B-2016-2105CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2016-2105
22167 WALLACE DR CUPERTINO, CA 95014-0118 (326 02 047)
MAINE ELECTRIC INC
LIVERMORE, CA 94551
OWNER'S NAME: WHETHAM FRANCES TRUSTEE
DATE ISSUED: 06/10/2016
OWNER'S PHONE: 408-736-8378
PHONE NO: (925) 443-3377
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class ELECTRICAL Lic. #8 25
Contractor MAINE ELECTRIC INC Date 04/30/2017
X BLDG X 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:
UPGRADE PANEL (200 AMP) SAME LOCATION; ADD CIRCUIT FOR
I hereby affirm under penalty of perjury one of the following two declarations:
DRYER
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.
I have and will maintain Worker's Compensation Insurance, as provided for by
Section 3700 of the Labor Code, for the performance ofthe work for which this
Sq. Ft Floor Area:
Valuation: $7105.00
permit is issued.
ecertifyat
APPLICANT CERTIFICATION
I have read this application and state that the above
Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
326 02 047
3 26
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
8.
source regulations per the Cupertino M=Date
180 DAYS FROM LAST CALLED INSPECTION.
Signature 2016
Issued by: Abby Ayende
Date: 06/10/2016
R -BUILD ER DE L
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS. -
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
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)
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: 6/10/2016
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
t. 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
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
3. 1 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 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
be deemed revoked.
Owner or authorized agent:
APPLICANT CERTIFICATION
Date: 6110/2016
I certify that I have read this application and state that the above information is,
CQYJ?fU_UCTI0N L GENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a constr on lendi ency for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is iss . 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 6/10/2016
professional
CUPERTINO
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 MISC
(408) 777-3228 • FAX (408) 777-3333 • buildingp_cupertino.om(P
❑ PLUMBING ❑ MECHANICAL ❑ELECTRICAL ❑ MISCELLANEOUS
PROJECT ADDRESS Z2-16 i OA-' , . J .,1PN
# ®n
J r ' C- 1 d A-
OWNER NAME ' 1 — "_ ct-2� IJ
�j\f �1
PH 44 ` J 6 - 3 N
E-MAIL
STREET ADDRESS
2-16 '7 i* I
CITY, STATE, ZIP
c�r��,2 1 AJ0 G /4- 7.510t `f
FAX
CONTACT NAME JEFF RAINEY
PHONE
E-MAIL E-MAIL
jeffrey.rainey@aft.net
STREET ADDRESS
1069 EDGEMERE LANE
CITY, STATE, ZIP
HAYWARD, CA 945454
FAX
510-783-1041
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR 0 CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTORNAME
LICENSE NUMBER J(/ C `Z �-7'
7LICENSE:TYPE
BUS. LIC #
COMPANY NAME C_
E-MAIL
2�-
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STREET ADDRESS / / [il': t S '
CGS ��✓C' '1 P C /4 / 451 1
PHONE
L14 3-
ARCHITECTIENGINEERNAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF SFD or DUPLEX ❑ MULTI -FAMILY
BUILDING. ❑COMMERCLII. -
PROJECT IN WILDLAND ❑ YES
URBAN INTERFACE AREA ❑ NO
PROJECT IN ❑ YES
FLOOD ZONE ❑ NO
IS TBE BLDG AN ❑ YES
EICHLERHOME7 ❑ NO
DESCRIPTION OF WORK / r �� p„,C.� 9 rA+t
1 ��f�- �,
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TOTAL VALUATION:
By my signature below, I certify to each of the following: I am the property owner or auth ent to act on the property owner's behalf. I have read this
application and the information I have provided is correct. I have read the DescriWiwrbTWork and verify it is accurate. I agree to comply with all applicable local
ordinances and state laws relating to building construction. I autho entatives of Cupertino to enter the above -i ntlfied property f r inspection purposes.
C9fSignature of Applicant/Agent: Date:
EMENT ORMA
REQUIRED
t,'r OFFICE`USE'ONiY
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W
up
4 Fa
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STANDARD
0 MAJOR
MEPMiscApp 201 ].doe revised 06121/11
Patricia Garcia
From: Danielle McCleary [daniellem@maineelectricinc.comj
Sent: Thursday, December 08, 2016 3:40 PM _
To: Patricia Garcia
Cc: inspections@maineelectricinc.com; Karen DeCock
Subject: Maine Electric, Inc. permit extension request
®r! ff�ff 41U4- r-- 4--,
12/8/2016
City of Cupertino — Building Division
10300 Torre Avenue
Cupertino, CA 95014
To Pat G. :
•
Our company would like to request a Permit Extension for permit number B=2016-2105, project address: 22167 Wallace
Drive. Construction on this project is complete.
We have had a hard time trying to coordinate an inspection time for this client and the permit is due to expire soon. We
do expect to get it scheduled within the next six months. Thank you for your time.
Regards,
Danielle M.
Permits/Inspections Admin
Maine Electric, Inc.
(925) 443-3377
(925) 443-3376 Fax
inspections@maineelectricinc.com
daniellem@maineelectricinc.com
1
t A.
CUPERTINO
SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org
Address 22,10 WQ I k& -Drlyy
PERMIT CANNOT BE FINALED AND IS CERT
HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION
PURPOSE
G - 216'
Monoxide:
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, 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 the X X i
bedroom(s)
I On every level of a dwelling unit including basements --+—_ X X
Within each sleeling room
Carbon Monoxide alarms are not required in dwellings which do not cuatain fuel -burning appliances and that
do not have an attached garage. Carbon monoxide 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 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 8314 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 have been tested and are operational, as of the date signed
below.
i have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name: r
e+
Si nature.......... ...... .. ............... ..... ..... ................ Date: ..........
Contractor Name:
Signature...................................................................Lic.#...................................... Date: ...................
Smoke and CO forni.doc revised 03/18/14
Owner Name
Address
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a�cupertino.org B y -2-0)(,— �!
U V f 1 a -4^A _ Permit No.
05
IV V7 Uv a U0, -& V, -O,
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 fortn 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 plutnbing 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 110 1. 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. se check ONE of the following:
PlMMy 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 plutnbing 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', , 2014, specified building alterations or improvements shay. 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 plutnbing 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 nate. .
Owner or Owner Agent's Signature:sJW,�4e0S4 Ct'J 4t_e 'g�� Date: (Qb651 I 1
Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit.
SB407 2015. doc remised 08/26/15