-3333•buildingCcDcupertino.org
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#
PROJECT ADDRESS
7_3
S t r
iO8 6 L IH/pA YI 5TA 4R ge C."P60"Ov'o 6qr
O\✓NER NAMEF(IZOT ISR AQ N(Fly PHONE 4 0g �t•20 5 2 E-MAIL
STREET ADDRESS `®jt'(, CITY, STATE,ZIP FAX
CONTACT NAME / ORaz_ AeA ow'. l PHONE ld/.v S•82/•2A 52 E-MAIL
STREET ADDRESS `&,9` 4/1V,0A v/_*,A A7,e CITY,STATE,ZIP FAX
Gv�T/neon to S�.S9✓'y
❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT tPPICONTRACTOR ❑CONTRACTOR AGENT. ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
CONTRACTOR NAME JV 0,0V DEX LICENSE NUMBER LICENSE TYPE BUS.LIC
COMPANY NAME E-MAIL FAX
STREET ADDRESS S�Z/ p� CITY,STATE,ZIP .S/10-� Ej`L} 9S/2�y PHONE L/LsB'SZ/•20
ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC#
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE
DESCRIPTION OF WORK
AAx A. wc,, 8 Ace!
oe
EXISTING USE PROPOSED USE CONSTR.TYPE #.STORIES
USE TYPE OCC. SQ.FT. VALUATION($)
EXISTG NEW FLOOR DEMO TOTAL - -
AREA AREA AREA NET AREA
BATHROOM - - y- - KITCHEN - _ OTHER
REMODEL AREA 3 v REMODEL AREA REMODEL.AREA
PORCH AREA DECK AREA JTOTAL DECK/PORCH AREA GARAGE AREA: El DETACH -
❑ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES -
BELNGADDED? ❑NO ADDITION? - [:]NO
PRE-APPLICATION ❑YES: IF YES.PROVIDE COPY OF IS THE BLDG AN - 7. TOTAL VALUATION:
PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑.NO. 777
s '
00
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act o roperty owner's behalf. I have read this
application and the information I have prgVldcd is rrect. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to ing c irdetion.. I authorize representatives of Cupertino to enter the above-identified property for inspection proposes.
Signature of Applicant/Agent: Date: a/!a/iG
SUPPLE M INFORMATION REQUIRED
RE '
Q PSA CHECICrTS PE 5 ROUSL
1PY, r
New SFD or Multifamily dwellings: Apply for demolition permit for
— ❑ O E 2 THE C(IUVTER ❑ BUILDING PLATS AEVIEw �
existing building(s). Demolition pelmet Is required prior to Issuance of building f £
permit for new building. ❑ EXPREss ❑ pLA��ING�L�iytE �
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure l] sTArDARD ❑pIJBLIc vt olucs
Form if any Hazardous Materials are being used as part of this project. n,
_Copy of Planning Approval Letter or Meeting with Planning prior to fi
I ARGE Y x' ❑ FIRE DEMI'
submittal of Building Permit application. L7\MA?ax ;$AVITARirSEtLERDISTRICT
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COMMUNITY DEVgE-OPMENT DEPARTMENT
BUILDING DIVISION-CUPERTI!NO
AP PR0V,ED
This set of plans and specifications MUST be kept at the <_
job,em during construction. It is unlawful to male any ;U mCD
t i
changes or alter-tions on sane,or to deviate
theroirorn,without approval from the Building Official.
Thcnte.mping of this plan an spe-q ications SHALL NOT � O
o pe- i o be an ;, roval of
the violation
ofrv"; vd;d s of as>, 6tl Ordinance car State Law. a �z c.
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5MUML UGARHON MONOXIDE ALARM -5
OWNM CERTFICATEOF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT,BUILDING DIVISION
.Lill 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
CUPERTINO (408)777-3228- FAX(408)777-3333-building(oftupertino.org
K
L—A 4i ft,
WAide
PERUTITCANNOT BE FINNLED AND COMPLETEP UNTIL THIS CEF 11FICATE
ITAS DW A0 1kU4' DjNG WVTWN
PURPOSE
This affidavit is a self-certification for the installation of all required Smoke and Carbo ri 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
TION
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
$10090,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 AAL 1,1VI CO UA,,RM
Outside of each separate sleeping area in the immediate vicinity of the X X
0
bedroom(..�S)
On.every level.of a dwelling unit including basements X X
Within each sleeping,room I X CO`
Carbon Monoxid e alarms are not t require d ii i dwellings which do not contain f u el-bur,-,mi-ig appliances and that
do,not have an attached garage. Carbon monoxide alarms combined with smoke alai ms shall comply with
CBC Section 4201.6 and shall be approved by the Office of the State Fire,MarshaL
Power Sit I a,dwelling units with no commercial power. supply,alarm(s),may be 3 olely battery operate-di.
In,existing.,dweIlnng.uints,alarms are permitted to be solely battery operated,where repairs or alterations,do,
not result In,the rem-'oval of wall and ceiling firdshes,or there is:no access by means of altic,basement or crawl:
space..Refer,to,CR-,C Section,8314 and CBC Sections,907.2.11.4 and 420.6.2..An electric al permit is required for
alarans,wI-Lkh must-st be,co uaected ter the building wiring,.
As,owner ofthe abzve-referenced property,11 hereby certify tlial the alarm(s);referen ed above has/have been
installed ih- aceordlamce,with the manuf actu,,rer's instyum,dionsanid in,com,tplitana ce with t he California B,11,41dibaig,
a,j,j�dl Cal=bfojaq,,ai Residlentiall Codes.The allarms,have beezi.testedan.-d,are opeTafio nal,z&of the elate signed
b'dillow,..
1"Wive#p�Wgfiogqraq 4 pompk v�ft ME&and!con,aftm&of la tie m,a net
z; RAW
.........................................
Sinature ......................... ....... ......... .............. ...................
WATER-ZONSERVINGPLUMBING FIXTUI ES FILE
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT 10EPl1:RT ENT•,BULCD.ING MOON
U �,TfM 01+0300 TO RR,E�t�JE NUE•C`RERTMO,CA 95014-3255
(408)777-3228•FAX{ 085 7:77-3333•buifdirFgfa)cuoerur€o.or� ®'�
)wrier Name r«� ��Gt,&- Permit Nod
kddress 0
1. Is your real property a registered historical site?
❑ ' s Civil Code Sections 110 1.1 through 1101:8 do not apply. Skip the rest of the form;and sig 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.
❑ 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?
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?
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 si bottom of form.
END
/ 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 ON ER of the following:
Myproperty,mis a sligle-fanvily residential real property.Y• See Civil Code Section 11014
On and after January 1, 20,14,building alterations or improvements shall require all non-compliant plumbingfixtures
to be replaced with water-conserving plumbing fixtures throughout the building.Onor before J an u ary 1,2017,all non-
compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether
property undergoes=alterations or unprovements).
My pr..operty is,a.rt ultifamily residential real property,. Sce Civil Code Section 1.101.5.
On and.after January 1,20.1.44,specified building alterations or improvements shall require non-c mpliant
plumbing fixtures tol be replaced with water. conserving plumbing fixtures.
On or before January 1,2919,all non-compliant plumbing fixtures shall be replaced with-water-
conserving:plumbing fixtures throughout the building(regardless of whether property m,dergoes alterations or
improvements).
My property is a commercial real property: See Civil Code Section 1101.5
On and after January 1,20,14,specified building alterations or improvements shall require non-ecympliant
plumbing fixtur•.est ter,be replaced with wafer conserving plumbing fixtures.
0'n or: before.January 1.,, 2019, all, non-compliant plumbing fixtures shall be replaced witth water- conserving
plumbing fixtures tl xougkout the building(regardless of whether property undergoes alliterations or improvements)
I,as the owner or owner's agent of this property,certify under penalty of perjury that noncom pliplumbing fixtures will be
replaced prior:to date,,specified above,with,water-conserving plumbing fixtures in accordance with iv l Code Sections 1101.1
through 1101.8,.the current California Plumbing Code and Califomma Green Buildiii,g Standards Co e' ,and manufacturer's
installation requirements,and that the.water conserving plumbing fixtures comply with the requir cuts as indicated in the
table on the-follow—in•<,page.e.
Owner'or O�nmer It eats,Si natwe t Rate
Upon compietilig and signibg this+Certifi ate,,pl ease return:it to the Building Divisions in order to,fin 1.yourbuilding.permit. '
040.7 2015.doe revued''08l26/1'5