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B-2016-1451CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1451 10631 GLENVIEW AVE CUPERTINO, CA 95014-4514 (369 26 027) ( QUALITY PLUMBING & REPIPE INC) SAN JOSE, CA 95112 OWNER'S NAME: MARVIN GREGORY S SR AND PATRICIA DATE ISSUED:I 03/01/2016 OWNER'S PHONE: PHONE NO: 4084376207 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C6 Lic. #1007379 Contractor ( QUALITY PLUMBING & REPIPE INC ) Date 3/1/2016 X BLDG —ELECT X 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: INTERIOR COPPER REPIPE; REMOVE AND REPLACE WATER I hereby affirm under penalty of perjury one of the following two declarations: HEATER, SAME LOCATION; REPLACE BUILDING WASTE LINES IN i. I have and will maintain a certificate of consent to self -insure for Worker's CRAWLSPACE 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 Sq. Ft Floor Area: Valuation: $6400.00 this permit is issued. 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 36926.027 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 so rce regulations per the Cupertino Municipal 180 DAYS FROM LAS CALLED INSPECTION. Code, Section _9.18. Issued by: PAUL O'SULLIVAN Signatur Date 3/1/2016Date: 3/1/2016 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 n. 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: z. I, as owner of the property, am exclusively contracting with licensed Date:/1/3 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 n. 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. 1 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 5, 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 agent: be deemed revoked. Date: 3/1/2016 APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY 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 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 Professional Signature Date1/3/ 2016 CUPER.TINO GENERAL PERMIT APPLICATION �b °' 4 I N=1 E mr COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 = = Isc (408) 777-3228 • FAX (408) 777-3333 •- buildingQcupertino.org all Iva PROJECT ADDRESS vbq OWNER NAME o PHONE E_ngATI STREET ADDRESS / CITY, STATE. ZIP f / FAX CONTACT NAME - �' PHONEV E -MAI; STREET ADDRESS CITY, STATE, ZIP ❑ owNER ❑. owNER-BuI DER ❑ OwNERAGENT ❑ CONTRACTOR ❑ CONTRACTORAGENTT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NA LI NSE NUMBER LICENSE T E BUS. LIC # COMPANYN?AME r J//r �/- E -MAR STREET ADDRESS CITY, ST ZIP HONE ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LICA COMPANY N?AA4E E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD or DUPLEX ❑ MULTI -FAMILY PROJECT IN WILDLAND ❑ YES BUILDING: ❑ COMMERCIAL URBAN. INTERFACE ANO PROJECT IN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN EICHLER HOME? ❑. YES ❑ NO DESCRIPTION OF WORK f TOTAL VALUATION: RECEIVED B3, By my signature below, I , e ify to each of the following: I am the property owner or authorized agent to act on the property owner's be'alf. I have read flus application and the information I have provided is olrect. I have read the Description of NVork and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buildings struction. I authorize representatives of Cupertino to enter the above-iden ' Ied pr erty for inspection purposes. Signature ofApplicant/Age t: — Date: SUPPLEMENTAL INFORMATION REQUIRED, ,,;..n.. oFz it tlsE anY . _ . A,fEPA,fiscApp_201 ].doe revised 06/21/11 —.. ......-..,,...•el. plii,woo,M li lhaWinqi&Oleo eTiromRIMINIT;0 OWNER CERTIFICATE OF COMPLIANCE A 41141,N. COMMUNITY DEVELOPMENT DEPARTMENT 0 BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE 6 CUPERTINO,CA 95014-3255 (408)777-3228.FAX(408)777-3333.buildinqAcupertino.orq e -41021.- 20[C,,_ (-{,s-1 lwack, IC C ( 6 leAti 0 4ad A v-e c.,r ,,:-";iituaotti:7-.) e. !; - .2.4 .t e: I PERMIT CANNOT DE FINALED AND COMPLETED UNTIL TILLS CERTIFICATE HAS WEN Malra AND,lattann TO'AVE BALDING DIVISJON - - - -. ... ._.. ... ;......,_:_,_. ........____... --— 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: APIA SMOKE ALARM Co ALARM 1 , Outside of each separate sleeping area in the immediate vicinity of the X X I bedroom(s) On every level of a dwelling unit including basements X X Within each sleeping room X J1 Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that i 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 The Marshal ,1 i 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 R31i4 and CET Sections 907.2.11 4 and 4206.2.An electrical permit is rewired for 1 1 Anil-its 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 instalTed in accordame with the manufacturer's instructions and in compliance with the California Binigcliing and California ResiderIga Cedes.The alarms have been tested and are operational, as of the date signed below 11 11.111aue maxi'p tad avea to?cqmpV with Mei rermsi aigli com Sams off thPs statbalerat 1 _ _ f--a*ANZMVive,p,WeAltgamet 1 dr .9 M 44 s . gaam iolor,--- --: --. , emel: i _ ,_ 1 Si9nAture;.... .... La'i We' i[ iI Smoke andie0form dee revised203/P8/1::,P II z - \,,,„,/./ WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE 4",1. ,5`.`` COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-g333• ildinq(a�cupertino.orq / Owner Name est,>1 5 illV /P Permit Nof 1 I 61, (� / c1r1 _ y / �'!`c.�B �d �� �4d �e�" �"`�-� & 9 �'"'G 1 I Address f /6 6 1. Is your real property a registered historical site? D Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. c ❑ 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. I "iJ ❑ No Go to Question 3. it 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. f ) CINo Go to Question 4. c 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 through1101.8 do not apply. the rest of the form and sign bottom Skip of form. ;tet ❑ 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: ❑ My property 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 g 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 1I improvements). 1 ❑ 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. 1 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). 1 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 1 through 1101.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's i li installation requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the 1 table on the following page. Owner or Owner Agent's Signature( ! Date: 7 Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08/26/15