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B-2016-1417
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1417 1585 JAMESTOWN DR CUPERTINO,CA 95014-5312(366 10 096) (A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC) MEMPHIS,IN 38120 OWNER'S NAME: TANG ALEX GA B ING AND KO JU HSING DATE ISSUED:02/23/2016 OWNER'S PHONE:408-318-3855 PHONE NO:408-982-0405 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-36.C-42&A Lic.#965155 Contractor(A R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA X BLDG _ELECT X PLUMB 1NC 1 Date 02/23/2016 _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 JOB DESCRIPTION: license is in full force and effect. REPLACE SEWER LINE&BOTH FOUNDATION&PROPERTY LINE CLEANOUTS I hereby affirm under penalty of perjury one of the following two declarations: L I have and will maintain a certificate of consent to self-insure for Worker's Compensation,asprovided for by Section 3700 of the Labor Code for the performance of the work for winch this permit is issued f�. h7 l z. 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 '• j`3 r„�' this permit is issued. Sq.Ft Fl or_Area luation $ 799.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupancy Type: information is correct.I agree to comply with all city and county 316610096 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 PERMIT EXPIRES IF WORK IS NOT STARTED harmless the City of Cupertino against liabilities,judgments,costs,and WITHIN 180 DAYS OF PERMIT ISSUANCE OR expenses which may accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will 180 DAYS FROM LAST CAL INSPECTION. comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. issued'b Signature', Date 02/23/2016 Date:02/23/2016 RE-ROOFS: OWNER-BUILDER DECLARATION All roofs shall be inspected prior to any roofing material being installed.If a roof is I hereby affirm that I am exempt from the Contractor's License Law for one of the installed without first obtaining an inspection,I agree to remove all new materials for following two reasons: inspection. i. 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 Signature of Applicant: for sale(See.7044,Business&Professions Code) Date:02/23/2016 2. 1,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Sec.7044,Business&Professions Code). ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER I hereby affirm under penalty of perjury one of the following three declarations: i. I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE Compensation,as provided for by Section 3700 of the Labor Code,for the I have read the hazardous materials requirements under Chapter 6.95 of the performance of the work for which this permit is issued. California Health&Safety Code,Sections 25505,25533,and 25534. I will 2. 1 have and will maintain Worker's Compensation Insurance,as provided for maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the by Section 3700 of the Labor Code,for the performance of the work for which Health&Safety Code,Section 25532(a)should I store or handle hazardous this permit is issued. material. Additionally,should I use equipment or devices which emit hazardous 3. I certify that in the performance of the work for which this permit is issued,I 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 the Health&Safety Code;Sections 25505,25533,and 25534. Worker's Compensation laws of California. If,after making this certificate of /;F 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 Date:022//23/2016 authorized agent: be deemed revoked. CONSTRUCTION LENDING AGENCY APPLICANT CERTIFICATION I hereby affirm that there is a construction lending agency for the performance I certify that I have read this application and state that the above information is of work's for which this permit is issued(Sec.3097,Civ C.) correct.I agree to comply with all city and county ordinances and state laws Lender's Name relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Address to save indemnify and keep harmless the City of Cupertino against liabilities, judgments,costs,and expenses which may accrue against said City in ARCHITECT'S DECLARATION consequence of the granting of this permit. Additionally,the applicant I understand my plans shall be used as public records. understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. Licensed GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUF'ERT N 3 (408)777-3228•FAX(408)777-3333•building(a)cupertino.org MISC (3 - 2-01 ,6 - 1 Y - ❑PLUMBING ❑'MECHANICAL ❑ELECTRICAL / ❑MISCELLANEOUS//�� PROJECT ADDRESS ^ 777# OWNER NA J P.ONE �7 E-MAIL STREET ADDRESS { CITY,STATE,ZIPy, %-b FAX CONTACT NAME n PHON�C oq � Z ro� E-MAIL STREETADDRESS�ncss- CA J FAX 11 OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ONCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NIIMBE�lCo"S+ LICENSE TYPE BUS.LIC# COMPANY NAME E-MAIL FAX i� ' ' 4 at �' t t� S �i P • C _j, STREET ADDRESS CITY>S P �I , ONECA ARCMTECT/ENGINEERNAME LICENSE NUMBER BUS.LIC# 1� V COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD o,DUPLEX ❑ MULTI-FAMILY - PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑.YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑NO EICHLER HOME? ❑NO I DESCRIPTION OF WORK TOTAL VALUATION: RECEA ED BY' = By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the prop wner's behalf. I have read this application and the information I have provided 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 laws relati>g to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature ofApplicant/Agent: Date: ,��' 40 SUPPLEMENTAL INFORMATION REQUIRED s- . �,. .a?, -OFFiC USE ONLY, y UV�It�TI�-COUI1'TER � x "� ❑ STANDARD w� 3>�1R�GE z 0 11IAJOR MEPMiscApp 2011.doc revised 06/21/11 f _ ___._... _ --._ —_ �.— ... wwwm�:p•wiwmllAID'R+:6«'tI+,NGa:I^�,O�:.Y:�.Y'.Ye� F LL E COMMUNITY'DEVELOPMENT DEPARTMENT I-BUILDING DIVISION 10300 TORRE AVENUE®CUPERTINO,CA 95014-3255 (408)777-3228 a FAX(408)777-3333•buildin4(a.cupertino.org r�1 YT c -N"T DF r'1NAJ1F1D AWS-CON LETTD UNTH Taus CrRTWCATE, DIV 0-0 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. GENE AL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. Then the valuation of additions,alterations, or repairs to existing dwelling units exceeds $1000.00,CRC Section R-314 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: AP,-EA SMOKE AIARM CO At l Outside of each separate sleeping area in the immediate vicinity of the X X bedroorn(s) On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide allatms are not required in dwellings which do not contain fuel-burning appliances grid fllat do,not have 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 dwellnireg,units with no commercial power supp'y, alarm(s) i,-ay be solely battery opyeratedl. In exisft dwelln2g,unrts alarms are perm ted to be solely battery operated where repairs or alterations clog not resldt •_ the removal of wall and ceil nig,fnru.s-tes or there,is no access by �,jeans of attic,basement or cratwl`=. space..X'efer�to CRC Sect an 8314 and CSC Sections 9'0'7.2.11.4 and 420..6:2.An electrical perm,it is required for alarms wfaich,must:be connected to the building wiring. As owmer a4the above=reter:eilced propezfy,I hereby certify that tl`n.e alaymo(p))refeireilced above has/leave beeiz; InstaTTe L in:accord=anwce,wlfh the:rtmanuf acturer`s instruefioYis.anid In eo=r-,p.Tkamce with the CalifornYa 134,ldhiAgg, Y anidt Calti�© �a Residen tial Codes,.The alarm,&have beeint tested and are operafional]as,o-i the,date signedt b el'owev.. [I have?rEadt andi actTee fb�coNn{f' wrt�n t ,tarm5_and c.©nd�t ens o�tftfs,atate�rtanf riasire........... ...._.... .................... .. Gbt'%pot Nerve n.. . Smok-eand CO fbrnzado:c rei,ised!03/1811:4', _ WAT 1pF. M NXTURES U ,j OWNERCERTIFICATE OF OMPL# E F1 COMUU, ITYDEVELMMENT DERARTMENT*!BUILD.lNG DQUfStf N �tJ€� 6&i 1�6t 0300 TORR�`E.AVE�tll�-OUPERTINO CA 9501-�aM (4D )777 3228•:FAQ t40 "777-3333 o build ingf�i.c+i, rtinobm Owner Nam A Q 4l ra Permit No -'(3`P 'i t4A-`l Address ✓ S S �}a�5 h r �it�t i tti0 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 forin and sign bottom of form. �11 No Go to Question 2. 2. Does your real propertyhave 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 ficensed 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. 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, 199'4. Civil'Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the forrn and sign bottom of form. ffiR, �4 Yes ley 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 0RE of the following: G MY property is a real property. See Civil Code Section.110-1.4. On amid after January 1,2014,,building alterations or improvements shall require all nom=compliant pha bing fixtures tube replaced with water-coriserving plurnbmg fixtures throughout the building.On or before January 1,2017,all non- compliant pl'urnbitig, fixtures shall: be replaced with water-conserving plumbing fixtures (regardless of whether property undergoes alterations or irnpFfovements). ❑ Myproperty-is a.mulgrami'ly residential realproperty. See Civil Code Section 1101.5. dl.and after Jamivary 1,2014,specified bu71d1ng alteratiorrs or imptos shaYl i6 ire non-compliant plumbing fixtures to'be repFaced withi water coriservii2g plumbing fixtures. On or before January 1,.20`19,all`.non comphantplumbing.fixtures shall be replaced,with water- conserving plu2nbing fixtures throughout the building(regardless of whetherpropwty wi dergoes alterations or improveinents). 0 may property is,a commercial real:property. See Civil Code Section 1101.5. On and after Jawaary l,,29.14,,specified building alterattions or improvements shall requmre non-compliant plumbing fixtures to be replaced with water conserving plumbing fixtures. Ort or bd-we;January- I,. MIR,: al<1 non-compliant pli m-bing fixtures; sha11 be replaced with water= conserving plurrnfi%ng fixtares tkougT out the:building(regardless of whether property undergoes alterations;or improvements)). I,as the owner or'owner"s agent of this property,cerci fly under penalty of perjury that non co-mpliant plum i fig€fixtures wi+IT be i repPaced.priior to d�att,t speci�fred=abave with;water-canserving plumbing fixtures in accordance withY 4Crvi1 Cade Sections.l 101,.l `. through 110'1X,,the current Calrfornia Plurning Code and California Crreen Building Standards:Code,and;manufac,turee's installation requirements,.and;that the.water-conserving plumbing fixtures comply with.the requirements as indicated in,the table on the iollowin E a ;e: Owner 1 .or QW.nmeF pnitsz Sit,nature G_s p t Upon compYetrng and signing this Ceitirhnate,,please return it,to the Building Division irm order=to.fuali your building.permit, SR407 20,15.69c revisen,8/26/1 S