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B-2016-1915 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMI NO:B-2016-1915 10574 CULBERTSON DR CUPERTINO,CA 95014-3556(375 34 036) OVERMILLER INC CONCORD,CA 94520 OWNER'S NAME: LEE CHANGHWAAND LEEYEH MINGLI TRUSTEE DATEISSUED:05/09/2016 OWNER'S PHONE:408-712-1435 PHONE o:{925)798-2122 CONTRACTOR'S DECLARATION I ICENSEDBUILDING PERMIT INFO: License Class GENERAL ENGINEERING CONTRACTOR Lic.#323839 Contractor OVERMILLER INC Date 07/31/2016 X_BLDG —ELECT X PLU 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: RE-ROUTE GAS LINE PER P &E(LEAK)TO OVERHEAD FROM I hereby affirm under penalty of perjury one of the following two declarations: METER TO WATER HEATER LOSET(INTERIOR) i. 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: Valuation:$2200.00 APPLICANT CERTIFICATION 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: Occupai icy Type: and state laws relating to building construction,and hereby authorize 375 34 036 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 I F WORK IS NOT STARTED may accrue against said City in consequence of the granting of this permit. WITHIN 180 DAYS F 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 L S SPECTION. Signature Date 05/09/2016 Issued Da e:05/09/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the -ROOFS: following two reasons: All roofs shall 1) inspected prior to any roofing material being installed.If a roof is I. I,as owner of the property or my employees with wages as their sole installed without first obtaining an ii ispection,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:05/09/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINS TO BE CLASS"A"OR BETTER I. 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 ATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous mate►ials 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 Cal iertino 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 5532(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 u e equipment or devices which emit hazardous air contaminants as defined by th 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,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall bed Owner or authorized agent APPLICANT CERTIFICATION Date:05/09/2016 Irect.I agree to comply is application and state that the above information is CONSTRUC 1 ON LENDING AGENCY certifywith I hereby affirm that there is a con truction lending agency for the performance all city and county ordinances and state laws y g 9 y relating to building construction,and hereby authorize representatives of this city of work's for which this permit is i sued(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 MunicipalARCHITECT'S Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 05/09/2016 Professional GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION MEP 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 UPIERT( t€) (408)777-3228•FAX(408)777-3333•bullding(a)cupertino:ora MISC o7- 1' 016 -tg�s PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MIS ELLANEOUS PROJECT ADDRESS l_ 6,5"74 v+t` � C;a'\ �cr < APN# 3}-S' I, r o3 OWNERNAME PHONE pp�� [b r J i `( L, C! (Va �ff2^IJ,s EMA STREET ADDRESS CITY, STATE,ZIP FAX C a�7 y �n t �d o / a CcA �✓} "�. C,4 CONTACT NAME PHONE N� E ' STREET ADDRESSj� CITY,STATE,ZIP ,/ FAX Cu�YjeY' d 'Lu o-i +c- LIT OWNER ❑ OWNER-BUILDER ❑ OWNTERAGENTT ❑.CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT 11 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBB R LICENSE TYPE BUS.LTC# tA 'h COMPANY NAME CD ol3Y vIn'9 ii C,s/ 3`^'9 C $ s E-MAIL FAX 4e, STREET ADDRESS , I, 1 CITY,STATE,ZIP ( PHONE y 33-® Acdq neGAS � � Fit f� �(fir/'� � Y 6ri - ��`6Z�•��5/ ARCHITECT/ENGINTEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD or DUPLEX ❑. MULTI-FAMII.Y PROJECT 11\1 WILDLAND ❑. YES PROJECT IN ❑YES IS THE BLDG AN ❑ YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA ❑.NO FLOOD ZONE ❑No EICHL.ER HOME? ❑ NO DESCRIPTION OF WORK e TOTAL VALUATION: By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on th ner'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 building construction. I auth e resentatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent Date: 57, / G SUPPLEMENTAL INFORMATION REQUIRED -r �k ,O><FiCE USE ONLY' 03 ER SHE COIJITER ' li X U LARGE �. ME MiscApp 2011.doc revised 06121111 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION UPRTINQ 10300 TORRE AVENUE e CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333•building c(ilcupertino.org Owner Name AIA, L.i Permit N o. Address 10.514 CL6er4fate. IC-Nis+'livia C,4 iJo/y 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. -K No Go to Question 2. 2. Does our real roe have a licensed lumber certifying that due to the e or configuration of the property or its Y property rtY p �g g g p p �3' 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. W 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. I '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. -1< 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: 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). ❑ 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 plurnbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 110 1.1 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 Signatur :. Date: cS�/6 Upon completing and signing this Certificate, lease return it to the Building Division in order to final your building permit. SB4072015.doc revised 08/26/15 BUILDING PERMIT CAleTI�'OT BE FINALED AND C®NTPLETED UNTIL THIS` CERTIFICATE iiAS SEEN SIGNI; AND RETITT2NED I(�THE SUILIIING Di�'ISI®N Non-Compliant Water-Conserving Plumbing Fixturel Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate 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, I 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. SB407201.5.doc revised 08126115 SMOKE CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE jt COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE.CUPERTINO, CA 95014-3255 (408)777-3228•,FAX(408)777-3333- buiIdinqCa_)cupertino.orq Permit No. LU((3 - 151 Address 10 5-1q Ck I 6-ur-41g�� #of Alarms Smoke: Carbon Monoxide: J ............... .... ......... PERMIT,CANNOT-;BE FINALED.AND.COMPLETED,UNTIL TRIS CERTIFICATE AND, TLIME TO BUILDING DIVISION. HASBEE S RE 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,_qRC 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. Carboninonoxide 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 per ' itted 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 CBSections 907.2.11.4 and 420.6.2.An electrical permit is required for alarms which must be connected to the bul' ding wiring. As owner of the above-referenced propert I hereby certify that the alarm(s)referenced above has/have been -t installed in accordance with the manufac rer'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. have read and agree to complywith the terms and conditions of this statement Owner(or Owner Agent's)Name: Signature............................................................................ ......................................Date: ................... Contractor Name: ISigna j��... ....... ..................... ................Date: Smoke and COforin.doc revised 03118114