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B-2016-1778 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1778 10471 SCENIC CIR CUPERTINO,CA 95014-2744(357 07 004) OWNER/BUILDER SAME AS SITE OWNER'S NAME: WONG CAROL CHING WAI AND WESLEYYW DATE ISSUED:04/18/2016 OWNER'S PHONE:408-888-8129 PHONE NO: LICENSED D CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic.# Contractor OWNER/BUILD R Date X_BLDG —ELECT _PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTIAL—COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my &cense is in full force and effect. JOB DESCRIPTION: REPLACE 11 WINDOWS&2 SLIDING GLASS DOORS(WILL MEET I hereby affirm under penalty of perjury one of the following two declarations: EGRESS&BE TEMPERED WHERE REQUIRED BY CODE) 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 performance of the work for which this permit is issued. 2. I have and will maintain Worker's Compensation Insurance,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$3260.00 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 ordinances APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 357 07 004 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 DAYS OF ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FRO ST SPECTION. Signature Date 408888-8129 Issued by: Date:04/18/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: followingawo 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:408888-8129 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER i.V 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 ofthe work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. 1 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 3. 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 Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sec s 2 505,ZSSq,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:408888-8129 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING 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 city 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 Signatur z Date 408888-8129 Professional . 7 CONSTRUCTION PE=RMIT AP'PE_ECA i EON ._E COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 T ORRE AVENUE-CUPERTINO, CA 95014-3255 CUPERTINO (408) 777-3228 FAX(408)777-3333• building(Dcupertino.ora 1\TW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORiGI>\A.I.PERly=4 L PROJECT ADDRESS, b 7 AP�tn 7 �� to 1-3-55)— o . � 6y OWrNTERRAMt, I E-lI IL ?HON-' PIAR , 1A64 v � o - - �a - STREETADDRESS CITY, STATE,ZIP fAK 10yz 421 CONI TTACT NAIMEpxo?:_ STREETADDRESS CITY,STATE, ZIP FAX El OVTNER ljp OZ; tR-BliIIDER © O)�T'ERLG NT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEticLOPLR ❑ TENANT CONTRACTORNAIME � LICEh?SEhLT�ER LICENSE TIDE 3L5.LTC COMPAi`1 NAME I E-MAIL FAX STREET ADDRESS I CITY,STATE,ZIP I PHONE AR C H I TE C T!E IN G I3,7TEERNAT,4E LICENSE NUMMER ( BLS.LIC- � COh iPANY NA?✓EI --- E-IAIAIL FAX STREET ADDRESS I CITY,STATE,ZIP PHONE DESCRIPTION OF WORK _ pp pp (l1 i e Iii E%ISTYNGUSE PROPOSED USE CONS-1 T K.TYPE -STORIES ----m LSF I TYPE DCC. SQ.FT, I VySli:1 iG.;(S) E'QSTG I NEW FLOOR DEMO P07-TiE�RE AREA AREA AREA .A BATHROOM! KITCHEN -OTHER RE11,40DELAREA REMODEL AREA I MAODELARE.A PORCH AREA I DECK AREA TOTAL DEC?CTORCH AR-.4 I G"3=.GE AREA: DETACH. - -- ❑ATTACH =DIVE--1G LNITS: - - IS A SECOND LYIT ❑YES SECOND STORY E:3)-ES . I ----- BEING.A-DDED EDNO ADDITION? [].NO PRE-A-PPLjCA i 10N 0}'ES ff YES.S F?O\IDE COPY OF I IS THE BLDG.A\ y TOT"L N:?L AT10 PL=�?�'T'T'.�G.4PPL= f-11\0 PLS?\-?�ihGAP?F.D\-P.L LETTER EICHLER A ' 0 L' 2- By ..... c By My 62nature below,I certify to each of the following: I am the property=owner or authorized azeL on the property own is be-1W. I have read this in- application non and the i form?:ion I have provided is correct. I ha}-e read the Description of I Vor,• . %erifv it is Ec urate. I agree to cor.,ply with all applicable local ordinances and state laws relating to building c i eti I size representatives of Cnpei Lino to enter the above-identified property for inspection papooses. Signature of Applicant'Agent: SUPPLEMENTAL INrOR11_AI IGN REQUIR .Dt CiIECT.,T1 PE ROliTI�G CLIP _I\Te,s-SFD or Iultizr_iily dv,elllns: ADply fer demolition permit;or C . • 01�R TYE COUNTY R. rLILDI\GPI 4\Rte}IF}} ` eXIS%lI1Q DL11Gina(S) D�L'lUliiiOn pv il'.t 15.reClulred prior i0 1SSua.nCe O bLi1d111- " perrrlit for new buildiil Q. I a F ? n r r R£SS IJ Pr \\L\G Pr A\ Et IEZ r Commercial DidQs: Provide a.completed HaZarCOL'S'`atcrials Disclosure I ST p LBLIC`}ORbp 101,-1 1:i: �y lal=-d0L'S lViaierials age bt 1a _'Sed as na i"Of this 7p17oject. J d Copy Of Planning Apprm -1 Letter or 1\/eetina w._h P'anniP.Q prIOI t0 } h Sub1•niiialofBuildin2Perraitaoplication. ?� `L4JOR S \IT R1 SE}3 ERDI�TRICr E\}'IRO\-iEAT4L HE..LTH Bldg=-pp_011.doc revised 05./?I/1 OWNER-BUILDER DISCLOSURE FORM C COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408)777-3228 •FAX(408)777-3333•buildina(a.cupertino.org —. CUPERTINO Dear Property Owner(s): An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at: _ / SITE ADDRESS/ ��- : _ AP. I By 17-91 . OWNER NAME DRESS- . ADD 0 �; .� l r ` ... .DESCRIPTION OF WORK:' ' ,�dI We are providing you with an Owner-Builder Ackhm0edgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision,signed,and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property Owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION (DIRECTIONS:Please read and initial each statement below to signify you understand or verify this information.) 1.I understand a frequent practice of unlicensed persons is to have the property owner obtain an"Owner- Builder"building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. CiAE2. I understand building permits are not required to be signed by property owners unless they are responsible for s the construction and are not hiring a licensed Contractor to assume this responsibility. 3. I understand as an"Owner-Builder" I am the responsible party of record on the permit. I understand that I may 1 protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. 1; 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license �f numbers on permits and contracts. � l( 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be 1 considered an `employer under state and federal law. Lrn• I understand if I am considered an "employer" under state and federal law, 1 must register with the state and Ii federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to ` unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject l me to serious financial risk. l6L;, 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family II residential structures cannot legally build Them with the intent to offer them for sale, unless all work is performed by j licensed subcontractors and the number of structures does not exceed four within any calendar year, or ail of the work J is perfo mel under contract with a licensed general building Contractor. f I understand as an Owner-Builder if I sell the property for which this permit is issued, 1 may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. avnerBuilderForm 2010.doc revised 04/14/10 6W9. I understand I may obtain more information regarding my obligations as an "employer"from the Internal. I Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments 11 and the California Division of Industrial Accidents. 1 also understand I may contact the California Contractors'State License Board(CSLB) at 1-800-321-CSLB (2752) or wvrw.cslb.ca.gov for more information about licensed i contractors. �! 0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the site address listed above. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide i X12P plicable laws and requirements that govern Owner-Builders as well as employers. . I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information-i have-provided on this form. Licensed contractors are regulated by-laws designed to protect.the..public. if you contract with someone who does not have a license,the Contractors'State License Board may be unable to assist you with anyfinancial-loss you may sustain as a.result of a complaint..-Your only remedy against unlicensed Contractors maybe in civil court. It is also important for you-to understand that if an unlicensed Contractor or employee of that individual or irm is injured.while working on your property,you maybe he liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors,you will be responsible for verifying whether or note those Contractors are properly licensed and the status of their workers' compensation insurance coverage. CONSTRUCTION LENDING AGENCY (DIRECTIONS Please complete the following construction lending agency information.) I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097 Civ.) Lender Name: Lender Address: Before a building permit can be issued,this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note:A copy of the property owners driver's license, form notarization, or other verification acceptable t to may be required to be presented when the permit is issued to verify the property owners s -nature. Property Owner's Signature: Date: 2C� (NOTE: The following Authorization Form is required to b-e completed by the property ov✓ner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder). AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF- Excluding the Notice to Property Owner,the execution of which I understand is my personal responsibility I hereby authorize the following person(s)to act as my agent(s)to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project(or Description of Work): Project Location or Address: Mame of Authorized Agent: Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and Ipersonally filled out the above information and certify its accuracy. Note:A copy of the property owner's driver's license, form notarization, or other verification acceptable to the city may be required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: OwnerBuilderForm 2010.doc revised 04,/19/10 (�Hxl- wunlu) A KT,- , u A I DML&Ss: 10411 9C"C-MG C/R&lt- C/4 COMNIUNITY DEVELOPMENT,DEPARTMENT BUILDING DIVISION - CUPERTINO APPROVED This set of plans and specifications MUST be kept at thb job site during construction. It is unlawful to make any cnange, i 'iftelati '-'71 arae, car to deviate therefrom,without approval fro n the Building Official. an an a tl ca; SHALL NOT The Stamping of his pl. �cir, be held a prcval of the violation of an r, tangy W.we- -- PIER", T�6 N I K 714AA N qARvyA J wwD6V\/ 2- �6,p pul-tw\ 'k- 46 PIS PLANS NECKED BY CUPERTINO Buildinct Depaftent DATE 44L , � A E PLANNING DEPT CUPERTINO REVIEWED FOR CODE COMPLIANCE Reviewed By: s 10+71 SGZ-'/IiC C EJ2CL& �'6c . ion Vps (--Tmz ) A7t f W Dow G � f °/Z, 619614 7 Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 C U P E RT I N O Telephone:4087777-3228 Fax: 408-777-3333 CONTRACTOR f SUBCONTRACTOR DIST JOB ADDRESS: PERMIT# t 6 OWNER'S NAME: CA44, =— AkM 9 PHONE# GENERAL CONTRACTOR: BUSINESS LICENSE# ADDRESS: t CU _ , CITY/ZIPCODE: YOur municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY SPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONT CTORS HAVE OBTAINED A CITY OF CU ERTINO BUSINESS LICENSE. I am not using any subcontracts: . nignre Date Please check applicable subcontractors a Flet. a following information; SUBCONTRACTOR BUSINES AME BUSINESS LICENSE# Cabinets &Millwork Cement Finishing Electrical Excavation - Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing Heating _ Insulation - Landscaping Lathing Masonry Painting/Wallpaper Paving Plastering Plumbing Roofing _ Septic Tank Sheet Metal _ Sheet Rock - Tile Owner/Contractor Signature Date i WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT.BDILD,"ING DIVIStON CUPEERT1 it'} 10300 TORRE.AVENUE•CUP.ERTINO,GA 96014-3255 (408)777-3228 FAX.(408)777-3333 m buildingAcuaertino.o[g Owner Names Permit Nod) _ ` IMS Address . � 1ki. i kin r 1. Is your real pro erty a registered historical site?' ❑ j es 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, 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. WNo Got Question 3. 3. Is water service permanently disconnected for your building? YY es I Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Li VNo Go t Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? No Myr al property is built and available for use or occupancy after January 1, 1994. Yes MCivil al proSertions s buillt1.1 through t and available for eoorot apply.oc occupancy on or before the t of the form and sign bottom of form. Y � property rtY� ore January 1, 1994.: Civil Code Sections 1101.1 through 1101.8 apply. Check one of the';three following statements and sign bottori of form.. 5. jease check ONE of the following: ' My property 3s a single-family residential realproperty. 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 fix es 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 propertylis 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. j On or befor' January 1, 2019,-all non-compliant plumbing fixtures shall be replaced with water conserving plumbing futures throughout the building(regardless of whetherproperty 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 pjIumbing fixtures in accordance with Civil Code Sections 1101.1 through 1101.8,the current California Plumbing C/ode and C lifornia Green Building Standards Code,and manufacturer's g p g ply with the requirements as indicated in the installation requirements,and that the water-co ervm lu bin fixtures comply table on the following,page. _ Owner or Owner Agent's Signature r .r` Datil, Upon completing and signing this Ce ea eturn it to t uilding Division in order to final your bUding penni.t. i SB407 2015.doc revised 08126115 j I � I , Non-Compliant Water-Conserving PlumbingFixture Plumbing Fixture) (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usa a/Flaw Rate Fixture Type 2013 CPC Ch.4 2013 CPC Ch,4 2013 CPC Ch.4 )Flow 4VaE w bate usage 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3 Single-Family Niulti-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 f gallons/flush Gallons/flush 0.5 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 minimums 0.8 gallons per minute @ 20 psi I. In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets— Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 22 i minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi,and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or j reduction. other means may be used toy achieve reduction. 1. If the existing)plumbing fixture water usage/flow rate is equal to or lower than the figure shown,it is not required to be upgraded. j I j SB407 2015.doc revised 08126/15