Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
B-2016-1897
CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-1897 10019 DOVE OAK CT CUPERTINO,CA 95014-5607(342 32 094) TRENCHFREE INC SAN JOSE,CA 95151 OWNER'S NAME: CALGHER PAUL F AND SONDRA R TRUSTEE DATE ISSUED:05/05/2016 OWNER'S PHONE:408-286-8842 PHONE NO:(408)726-7926 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class EARTHWORK AND PAVING Lic.#R ( 6 Contractor TRENCHFREE INC Date 03/31/2018 X BLDG _ELECT X 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: INTERIOR REPIPE OF RESIDENCE. I hereby affirm under penalty of perjury one of the following two declarations: 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:$3800.00 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: 342 and state laws relating to building construction,and hereby authorize 342 32 094 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 pe-t 1 upertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. ignature Date 04/05/2016 Issued by: SEAN HATCH Date:05/05/2016 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:04/05/2016 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 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,Section 5505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. O Iner or authorized agent: APPLICANT CERTIFICATION iSae:04/05/2016 ` 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 Signature Date 04/05/2016 Professional GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 (408)777-3228 a FAX(408)777-3333. buildingQcupertino.org CUPERT'INO m I f2 ! 7 LUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT AllDRESS ^^ � /1� 1-1APN# � 3 ' a OWNER NAME !4 tj h r- PHONE y t E-MAIL -- L G STREET ADDRESS CITY, STATE,ZIP �, A Q��'�1/� FAX CONTACT NAME , PHONE r.q^��/- r E-MAIL STREET ADDRESS �I �, CITY,STATE, ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEQ`•,o LICENSE NUMBER 'f sR � LI,CEI�'SET YP BUS.LIC n /� 107 COMPANY NAME �j c•� l _ E-MAIL /1J U (/ FAX I1 STREET ADDRESS '�/° J l � CITA f� n f 11 �/" � PHO S2,6 ARCHITECT/ENGINEER NAME ( LICENTSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF SFD or DUPLEX ❑ MULTI-FAMILY PROJECT IN WII.DLAND ❑ YES PROJECT IN ❑ YES IS THE BLDG AN ❑ YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA 11FNO FLOOD ZONE 0 EICHLER HOME? NO DESCRIPTION'OF WORK 914 I t -- - TOTAL VALUATION: 4 0G 0 o o RECEIVED BY By my signature belo ,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the infonnation 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 builaiwa construc I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent:_ Date: Cj SUPPLEOENTAT,INFORMATION REQUIRED OFFICE USE oNLY. W O1 ER THE-COUNTER ❑ EXPRESS U, ❑ STANDARD V a ❑ IARGE a. ❑ MAJOR z MEPMiscApp_2011.doc revised 06/21/11 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION KUPETIINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•_'building(a)cupertino.org /� Permit No. O �r7 ` 7 Address U om LA #of Alarms Smoke: � Carbon Monoxide: ni >PERMIfT CA 1�T© BE FI1'IALED AN>a C0�1',IPLETEIJ iJN ,1L THIS CERTIF C T ON .,1aaa � � a 12 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 ,icinity 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 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 hasihave 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 a ree to compLy with the terms�and cgeditions of this statement Owner or Owner Agent's)Name: P_"6,vGQ9�e#/ Si nature ...F:... ...,.... Date:,A/*_ Contractor Name: Signature...................................................................Lic.#......................................Date: ................... Smoke and CO form.doc revised 03/18/14 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION + 1JP1iTIiNt 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255. '(®08)7 7-3228•FAX(408)777-3333'•building(cb-cupertino org 2 Owner Name Permit No. Address �U V � ��Q1d�Q.l 0 K_ �,.�1 � -4 fi(6 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. V' 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. 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. �60 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. Yes My real property is built and available for use or gccupancy 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. Pease 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). El 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 lion-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 Cod"d California Green Building Standards Code,and manufacturer's installation requirements,and that the water�erVu g plumbing f es comply with the requirements as indicated i the table on the followingpage. /� Owner or Owner Agent's Signature: s Date: Upon completing and signing this Certifrc re, -lease return it to ffie Building Division in order to final your building permit. SB4072015.doc revised 08/26115