B-2016-1753 CITE'OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1753
10391 CASTINE AVE CUPERTINO,CA 95014-1308(326 41 040) HIGH TECH
CONSTRUCTION
MORGAN HILL,CA
95038
OWNER'S NAME: MAXWELL BRENT K AND FARRELLY KAREN E TRUSTE DATE ISSUED:04/13/2016
OWNER'S PHONE:408-529-8481 PHONE NO:(408)458-6565
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class B Lic.#8 005
Contractor HIGH TECH CONSTRUCTION Date 06/30/2016 X BLDG _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:
BATHROOM REMODEL-(60 S.F.)
I hereby affirm under penalty of perjury one of the following two 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.
have and will maintain Worker's Compensation Insurance,as provided for by
I y
ection 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area:60 Valuation:$12500.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above APN
information is correct.I agree to comply with all city and county ordinances Number: Occupancy Type:
326
and state laws relating to building construction,and hereby authorize 326 41 040
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 PERMIT EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAB'S OF PERMIT ISSUANCE OR
Additionally,the applicant under ds and will comply with all non-point
source regulations per the p ino Municipal Code,Section 9.18. 180 DAB'S FROM LAS CALLWINISPECTION.
Signat re Date 4/13/2016 Issued by:Alex Vallelunea
Date:04/13/2016
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. I,as owner of the property,or my employees with wages as their sole installed without first obtaining an inspection,I agree to remove all new materials for
compensation,will do the work,and the structure is not intended or offered for inspection.
sale(Sec.7044,Business&Professions Code)
2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant:
contractors to construct the project(Sec.7044,Business&Professions Code). Date:4/13/2016
I hereby affirm under penalty of perjury one of the following three declarations: 'ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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
performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE
2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous materials requirements under Chapter 6.95 of the
Section 3700 of the Labor Code,for the performance of the work for which this California Health&Safety Code,Sections 25505,25533,and 25534. I will
permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
s. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 25532(a)should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous
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 Mu ' 'pal"C•Zle,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sectio 505,255 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. i wm�-aut I z" 'agent:
APPLICANT CERTIFICATION Date:4/13/2016
1 certify that I have read this application and state that the above information isUCTIO LE G AGENCY
correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance
relating to building construction,and hereby authorize representatives of this bity of work's for which this permit is issued(Sec.3097,Civ C.)
to enter upon the above mentioned property for inspection purposes. (We)agree Lender's Name
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in Lender's Address
consequence of the granting of this permit. Additionally,the applicant understands
and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. 1 understand my plans shall be used as public records.
Licensed
Signature Date 4/13/2016 Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
N 10300 TORRE AVENUE ` CUPERTINO, CA 95014-3255
CUPERT[Pt0 l(408) 777-3228 • FAX(408)777-3333 ` building(a>cuoertino.org 2-01 L9r I
I
❑ NTEW CONSTRUCTION ❑ ADDITION �TERATION/TI ❑ REVISION/DEFERRED ORIGNAL PER1,Ii T
PR07ECT ADDRESS,16 _ G � �_ v�1 APN R 5=)--/ V
n l (, (1� f
OWIER NAME —� II PHONE `(/E-";i ` V
STREETADDRESS CITY, STATE. IP FAX
/ d
CON'TACT NAME PHONE E-1,I.4IL
STREET P.DDRE CL 6RX.
1126 Cl TY,STAT , ZIP FAX
❑ ON NER ❑ OUTER-BUILDER ❑ OWNERAGENT ffI CD:NTR-4CTOR ❑CONTR4CTORAGENT ❑ ARCHITECT ❑ENGLN7EER ❑ DE4LLOPER ❑ TE-N-.4'T
CONTACTOR NAME LIC 'SE I UI BER� LICENSE TYPE BUS.LIC
4 rJ' ( rs - f�-4 O i J
COM)DAIUZ'N.4114E E-MAIL FAX
41 6d )MCH G
STREET.4DDRESSC,. S �L� CITY,STATE. �r PHONE
ARCHITECT/ENG;,1EER NAI,4E LICENSE NUMBER I BUS.LIC
COMPANY NAMiE E-MIAIL I FAX
STREET ADDRESS I CITY,STATE,ZIP PHONE
DESCRIPTI01:OF\4'ORK
EXISTING USE PROPOSED USE I CONSTR.TYPE 4 STORIES
USE TYPE OCC. SQ.FT. VALUATION(S)
EXISTG NEUV FLOOR DEMO TOTAL
AREA AREA AREA NETAREA
BATH ROOM KITCHEN OTHER
REMODELAREA REMODEL AREA REMODELA.REA
PORCH AREA DECK AREA TOTAL DECKTORCH AREA GARAGE 4GE AREA: DETACH
[]ATTACH
DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY (:))--FS
BEINGADDED' NO ADDITION? ❑NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF I IS THE BLDG AN ❑YES RECEII ED B1 I TOTAL.VALUATION:
PLA?ININGAPPL' ❑NO PLANNING APPROVAL LETTER EICHLERHO?TE? ❑NO '�� ,� C3 0
'si Z `Q
By my signa't re below,I certiffy to each of the f0IIoNvinE: he property owner or authorized agent to act on th property o\> ehalf. I have read this
application and the information I have provided is c ct. a\'e rend th Description of\Mork and verify it is accurate. I agree to comply With all applicable local
ordinances and state laws relating to building c tlu '' n. I r- presentatives of Cupert no to enter the above-identified property for inspection purposes.
SignatureofApplicant/Agent: Date:
SLPPL .IHN INFORSATIONT REQliIRED
TI\G,'SLIP
I\tew SFD or Multifamily dwellings: Apply for demolition permit for � � w
— ❑ O\It TYP-COII\TER ! BUILDI\G PL4\RE\IE\\ k
existing building(s). Demolition PCrnut IS required prior to issuance of building
permit for new buildii7g• '❑ 3ERESS' y x r LJ E PL+\\L\G PL4�RE\IE\\ ; '
z
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ;:❑ sT�m4RD ' ❑ PUELIC\1ORkat
if _m if an} Hazardous 1\ aterials are ben-a i_ced as part o:^tii-s m-0joct. s t`
a
=,❑�L4RGE rf e � x ❑a FIREDEPT �'`� t�& � `'
_Cop)'of Plalming Approval Letter or?��eetina\v ith Planning prior to ❑� a�4JOR ❑ S \IT4R1 SE\'ER DISTRICT
submittal of Building Permit application. x r {
� � ,� " { ❑f E\TIRO\..\iENT.4L.HE.4LTH�Y
Bldg. pp_?01].doe revised 06121/11
r
�VELOPMENT.DEPA,RTNIE AA
OMMUNITY D�
BUILDING DIVIS ON - GUPERTINO �r�
ations MUST be kept a t e A'%)
his set of plans ai,d speafic
�b site during construction. It is unlawful to make 'y A . 4-
hang
Ps or alterations on-same, br. to devi e n
WIN
out a royal from the Building Offi
The Stamping of spraNnPtul
a
-
be held to permit or t be approval of the violation QUPERTINO.
y ;� �.
+ ance or State W. 0 f h k— RECEIVED
of any pro-)isions o n �� ,�, Builth ,-bq �-Etc�
BY I
DATE
APR 20
PERMIT # 61
REVIEWED FOR OODE COMPLIANCE
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION -.. :—=1
+CU ERTINO 10300 TORRE AVENUE CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333-_building(d)cupertino.org
; J 7`d' j `� Permit 310. ` of b 1 6 ~— 5
ddr-ess ® I M F— AVE #o tartns &no ;`CMb Mono
VERMi'E".CANNOTBEYINALED,AND COMPLETED'UNTIL M.CEI€tTIEI+CATE
HAEEN, .,.` ,tANDt Frr; TO THE ItIiYT� +U11 . ,
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) 1 Ccarno urv,:� ;� 1 11
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
` er{cir t?w1eA yell-, �r211 j Name:
1
S"r nature . oats
..................... :... 1�.
~0`I�i�tractor Name:
LoutT 5 IV AV44s --
�S:i na'Eute, .... - ... ............................... ...`.,:Lrc#�.....�.�..�.
Sinoke and COfonmdoc revised 03118114
WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION
CUPERTINO 10300 TO'RRE AVENUE•CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333•buildingAcupertino.org
wne0_._r Name; K P P et.4 i z gN r- AAAyrza=z e=mit
A_4ess A-sfirvti (� r'ra � ca7�l
L 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. "
No Go to Question 2.
(Z 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 isnot 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.
No Go to Question 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.
No Go to Question 4.
Is your real property built and available for use or occupancy on or before January 1, 1994?
El hTo 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.
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..
n Please check ONE of the following:
My property is a single-family residential real property. See Civil Code Section 1101.4.
On and after January 1, 2014;building alterations or improvements shall require all non-compliant plumbing fixtures
to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017,all non-
compliant plumbing fixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether
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),
11 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).
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 11011.1
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 Owne_-en s Signa u f (D 'Is-
Upon completing and signing this Certificate,plea(e r tum it to the Building Di ision in order to final your building permit.
SB4072015.doc revised 08/26115
� " � ' TIM$ : r
2
,PRIMP-
C, 411
Water-Conserving plumbing Fixture
Iscable to New Construction}
Non-Compliant l (Fixture Complying with Current Code App
Plumbin Fixture Nlaximum Water Usa a/Flow Rate 2013 CPC Ch.4
2013 GPC Ch.4
2013 CPC Ch.4 Commercial
Fixture Type Usage LGreen Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div..5.
Fixt Y Water USag - 2013 CA Multi-Family
/Flow Rate Single-Family Reside, ailons/flush the composite,
Single flush toilets: 1.28 g
Water Closets Exceed 1.6 Dual flush toilets: 1.28 gallons/flush effective flush volume
Gallons/flush. avera a ush volume of tw
flo reduced flushes and one full flush
(Toilet )
05 gallons
/flush
Exceed 1.0 erformance criteria of
Urinals Gallons/flush g0 si. Also certified to the p
2.0 gallons per minute @ P
Showerheads Exceed 2.5 U S EPA WaterSense Specification for Showerheads
gallons per minute
ruin one shower,the combined ieov rate
shalllnot
(Ahand-held,shower is considered a showerhead.) a single
For multiple showerheads serving shall
to
80 etsi,or the shower shall be designed
showerheads and/or other shower outlets control Y
exceed 2.0 gallons per minute @ p
in 0.5 gallons per minute @ 60
allow onl one sho nsr eutlet tWithin units: 0.5 at a time .5
alto p Maximum 1.5 gallons psi
Exceed 2.2 gallons Maximum 60 g i,minimum gp psi;
Faucets— per minute minute @ P per minute @ P
Lavatory 0;8 gallons per minute @ P gallons
minimum 0.8 20 Psi
Faucets 20 psi per minute @ P
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
60 si minute 1.8 gallons per minute @ 60
8
allons per minute @ psi
Exceed 2.2 gallons 1.8 g 1. gallons per @ 60 psi
Faucets— 60 psi May temporarily
Kitchen per minute May temporarily increase to 2.2
gallons per increase up
Faucets up to 2.2
minute @ 60 Psi,and must 60 psiallons per minute and must
default to maximum default to maximum
1.8 gallons per minute @ 1.8 gallons per minute
60 psi @ 60.psi
Where faucets meeting Where faucets meeting
the above are unavailable, the above are
aerators or other means unavailable, aerators or
may be used to achieve other means may be
reduction. used to'achieve
reduction. itis not
xture water required to be upgraded*
er usag
flow rate is equal to or lower than the figure shown,
1. If the existing plumbing fl
;k
S.8407 2015-doc revised 0812611