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B-2016-1958 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1958 20377 CLAY ST CUPERTINO,CA 95014-4402(369 38 022) FISCHER PLUMBING &CONSTRUCTION INC SANTA CLARA,CA 95050 OWNER'S NAME: KELLER MARTIN I AND DEBRA A TRUSTEE DATE ISSUED:05/17/2016 OWNER'S PHONE:408-255-8496 PHONE NO:(408)727-2426 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#335614 Contractor FISCHER PLUMBING&CONSTRUCTION INC Date 12/31/2017 X BLDG —ELECT —PLUMB 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: RECONFIGURE/REMODEL(E)MASTER BATH(50 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: n. 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:$18500.00 APPLICANT CERTIFICATION 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 69 Number: Occupancy Type: 3 and state laws relating to building construction,and hereby authorize 369 38 022 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 Addition 11 aplly,the licant understands and will comply with all non-point source regulatio per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signa re Date 05/17/2016 Issued by:M Date:05/17/ 16 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 2. 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(See.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(See.7044,Business&Professions Code). Date:05/17/2016 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 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 ality Management District I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cu ino icipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Cod ctio 505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized APPLICANT CERTIFICATION Date:05/17/2016 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 05/17/20/ // / 16 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildingP-cupertino.org (3 _ Z G/4 - J S� CUPERTINO l ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS ,2 U Z JSLAPN# s�//t' Q ® �� OWNER NAME ,^ L J / PHO h � E-MAIL STR:V ADDRES (/�f K / CITY, S /T/E,ZIP FAX CONTACLNAME C- � PHONE 7 LMS IFS 7r LIG �I�V i CbY� STREET,D S$ / C� C �1, , CFY,STAT ,ZIP FAX 7[ oG l06 r 7. ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMLICENSE Nl�) ` LICENSE-YPE BUy5 LIC# COMPANY NA MAIL FAX - STS IT TA $ZIP ON o�� �' el&r* ARCHITECT(ENGINEERNRME ^ LICENSE NUMBER BUS.LIC# COMPANY NAME f E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES OFFICE USE ONLY = TYPE DE CRiPTI ` S .Fr"� =VALUATION.. EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM %Co.,-), OTHERREMODELAREA (1L AREA REMODEL AREA A ' PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA:❑ DETACH r ❑ ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES _ BEING ADDED? ]NO ADDITION? ❑NO PRE-APPLICATION El YES DYES,PROVIDE COPY OF PLANNER'S NAME; -RECENED TOTAALUATION. PLANNING ADPL# E] NO PLAWNG APPROVAL LETTER By my signature below,I certify to each of the following: I am the property owner ed agent to n the pro o ner's behalf. I have read this application and the information I have provide correct. I ha ad the Des tlOn of Work and verify it is ace e. I agr to comply with all applicable local ordinances and state laws relating to buil onstructio au/'onze repre tatives of Cupertino to enter th abovIfled property for inspection purposes. Signature of Applicant/Agent: lil Y Date: -b SUPPLEMENTAL INFO ION REQUIRED rim CHECK TYPE RovTIxG stir _New SFD or Multifamily dwellings: Apply for demolition permit forElovER=TxE coDNTER ❑ BUILDING PLAN IiEvUEw existing building(s). Demolition permit is required prior to issuance of building permit for new building. ❑ ExPREss ❑ PL,ANNING PLAIN REN cw _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDAR6, '- ❑-PUJBLICWORKS 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 © >hAdoR" ❑ SAN'ITAUY'SEWFR nITRICT ' submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH B1dgApp_2011.doc revised 03116111 Assessor's Parcel Number: �o �7— Z RE cEiv Plumbing Notes: _ ty 1. Neater closets shall have an average water consumption of not more than 1.28 gallons per effective flush.(CPC 403.2) Name of Owner: Al A kj L Ke,( I-((_ 2. Shower heads shall have a water flow not exceed 2.0 gallons per minutes @ 80 psi.(CPC 408.2) 3. Faucets.in lavatories shall have a water flow not exceed 1.5 gallons per minutes @ 60 psi and shall not be less than:8 gallons per minutes at 20 psi.(CPC 403.6) > Id`" 4. Shower stalls shall have a clear Interior finish area of 7.1 s ft and be able to accommodate a minimum 30 inch circle at the threshold level.These clearances shall be Contact Person: (. rV L a t l 5 �. Phone: �� � _ aZ L-� maintained up to a height of 70 inches able the shower draln.(CPC 408.6) 5. Shower compartments and walls above bathtubs with Installed shower heads shall be finished with a smooth,nonabsorbent surface to a height not less than 72 inches -�1 (0).(CRC 8307.2) Project Address: O� �T �i, ? Lq � _ 6. The maximum hot water temperature discharging from the bathtub,shower and whirlpool bathtub filler shall be limited to 120 degrees Fahrenheit The wafer heater - thermostat shall not be considered a control for meeting this provision.(CPC 409.4&408.3) ( r 7. Water closet shall be set minimum 15 Inches from Its center to a side wall or obstruction and 24 inch clearance In front of water closet.(CPC 402.5) Scope of Work: i�f l ,^,(� I. f^ j �-(Y}ry d�y1 Q� >L�� �1 � 1,-�J,,y, Electrical Notes: 1. The Installation of smoke alarms In all of the following areas shall be provided: (R314,3) Code Editions: 2013 California Residential Code a. On the ceiling or wall outside of each separate sleeping area in the immediate vicinity of bedrooms. 2013 California Plumbing Code b, In each room used for sleeping purposes. c. In each story within a dwelling unit,including basements but not including crawl spaces and uninhabitable attics. 2013 California Mechanical Code - 2. Approved In monoxide alarms shall be installed outside of each separate sleeping area In the Immediate vicinity of the bedrooms and on every level including I OFFICE basements in dwelling units that have fuel-fired appliances or attached garages.(CRC R315,1) 2013 California Electrical Code 3. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets.Such circuits shall have no other outlets.(CEO 210.11(0)(3)) 2013 California Ener Code ®� 4. All receptacles In bathrooms garages,accessory buildings,outdoors,$y p ,9 9 Y 9 , r ,crawl spaces,unfinished basements,kitchens(where receptacles serve countertop surfaces), x� laundry,utility,wet bar sinks(within 6 feet of the edge of the sink),shall have ground-fault circuit interrupter(GFCI)protection. (CEO 210.8) Mechanical Notes: 5. In all areas specified in 210.52,all 125-volt,15-and 20-ampere receptacles shall be listed tamper-resistant receptacles. (CEC 406.11) t 1. Bathroom vents shall terminate not less than 3 feet from openings and property lines.(CMC 504.1) Energy Code Mandatory Measures: 1. All permanently installed high efficacy luminaires shall be switched separately from low efficacy lumlaaires(150(k)(7)) 2, Permanently installed luminaires in bathrooms shall be high efficacy luminaires OR are controlled by an-occupant sensors(s)certified to comply with Section 119 that U PERTI NO o does not turn on automatically or have an always on option.(150(k)(10)) , Building Department 6 AY 20166 <ar r�S is �rT a l A 4-f-- REVIEWED FOR CODE COMPLIANCE F f Reviewed BY, rLli 4� ,� j � _.r i S� j �•t � t^tom!''1.,/' `�,i�v�3' L:.l� "i�.'�(T N��_ kF ti t NO ej--e e oezo e" COMMUi SITZ'DEVELOPIL E l tN r i BUI_Dli iG DIVI-SION-CUPERTINO APPROVED r This sot of plant a d specifications MUST be kept at the 'Sife during construction. It is unlawful to make any f �t� ,:u�, t 4 aerations on same,or to deviate h r -r s —frG �, v�;r� approval from the Building Official. — i Tha Stamping of this plan and specifications SHALL NOT 'd to permit o t ._ �w�� of the violation •�y�,(Z n R to he, . .�f of at, -, ISIOr1S O ��s,a or State Law. _ l b ,� 7 BY PERIViIT NO. EXISTING BATHROOM FLOOR PLAN PROPOSED BATHROOM FLOOR PLAN j I. SMOKE l :CARBO. � ► Ft - a�c� � . OWNER CERTIF C TE OF COMPS IARC f i COMM'UNITY DEVELOPMENT:DEPARTMENT•BUILDINGDIVISION 10300TORREAVENU'E• GUPERTINO,CA95014-3255 (408)777-3228 FAX(408)777-3383 Uuildino:Ca4cL ,ino orq r I y_ z PURPOSB - This affidavit is a self-certification for the installation of all required Smoke and Carbor Monoxide Alarms for compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 when no interior access.for Inspect ons are required. DEIN'VIRAL 1NUO1 MATIO tXisting single-family and multi-family dwellings shall be provided with Smoke Alarnis and Carbon Monoxide alarms. When the valuation of additions,alterations,or repairs to existing g welling,g units exceeds $10"00.00,CIBC Section 8314 and CBC Sections 907.2.11.5 and 420.6 require that SmokeAlarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA SMOKE ALA IA CO ALA]�I11€ Outside of each separate sleeping area in the immediate vicinity of the X bedroom s' On everlevel.of a dwellin&unit zncludin_ basements h tiVi thin each sleeping,room, Carbon IVlonoxide alarms-are not required in dwellings which do not contain fuel-bu n ing appliances and that do not have an attached garage. Carbon monoxide alarmsz combined with smoke alarins shall comply wifh CSC Section 420.6 and sl-tall be approved by the Office of the State Fire Marshal. Power Supply:In dwelling;units with no couunercial power supply,alarm(s)may be s leTy battery operated. In exisfing.dwelling units;alarms are permitted to be solely battery operated where repairs or ailferation's do not result m the removal of wall mild ceiiu1g,finishes or there is no;access by means of attic,basement or crawl space Refer to CRC Secfro 18314 atnd CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is,requiried far, alarms which must be corauected to the bui=lding wiring. As owner of the above-referenced property,.I hereby certify that the alarin(s)referencE d above has/have been installed in accordaizce with the manufacturer's ins r uctions and in compliance with t e Califoxn=iaE Buildnzg and Cahfon�'a.Residential.Codes.The alarm,sItave been tested and are operational,as of the date sigiZed below. F`have readand a r=ee.to comp(f with,.the terms and cond!kons of this s te temente ��--' etro "'�v , f�afe WATER-CONSERVING PLUMBING FIXTURES FIL, OWNER CERTIFICATE OF COMPLIANCE i COMMUNITY DEVELOPMENT DEPARTMENT-BUILDING'DIVISION ��� CUPERTINO 10300 TORRE AVENUE-CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333-buildin-gRcupertino.oro ( O�N � dCam AACI �.d o t_e-1 Permit No. oil L �Acdress ° 8 1. Is your real property a registered historical site? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. D 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. 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. Yes My real property is built and available for use or occupancy on or before January 1, 1994. Civil Code Sections 110 1.1 through 1101.8 apply. Check one of the three followi ag statements and sign bottom of form.. 5.d PJ;ease check ONE of the following: 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 beft re 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 on-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 ter- conserving plumbing fixtures throughout the building(regardless of whether property unde goes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after Januaiy 1,2014,specified building alterations or improvements shall require ri on-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 alteral ions or improvements). I,as the owner or owner's agent of this property,certify under penalty of perjury that non-coin liant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in accordancewith Civil Code Sections 1101.1 through 1101.8,the current California Plumbing Code and Calif6mia-Al4reen Building Standards Code,and manufacturer's installation requirements,and that the water-co serving pl bingtures comply with the requirements as indicated in the table on the following page. -' Owner or Owner Agent'sSignatdre: ,` Date: 6/,91 .4 6 Upon completing and signing this rtificate, lease return i6to the Building Division in order W final your building permit. SB40 7 2015.doc revised 08/26115