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B-2016-1953 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1953 21398 KRZICH PL CUPERTINO,CA 95014-4943(362 06 041) ALTERNATIVE POWER AND ELECTRIC BOULDER CREEK,CA 95006 OWNER'S NAME: SINGH RAM D AND SPRIHA TRUSTEE DATE ISSUED:05/16/2016 OWNER'S PHONE:408-605-3084 PHONE NO:(408)605-3084 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class ELECTRICAL Lic.#639615 X BLDG X ELECT _PLUMB Contractor ALTERNATIVE POWER AND ELECTRIC Date 03/31/2018 — MECH X RESIDENTIAL_COMMERCIAL I hereby affirm that I am licensed under the provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: REPLACE MAIN ELECTRIC PANEL(200 AMP) I hereby affirm under penalty of perjury one of the following two declarations: 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. 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:$1000.00 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: 362 and state laws relating to building construction,and hereby authorize 362 06 041 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 Cu^inse liab" ments,costs,and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accry i nse uence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionalrstands and will comply with all non pointsource ree C o unic' ode,Section 9.18. 180 DAYS FROM L PECTION.SignatureDate 05/16/2016 Issued by:MELISSA ES Date:05/16/2016 OWNER- LARATION 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 ofApplicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date:05/16/2016 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. I will permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the s. I certify that 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 d vices 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 ality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Caper) ' rcipal Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,S c 25 3 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:05/16/2016 I certify that I have read this application and state that the above information is CONSTION LENDING AGENCY is a correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there s a construction lending agency for the performance of work's for which this permit is issued(Sec.3097,Civ C.) relating to building construction,and hereby authorize representatives of this city 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"' per dditionally,the applicant understands and will comply with all emT-p&yource/%uratiQns per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Sectior°9R I understand my plans shall be used as public records. Licensed Signature Date 05/16/2016 GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT' BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228^ FAX(408)777-3333•building o)cupertino.org IVI b L; (7' 0,o 1,6 q5 _3 ❑PLUMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS fZ t 2C,7P1_ r_��yz_p6C k PL APN# 36 6.7J — 0 6 O / OWNERNAME �� 1 PH&C � �� �� (' E-M SIL`— STREET ADDRESS �i�� CITY, STATE,QIP FAX `2��Gh - C�3rO �ai � E-J�1"7 CONTACT NAME r©�r�� E-M,411, STREET ADDRESS. CITY,STATE,ZIP FAX ❑ OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT ❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRA R E LIC ENS B LICENSE TYPE BUS. $ COMPAK�V E-MAIL F��1�3 P161`7 STRE `IESS�A p� p�4-('r CITY 6��ATF�Zf=VGeet /�� P�i ?� ARCHITECT/ENGINEER N V V 1 LICENSE NUMBER( Ce BUS.LIC#i COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF ❑SFD u DUPLEX ❑ MULTI-FAMB.Y PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑ YES BUILDING: ❑COMMERCIAL. URBAN INTERFACE AREA ❑ NO FLOOD ZONE E]NO EICHLER HOME? ❑ NO DESCRIPTION OF WORK id�� u1(c 1` y TOTAL VALUATION: 'RE ,�. . By my signature below,I certify to each of the follow' a the property owner or authorized agent to act on thewner's'behalf. I have read this application and the information I have provide o -ect. I ave cad the Description of Rork and verify it is acc e. I agree to comply with all applicable local .ordinances and state laws relating tob dint 6 cti au rize representatives of Cupertino to enter the above-identified__property for inspection purposes. Signature of ApplicandAgent: `' Date: S PPI,EMENTAL INFORMATION REQUIREDoFFzcE USE oxLY <3 ca k SLR THE COULTER � �. 'EXPRESS *r x U �, <c r � STALDARD4 t MAJOR , }' MEPMiscApp_2011.doc revised 0612.1111 SMOKE ,/ CARBON MONOXIDE ALARMS { OWNER CIE"19CATE OF COMPLl� NCEIrma I L E i. COMMU'NITYDEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 (408)777-3228.FAX(408)777-3333+ buildin4(c),cupertino.org fl mar ? n 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 INVORMATION, 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, CIBC Section 12314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarn-'s and/or Carbon Monoxide Alarms be installed in the following locations;, AREA SMOKE ALARM CO ALAR, Outside of each separate sleeping area in the immediate vicinity of the X X bedroorn(s) On every_level of a dwelling unit including.basernents X j( 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 CDC Sectian 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)rnay be solely battery operated. In existing.dwelling,units, alarms are permitted to lre solely battery operated where repairs or alterations do not result in the removal of wall and ceilu,g finishes or, there is no access by means of attic,base rneyYt or crawl: space.Refer to CRC Sectian R3I4 and CBC Sections 907.2.11.4 and 420'.6;2.An electrical permit is,required for --alarins wlnicl,t must be co,ma to�the building wir hag. As owner of the above-ref er=eizced property,I hereby certify that the alarm(s)referenced above has/have been instalTed in accord aizce with,the.manufact urers instructions and in compliance with the Cahforknia Budding; and California Residential Codes:.T he alarms have been tested and are operational, as of the date signed below. t have=read and a re.e to corn;G Furth,the terms and!conditions of this statement' _. FI--- .. �`.................. .................................._...:Date;:, A6 SiRnatUre..: . ................................................ .......Lrc 'fi': ...... .Dates WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE. COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION CUPERTIINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 408)777-3228-FAX(408)777-3333•building(a-)cupertino.org Owner Name KO*" c5 A I. Al �Q/�/!} SIA'C JY Permit No. r j Address o?%3,6p ZiC / G'Ue&7InVL*j r cA q 1. Is your real property a registered historical site? 11 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. f }P 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. f 4 No Go to Question 3. 3. Is water service permanently disconnected for your building? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. l --� 1No 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. r Yes My real property is built and available for use or occupancy on or before January 1, 1994. >> Civil Code Section_s 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: f . 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 properly 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 C liforma Green Building Standards Code,and manufacturer's installation requirements,and that the water-conserving pluming fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: r Dater� i ,t`�f6 Upon completing and signing this'Certificate,please return it to the Building Division in order to final your building permit. SB40 7 2015.doc revised 08126115