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B-2016-1403 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1403 10244 DANUBE DR CUPERTINO,CA 95014-2146(369 48 006) (SARATOGA KITCHEN &BATH DESIGN INC) SARATOGA,CA 95070 OWNER'S NAME: LUGHEZZANI PATRICIA G DATE ISSUED:02/22/2016 OWNER'S PHONE:408-867-0771 PHONE NO:408-867-0771 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class D.C-5 Lic.#788350 Contractor(SARATOGA KITCHEN&BATH DESIGN INCL)Date 02/22/2016 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: REMODEL(E)BATHROOM,LIKE FOR LIKE NO STRUCTURAL I hereby affirm under penalty of perjury one of the following two declarations: CHANGES. 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:$7000.00 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 APN Number: Occupancy Type: ordinances and state laws relating to building construction,and hereby 369 48 006 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 ISS EOR granting of this permit. Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal 180 DAYS FROM LAS ECTION. Code,Section 9.18. -" Signature Date 02/22/2016 Issued by:Date:02/22/2016 " I DER DEC�l�AR6;O>N 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:02/22/2016 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 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 shall not employ any person in any manner so as to become subject to the 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 Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code,Sections 25505,25533 4.2553 . 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 agent: be deemed revoked. Date:02/22/2016 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that there is a action 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 02/22/2016 CONSTRUCTION PERMIT APPLICATION 10 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingc5cupertino.org ❑NEW CONSTRUCTION ❑ ADDITION ❑ AL"fERA'I'ION/TI `S, O ❑ REVISIONN/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS /02 4 L^A -A/0 I ac AIN# /�r .G CD(4 OWNER NAME (,,, - PHONE (J`•G I E-MAILJ STREET ADDRESS CITY, S'rATE,ZIP FAX ZIf 4 ► ,q.J0gE c�J�az�1.,J� c A SSU/ [CONTACT NAME -j J C_�� , 1PHONE E-MAIL< � O . Z72GtiG Z/ l6,4-f-T )E STREETADDRESS CITY,STATE,ZIP / I6 LFII /hz►� �'�} `�`ff�� FS`i© '�� ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 1 CON'rRACTORAGEN"I' ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTOR NAME LICENSE NUMBER LICF,NSE TYPE BUS.LIC# '79934 0 c L J COMPANYNAME ..) ? _ E-MAIL FAX 7-/YlC41-A I'iLrtr� I 1 Z SET ADDRESS CITY,STATE,ZIP PHONE /f��r6.A-te56.4-71 S� ,o 6- 4 �A .. 50-70 e7g ` ;7`��77r ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK /I l NI UJ E My v ►V► q ..l' �t�t` ..�i 14 "T 1 C SHC�CrJL-lZ 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.q r REMODEL AREA REMODEL AREA PORCH AREA `DECK AREA=AL AREAGARAGE AREA DETACH ❑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 ATION: AN PLANNING APDL# []NO PLANNING APPROVAL LETTER EICHLER HOME? C �,;••B C By my signature below,l certify to each of the following: I am the property owner or authori gent to act on th roperty owner's behalf. I have read this application and the information I have provided is correct. I have read the Description of Work nd verify it t urate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize re resentatives of Cupe tino to eabove-identified property//for inspection purposes. Signature of Applicant/Agent: Datc: 17 2 fri SUPPLE FORMATIONRE PLAN CHECK TYPE ROUTING SLIP _New SFD or Multifamily dwellings: Apply f0 olitlOn permit for OVER-THE-COUNTER El BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. EXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ElSTANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06121111 COPv1�.1i_'NiTY C__1r=LOi RtENT APART(✓IEiVT BUILDIN!, 3IVISION - CUP RTINO CUPERTINO ,APPROVED Building Department This set of pla^s �~,. specti::at'crs'M. ST to kept at the Q cb site dur i. ., . _. .,cdon. It is to make any H8 L 2 2016 changes or _. t :-•itions on same. or to deviate therefrom, uYprovai from 1 Building Off'cc�� D FOR CODE COMPLIANCE The Star,p ng c ., s Dan an a;.�j SHALL Nb REVIEWS _ de help <<o he a ai'� he viol:.n 39 N Reviewed By: �`:� of a g. any G,t ,ice or State r. — Ln - _- �(0 PERMIT# G-I_oI&— j 00 � t o 00 O 24EEC — I Existing Tile 'Remove - Floor to emove Tub Remain As-Is Rep lac Here Hep n °d ' New Tile — - CN /Lig t Shower Pan & Unit m Walls - °� Replace r- - ---- -- -- ----- p i Remove& eplace Plumbing Cabi t & C nter w/ 1Lo YFixtures w/ I New New -- 60 -----. 106 - 61 f -- Q 0 aratoa Kitchen & Bath Lughezzani Residence Forp lolan 0 20430 Sara Los Gatos Road -- - Bathroom New Plan A Room 1 Current Date:Feb 09,zots Scale: NTS Saratoga,Ca.95070 m Phone:A08-a87-0771 Fax 408-867-5923 - a f -- - @•...-v wa-m.w.m ee�.4aP`19n../1�9 R�Y�fi:� ' OWNER CERTIFICATE OF COMPLIAN E COMMUNITY DEVELOPMENT DEPARTMENT b BUILDING DIVISION 1-7 (CUPERIFINQ 10300 TORRE AVENUE o CUPERTINO,CA 95014-3255 (408)777-3228 o FAX(408)777-3333®buildina(o Cupertino org _ e- I: a ;e PER- YT CA�"OT'iE "AND CON LE El)VJl`�TYL THIS CFILTIF�CATE, 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. GMERAL INVORMAT ON, - ---_r_ _- ' - _-_--- — _ --- — 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 it the following locations: AREA SMOKE AZAR- CO AlLA Outside of each separate sleeping area in the immediate vicinity of the X ' bedroorn(s) X On every level of a dwelling unit including basements X X 41Xiithm each slee t in morn X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do notlnave an,attached garage; Carbon monoxide alarms combined:with smoke alarms shall comply with CBC Sech©n 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply:In&ve ihng t mftis witl-i no commercial power supply,alarms)maybe solely battery op- rated Ih existing dwe-Ntag amts; alarms are permitted to be solely battery, operated where repairs or alterations dol not result in the removalof wa Bland ceiling finishes;or there is, aecess by means of attic,basement or crawl space.Refer,to CRC Secfor8314 ani CBC Sections 9`07.�T1.�and�2f.6:2.Arelectrcal perruif- is re-q,ulired fox alamns,wlnikhii mmst be cou�eected to the b-ukldiing wiring. As owner o£the ab'ave refereraced property,I hereby certify that the reffeitenced above has/have Fieei-L +stalTed in accordiance wAh the rmanufactr,er's ins =U cti(Dnis,and in eo=m-ip)li =ne,with the Calliforma-fl'aill iTt+g am}d Calii£lonn a R}esidien�ia�f-Colles.The a�latrm,&hla+ve°beei2 tested{aindl aTre o=pera,t:onall,.as.of t m dafie signed belio�v; 11havelreladandt_ ee�fia+cakn f, witht3e)fBrmssandt� nidltitns>Qfr't�iisstaternent Si' *Ibl.. ........ 7 2 /' ��nt�"�cfQt�Narn'e=; i .........Qatsa; .. Pure:_ ,..,... . .. ... L[ 3 ........_Qat . 77 e5 Shzake;and,''C0-fbrn7,.dbe revised 03/I8f141 'WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE _ COMititfilPBfl'Y D. L:fJiPlltftrW"f''D.i=p�1RTi4��'t�T•;BU[LD.IP�t"x Dd�/i�{�Ot�t C IJ C� �i P l N P3 ELI 10300 TO RR.E AVENUE-CUPERTINO,CA 9W4 3255 (� (-4 -3222 •;FAx.(408)777-3333•buildings mperfitui org Owner Nam f ����if° Address 1. Is your real property of 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. o Go to Question 2. 2. Does your real property have a licensed plumber certifying that,due to the age or configuration of theri ro e pombing,installation of water-conserving plumbing fixtures is not technically feasible? P p Y or its -Z 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? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. �W—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. M� Yes property y real p ro p rty 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: IVlyproperty rs asttzgFe family residential Yea1Ppertyro= See Civil. Code Section 110! .4. On and after January 1, 2014,building alterations or irnprovernents 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 plurribimg fixtures (regardless of whether property undergoes alterations,or in pfavements). 4R"ivly propertyis.a.mtdtifamily residential real,property. See Civil Code Section 1101.5. On after,January 1,2014,specified building alterations or irnpravernents shalt require non-compliant plumbing fixtures.to be replaced with wafer-conserving plumbing;fixtures. On or bef©re January 1, 2019,all non compliantplumbing fixtures shall be replaced with,water- conserving plumbing fixtures throughout the building(regardless of whetherproperty>axdergoes 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 regauire.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 plum,firng,fixturies 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-compliantplumbing fixtures will be replaced prior to date specified above..with water-conserving plumbing fixtures in,accordance with.Civil Code Sections 1101.1 through 1101 S,the current Calrfomia.Plum-Bing Code and Califomia Green Building,Standards Code,and manufacturer's, installation requirements,.and that the.water-conserving plumbing fixtures comply with the requirements as indicated in hhe table an the followin:_. a•-e. Ownor or OvvnenAg n.Fs Signature .1 Date �,p Upon cornpletirig and signing this Certificate,please return it to the Building Division,in order to.final your,building,permi t. SB407 2011,51.doc r.euised 0812.6/1.