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15120184CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10191 PHAR LAP DR CONTRACTOR: JM CONSTRUCTION PERMIT NO: 15120184 OWNER'S NAME: DOWD TIMOTHY A AND BONICELLI LYNN E 562 DIVISION ST DATE ISSUED: 12/22/2015 OWNER'S PHONE: 4088868047 CAMPBELL, CA 95008 PHONE NO: (408)379 -9852 ❑ LICENSED CONTRACTOR'S DECLARATION JOB DESCRIPTION: RESIDENTIAL COMMERCIAL TREE DAMAGE REPAIR - REPLACE ROOF FRAMING AT jy�7[� License Class�� Lie. # � Y✓ � G O PATIO Contractor it1 ate � `� ROOM; REPAIR ROOF &CEILING FRAMING AT FAMILY It��VI ROOM; REPAIR CHIMNEY; REPLACE 1 WINDOW AND I I hereby affirm that I am licensed under the provisions of Chapter 9 DOOR (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: 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 Sq. Ft Floor Area: Valuation: $80000 ante of the work for which this permit is issued. iaer ave 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 APN Number: 32639053.00 Occupancy Type: permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is PERMIT EXPIRES IF WORK IS NOT STARTED correct. I agree to comply with all city and county ordinances and state laws relating WITHIN 180 DAYS OF PERMIT ISSUANCE OR 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, 180 DAYS FROM LAST CALLED INSPECTION. costs, and expenses which may accrue against said City in consequence of the ° granting of this permit. Additio ally, the applicant understands and will comply Issued by: I� -u�`� " V Date: ✓" with all non- 'nt source regul ons per the Cupertino Municipal Code, Section 9.18. G v RE- ROOFS: Signat e Date All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. ❑ OWNER - BUILDER DECLARATION Signature of Applicant: Date: I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) I, as owner of the property, am exclusively contracting with licensed contractors to HAZARDOUS MATERIALS DISCLOSURE construct the project (Sec.7044, Business & Professions Code). I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will I hereby affirm under penalty of perjury one of the following three maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the declarations: Health & Safety Code, Section 25532(x) should I store or handle hazardous I have and will maintain a Certificate of Consent to self - insure for Worker's material. Additionally, should I use equipment or devices which emit hazardous Compensation, as provided for by Section 3700 of the Labor Code, for the air contaminants as defined by the Bay Area Air Quality Management District I performance of the work for which this permit is issued. will maintain compliance wit the Cupertino nicipal Code, Chapter 9.12 and I have and will maintain Worker's Compensation Insurance, as provided for by the Health & Safety Code, cc ons 25505, TV and 2553 Section 3700 of the Labor Code, for the performance of the work for which this r� .,ter Owner or authorized a ent: 6Date: G- C permit is issued. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after malting this certificate of exemption, I CONSTRUCTION LENDING AGENCY become subject to the Worker's Compensation provisions of the Labor Code, I must I hereby affirm that there is a construction lending agency for the performance of forthwith comply with such provisions or this permit shall be deemed revoked. work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name APPLICANT CERTIFICATION Lender's Address 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 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, ARCHITECT'S DECLARATION costs, and expenses which may accrue against said City in consequence of the I understand my plans shall be used as public records. granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section Licensed Professional 9.18. Signature Date E RM" CITY OF CUPERTINO FEE ESTIMATOR - BUILDING DIVISION ADDRESS: _10191 Phar Lap Drive DATE: 12/22/2015 REVIEWED BY: PAUL APN: 326 39 053 BP#: *VALUATION: 1$80,000 "PERMIT TYPE; Building Permit PLAN CHECK TYPE: Alteration /Repair PRIMARY USE: SFD or Duplex Suppl. PC Fee: 0 Reg. 0 OT PENTAMATION PERMIT TYPE: 1 GENRE A wORK . Tree Damage Repair - Replace roof framing at patio room' Repair roof & ceiling framing at family room' SCOPE Repair chimney; Replace 1 window and 1 door at living & family room ilfeL'It. }' }CtYi t "`fi2C,t;; :Slech. t3 ?i °7tt ?I I C0 o.110, Yle" n :). NOTE: This estimate does not include fees due to other Departments (i.e. Planning, Public Works, Fire, Sanitary Sewer District, School District. etr-L Theve fees are hated on the nreliminary infnrmatinn availahle and are nnh? an nctimato_ rnntart the nont fnr addn'1 info FEE ITEMS (Fee Resohition 11 -053 Elf. 711113) FEE QTY /FEE MISC ITEMS Plan Check Fee: Hourly Only? 0 Yes (j) No $0.00 hours $143.00 Plan Check, Hourly ISTPLNCK Suppl. PC Fee: 0 Reg. 0 OT 1 0.0 1 hrs $0.00 PME Plan Check: $0.00 Permit Fee: Hourly Only? ()Yes Q No $0.00 Suppl. Insp. Fee:Q Reg. Q OT 0.0 1 hrs $0.00 PME Unit Fee: $0.00 PME Permit Fee: $0.00 A41inini,,lrcali e c}c: E E) Work Without Permit? 0 Yes (F) No $0.00 Advanced Planning Fee: $0.00 Select a Non - Residential E Building or Structure 0 i D.cnvl 1.)Oc;unle:r-aation IP'C' S: Strong Motion Fee: IBSEISMICR $10.40 6.0 hrs $858.00 Inspections ISTINSp Inspection, Hourl Bldg Stds Commission Fee: IBCBSC $4.00 SUBTOTALS:, $14.40 $1, 001.00 TOTAL FEE:.; $1,015.401 Revised. 5 CUPERTINO CONSTRUCTION PERMIT APPLICATION t51�I�jI�- . COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 • FAX (408) 777 -3333 • building(a.cupertino.ora ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/ TI ❑ REVISION/ DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10191 Phar La Drive APN # 326 -39 -053 OWNER NA Tlmot y Dowd /Lynn Bonicelli PHONE 4 0 8- 8 8 6 - 8 0 4 7 E -MAIL STREET ADDRESS 10191 Phar La Drive P CITY, STATE, ZIP Cu Cupertino, CA 95014 FAX CONTACT NAME Jeff Guinta /Shari Parker PHONE 408 - 379 -9852 E -MAIL STREET ADDRESS 562 Division Street CITY, STATE, P Campbell, Ca 95008 FAX 408-379-9857 ❑ OWNER ❑ OWNER - BUILDER ❑ OWNER AGENT CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME JM Construction LICENSE NUMBER 736056 LICENSE TYPE BUS. LIC # 20955 B COMPANY NAME JM Construction E -MAIL FAX 408-379-9857 STREET ADDRESS 562 Division Street CITY, STATE, ZIP Campbell, Ca 95008 PHoNE 4 0 8- 3 7 9 - 9 8 5 2 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK Reconstruction repairs from fallen tree onto the property / home EXISTING USE PROPOSED USE CONSTR. TYPE F STORIES I USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AARIE GARAGE AREA: []DETACH I ATTACH I 9 DWELLING UNITS: IS A SECOND UNIT ❑YES SECONDSTORY ❑YES BEING ADDED? []NO ADDITION? []NO PRE-APPLICATION LANNI G APPON ❑YES IF YES, PROVIDE COPY E PLANNING ATI # ❑ NO PLANNING YES, PR APPROVAL LETTER IS THE BLDG AN ❑ YES IS THE B HOME? ❑ NO P IVED BY: ` lG� TOT t VQLUAT ( 1. V `�/j By my signature below, I certify to each of the following: I am the property owner or authori1led agent to act on the property owner's behallf. 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 relay to bl �Iding onstruc on I authorize�fep sentatives of Cupertino to enter the above- identified property for inspection purposes. Signature of Applicant/Agent: (; Date: 2 SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP IKBUH.DING New SFD or Multifamily dwellings: Apply for demolition for permit existing building(s). Demolition permit is required prior to issuance of building OVER - THE - COUNTER PLAN REVIEW permit for new building. ❑ EXPRESS 1 PLANNING PLAN REVIEW Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD / ❑`PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BidgApp 2011.doc revised 06121111 • Building Department City Of Cupertino 10300 Torre Avenue ELI Cupertino, CA 95014 -3255 Telephone: 408- 777 -3228 C U P E RT I N O Fax: 408 - 777 -3333 CONTRACTOR / SUBCONTRACTOR LIST JOB ADDRESS: p a r L,V PERMIT # OWNER'S NAME: L I yn OA` 0 ow PHONE # LID •- 366— 504-7 GENERAL CONTRACTOR: BUSINESS LICENSE # f3-1 -7-36056 ADDRESS: _96), 0 ; v , -- cQ S -}- CITY /ZIPCODE: C ., ,l� 5 G *Our municipal code requires all businesses working in the city to have a City of Cupertino business license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTION(S) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONTRACTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. I am not using any subcontractors: Signature Please check applicable subcontractors and complete the following information: Date Owner / Contractor Signature '51 �� l(; Date SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring/ Carpeting ( ,, n u rtin- Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing on �M Septic Tank 3 Sheet Metal Sheet Rock Tile Owner / Contractor Signature '51 �� l(; Date fCVPE K'T6MQ :•. At�(p -4s AWOKE f C BON MON®XI LARMS - 'DER CERTIFICATE OF C LIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014 -3255 (408) 777 -3228 o FAX (408) 777 -3333 • building(a)cupertino.org 1l'eratt °.liio„ 2 , q, V, 4,dfWl' iCl@gS f-6- 0- Cc: Ll (-'srbnn-Mnnni Ma• I PERIWT CANNOT BE FINAIJED AND COMPLETED PLETED UNTIL THIS CERTIFICATE fd.AS 'BEEN � Y '_ �� Attu IZk _1C >i1�1+7�D TQTH1 1(3[7II,AINQ D><4jSiQ►.i41 PURPOSE This affidavit is a self- certification for the compliance with 2013 CRC Section R314, inspections are required. GENERAL INFORMA'T'ION Existing single- family and multi- family d, Monoxide alarms. When the valuation of $1000.00, CRC Section R314 and CBC Sect Monoxide Alarms be installed in the follo llation of all required Smoke and Carbon Monoxide Alarms for CBC Sections 420.6 and 907.2.11.2 where no interior access for ags shall be provided with Smoke Alarms and Carbon .tions, alterations, or repairs to existing dwelling units exceeds 907.2.11.5 and 420.6 require that Smoke Alarms and /or Carbon locations: AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the bedroom(s) immediate vicinity of the X , On 6very level of a dwelling unit including basements X Yf S Within each sleeping room I I X Carbon Monoxide alarms are not required ii do not have an attached garage. Carbon me CBC Section 420.6 and shall be approved by dwellings which do not contain fuel- burning appliances and that ioxide alarms combined with smoke alarms shall comply with 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 Sffections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the bull ing wiring. As owner of the above - referenced property, 1 hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in; compliance with the California Building and Cal fonda Residential Codes. The alarms have been tested and are operational, as of the date signed below. 1 have .read and a • reO to comply with the germs and' conditions of this statement "(�v��' crtQWrrer�?;�en�sl;6�tar�tec 't j� Ih !%C� h� Si nafure :i......r•;:� f-i .............. CbniraFfo "r�Name; , Si�naliire .................... ....... .. ............................... Lich: -811 Smoke and CO form.doc revised 03118114 CUPERTINO Owner Name' _- Address ` i i d 1 WATER-CONSERVING PLUMBING FIXTURES OWNER CE COMMUNITY DEVEL 10300 TORRE AVENi (408) 777 -3228 • FAX r FICATE OF COMPLIANCE DEPARTMENT • BUILDING DIVISION • CUPERTINO, CA 95014 -3255 777 -3333 - buildingAcupertino.org Permit No CA - b3 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. -� LI—M Go to Question 2. 2. Does your real property have a licensed plumber plumbing, installation of water - conserving plum ❑ Yes Civil Code Sections 110 1. 1 through 1 ❑ The licensed plumber's certificati( P/<,--Skip the rest of the form and sign boll i 0 Go to Question 3. certifying that, due to the age or configuration of the property or its ping fixtures is not technically feasible? .01.8 do not apply. n has been provided to the Building Division. )m of form. 3. Is water service permanently disconnected for your building? s 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 4. 4. Is your real property built and available for use dr 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 occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1 01.8 apply. Check.one of the three following statements and sign bottom of form.. 5. Ple check ONE of the following: My property is a single-family residential re, On and after January 1, 2014, building alter to be replaced with water - conserving plumbi compliant plumbing fixtures shall be rep] property undergoes alterations or improveme ❑ My property is a multifamily residential real On and after January 1, 2014, specified built plumbing fixtures to be replaced with water On or before January 1, 2019, all non- compl: conserving plumbing fixtures throughout the improvements). ❑ My property is a commercial real property. On and after January 1, 2014, specified built plumbing fixtures to be replaced with water On or before January 1, 2019, all non -co plumbing fixtures throughout the building (r( property. See Civil Code Section 1101.4. :ions or improvements shall require all non - compliant plumbing fixtures g fixtures throughout the building. On or before January 1, 2017, all non- ced with water - conserving plumbing fixtures (regardless of whether )erty. See Civil Code Section 1101.5. alterations or improvements shall require non- compliant ,erving plumbing fixtures. plumbing fixtures shall be replaced with water- [ding (regardless of whether property undergoes alterations or Civil Code Section 1101.5. alterations or improvements shall require non- compliant serving plumbing fixtures. iant plumbing fixtures shall be replaced with water- conserving dless 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 pate: r, Owner or Owner Agent's Signature. - —Date:. Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08126115 BUILDING PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION 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 Non - Compliant Water - Conserving Plumbing Fixture Plumbing Fixturel (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 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 0.5 gallons /flush 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 \ _- h_�,_•ham °�( � mat �y , a _ r i 5 � '''�^ . - � (i �, _ __ �i�.._...�._...._.. - _- •, � J fir- i r� r } t r rl j I ti } a t sc s t; o i2 oz za m � v t eec��srm I : i EL ZE Lu r LL y LLs o i2 oz za m � v t I : i ZE r o i2 oz za m � v t jk Cl mV - - ------------------ I M',IJNUJ aAILVAo,,TNT -i=° V-) jk Cl mV - - ------------------ I I\A IAN EE 11 rl ED 11 1 lo S 6 V�) > 9 m ugh' a j i j l �j �y OU:, }..ivGYll") '� es��os � _'� a G �7a�� IE'IU'I ,� �� I � ��U7/7ISV� p�/j �L�, @� ,� �' � �c �1j�� V i v v �_ � " �.�. ii% Q 2 z 0 �� z O �� nMMMEMi L, t SIZ L -,Iuj I v II , L, t SIZ L -,Iuj I v 2i L, t SIZ L ins 2i , lj�l ins