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B-2016-1489 i i CITY OF CUPERTINO BUILDING PERMI'T BUILDING ADDRESS: CONTRACTOR; PERMIT NO:B-2016-1484 21723 CASTLETON ST CUPERTINO,CA 95014-4704(356 18 069) (AAA CONSTRUCTION I SERVICES) f CAMPBELL,CA 95011- 0971 1 OWNER'S NAME; JOSHI RAMAKRISHNAAND NAGARAJA JYOTHSNA DATE ISSUED:03/08/2016 i OWNER'S PHONE:408-930-4730 PHONE NO:408-510-9382 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class.@ Lie.#984062 Contractor(AAA CONSTRUCTION SERVICES)Date 03/08/2016 X BLDG X ELECT _PLUMB _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 license is in full force and effect. JOB DESCRIPTION: UPGRADE PANEL 200 AMP(N)50 AMP CAR CHARGER,(N)LED I hereby affirm under penalty of perjury one of the following two declarations: CAN LIGHTS&ADD 2X8 LVL JOIST BETWEEN EXITING 2 X 6 JOIST 1. 3 have and will maintain a certificate of consent to self-insure for Worker's TO CREATE ATTIC STORAGE. Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ave and will maintain Worker's Compensation Insurance,as provided for by ection 3700 of the Labor Code,for the performance of the work for which S permit is issued. Sq.Ft Floor Area: Valuation:$5000.00 APPLICANT CERTIFICATION 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 18 069 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 source regulations per the Cupertino Municipal 180 DAYS FROM:LAST CALLED INSPECTION.. Code,Section 9.18. Issued by:ABBY AYENDE Signature Date 03/08/2016 Date:03/08/2016 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 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(Sce.7044,Business&Professions Code) Signature of Applicant: 2. I,as owner of the property,am exclusively contracting with licensed Date:03/08/2016 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 t. 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 a. 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 ofCalifornia. If,after making this certificate of the Health&Safety Code, a tions 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 agent be deemed revoked, Date:03/08/2018 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 consequence of the granting of this permit. Additionally,the applicant ARCHITECT'S DECLARATION 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 Date 03/08/2016 i CONSTRUCTION PERMIT APPLICATION I COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING IDIVIS16N 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 C #PERT[ND (408) 777-3228• FAX(408) 77-3333 •building(U�cupertino.Orq P, ❑NEW CONSTRUCTION El ADDITION ALTERATION/Ti ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS /72,3 APN# � Q c� A OWNERNAME � f �® �y®® IE-MAIL STREET ADDRESS CITY STATE,ZIP . /1 FAX Z11LaZS �J ✓ J C yy �/ CONTACT NAME PHO IE-MAIL STREET ADDRESS CITY,STATE, ZIP FAX ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER � ❑ TENANT CON TO NAME LICEN LICENSE TYPE BUS. IC# ��V '00 CON EMAIL FAX PMS/��/(� 4? �3(id� TY,STAT >ZIP 1 S0^ 2 ARCHITECT/ENGLNEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DE CRIPTION OF 0 EXISTING USE PROPOSED USE CONSTR.TYPE STORIES USE TYPE OCC. SQ.FT. VALUATION(S) EXISTG NENV FLOOR DEMO TOTAL AREA AREA AREA NET AREA t BATHROOM - KITCHEN - OTHER - REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: [ DETACH ❑ATTACH DWELLING UNITS; IS A SECOND UNIT ❑YES SECOND STORY n YES BEING ADDED? []NO ADDITION? ❑NO PRE-APPLICATION' F1 YES IF YES;PROVIDE COPY OF IS THE BLDG AN ❑;YES CEIV.ED BY z °"4 ,i z r: TOTAL VALUATIO. PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HONTE? ❑.NO sew= .� a ,v'r -�+� �; By my signature below,I certify to each of the following: I am the property owner or authorized agent lo act on the property owner'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 relating to building construction. I authorize representatives of Cupertino to enter the above'-identified property for inspection purposes. Signature of Applicant/herr Date: SUPPLEMENTAL INFORMATION REQUIRED Q L SIN CHECK'I I P,E -ROUTIi\ SLTP,-�� . Mew SFD or Multifamily dwellings: Apply for demolition permit for s O�ER THE COU\TER VLD \existing building(s). Demolition permit is required prior to issuance of building espermitfor new building. L7 Ears �^ri�GPL 6' X _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure sTANnARD PUBLIc�c©Alas form if any Hazardous Materials' are being used as part of this project. < L LARGE FIREI)IE u Copy of Planning Approval Letter or Meeting with Planning prior to LD MAJOR ❑ SA\ITAIti SEZiERDISTRICT submittal of Building Permit application. k w D_ -NI tENTALHEALTFIr Bldo4pp_2011.docrevised 06121/11 i ZOD �r�o G''� �v7i�i �0iMkl!-!N1 Y ELOPt.,JEN r ; f A R T M E N T B`JILDIN ';VISION - cL`-,ERTINo uUPERTINO AP $V ?✓1 ,_ �! �1 °� _ ^4 ,aartment his set of plans a , spe i cb site during :rstr Act o . It is un e a i r r t MAR, 016 cnanges or alta atio on sant ox' .vi , /r ihErefrJrll, LV!in.^,u:appr I frCfTl (t 2 bu!!ding U' a! // /�p ' _ �" �`�Vi LYS:`�, nO The Stamping c finis ala d speciel `c tions S L i I �� COMPLI� be held io pern,,t or to an appro e V' ! n GA,'', reviewed By: n �,ny r,ro Vin; of an ini �(JUlob /J y,s9 43 c Z W f� S `�T 20' c, M< zw RI O 2`x8" zvZ ,?, /mss 2 C?v L.vL J-2a-/ pox ,�iy���d �3� ,itrd/ �/8•/ ��yu/c�.Oy��'j".�s�'� tis Zx6 ��des �� P�'`� I OWNER GE"FICATE OF COMPLIANCE COMMUNITY 1DEVELOPMENT'DEPARTMENTBUILDING DIVISION 10300 TORRE AVENUE m CUPERTINO,CA 95014-3255 (408)777-3228 o FAX(40.8)777-3333•Ibuilding(okupertino.org ♦.e: 2 P>>a',)E2MIT C KNOT HIF,VINtr IAELID A_ND'COMPLIF'I`EI)UNTIL THIS X VWCpa"IFICAT y 1, 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.. GM,EFAL IiNFORMATION 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 $1000.000, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: A1Zl$A SA40KE AT,AARM' CO'A>I.ARVA Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements X X Within each slee;in, 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,alarms)may be solely battery operatedl. In existing,dwelling units;alarms are permitted to be solely baftery operated where repairs or alterations,do= not restflt inthe removal of wall and ceiling.firuslaes or there is no accesa by means of attic,basernent or cmwl', space.Refer to CRC Section 8314 and CBC Sections 907.2.11.4 and 420=..6.2.An electrical'permit is.required for alarins whkc,h mast:be co elected to fhe buitdh'1g wiring. As owner, of'the above=refereiaced propezfy,I hereby cerci{fy that tl'h.e above hasjh-ave been, installied inaccor-.d=armee°with the f pan{��acturer's ins-tir s lction&ant l irL co i?phainace with the CaNiforns a3 B,)%rldhjjg am)d Cairkifle•mita Reslenhab Codes.The alllarms have beef%festedindt atre olperaffbnall as,od the-,diate signed bel'owF. !!haver read amd a ee fog carni :l'�witfir hp tteam&and!condt#lbnis,ofi thin st�fiement' ............. ... D 3t s �P�CdIQ;S i SI ,Rat�re_, ...Lac'; ... ........ Dat J i� Smoke and COf6r ndoc reuised 03/1'8/1'4:; ELM OWNER C 'RTITE OF COMPLIANCE COMMUNIT'yY D:E1ELlJ E.NT.�,,f?ART& NT*;BU-fLIDI G GIVIsION UPERT'INO "030! TO,R-RE-"EFPlUE'CURERTWO,CA r95-014:3255 8 777-3228 FAX,41R 777-333 oliuildi ertlrio.o Owner Nam tOl }mit N /3 "/ Address r7a3 .. a 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 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 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,er,s cei tification has been provided to the Building Division. Skip the rest of the-form and sign bottom ofform. Go to Question 3. 3. Is water service permanently disconnected for your bitilding2 ❑ Yes Civil Cade Sections 1101.1 through 1101.8 do trot apply. Skip the rest of the form and sign bottom of form. o 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 foam. Yes My real property is built and available for use or occupancy on or before January 1,19.94. Civil Code Sections 1101..1-through 1101..8 apply. Check one of the three following statements and sign bo torn.of form.. 5. Plea check M of the following: Tv> property is asrrrgie amal}�resideri'tiad real pr.'operty. See Civil Code Section 11014. On and after January 1, 2614,building alterations or irnprovements shall require all noii=compliant pljjmbin futures tube replaced`with water-conserving plurnbing fixtures throughout the buil,_+mg.4n-or before January 1,2017,all non— compliant plumbing fixtures shall be replaced with water-conserving phimbin,g fixtures (regardless of whether property unde7gaes alteraifions or improvverents),, My propertyis.a�nath�miiy .resident'i'al real propetty. See Civil Code Secti©r,1 p0-11.5. On and after Jannary 1,2014,specified building alterations or in pt-ovetnents shal-T require non-compliant plumb i n g,fixtures to be replaced with water conserving plumbing,fixtures. On,or before January 1, 2019,,all nou complian�tplumbing fxtures shall be replaced with,water- cc aservigg ater-ccaservimng pluinbinig fixtures throughout the building(regardless of whethi-u*rproperty-ondergoes alterations or improvements). ❑� My prop:=zt, is a,comm,erciaF real:property. See,Citvil Cede Section 1101 5. On and,after January 1,2614„specif ed building alterations or improvements shall require"non compliant plumbing fixtures to be replaced with,water-conserving piluinbing fixtures. On m before;T nttaryE L,; 2019,, all non-compliant plumbing, fixtures,, shall be replaced with water- c©nservin;g: pluinbiii'g fixtares throughout tht,buil6ing(regarrdl!ess of whether property undergoes alterations or iinpro vernents). I,as fihe owner or,owner"s;agent,of this property,,certify under penalty,of perjury that non co-mplliant plumbing fixtures willbe replaced!prior:to date speciFf ed'.aba�ve.with water-conserving plumbing fxtnrcs in accordance wrath:Civil Code Sections 110''+1.1 } through 114011.:x„the current C'ahfom+ia Plauinbing Code and California Green�Bunlding Standards Code,.and manufacturer's installations requ r,ernents„and that the:water-copse ng plumbing fixtures comply with the:requirements as indicated in the table on t ec followin a-aa Ou�mer©n OW.ne-rAgp'atTsSS,gnature< i Dat ,` Upson com- pi'effiig.,and signing this,Cei:tifFca ,p` se return it to.the Bulling Division.int order to finalt your"buil`di+ng permit. ' SB407 2011 digs revised 0$/26/1}S