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B-2016-2085i CITY OF UPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO:B-2016-2085 10391 CASTINE AVE CUPERTINO,CA 95014-1308(326 41 040) HIGH TECH CONSTRUCTION MORGAN HILL,CA 95038 OWNER'S NAME: MAXWELL BRENT KAND FARRELLY KAREN E TRUSTE DATE ISSUED:06/08/2016 I OWNER'S PHONE:408-529-8481 PHONE NO:(408)458-6565 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#810056 Contractor HIGH TECH CONSTRUCTION Date 06/30/2018 X BLDG —ELECT _PLUMB T I hereby affirm that I am licensed under the provisions of Chapter 9(commencing MECH X RESIDENIAL COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: REMODEL 1 ST FLOOR MASTER BATHROOM-MEP;(120 S.F.) 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 01 permit is issued. Sq.Ft Floor Area: Valuation:$16500.00 APPLICANT CERTIFICATION 1 certify that I have read this application and state that the abode information is correct.I agree to comply with all city and county ordinances ATN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 326 41 040 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 per th rtino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date–_61aLZQ16 Issued by:Abby Ayende �j�� Date:06/08/2016 �/W�►��, ak_ 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 roofmg material being installed.If a roof is t. 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:6/812016 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 shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous 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 Munici ode,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 2.35ff5,25533 and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:6/8/2016 1 certify that I have read this application and state that the above information is CONST4CZT1ONLENDING 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 6/8/2016 Professional CONSTRUCTI®N PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION I 10300 TORRE AVENUE•CUPERI INO,CA 95014-3255 CCIPEF3 flhlC� (408)777-3228•FAX(408)1777••3333®building ftupertino.org --W k(P.. � ❑,NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS o 3 /_ APN# '5 /_ 040 L (� 41 U OWNER NAME PHONE E-MAIL STREET ADDRESS CITY,STATE,ZIP 6�9 = VAI _D CONTACT NAME 1 PHONE E-MAIL �1� 1 S T Ill lJ Nuc/Z �' O L.CCO� STREET ADDRESS ��. Q x �� CITY,STATE,ZIP C F-3 — ❑OWNER ❑ OWNER-BuiLDER ❑ OWNERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER 1i DEVELOPER ❑ TENANT I CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# 1r,x� 1S 10 COMPANY NAME E-MAIL FAX A/ n T STREET ADDRESS �-^^ CITY,STATE,ZIP _ PHONEE V Zia- J ARCHITECT/ENGINER NAME ICENSE NUMBER BUS.LIC# COMPANY NAME ��- — --�- E-MAIL TM FAX STREET ADDRESS - ----,---_ CITY,STATE,7JP --- PHONE - DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR TYI'F. #STORIES USE TYPE OCC. SQYT. VALUATION(.$) EXISTG NEW FLOOR DEMO DOTAL AREA AREET AREA BATHROOM KITCHEN OTHER 11 REMODEL AREA 110 REMODELAREA REMODE AREA PORCH AREA 1 DECK AREA TOTAL DECK/PORCH AREA G GE AREA: ❑DETACH ❑ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE$LDG AN ❑YES nECED BY: ,` ' T TAL VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? ❑NO ' By my signature below,I certify to each of the follow I the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided i orre 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 buildin on ction. I aut e r entatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: /C SUPPLEM AL INFORMATION REQUYRED PLAN CHECK TYPE ROUTINdSL11R., New SFD or Multifamily dwellings: Apply for demolition permit for ❑'O�ER THE COUNTER ❑ BUILDING PLAN REVIEW existing building s). Demolition permit is required prior to�ssuance of building W permit for new building. ❑- EXPREss ❑ PLAIVNINGPLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous M terials Disclosure Eli-' sTANDARn ❑ PUBLtC WORKS 3 form if any Hazardous Materials are being used as part oft 's project, Q LARGE ❑ rRE DEPT _Copy of Planning Approval Letter or Meeting with.Pla ning prior to ❑ D7AJOR 'f ❑ snNrrARY SEWER DISTRICT 3 submittal of Building Permit application. ❑ .`ENVIRONMENTAL HEALTH i I BldgApp_2011.doe revised 06121/11 COMMUNITY DEVELOPMENT EPARTMENT BUILDING DIVISION = CUPERTINO APPROVE �f�fli 4 � e This set of plays ano s e i� a`i - ic o site during construction. It is unlawful to make any ELECTRICAL LEGEND: manges or a.iterations on same, or to devia e rh ;l 2(ef(onl Wlthcut approval from the Building Official. (N)PONY WALL CAN LIGHT,LED Tie Stang ging of this plan and specifications SHALL NOT _� SWITCH (OCC e held to;)ermit or to bean approval of the.vt'L'. on ocC SENSOR r any proti,isions'of any City Ordinance or State Law. 36" 6311 L =3Q OUTLET, GFCI Y v E)WALL WALL SCONCE ERMs t'iTt TE FAN-LIGHT "tom' COMBO I T. t•' I7-I I 5 77" 0" ' (N)WALL � 151 Je W N a UE' 74" 0 U 33" U Ell (N)POCKET DOOR -JL29" EXISTING FLOOR PLAN PROPOSED FLOOR PLAN ALL DIMENSIONS ARE FOR REFERENCE ONLY AND MUST BE CHECKED ON SITE BY CONTRACTOR JOB: SCALE: HEET NO: OF: CUSTOMER NAME p� FMIIIUL4`1 V`N'=1'-V 1 2 KAREN r-ARR2EL-y aia Kitchen & Bath MA-.STRR(3AT1I DATE: (w?_A(o RAWN BY: 5E(� ADDRESS 103141 ClArSTZNE AVE. CITY c(,IPERZTJ-'NO FOR BEAUTIFULLY USEFUL SPACES 2043 RALSTON AVENUE.,BELMONT,CA 94002 TEL:650.595.2644 FAX:650.595.2646 STATE CA ZIP `t5011f PHONE g05_ DESIGN PLANS ARE THE PROPERTY OF THIS FIRM AND CANNOT BE USED OR REUSED WITHOUT PERMISSION 5, 95" 901, rr- 42' ALL DIMENSIONS ARE FOR REFERENCE ONLY AND MUST BE CHECKED ON SITE BY CONTRACTOR JOB: SCALE: SHEET NO: OF: CUSTOMER NAME .?� Kitchen VZ" I'-�` 2 2 �N Ff�[2[2Eu-`1 '�`aia Kitchen & Bath &Vk5rMQAC DATE: 6/7✓I(o RAWNBY: 5E(7 ADDRESS 103'11CA-5T TIE/AVE. CITY C�l�E1Z1ZN0 FOR BEAUTIFULLY USEFUL SPACES 2043 RALSTON AVENUE,BELMONT,CA 94002 TEL:650.595.2644 FAX:650.595.2646 STATE CAr ZIP a501q PHONE y,0� DESIGN PLANS ARE THE PROPERTY OF THIS FIRM AND CANNOT BE USED OR REUSED WITHOUT PERMISSION SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE I� COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION tNO 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255 CUPERT (408)777-3228•FAX(408)777-3333•building(cDcupertino.org PRMI CANNOT&E FINALEI7 TTNTIL THIS CERhIPICATE HAS BEEN COMP TED; D T'C7R1�1;ED T I E'I3I IIs INNG AMA _. Oy fi _ PU�POSE 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. GEIINERAL INFORMATION Existing single-family and multi-family dwellings shall be provided with Smoke Alarms and Carbon Mc noxide 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 vicinity of X X the bedroom(s) �'''`'` h L• l l On every level of a dwelling unit including basements X X Within each sleeping room X C4'bon bon 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 CBII-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 spice. 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 has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential Codes. The alarms specified below have been tested and are operational, as of the date signed below. Address; t> ci1 (f(5-ihe Ave Permit No. D 0g5 r� Specify Number of Alarms: #Smoke Alarms: 5 #Carbon Monoxide Detectors: CLDmhD s✓�'blr{ i have read and agree to comply with the terms and conditions of this statement G � Owner(or Owner Agent's)Name: Signature �Gra�,,v� d" ........Date: .............. ` Contractor Name: Signature ..............................................................Lic.# .... ................Date: Smoke and CO form.doc revised 09127116 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTI1�It7 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildinp(alcupertino.org Owner Name In!n Permit No. C) d Address D 3 C( ( 6ws - lne Ave (L p-i--F ii, e"A- 15b)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. 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. i 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 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 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 page. f Owner or Owner Agent's Signature: Date: D r Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. L SB407 2015.doe revised 08/26/15