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16010032 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: 16010032 10380 SCENIC BLVD CUPERTINO CA 95014(357 08 005) SILVA CUSTOM CONSTRUCTION INC 785 SAN SEBASTIAN PL MORGAN HILL CA 95037 OWNER'S NAME: TOM TARSHIS DATE ISSUED:01/06/2016 OWNER'S PHONE:408-497-2249 PHONE NO:408-314-2212 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic.'# Contractor SILVA CUSTOM CONSTRUCTION INC Date 2/2/2016 _BLDG —ELECT —PLUMB MECH RESIDENTIAL COMMERCIAL I hereby affirm that fam licensed under the provisions of Chapter 9(commencing — with Section 7000)of Division 3 of the Business&Professions Code and that my licedse is in full force and effect. JOB DESCRIPTION: REMOVE SPIRAL STAIRCASE AND CONSTRUCT NEW STAIRWAY I hereby affirm under penalty of perjury one of the following two declarations: IN SAME LOCATION(80 SQ FT);REMOVE AND REPLACE t. I have-and will maintain a certificate of consent to self-insure for Worker's (2)DOORS;REDUCE SIZE OF PANTRY AND INSTALL NEW Compensation,as provided for by Section 3700 of the Labor Code,for the STRUCTURAL BEAM. performance of the work for which this permit is issued. a I have and will maintain Worker's Compensation Insurance,as provided for REVISION#1-HOLD DOWN AND BEAM STRUCTURAL CHANGES- by Section 3700 of the Labor Code,for the performance of the work for which ISSUED 2/2/2016 this permit is issued. Sq.Ft Floor Area: Valuation:$25000.00 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 357 08 005 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 Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Issued by: S' t Signature Date 212/2016 �v""(�� Date:2/2/2 16 OWER-B[LILDER DECLARATION RF.-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: i. I,as owner of the property,am exclusively contracting with licensed Date:2/2/2016 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 i. 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 Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: Date:2/2/2016 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 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 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 14380 SCENIC BLVD CONTRACTOR:SILVA CUSTOM PERMIT NO: 16010032 CONSTRUCTION INC OWNER'S NAME: TOM TARSHIS 785 SAN SEBASTIAN PL DATE ISSUED:01/06/2016 OWNER'S PHONE: 4084972249 MORGAN HILL,CA 95037 PHONE NO:(408)314-2212 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION:RESIDENTIAL F COMMERCIAL _ REMOVE SPIRAL STAIRCASE AND CONSTRUCT NEW License Class ` j Lie.#__ '7i2-q:13(= STAIRWAY IN SAME LOCATION(80 SQ FT);REMOVE AND REPLACE Contractor StLa)w C_cr i��sr-Date i�fa !d© (2)DOORS;REDUCE SIZE OF PANTRY AND INSTALL NEW 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. I hereby affirm under penalty of perjury one of the following two declarations: 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 erformance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$25000 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 APN Number:35708005,00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct.I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save 180 DAYS FROM LAST CALLED INSPECTION. indemnify and keep harmless the City of Cupertino against liabilities,judgments, �j r costs,and expenses which may accrue against said City in consequence of the Issued b / =� Date granting of this permit. Additionally,the applicant understands and will comply y: a with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. RE-ROOFS: Signature Date )- b 1 All roofs shall be inspected prior to any roofing material being installed.If a roof is installed without first obtaining an inspection,I agree to remove all new materials for inspection. ❑ OWNER-BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOFCOVERINGS TO BE CLASS"A"OR BETTER 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 for sale(Sec.7044, Business&Professions Code) I,as owner of the property,am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project(Sec.7044,Business&Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health&Safety Code,Sections 25505,25533,and 25534. 1 will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the declarations: Health&Safety Code,Section 25532(a)should I store or handle hazardous I have and will maintain a Certificate of Consent to self-insure for Worker's material. Additionally,should I use equipment or devices which emit hazardous Compensation,as provided for by Section 3700 of the Labor Code,for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and I have and will maintain Worker's Compensation Insurance,as provided for by the Health&Safety Code,Sections 25505,25533,and 25534. Section 3700 of the Labor Code,for the performance of the work for which thismer or authorized agent: — Date: permit is issued. I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Worker's CONSTRUCTION LENDING AGENCY Compensation laws of California. If,after making this certificate of exemption,I become subject to the Worker's Compensation provisions of the Labor Code,I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued(Sec.3097,Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 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 ARCHITECT'S DECLARATION indemnify and keep harmless the City of Cupertino against liabilities,judgments, costs,and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit.Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section Licensed Professional 9.18. Signature Date CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING 1 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 CUPERTIRIO p�ee (408)777-3228• FAX(408)777-3333• building(cDcupertino044 • ❑NEW CONSTRUCTION ❑ ADDITION M ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS APN# 7.��v z> ops• co 15- OWNER OWNER NAME PHONE E-MAIL t4os •yah- •Zz't1 'TCitsµ CW1A*,%.CoM STREET ADDRESS CITY, STATE,ZIP FAX lo3ao �Sc•,­W1'3. W D. C%A NiD CA- CONTACT NAME PHO E-MAIL '�cN n.1 S i L.v Its �� — �1�{-2 212 $Cu T�F� STREET ADDRESS CITY,STATE, ZIP _+1B19 S4,. Stba �.�. 1 /��. a,. li�� C'tA �i'S °b^ 93- Z ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BIDS.LIC# S C�rnl,t.� G��sf. ` ?_Ct�3 fo '1 (19 3L COMP NY NAME E-MAIL FAX Sy! .Y Z eAN S i 1. S 1 .nn STREET ADDRESS CITY,STATE,ZIP PHONE ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# �.s a✓ C Ll (.-1 (0 4 5-(0 COMPANY NAME V CE-MAIL FAX CovL5.y1A; V-CC?, C-,, L(c)9'. T7_9 •815 STREET ADDRESS CITY,STATE,ZIP PHONE P--e- say. �,;� Gtk 9SII g018- 2Zq. 1 DESCRIPTION OF WORK (71 -s lUnr _ C k AA( 6 ;Al S7n c2Cv(Lt vt4rC_ L E-XISTING 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 REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: LJ 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 AN ❑YES `VED BY, TOTAL V DATION: N PLANING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO •' By my signature below,I certify to each of the following: I am the property owner or authoriz d agent to act on the property owner's behalf. I Ave 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 co s ruction. I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: Z SUPPLEMENTAL INFO ATIO REQUIRED PLAN Cilhek-TY PE,,• ,' r, ROUTING SLIP, _ New SFD or Multifamily dwellings: Apply for demolition permit for VER THE COUNTER UILDI\G PLS REVIEW existing building(s). Demolition permit is required prior to issuance Of building permit for new building. 6❑ EaTRESS f ❑6;PLA\NINGPLAnREVIEW•iJ _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑',STANDARD',, ❑`PUBLIc a roRLs 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 a` ❑ M JOR ❑ SANITARY SE\ ER DISTRICT submittal of Building Permit application. a ❑'E\VIROVMENTAL HEALTH BIdgApp_2011.doc revised 06/21/11 CONSTRUCTION PERMIT APPLICATION `j cammiium i i DEVEL"0P%1iENT GEPARTiJiENT BUiCDING DIVISION _,. 1030D T ORRE AVENUE• CUPERTINO,CA 95014-3255 r (408)777-3228•FAX('D8)777-3333-buildina(c—v. ,jDetno.ora CUPERTINO• 1- 0-1<-tW COT"STRUC11014 u ADDY-110N =Li���TiO?T/TI El RETISIONIDErE3R D G?1Gi?�Qt a Zt FROWrADDpass 0 I A3N��5 7 , !�6) C ./ 1 'G/ �� s ►s _ �4 _Z2 �jfert ST?.ETADD?.ESS Cr?Y,STATL,Z3 -r+ {� xNZ � Yi�r I P�tZT� D i I r. ACT NA'✓_' 7110 3�.tj5�1,j Si t_CONT STR=,AJD_T=SS C:?Y,STAT---, Z3 r k y r� Sci3�s r ra Ku 1i6y,,o 2_Lj OWNER D. O 1 _?-3 u'T D=it ❑ o-m,_ Aca T CO v {COR ID Co\-.?.6CTOIt F.GTr1 I� ,-,,c .TCT EruG?�sR ❑ D1SLOPzK ❑ 1 E k t COlvi?AC70RNA N 14 C ?L.VA2 LIC'l S�h'tJ1J�' L L1CT 'Y:3 I nUS.LC �4 53 C01✓°FhYNAJ r-NAL FAX �-(o£i-'-1"l 3• �2--Lf�-� STRZET A.DDRBISS aml,STATc,ZIP 5 Atj �1 t!ZAN �L- tZ.C.(r1 l••-d:l-`. f c1 �,3 ! ��+% - 3'?j A3.0 tr CTrlv�3�'cF�NA�✓:3 - LICn\� l � ER BUS.LiCn Cc�ry S`t L 67/�'(ra , /lS r'a ' G Ll(O?sc, I 4 G?5(0 CiftfEsgi,t44�- I rce. Q©I. Gesint J =1Qg,• STREET ADD? s. Cit,srATL,zI? ?rior DBSC??TIONOr WOPK ` `�F•f�i-��c,��> Sl'tjL� � �'�+:d�5 a�.�/ S�'-x�r2.t.•ve�c.h•- rmaTDdG US I ?RO?OSHD US cms R I •c-Or S -t `� t�" �P, ..00C.. L-r, I � I I SQ.r� V=.LU.=TiO't;Sj i =1 TG Ta,V FLOOR DE".:0 TOTAL � t.REA I A-PaA I ASA I ?\.i AR=A I I I 3A711MOOA•1 I u.-.c-.m4 I Oir R RM.WD:.L AR-A m-mOD=L AREA RaMODEL c IB.{ - PGRC'rIA_R A DECKAR=A TOT:�LDBcX1'?D?C_1ARBAI GA-,',AC-Z,IICEA. Q 7:tACi I n15TH D"ou:`TtS: 15ASECONDUNIT ❑YT_S I SECOADSTORY ❑1=.S ( I BEING ADDED? .D1N0 ADDITION? NO P?,= U?T.CATiON ❑YES �yz—s, ailECOPYOF ( IST?IEBLDGA.N ❑4a. �",LC_j ' 3ti� `` - �� -,()TAT.\SiU PLA_M,NvA.??Lm MNO ETC=RHOMZ? jga0 s .•�' '8" - C',�/('�7^' y°� $y r.y sigortu`e below,I c .:iy to each of the fclio"in_: I zn theproperty owner or author zed age, to act on th grope Dq•^er'S be lcl I haS ead his app!.cation and the information I have provided is co,-ect. I have read the Descr ip.ion of WoTk end Verify it is accu-ate. I area to-comply -'ath all ami ic_ble local Or CinanC-S and sta e l'd�S I:.Ic�r:�•%O building constrt.ction• I aLtllor in rep:esentatlPES'Of Cr:pertl±Io t0 enter t'~•e€bene-ide,tl=led prOpery r0I L'1SpeCtlOn?LrpCSeS. Si_nat e of Appliunt/A e t: Tete: SUPPLEAf-ENTAL D> OR LAA TIO?\RET T D - v Q - �:c-�`U�_'L'_._'�C~�CTK�1�?E•� '���� .��O_L�L1G .>�°��.��__t MEA is--t 1 nji-tc demolition —ti t r "� -t••. - .� -� .7. .`` New-SM Oe �=- t L._1_y d�� pr+ly Oa Ol, Orl t7 _t_O_. "1=t�COL�tTFR �� � fiLT?S�'DL�GPT - tXlst nig boIld-+c(s). Demolition per�I:is r:.Ott-:..d prior to.SSU SCO OI h-uilldi-Q Ipannit for new bail_ding, pL �h GE tF h1E< 1 c Provide 1 7 14 D-sclos _Co r___e c Bldgs: a co D et dLz.eo Materials zls L 3 Tor'1 L anyHaz—LOLs��G.�.i"LI� are being us,,?as part e his project. 1=� �" EN r �. `«ti 11 ^PTS Copy 0=Plzns,na AL)woval Letter or Mlect-._„ru r- l_�xioI t0 T�i�OR �� kATL 11�L IGdRIG�a a SLtb ual OT-Be11din1penmitaT)T)Bcatlon. -;= - .. >.f.-�t �._- BIo'.X pp._2011.do revised 46/21/11 CITY OF CUPERTINO FEE ESTIMATOR- BUILDING DIVISION ADDRESS: 10380 Scenic Blvd DATE: 01106/2016 REVIEWED BY: Sean APN: BP#: "VALUATION: 1$25,000 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex PENTAMATION 1GENRES USE: PERMIT TYPE: WORK Removespiral staircase and construct new stairway in same location 80 sq ft); Remove and replace SCOPE (2) doors; Reduce size of pantry and install new structural beam. ,1 fech. '1";n(,'heck i'r%L'i?L'. he`'ii!Ch,c.rt zhoc.Pla,"t Ch c.'i il'ke,fi.PG'rnv Foe: J;7cc'1 ePiil I` C'Y?..1, El SP 011WI,r(;tP,?:It::°S�: 0,,heY 111e rl;},j). it'i.`.P 1'Ei. flq..!. F-6' l:i c'!I. Ji1.`ij). V : NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District, etc.). TheseLees are based on the preliminar information available and are only an estimate. Contact the Det for addn'1 info. FEE ITEMS (Fee Resoh?tion 11-053.E{f'. 7/U13� FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes Q No $0.00 hours Plan Check,Hourly Suppl. PC Fee: ) Reg. 0 OT 0.0 1 hrs $0.00 $143.00 ISTPLNCK PME Plan Check: $0.00 = # Window/Sliding Glass Door Permit Fee: Hourly Only? Q Yes ) No $0.00 $431.00 1 WINREP Replacement Suppl. Insp. Feer Reg. Q OT0 0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 stlfiZdi?d,.Sld'/tldt't'. 'c?C'.." 0 Work Without Permit? 0 Yes 0 No $0.00 0 Advanced Planning Fee: $0.00 hours Inspections 7""'evve/ Do;umc tfeition F-es: - $429.00ISTINSP Inspection,Hourly 0 Strong Motion Fee: IBSEISMICR $3.25 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SUBTOTALSr , $4.25 $1003.00 - -TOTAL FEE: . $1,007.25 Revised: 10101/2015 SMOKE i CARBON MONOXIDE ALARMS OWNER CER,rIFICATE OF COMPLIIANCE FIL No .Alz COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION �-►\_t �����.�.��� OM &a 10300TORRE AVENUE•CUPERTINO,CA 95014-3255 �f (408)777-3228 o FAX(408) 777-3333 o building(a.cupertino.org J fo032 PFRNIIT CANNOT BE FINALED ANN) COMPLETED UNITI,THIS CERTIFICATE 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 X X bedroom(s) 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 manufacturers instructions and in compliance with the California Building and Cahfonnia Residential Codes.The alarms have been tested and are operational, as of the date signed below. 6 have read and agree to comply with the terms and conditions of this statement erRge€� s}: a $i Wafat . .......... .................................................... 'Coni�acfor�Name; Sr_., C,,kv-- Sig .;c � o-{a e Smoke and CO forni.doe revdsed!03/18/141 WATER-CONSERVING PLUMBING FIXTURES "4k- OWNER "+CERTIFICATE OF COMPLIANCE �f COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 950143255 _ (408)777-3228•FAX(408)777-3333•buildincj(d-cupertino.org Owner Name c�-Ta rs1�,� Permit N o- 1, l 003 2 Address J! 1` `a Q w. ��^'� C C,✓a:L_A,-�_0 .o 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 110 1.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 'Z 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. K 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. ,KNo 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. 171 ©,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: tj R' 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 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 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 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 improvements). 1,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 through 1101.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements,and that the water-conserving plumbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Si naturef -y fi � 3-I�-I( � 9 ent9 - Dat :3 � Upon completing and signing this Certificate,please return it tXthe Building Division in order to final your building permit. SB407 2015.doc revised 08126/15 CITY OF CUPERTINO FEE ESTIMATOR—BUILDING DIVISION ADDRESS: 10380 Scenic Blvd DATE: 01106/2016 REVIEWED BY: Sean APN: BP#:-T- "VALUATION: 1$25,000 '°PERMIT TYPE: Building Permit PLAN CHECK TYPE: Alteration I Repair PRIMARY PENT MATION USE: SFD or Duplex PERMIT TYPE: 1 GENRES WORK Removespiral staircase and construct new stairway in same location 80 s ft ; Remove and replace SCOPE (2) doors; Reduce size of pantry and install new structural beam. 1"o, .{t.... :t`xE 15".1"i?"d is 1'G'f.': ji"w'%?It.'. :}.'.,t.: // { .,s.... eLi NOTE: This estimate does not include fees due to other Departments(i.e.Planning,Public Works,Fire,Sanitary Sewer District,School District,etc. . These ees are based on the preliminar information available and are only an estimate. Contact the De t or addn'l info. FEE ITEMS (Fee Resolution 11-053 E f 711113) FEE QTY/FEE I MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes No $0.00 [,__I__j hours Plan Chec ,Hourly Suppl. PC Fee: Reg. 0 OT 0.0 1 hrs $0.00 $143.00 1STPLNCx PME Plan Check: $0.00E-2--j # Window/ tiding Glass Door Permit Fee: Hourly Only? Yes Q No $0.00 $431.00 1 WINREP Replacement Suppl. Insp.Feer Reg. 0 OT 00 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 -41(Imir)isIra'!iI� 1'ee 0 Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 3 hours inspections $429.00 ISTINSP nspection,Hourlyi Strong Motion Fee: IBSEISMICR $3.25 Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 SI7BTOTALS;' $4.25 $1,003.00 OTAL FEE; $1,0n7 95 Revised: 10/01/2015