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B-2016-1470CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10598 STERLING BLVD CUPERTINO, CA 95014-3834 (375 23 025) CONTRACTOR: (PAB CONSTRUCTION PERMIT NO: B-2016-1470 INC) CUPERTINO, CA 95014 OWNER'S NAME: ZISHAN ZHANG DATE ISSUED: 03/04/2016 OWNER'S PHONE: 408-725-3692 PHONE No: 408-499-6595 LICENSED CONTRA TOR' DECLARATION BUILDING PERMIT INFO: License Class Lic. # =D ck go 5 � P Contractor ( PAB CONSTRUINCTION INDate1_---03_0_t4_ W 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: RELOCATE FURNACE FROM l ST FLOOR ATTIC TO NEW CLOSET. 1. I have and will maintain a certificate of consent to self -insure for Worker's LINKED TO PERMIT# 15050149. 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: $0.00 APPLICANT CERTIFICATION 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 ordinances and state laws relating to building construction, and hereby 375 23 025 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 granting of this permit. Additionally, the applicant understands and will WITHIN 180 DAYS OF PERMIT ISSUANCE OR comply with all non point source regulations per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION. Code, Section 9.1 Signature _ g Date 3 m C Issued by: 1979 Date: OWNER - I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: 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. 1, 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. 1, 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 &i 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. 1 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 Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the upe 'no Municipal Code, Chapter 9.12 and the Health & Safety Cod , Sec ns 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 authorized� be deemed revoked. �aygent. Date: WV �f APPLICANT CERTIFICATION _r �Q CONSTRU TI N LENDING AGENCY I certify that 1 have read this application and state that the above information is I hereby affirm that there is a co s uction 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 i sued (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 Signature Date Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building d1cupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ALTERATI / TI ❑ REVISION / BldgApp_201 1. doc revised 06121/11 DEFERREL Ul'UUIIVfi1.YtKAU1 # PROJECT ADDRESS� k � d � v "t v APN TM AJ �J n L OWNER NAMEmJ PHONE 4- 1514 � ��°re✓i E-MAIL Y0 li��� � �� -3 STREET ADDRESS f q e V CITY, STATE, ZIP FAX CONTACT NAME PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑.OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT krCONTRACTOR ❑. CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME�' f� `, LICENSE LICENSE TYPE BUS. LIC COMPANY NAME `j EMAIL a, (� � r , t FAX STREET ADDRESS / 2 S �^L'c .� { � Z 1/ CITYSTATE, ZIP , Cu PHONE PHO ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LTC # COMPANY NAME E-11 IL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK (� � VQ k c- (2 V` vk ` AD EXISTING USE PROPOSED USE CONSTR. TYPE n STORIES - - USE TYPE. OCC. SQ,FT. VALUATION (S) ERISTG NEw'FLOOR DEMO TOTAL - -- - - - AREA AREA AREA NET AREA BATHROOM KITCHEN - OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOT.SL DECKIORCH AREA GARAGE AREA: DETACH _ ❑ ATTACH `DWELLING UNITS: IS A SECOND UNIT ❑ YES :SECOND STORY ❑ YES BEING ADDED? ❑ NO ADDITION? []NO PRE -APPLICATION ❑ YES IF '�`ES, PRO\'IDE COPY OF IS THE BLDG AN ❑ YES RECEIVED BY -- �. �. , q.,:. TOTAL VALVA N'. PLANNTNTG APPL t.` ❑ NO PLANTING APPROVAL LETTER EICHLER HOME? ❑. NO By my signature below, I certify to each of the following: I am the property owner or authorized a__'/4y.act on t p perry owner's behalf. I have read this application and the information I have pro"'' ed 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 buildi co t 'an. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: Q11 SUPPLEMENTAL lt)RM&ION REQUIRED y 9� �° PLAI1 LgIECK-TI E_ � OIITII�G SLIP ❑O� New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building ER THE COUNTER ❑ BUILDI\G PLS RE�IE�i' permit new uildin p it fbg ERESS ❑ PLA�ISGPLREiTE�s� - Bldgs: Provide a completed Hazardous Materials Disclosure L 4 STANDARD °4 ❑ usLlc�olils _Commercial fonn If any Hazardous Materials are being used as pall of this project. � ❑� L.�2GE ' � � FII�E DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to � rr � ❑ ��x � = submittal of Building Permit application. I�I��aR> s��ITARi sEi�ER�ISTRIc ���sn.,: r, € _ a , t ,,, : ❑fi: E\i'IRO\R'iEI�TAL S3EALTH' BldgApp_201 1. doc revised 06121/11 CUPERTINO SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingna.cupertino.org PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN COMPLETED, SIGNED. AND RETURNED TO THE BUILDING DIVISION 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 bedroom(s) X X On every level of a dwelling unit including basements X X Within each sleeping room X 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 specified below have been tested and are operational, as of the date signed below. 1 Address: t 011 yj�—y Specify Number of Alarms: # Smoke Alarms: Ku Permit No. 9 ^ l 6 " # Carbon Monoxide D I have read and agree to conwh &b -the termed conditions of this statement Owner ( r Owner Age 's) me: 115 .1 Signature ...................... .... . ...................................................................Date: & ............................... ... Contractor Name: Signature.................................................................. Lic.#...................................... Date: y 7a Smoke and CD form.doc revised 09/27/16 CUPERTINO Owner Name Address r 07 � U WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408) 777-32?8 • FAX (408) 777-3333 • buildingna.cupertino.org _'? v l �__ PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION s Please refer to the attached California Civil Code Sections 1101.1 —1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: Ao 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. Sign below and skip the rest of the form. Owner' Signature: XN 0 Go to Question 3. Date: 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Date: No Go to Question 4. 4. Isour real property built and available for use or occupancy on or before January 1, 1994? o 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. Sign below and skip the rest of the form. Owner' Signature: Date: ❑ Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1. 1 through 1101.8 apply. Refer to the attached. 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, 4o On2017, 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. 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- knservingplumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). My property is a commercial real property. See Civil Code Section 1101.5. n and after January 1, 2014, specified building alterations or improvements shall require non- compliant co plumbing fixtures to be replaced with water -conserving plumbing fixtures. SB407 2014. doc revised 03/18/14 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). I/We, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures have been replaced with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8, the current California Plumbing Code and California Green Building Standar­As�Code, and manufacturer's installation requirements, and that the water -conserving plumbing fixtures comnly with-ffic:Feq> irp'ments as indicated in the table below. Owner's (or Owner Agent's) Signature: f / / Date: / f l Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2014.doc revised 03/18/14 �v/7 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi -Family Commercial Residential Residential Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons/flush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons/flush Gallons/flush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 p s Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2014.doc revised 03/18/14 �v/7