Loading...
15090114CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10461 SCENIC BLVD CONTRACTOR: SOLARCITY PERMIT NO: 15090114 OWNER'S NAME: GRINELS SAMUEL C AND FRANCES .3055 CLEARVIEW WAY DATE ISSUED: 09/17/2015 O NER'S PHONE: 4084462804 SAN MATEO, CA 94402 PHONE NO: (650) 638-1028 LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALL (N) ROOFTOP MOUNTED SOLAR - 31 PANELS Mp CI License Class �. l0� Cry c� Lic. # C �/ 1 (8.06 KW) AND UPGRADE (E) PANEL TO (N) 200 AMP PANEL / Contractor ic'ec-in Date / S-5/ 15 I hereby affirm that I arrt liccnA under the provisions of Chapter 9 REV # 1 - ADD 1 ADDITIONAL PANEL (32 TOTAL / 8.06KW TO 8.32) - ISSUED (commencing with Section 7000) of Division 3 of the Business & Professions 9/25/15 Code and that my license is in full force and effect. Sq. Ft Floor Area: Valuation: $17500 I hereby affirm under penalty of perjury one of the following two declarations: r. 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 APN Number: 35704034.00 Occupancy Type: performance of the work for which this permit is issued. 2. 1 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 EXPIRES IF WORK IS NOT STARTED permit is issued. WITHIN 180 DAYS OF RMIT ISSUANCE OR APPLICANT CERTIFICATION 1 DA CALLED INSPECTION. I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state laws rel to building construction, and hereby authorize representatives of this city to enter Date: Z.s upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the ity of Cupertino against liabilities, judgments, gainst said City in consequence of the costs, and expenses which may c7YeCupertino granting of this permit. Addit' a] y,a applicant understands and will comply with RE -ROOFS: all non -point source regula Municipal Code, Section 9.18. All roofs shall be inspected prior to any roofing material being installed. if a roof is Signature Date 1 installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: ❑ OWNED -BUILDER DECLARATION ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER I hereby affirm that I ant exempt from the Contractor's License Law for one of the following two reasons: t. 1, as owner of the property, or my employees with wages as their sole HAZARDOUS MATERIALS DISCLOSURE compensation, will do the work, and the structure is not intended or offered for I have read the hazardous materials requirements under Chapter 6.95 of the sale (Sec.7044, Business & Professions Code) California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain 2. 1, as owner of the property, am exclusively contracting with licensed contractors to compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & construct the project (Sec.7044, Business & Professions Code). Safety Code, Section 25532(x) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air I hereby affirm under penalty of perjury one of the following three declarations: contaminants as defined by the Bay Area Air Quality Management District I will t. l have and will maintain a Certificate of Consent to self -insure for Worker's maintain compliance w'th th Cupertino Municipal Code, Chapter 9.12 and the Compensation, as prov�ded for by Section 3700 of the Labor Code, for the Health & Safety Co ec ns 25505, 25533, and 25534. performance of the work for which this permit is issued. 2. l have and will maintain Worker's Compensation insurance, as provided for by a Owner or � en Date: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. s. I certify that in the performance of the work for which this permit is issued, l shall CONSTRUCTION LENDING AGENCY not employ any person in any manner so as to become subject to the Worker's l hereby affirm that there is a construction lending agency for the performance of work's Compensation laws of California. If, after making this certificate of exemption, I for which this permit is issued (Sec. 3097, Civ C.) become subject to the Worker's Compensation provisions of the Labor Code, l Lender's Name must forthwith comply with such provisions or this permit shall be deemed revoked. Lender's Address ARCHITECT'S DECLARATION APPLICANT CERTIFICATION I certify that 1 have read this application and state that the above information is I understand my plans shall be used as public records. correct. 1 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 Licensed Professional 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 expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION [))'iE PA1','.� j',, EE 1 L U;i_D1Nl ty /°��9 �IL�%)'- Si [n i. Y^Sv Ir-' C.I.I ERT 31 _.� �.'.S� '�� �� i JJ9li�lia G1 9E1'r , D 150oljy PROJECT ADDRESS 10 I ; C �A I c g I VA, .APN # OWNERNAME � M %� r ] �Q,PHONE L}- L, E-MAIL y o ' STREET ADDRESS�C� 1 CICT STATE , ZIP } ^ L FAX CONTACT NAME Marjan Javanmard PHO"E650.477.6430 E_MA`�mjavanmard@solarcity.com STREETADDus5391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR A CONTRACIOP, AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME SolarCity Corporation LICENSENUMBER888104 LICENSE TYPE C10 BUS LIC928840 COMPANY N111 SolarCity Corporation E-MAIL rrijaVVvVVarimard@solarcity.com I ST RE ET ADDRESS 391 Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 P"'650.477.6430 ARCHTTECT/ENGtNEER NAME LICENSE NUMBER BUS. LIC # COMPANY NANIE E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD Or Duplex ❑ Multi -Family STRUC URE ❑ Commercial PROJECT N WILDL.AND URBAN INTERFACE AREA ❑ Yes ❑ No PROJECT N FLOOD ZONE ❑ Yes ❑ No SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: �� KILOWATTS (COMMERCIAL ONLY), 3 TOTAL VALUATION DESCRIPTION OF', W ORK � h t o -thy n.�►•� b`� �,� z1 S �' o , � `31 k e} k LJ Li ' , i (' i trt � � � k a L "1 By my signature below, I certify to each of the following: I am the propeveer or authorized agent to act on the pro ehalf. I read this application and the information I have provided is correct. I hav cad the D cription of Work and verify it is accurat =' rth all applicable local ordinances and State laws relating to building construction. I t ize re„pr6sentatives of Cupertino to enter the above-identi Ted propertv for inspection purposes. Signature of Applicant/Agent: Date: SUPPLENTENT L INFORMATI •REQUIRED OFFICE USE ONLY ❑ OVER-THE-COUNTER ❑ E\PRESS U ❑ STANDARD U C ❑ LARGE LMAJOR PVApp_2011. doc revised 03/16/11 CITY OF CUPERTINO Fm -7, FEE ESTIMATOR - BUILDING DIVISION 1AADDRESS: 10461 SCENIC BLVD DATE: 09/25/2015 REVIEWED BY: MELISSA MISC ITEMS APN: 357 04 034 BP#: 15090114 "VALUATION: Iso PERMIT TYPE: Building PermitPLAN CHECK TYPE: Alteration / Repair PRIMARY SFD or Duplex USE: 0.0 PENTAMATION 1GENRES PERMIT TYPE: WORK REV # 1 - ADD 1 ADDITIONAL PANEL 32 TOTAL / 8.06KW TO 8.32 - ISSUED 9/25/15 SCOPE NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 a.7/1/] 3) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes E) No $0.00 V Ll Li 0.0 hrs $0.00 NOTE. This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 a.7/1/] 3) FEE QTY/FEE MISC ITEMS Plan Check Fee: Hourly Only? Q Yes E) No $0.00 1 hours Plan Check, Hourly $143.00 ISTPLNCK Suppl. PC Fee: 0 Reg. Cl OT 0.0 hrs $0.00 PME Plan Check: $0.00 Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 f' Work Without Permit? 0 Yes (F) No $0.00 Advanced Pl'gnning Fee: $0.00 Select a Non -Residential Building or Structure A 77 J7^L�iCt i��,•,'�lda�r r ±c',rtf{ i' 1`c''g. Strong Motion Fee: $0.00 Select an Administrative Item Bldg Stds Commission Fee: $0.00 SUBTOTALS: $0.00 $143.00 TOTA » E $143.00 Revised: 07/02/2015 ' CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10461 SCENIC BLVD I CONTRACTOR: SOLARCITY PERMIT NO: 15090114 1 OWNER'S NAME: GRINELS SAMUEL C AND FRANCES 13055 CLEARVIEW WAY I DATE ISSUED: 09/17/2015 ER'S PHONE: 4084462804 D LICENSED CONTRACTOR'S DECLARATION License Class C (OsC.)_0 Lic. # yl t 1) I Contractor E& lckIr C 1 � Date 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. 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 performance of the work for which this permit is issued. 2 1 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. 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 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 harmless theqty of Cupertino against liabilities, judgments, costs, and expenses which may.4 e a Inst said City in consequence of the granting of this permit. Ajdditip Ily, th applicant understands and will comply with all non -point source regulattio gr Cupertino Municipal Code, Section 9j5 .18. Date /1 Signature ,�'� ��"--- ❑ OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 1, 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) 2 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: 1. 1 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 performance of the work for which this permit is issued. 2. 1 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. 3. 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 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 forthwith comply with such provisions or this permit shall be deemed revoked. APPLICANT CERTIFICATION I certify that l 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 indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date SAN MATEO, CA 94402 1 PHONE NO: (650) 638-1028 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ INSTALL (N) ROOFTOP MOUNTED SOLAR - 31 PANELS (5.06 KW) AND UPGRADE (E) PANEL TO (N) 200 AMP PANEL Sq. Ft Floor Area: I Valuation: $17500 APN Number: 35704034.00 1 Occupancy Type: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS lFROM dLAST �C�ALLED INSPE TI N. Issued by: l.�L®I/l�al/�leV Date: RE -ROOFS: 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. Signature of Applicant: Date: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain complia ewitblhe Cupertino Municipal Code, Chapter 9.12 and the Health & Safety de, Se tions 25505, 25533, and 25534. Owner or aut ri2�ed'a t: q % Date: I / l 5 t CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Ad ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional ALTERNATIVE ENERGY PERMIT APPLICATION DEPAR t TNI • 6�! {J Sl . �RTl;r_? L ,a-,;- build CUPEWrINO — I _ oq,0,3Ll PROJECT ADDRESS % n r APN � .{!.._�.i IC��%� ��Cc rl tC. C�1U� • JJ_I OWNER NAME A r Y C¢ Y t "A I S PHONE C ji E-MAIL STREET ADDRESS Q (-i I ,-1 till �V C,A, l C [TY, ` Y t i ^I� l ! CA '5() t UuPCONTACT FAX NANIE,Mar jan Javanmard PHONL650.4`7--7.6430 E-MAImjavanmard@solarcity.com STREETADDRESs391 Foster City Blvd CITY, STATE, Z(P Foster City, CA 94404 FAX ❑ OWNER ❑, OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 0 CONTRACTOR AGENT ❑ .ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME SolarCity Corporation LICENSE NUMBER 888104 I LTCENSETYPE CI BUS. LIC g28840 COMPANY NAME SolarCity Corporation E-MAILn-ijavanmard@solarcity.com FAX STREET ADDRESS Foster City Blvd CITY, STATE, ZIP Foster City, CA 94404 PHONE 650.477.6430 �391 ARCHIIECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE. ❑ CommeIcial PROJECT LV WILDLAND URBAN INTERFACE AREA ❑ Yes [I No PROJECT' IN FLOOD ZONE ❑ Yes ❑ NO SOLAR PANELS ❑ ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: I KILOWATTS (COMMERCIAL ONLY): p / l �4 TOTAL VALUATION 5E DESCRIPTION OF WORK Installation (31) rooftop flush mounted solar panel O kW A RECEIVEDBY:TrljLasclu-�"j By my signature below, I certify to each of the following: I am the property vner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is correct. I have'z, ad 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 authori e,representatives of Cupertino to enter the above-Identi iedproperty for inspection purposes. Signature of App] icant/Agent: �' Date: 01/11 5 SUPPLEMENT Ai INFORMATION IRED OFFICE USE ONLY OVER-TAE-CrOUNTER ❑ EXPRESS U y ❑ STANDARD U ❑ LARGE a ❑ MAJOR PVApp_2011.doc revised 03116111 CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fare, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 Ef7/1/13) ADDRESS: 10461 Scenic Blvd DATE: 09/17/2015 REVIEWED BY: PAUL Elec. Plan Check 0.0 hrs $0.00 APN: 357 07 003 BP#: *VALUATION: 1$17,500 *PERMIT TYPE: Building Permit PLAN CHECK TYPE: Addition PRIMARY SFD or Duplex USE: hrs PENTAMATION SOLAR -RES PERMIT TYPE: WORK Install N rooftop mounted solar - 31 Panels 8.06 K and Upgrade Epanel to N 200 Amp Panel SCOPE Electrical IBELEC200 Services NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fare, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 Ef7/1/13) FEE QTY/FEE MISC ITEMS Elec. Plan Check 0.0 hrs $0.00 Plan Check Fee: $0.00 Elec. Permit Fee: IEPERMIT Alternative Energy System IPHOTOVRES I Photovoltaic System OtherElec.Insp. [EE] hrs $48.00 0,0 hrs $0.00 NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fare, Sanitary Sewer District, School District, etc.). These fees are based on the preliminary information available and are only an estimate. Contact the Dept for addn7 info. FEE ITEMS (Fee Resolution 11-053 Ef7/1/13) FEE QTY/FEE MISC ITEMS Plan Check Fee: $0.00 T-1 # $236.00 Alternative Energy System IPHOTOVRES I Photovoltaic System Suppl. PC Fee: Q Reg. 0 OT 0,0 hrs $0.00 PME Plan Check: $0.00 200 amps $48.00 Electrical IBELEC200 Services Permit Fee: $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $48.00 /"'Lv: F Administrative Fee: ]ADMIN $45.00 l Work Without Permit? Yes (j) No $0.00 Advanced Planning Fee: $0.00 / Select a Non -Residential Building or Structure E) 0 i Travel Documentation Fee: 1 TRA VDOC $48.00 Strong Motion Fee: 1BSEISMICR $2.28 ' Select an Administrative Item Bldg Stds Commission Fee: IBCBSC $1.00 , - SUBTOTALS: 1 $144.281 $284.001 TOTAL FEE: $428.28 Revised: 07/02/2015 (;'iTY OF CUPF-I'M`v LOEL€'i (: I'IJRNTIT INSFECI'ION CARD I AUI!.DING ADDRESS: 10461 .SCENIC BLVD CONTRACTOR: SOLARC:T) PERMIT NO. 15090114 s' aAVNER'S NAME: GR9NFLS SAMUEL C AND FRANCES 3055 CLEARVIEW WAY DATE ISSUED: 09/17/2015 l➢WNER'S PHONE: 40844o2804 ISANMATE0, CA 94402 PHONE NO: (.650) 638.1028 JOB DESCRIPTION: RESIDENTIAL ❑ COMMERCIAL ❑ rOUNDATION/PIERS/H.D,S INSTALL (N) ROOFTOP MOLINTFD SOLAR - 31 PANELS 1FER GROUND 8.06 KW) AND UPGRADE (E)PANEL TO (N) 200 AMP PAD/';ET BACK -CERT '.A iv F :.,ARAGE SLABS/PREGUNITE s: NDERGROUND/SLAB :NDFRGRGUND PLUMBING I i;'dDFRGROUND E!.ECTRICAI ,ti1`�RrL')OR PLUMRIhr � � I R: i.00R MECHANICAL ! F r WILDLAND URBAN' L" RFACE FIRE AREA t ER# 4 liF.'?F LX)R e!.ECFRICAL --- i h t L.00R V�RP.MI'1fi vi -N rs TO ARRANGE INSPECTION INSULATION Call 777-3228 een 7:30 am and 3:30 pm Monday through Friday, at least 24 hours 4Ytt �.ABBN1 before r uired inspection. Job address and Permit Numbers are needed when ` ',i•:[ r'eA i'i,INGrequesting an inspection. r(,ii P:JWPCJC; i CUPERTINO SANITARY DISTRICT Closed circuit video inspection of property line cleanout, !point of connection 1 W, 1 i`.c?� „ I, - and street lateral required prior to passing FINAL CITV PL UNIBING INSPECTION. Call the District (408-253-7071) for as Appoin meat. EGRESS NO BUILDING FINALS INSPEC-PIONS UNTIL ALL REQUIRED BUSINESS LICENSES ARE OBTAINED n 1+ O YVt➢ItK� , 'i I tAsi �i � :' a y p PERM17 E IRES IF WORKIS NOT STARTED WITH 11%,i 180 DAYS QUI` PERIvIii a..t� � i h< < hAfuHt)i.D UOWN� ISSL NCE OR 180 DAYS FROM LAST CALLF1) INSPFC:'TION. I Ca ii a � '. AR HOLD itv1VN FROCK SI 1FAR IMPORTANT J.When a permit has ired, a charge totaling one_half the xes to obtain a new per -nil \F v4 S('RCFU must be paid in orde reactivate the permit..; a peemit has been expired for 1r+.11 e ! �< <•A3.i than one year, a char totaling the full fees to o'taie a new permit must be paA 1 *o reactivate the permit. �tAiC 1 'OAS ? L7 ­7 J R, 1,A FR - � NOTES: d i -�IAR,:A1ECIFFLECT ABM/F l T:IL ? R "� :I R r I ^ASF � 1I1r.FCIA L IlSPfCTIJNS.------------------ nate:-------- e --- .OROS ROOF INSPECTIONS i L1u' -ill I!sLICU�ORYti PRE;1rvSPECi1JN.111spect(a Date ..,.,.408,378-46 - --- --- ----- — — -- — �4L, ,408)378-4010 TEAR-OFi�: inspector (408 3108 4 - -- -- -- - -- PLYWOOD Inspector Inspecror Oate __ { r i' , 408).5' 1171, 1 ..,,_...,,.......,..............�.a. ..,....,,,.. �r,��. _ [3AITFNS. luspcctoi- ----------- ----- ----- Date: -- f RICA, I 1. .... W ... ; «..... .1 !N PROGPE`,S :'°p - Oatt. _....�....�.......�..,......r.................,..�..........,,.....�.,,a➢ �kINaLiraoe�tor "• it l e NOTE: OSHA APPROVED AC 0,�-S TO ROOT 3HALI, til: PROVIDE.) FOR V',SPLA TION. i.• _ r. .....J..�.,_.1.1.........1.._..1_......._., .a......�.,.,,...� „,..., I t t * Ot:C➢ Pa'VCY vL 1➢U!t-D➢N,`G NU1 PEWNt1'rTGD 1. NT1I_ WALDING . 7.AI iS S1',NED BY INSINX-FOR i .,,f-Y-drs:p�'vYisai.vru5'fY 9Y"71f0frY�-4kA^��.,�.,,,..�....9.-..w..�.w,....,..-.e,�.y�.•,.�.......m.,..�.�.oa.,�..o�.�.e.........�..o.,.®,.®����.�-a.��m.. CVPERT1NO 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 • building(a)cupertino.org Permit No. I S Oqi 0 11 Z4 Address 10(dal SCenicr° 61d.i urxv ted, A #of Alarms Smoke: lq" Carbon Monoxide: 2.. PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN,SICZED 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 have been tested and are operational, as of the date signed below. 1 have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: -6/4h4 61z 1,J CLS Signature... Date: l.!!li'?h.. Contractor Name: Signature................................................................... Lic.#...................................... Date:................... Smoke and CO form.doc revised 03/18/14 CUPERTINO WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408)7 7-3228 • FAX (408) 777-3333 • building(a)cupertino.org �5 0///-1 � Owner Name `7f�/`�J G7 �2 /1J 4 4-s Permit No. Address l U C/ LU 4), �` U i�L /Z _7_1/1J 0 4f_X] `1,�0 / f Is your real property a registered historical site? ❑ �s Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Ck No Go to Question 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. R 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. R 1<No Go to Question 4. v 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 110 1. 1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 2 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.. [Ple e 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 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). ❑ Myproperty 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). 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 110 1. 1 through 1 101.8, 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 pane. /%� Owner or Owner Agent's Signature: Date: Uoon completing and signing this Certificate, ulease retunYlit to the Building Division in order to final your building permit. SB4072015.doc revised 08/26/15 BUILDING PERNUT- CANNOT BE FINALEI CERTIFICATE HAS BEEN SIGNED AND RETU JTIL THIS:; _ 1. if the existing plumbing fixture water usage/clow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015.doc revised 08126115 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 CcD 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute to 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 i 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 i reduction. other means may be used to achieve reduction. 1. if the existing plumbing fixture water usage/clow rate is equal to or lower than the figure shown, it is not required to be upgraded. SB407 2015.doc revised 08126115 >4 I o Z ,, a Soli 3� -�... M z� o ZD p LU N m3# /� a iii 0 N o- ig 2: U, F E .. F- ..., UL Q ( '� � H S4a w p Q V + j G W 1� (Sn QOUJ jW- O V V NN7I- m v+..• W »»> d w a d v EQ pp Z{ , CV W c > jai � m a „ W Z �Z m.�04> m Ya�i d a� oai w o --� '.. Q W W I- 0'3 -"6 ! d CWJ IZcl� ry 0p_ cn mm . W� t"=0 `c E o cQc L OQ ao0 �' o O ay v .4 c Z fl tJ? m W}a n.` nm g >pa� min ZN > c�� p LU w o <t=�_� � �00 U _� z y��Lo > O _� 2 Z0 nz 0'§.o a_I Z D -En xt ¢ > > E -2 o. m N Oa Q m W 2 � ©. O y m l4 m ~ � Z15 Dd z V 0 Z Q w m o J lf7 m I"f d - QCD (n O U .K. 00Jn1-gcN4 WLLJ m � zr z m m vi a v bi 0- 03 �p O z� wo .� �o w- ¢ a� Ow t=- W O Z N M w U�U 7- W Q W Z ,,N w wZ N W W U w�A; Z N� O�2 Q /�O WSN Z W O O m m -W Op W NON O N S W \,/ Z H Z m� O u7 Z p� w¢ a V H w z ~j m O O U W 5 W W m V D o O O 8 J J zzm � Wo�� zJNo�m¢��2Lo co ---�z�N� Z Cz7� rMNZ 3 0�3�1- N W W Q dd m wN _ice V d >0 � z Jd a Z dpY W U 0 0 oza_��F4�J�ornaz_a��v�ZWw Z I --I N NOS= VO A QI-W O�OU� W QSm �Zz wd I J Z�f-02w> V I- W NZ QOcn Q= W OZZU JZ i-_ W -Qd' =FT ¢ww4 zZ� ¢0�0 www Iwi 4� �O �9 Vp W YOo� OO ',,. JID o N m m a' O d N I- Z d f- z �. J w w w QOt.;o~ p m w F W ZU t�w NCKUwa JO_Um OU ~Oow Z p r3 d Q W 2 w _ Z 2 N d d U V Z J Q Z W V r o Z Z¢ N W 3 0 - N G w Z Z J 4 O O Q O O O W Od ZG7d FN w O J O W J =O O I m Q N N J d U U I Z (r Z Ww N N W W J Q O W Q O S O O Z N W w J d Q 0 0 - O N M W Q d N V N O O N r O E a .. N w E'E Ngo O o o Zo = ca z z z z o m o o F N LU Ln o Q w z v o z v €z�cV+r€�3�'g.a W a� z aH oHd W W� mF cw'�--�' O ¢ J UmQ Gr F-_V VQ m JZ¢w NNNWFoN J d� Q €r_zw F 0w 0� 0z < NY QoO On'.E �zd� � WWJ�0 -rr00Z W W N0-OZZ0 WOO d"Gd' Q W-dWW Jwd�r0002JYO�ZZZL GOOoma d-Jm VpOOW Q .. D Z V I -m QUO U Q $ 7 N 2 U N UJG�V U W'�N d W Z 0 y�~ymZ Z I- V w0>U O (L' AnOC QQm wvwWVS.'1OS. S.i—Wr Z02dd NNN/--»>}'SM O 0 m S S m+ :� cn `gg M m 75 Z < LU Lod <00 Lu 0 U 0 -) PH D z 10, 0 < -M Q LU o 0 uj CL, U3 cQ 0ce 0 <D O IO 15 0 z o < cL UO >. E 0 Z 1n V) F - z rvry -.E Y o0 CL OX cr 0 Oil OL LL 0 <D LU 0 > < 00 LLI @ @ Fcn -M < < P. < uj QQ G) z IO 15 0 z o < cL UO >. E 0 Z 1n V) F - z rvry -.E OX cr 0 Oil OL 0- <D LLO 0 < < LLJ Fcn -M < < < uj I \aj G) z ca) @ U4) X— a W X ON 7T IO 15 0 z o < cL UO >. E 4.j OX cr 0 Oil 0- <D < < Fcn -M < < < I \aj G) z ON 3: re) CL.6 Z LL 0 .� 0 < LU > u 0 0 'D 00 co rH11 X (2 = Uj cl� < g cc,, VL Q F- L -j ZCV as P) PE� u co (/-) IO 15 0 z o < cL UO OX cr 0 0- <D < < Fcn -M < < < I \aj IO 15 0 z o < cL UO \60 I i�+jr 1 1 Q1 Oa. IX> tll to M U I x x fo �ppLL I ry I `K C� IV,r>0�� � t rY:S( � : GG �T O V / 1 i { >8 E n _2:1 Z5 -q ft A o Ef — I LU o _ Z 1 1 N ...3 (: � W g A J p h Vo i I 4=i Q O:O. � 1 1 I I = L]� .p0 QQ Q¢ Z Ix � E _� E �a a L--- �: w. w} Q f,Q cr- Z cl� 0 w OP: 4 o¢ I C� o f wl Y w LLIz �ZN LLJ � � ��, o E', c W ¢ a � � 3 > 1.-I I L Tl .sstum35ftV: 1 ,rn 1 > mN Ca _ J mQ n OLL I > cf' cn �IJo � CIO, U5 CO w w �- z i g C7 .— C..) d- I g g ]Nib: to m m v I I ^151.. I. I I i 4 uj V) m S1f13N S.S.S. Er% d J Z � Ov fp ONO w N 225 a fi: Nra3 �:qq�cFi C' IN�j ats12 iW �vV 11 ""'� ✓hG v4 II _ �f 2fd Z 'Z' w > < W iI Z 0 zw_ It W -Z 1-w Iz- :0¢p1,53 -�o �-' WU u, C) LU wz Z �'W 3 Cw' o W U F-- Z 2! LIJ RIO w 1- woo, >- y 0 wo 0 0. 0)w ,F C'. 0 a: co Z < W O�? W > Z, OZ MUZ w W M 0:2 W Hw Z' >w W 0'j 22 z L! 2io Om l< D OF- 3� Z 'ut: --LL' 5N OO Lw S - 1) L > d 6'—woo�EEXO x 0 wz 1 L z w z , C� > =-5 0() < 0 ol :D < r -'m 1570z.- cm 2< 0, < =WE., �:�z z 2N�il - � a: C) 0 < W W w 0 LU m x <' WOz<' w W I: LEI <~mG C]1 0 0 11 u 0 < > > w Z< L� C < << oz 'ZWl w NSW < IL) < > 111 < 12 >m w 15 3 z '7 Lz� 'Z < , Z�D Lli z Z 0 K z C"F'- W d' .0 - (S) "D z '< �" .7, Z UO 1- 121 W 0 2-1 0 Z U L- < > 0 0- >-w C)z az ao MC ID O< U)U,<w �"O :107E� ot :�� 0 ry 0 :0 0 > �Qw d 0 > n O F- U) FL ax D O::l 0 < w 3-c—W oo-� < W 0 Z D 00 U x l <( >Z 0 E U X > cn x '7�5� 3:O� C)OoOO 0':iE'K Jw� wc�z( 00 <-<,< Luc X< < w W2 z O 0 W IIS S 0 0 C, E 0 0 CU9ERTWO RDepaft- SEP 15 2015 nt FC) Reviewed I r� COD6 (;OA4PLIANCE Y, aga Fm 6=qf Z8 ci trig &a 8&9 AA D CU9ERTWO RDepaft- SEP 15 2015 nt FC) Reviewed I r� COD6 (;OA4PLIANCE Y, aga Fm 6=qf Z8 ci trig 9 &a 8&9 UR D dl 9 N,02 ±0.1 00C: Lij I CUPERTINO Building Department SEP 2 5 2015 REVIEWED FOR CC Reviewed by. | V k ( \ �