B-2016-1210 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERNIIT NO:B-2016-1210
22415 PALM AVE CUPERTINO,CA 95014-2711(357 03 029) (AMERICA'S VINYL
EXTERIORS INC)
SACRAMENTO,CA
95826
OW'NER'S NAME: LIGOETT CHARLES F AND KATHLEEN I TRUSTEE DATE ISSUED:01/19/2016
OWNER'S PHONE: PHONE NO:
i.ICE,NSED CONTRACTOR'S DECLARATION BUILDING PERMIT INF O:
License Class Lie,## SCS ey
Contractor(AMERICA EXT RIORsINC)Date 1-19' 6 XBLDG _ELECT _PLUMB
I hereby affirm that d am licensed under the previsions of Chapter 9(commencing —MECH RESIDENTIAL-"COMMERCIAL
with Section 7000)of Division 3 of the Business 8e,Professions Code and that my
license is in full force and effect. JOB DESCRIPTION:
Kitchen remodel(256 sq ft)and install new PSL beam;Remodel(3)
I hereby affirm under penalty of perjury one of the following two declarations. bathrooms(270 sq ft).
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 pornttt is issued.
e2. 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:$180000.00
APPLICANT CERTIFICATION
I certify that i have read this application and state that the above APN Number: Occupancy Type.
information is correct.I agree to comply with all city and county 35703029
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 PERMIT EXPIRES IF WORK IS NOT STARTED
expenses which may accrue against said City In consequence of the WITHIN 1$0 DAYS OF PERMIT ISSUANCE OR
granting of this permit. Additionally,the applicant understands and will
comply with all non-point source regulations per the Cupertino Municipal 180 DAYS FROM LAST CALLED INSPECTION.
Code,Section 9.1:3.
c. Issued by: 1421
Signature Date Date:
OWNER-B iii D •R DE0,ARATiON RE-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
r. 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.o£ferod
for sale(Seo.7044,Business&Professions Code) Signattua of Applicant:
2. I,as owner of the property,am exclusively contracting with licensed Date:
contractors to construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penally of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS"All OR BETTER
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 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
2. ihave 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 Cade,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. 1 certify that in the performance of the work for which this permit is issued,l material. Additionally,should I use equipment or devices which emit hazardous
shall not employ any parson in any marmor so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I
will maintain compliance with the Cupertino MunicipalCode,Chapter 9.12 and
Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code,Sections 255 3-uxd.25534.
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
Owner or authorized agent:
be deemed revoked. Date; f!f
APPLICANT CERTIFICATION
fONSTRUCTIONLENDINGAGENCY
1 certify that I have read this application and state that the above information 1s 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 anter upon the above mentioned property for inspection purposes. (VJe)agree Lender's Address
to save indemnify and keep harmless the City of Cupertino against liabilities,
judgments,costs,and expenses which may accrue against said City in ARCgVrECT'S`DECLARATrON
consequence of the granting of this permit,Additionally,the applicant
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 8.18.
Licensed
Professional
Signature Date
CCNSTR.UCTION PERMIT APPLICATION
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SMOKE I CARBON MONOXIDE ALARMS
OWNED CERTIFICATE OF COMPLIANCE C!] F
f"7J
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
t'J� ItT06
(408)777-3228 a FAX(408)777-3333►buildintt(a)cupertinomg pp/ ii
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PERMIT CALKN'OT BE FINN ED AND CM,IPLF'1 ED UNTIL THIS CERTWICATE
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.
GENERA.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 u 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 429,.,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 laas[have b:eetl
installed to accordance with the manufacturer's instr uictions and I'M compliance with the California,Building;
and Caliifunr a Residential Codes.The alarms-have been tested ands are operational,as of the date signed
below-
f
tf have}, .,and-2; ee-to com;7 w,,th th,a,terms_and condfians off,, ftis statement
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Snvke•a id,COfbrm.db..c rezised.03/1017143
WATER-CONSERVING PLUMBING FIXTURES► OF
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION
CUPERT NO 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333 buildingocuperfino.ord
Owner Name' h}ed }`�+ ,A C� i�Q Permit No X 2 a 16 12- r
Address 0 2 2 4 15' PA L r-1 AU 6, C-uP c P 7 t N9's o 14-
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 and sign bottom of form.
L—� 'Er 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.
U'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.
F n"'No 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.
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..
5. Please check ONE of the following:
r L"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).
0' 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).
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 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 Signature'_ Datil;: f J 4 2' 14,44
Upon completing and signing this Certificate,pleasV return it to the Building Division in order to final your building permit.
SB4072015.doc revised 08/26/15
z
Non-Compliant Water-Conserving Plumbing Fixture
Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction)
Fixture Type Maximum Water Usage/Flow Rate
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
Gallons/flush 0.5 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
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 2.2
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
reduction, other means may be
used to 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.
SB407 2015.doc revised 08126115
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