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B-2016-1807 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-1807 21600 EDWARD WAY CUPERTINO,CA 95014-4786(356 18 015) EDEN LANDSCAPE MANAGEMENT SARATOGA,CA 95070 OWNER'S NAME: SHIN HYEOG SANG AND HYE BONG TRUSTEE DATE ISSUED:04/20/2016 OWNER'S PHONE:408-858-9085 PHONE NO:(408)858-9085 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-27 Lic.#709854 Contractor EDEN LANDSCAPE MANAGEMENT Date 07/31/2017 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 license is in full force and effect. JOB DESCRIPTION: DEMO(E)SWIMMING POOL&FILL WITH SOIL(FOR I hereby affirm under penalty of perjury one of the following two declarations: LANDSCAPING PURPOSES ONLY) t. I have and will maintain a certificate of consent to self-insure for Worker's Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 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:390 Valuation:$8000.00 APPLICANT CERTIP`ICATION 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 356 18 015 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 PERMIT 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 FROM LAST CALLED SPECTION. Date 4/20/2016 Issued by:Alex Vallelunga Date:04/20/2016 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 t. 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) z. 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:4/20/2016 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 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. 1 will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the a. 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 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,Sectio 55053 25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. t°t HUF or aainunzee�-agee-, e 4 - APPLICANT CERTIFICATION Date:4/20/2016 1 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. Signature Date 4/20/2016 Licensed Professional SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION S P 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228 • FAX(408)777-3333•building(cDcupertino.org +CUPEE�T[N© U PROJECT ADDRESS APN9 -t bop �Dw�-p w� 5 — l —� S OWNER NAME i1 `, PHONE E-MAIL STREET ADDRESS Z 16 w� CITY, STATE,ZIP FAX CONTACT NAME j. rJ 1 PHONE �-Ug !'S �D�S E-MAIL (1 /� -1OM` ^ Avo O 1 STREET ADDRESS __7CITY,STATE, ZIP 25 j5 b a FAX l jf J �j 1�-�ss� �-s��:�s ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT 0CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORNAME � LICENSE NUMBER �� LICENSE TYPE BUS.LIC# Aj p r:� L5C e 06,11-7 �� S C COMPANY NAME ' E-MAIL /� FAX i�17 S STREET ADDRESS i ` 6-5e O 5 CITY,STATE,ZIP CA— 0,k-01-D PHONEE�� ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# J COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK � ' C'( L�u- _.j-�I G 'i cOL 1,-,1-h'\ o1 LA-12 L)e,,1 L✓t �, ld s r USE OF ❑ SFD or Duplex ❑ Multi-Family TYPE T77RJAL TYPE(CODE) AREA (SQ.FT.) VALUATION (S) STRUCTURE: ❑ Commercial POOL POOL/SPA MATERIAL TYPE CODES: SPA V - VINYL-LINED JJJ F - FIBERGLASS DEMO G - GUNITE / P - PREFABRICATED RECEIULD B1 TOTAL VALUATION: By my signature below,I certify to each of the following: I am the property ow er 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 read the Description of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buil construction. I autl orize representatives of Cupertino to enter the above-//idel ified p operty for inspection purposes. Signature of Applicant/Agent: Date: T Z� SUPPLEMENTAL INFORMATION REQUIRED oF'F►cE usE`oNLY, PLAN GHECK:T]PE °° ROUTINGAW _Commercial or Multi-Family Buildings with Public Swimming Pools: Department of Environmental Health approval required. ❑ °ovER TAE COUNTER ❑ `BUILDING DEPT ❑`EXPRESS. . ❑ 'PLANNING DEPT' ❑."STANDARD ❑ ;PUBLIC W ORKS DEPT ❑`...LARGE,;, ENV`190 HEALTH ❑`ViAJOR'•;,, ❑.•'.SANIT,ARI SEwERDISTRICT SwimPoolApp_201 1.doc revised 03/16/11 ON i / I F �� tom.)£i�'"7 1 0�%�'; �✓li i �F-:�"�L f f'h f 171 COW UNITY DEVE �OPME:WT DEPARTMENT WILDING DIV `'r tJ. : CUPERTINO APPROVED RECEIED •�~� � This sel of plans and specifications MUST be kept at the job site during constructsn. It is unlawful to make any Chang s or alteratior s on same, or to deviate therefrom, without approval from the Building Official. The Sta ping of this plan )nd specifications SHALL NOT 1 be held to permit or to b an pproval of the violation 13Y------ of Yof any provisions of . y i ' nce or State Law. 9 BY L DATE i ( 1 PERMI # ( ._0it. _ 1 COLO v64' FFICE a �a I I i I i I r f 1 3 i �— J►(7i t9.,)I.�lJ i1� C;1'An\..�V .� d MONOXIDE LARM$ F L COMMUNITY OEVELOPMENT OC-FiARWE XT•BUILDINODIVI-SION H * k01050T1' 14,325-5 al - _pax ) uEtdin ,z�r cu gjrr lr�o rra Add ' s I ,®o #df farms inolke. afbc xil no �a:"-•r'�.*�.�u ,,�.±y�,.�.Q':ya'R-rr- � '��� '_' .' "yam'^'? F,s� ���'� �s �`�*�" .�:._ z. PURPOSE kTl�afffda t is a.se1ffce�ii�iu is��four th��t4ati�n of all,rept red :cue and C bow Mono)de Alarms fog conllane % € ectlox� {l 3 C13 € i+ na is and:JQ . . we lnxor adeeas frar ixsecti areuire i E g s gle a�.y: an l�-fa y dwells cgs shall be p tiled fli b els �?s arts ao, �bi� e- , *A,5e 41AMIs. Men,tie x alua,on of iv-tl tioets,.a��e afaorts ©x xepairs tc�`ems '. g divleBeed 1(1i Q Cl y t C. ecflon 1R 9 aild Sections t} ' s ,5 d regio mat `fie lams a d/or arba% Monoxide Alarms be installed in the following locations. AREA, SM10M A CO ALARM t e f cacti separate I e ling i ea ie di t �ricinity 4 the �ectror�xx��s , 4 16 I g urs ���l�ttl�� bas exits �thi ead Slee sit rooaat Carbon Ivl no ide alarms arenotteed in dwellings which donut contain. e V apgid that: do not ha ve an a taches garage. -Carbon.monoxide alarms combined:��.stoke arms,shalt—p1-W10 a c do and shallbe app owed by the Office cif the State Fire lit shal, :Power$apply;In dwelling units with no com erc al power aUpplT alarM(P)may be sc�le�y ba�zy operated. e st g dz,vell ng tests#alarms are permitted to be solelyba exy operated.w er regain or aldna not result in.the removal of wall and celling f lyds es��there no access 1� nears c�attic,basement or cras space,leer to CRC-Section T5U and 3C Sections }7� ..11.4 and 0,EAA..3e 'cad pern%t i requ% ed f alarms whit must l e cor►ne ed:to the bu lding iring.> As=owner i�f the abcive re ced o r Ihereb ce t Wthe 4Vm( xe� ced abo' e hash bei insta`,kd iii.acceo dance celx the iris tfa e s a asttu bn$And in,romp lame Zvi tl�e alifc��a B��ld rib and all£orrc%a Ieszdalacl .1'he alar hate be tested;ar%d a OPeratioS� t otl r*date signed Iselow Ia v -Mb and a see fix carp 1 , fir.fTio ferns and Eonditions 6f firs statement � Contrae#or Ma e: fid €o i5,j c l of anti Goform.4bc rev sed 031I8IN MF1 WATER-CONSERVING PLUMBING FIXTURE61 jib . OWNER CERTIFICATE SOF COMPLIANCE' COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION CUPERTIN'O 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 (408)777-3228-FAX(408)777-3333 building -cupertino.orq Owner Name HH -Q 0 40,P l4//j Permit Nord Address _! 606 wr,�tq J o i' 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form aid sign bottom of form. No Go to Question 2. i 2. Does your real property have a licensed plumber certifying that,due to the age or configuration f 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. 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 forma d sign bottom of form. j 1A No Go to Question 4. i 4. Is your real property built and available for use or occupancy on or before January 1,1994? j a ❑ 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 forma d sign bottom of form. '�k Yes My real property is built and available for use or occupancy on or before January 1, 994. 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: 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-c rnpliant 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 n n-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 w ter- 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 shalt require n-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-com pliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance th Civil Code Sections 1101.1 through 1101.8,the current California Plumbing Code and California Green Building Standar 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. _ ' �� Date: 611 L Owner or Owner Agent's Signature. -- Upon completing and signing this Certificate,p ease return it to the Building Division in order o final your building permit. SB40 7 2015.doc revised 08/26/15