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B-2016-1519
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-1519 20658 KIRWIN IN CUPERTINO,CA95014-4303(359 23 008) DAVID ZIMBAUER , SAN JOSE,CA 95118 OWNER"S NAME: HOCUTT KENNETH L R DATE ISSUED:03/15/2016 OWNERS PIIONE:4086464039 PHONE NO:(408)655-4139 LICENSED CON-TRACTOR'S DE CT ARATiON BUILDING PERMIT INFO: License Class GENERAL Dull DMG CONTRACTOR Lic.#B234Z5 Contractor DAVID ZIMRAI IFR Date 09130/2017 X BLDG —ELECT X PLUMB I hereby affirm that I am licensed render the provisions of Chapter 9(commencing —MECH X RESIDENTIAL,COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Cotte and that my license is In full force and effect. JOB DESCRIPTION: I hereby affirm under penalty of perjury one of the following two declarations- KITCHEN REMODEL(225 S.F.);INSTALL(N)TANKLESS WATER ILEATER AND(N)GAS INSERT FIREPLACE;INSTALL(N)GAS LINE n. I have and will maintain a certificate of consent to self-insure for Worker's TO STOVE,TANK ESS WATER.HEATER AND FIREPLACE;ADD(N) Compensation,as provided for by Section 3700 of the Labor Code,for the LOAD BEARING STRUCTURAL HEADER BETWEEN KITCHEN AND performance of the work for which this permit is issued. DINING ROOM Z-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:$70000.00 APPLIC NT C RTYPTCA'rT N 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 359 23 008 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 ISNOT STARTED May accrue against said City in consequence of the granting of this permit. Additionally,the applicant understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulationsper the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CA LED I SP CTION. Signature- rte/ { ' Date 3115/2016 Issued by:ALEX VALLELt11vt;A Date:31 51201& OWNER-BUILDER DECLARATION ARATION I hereby affirm that I am exempt from the Contractor's License Low for one of the R1rROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is t. I,as owner of the property,or my employees with wages as their sole installed without fust obtaining an inspection,I agree to remove all new materials for compeiisation,will do the work,and the structure is not untended or offered for inspection. sale(Sce.7044,Business&Professions Code) 2. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct[lie project(Sec.7044,Business&Professions Code). Date:3l15� , I hereby affirm tinder penalty of perjury one of tite following three declarations: s. 1 have and will maintaiun a Certificate of Consent to self-insure for Worker's ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. 1 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. Twill Permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the 3. 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 Worker's Compensation laws of California. If,after making this certificate of air contaminants as defined by the Bay Area Air Quality Management District I 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 Realth&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:-311512016 I certify that I have read this application and state that tate 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 ARCIIITECTIS DECLARATION Code,Section 9.18. l understand my plans shall be used as public records. Signature Date 3115/2016 Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 90300 TORRE AVENUE•CUPERTINO,CA 95014.3265 JZ01(I q CUPERTINO (408)777-3228-FAX(408y 777-3333•building aln erlino ora ❑NEW CONSTRUCTION ❑ ADDITION ALTERATION/TI ❑ REVISION 1 DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS. / OWNERNAME P IO E �. n S-MAIL. STREET ADDRESS A-01 �} ` CIT STATE,ZIP ` � FAX ` CONTACT NAME PHONE AIL STREETADDR'SS n CIT STATE,ZIt� FAX P i^g� y014 r._.w. ❑OWNER ❑ OWNER-BUILDER ❑ OWNER AGENT cp,CONTRACTOR 13 CONTRACTOR AGENT Q ARCHITECT ©ENGINEP.R 0 DEVELOPER ❑TENANT P MEg LICENSE NUMBER �^ LICENSE TYP EUS.LIG# \ E- IL _ FAXS CI],STATE,ZIP PHONE EER NAME LICENSENUMBER BUS,LIC E-MAIL FAX STREET ADDRESS CITY,STATE,'LIP PHONE PDES1C1RUIPT10:N0FE1WI01R1K , .�� EXISTING USE PROPOS US� CONSTI.TYPE #STORIES - - USE TYPE Dec. SQ.FT. VALUATION($) !3AT1IROOM TG NEW FLOOR DEMO TOTAL A AREA AREA NETAREA - KITCHEN_ - OTHER RRMODELAREA REMODELAREA// REMODELARRA PORCH AREA DECK AREA TOTAL DECKlPORCH AREA GARAGE AREA; DETACH ❑ATTACH #DWELLINGUNITS: TSA SECOND UNIT EIYES SECONDSTORY ]VES BEING ADDED? ❑NO ADDITION? ❑NO A. PRE-APPLICATION ❑YES 1F YES,PROVIDE COPY OF is THE BLDG AN Y5SR$CEIVI3p$ :. t • OTAL VALUATION: PLANNMGAPPL# ❑NO PLANNING APPROVAL LETTL+R EICHLERHOME? ❑NO �J• �L Ey my signature below,I certify to each of the following: I am the property owner or authorized agent to ac on thetpropeLty owner's behalf. I lulve read this application and the information 1 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 relating to bung Construction. I authorize representatives of Cupertino to enter the above-Identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INF TION REQUIRED PLAN,CIIECKT}'FE Ror5tl4csLTP New SFD or Multifamily dwellings: Apply for demolition permit for - existing building(s). Demolition permit is required prior to issuance of building °v�trrrltt CQtJ,IT Iz © $rJltbn�I SAN teEytEw permit for new building. CI; xras5 D I'I A�JILNGT' AN xi yi> v 1: „_.,.........:'.. ..: .:..;....: .;..it,_: -:..: ?<..:•,,r•�.ys,,.,.:i �:_:_.`,�'.._`;_..y',::,.::.:;:-.r;: _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ©'sxaNTtniin ❑ rtisl ICYvo7txs form if any Hazardous Materials are being used as part of this project. ,w d r,.AaaE p Fnur n'I�rT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ©.MAtoR Q sayrrARYSEw>mbasrxticae - Q, L+AtYSRONAil3NTAL IEALTH BldgApp_2011.doc revised 06121111 Building Department City Of Cupertino- ' 10300 Torre Avenue. Cupertino,CA 95014-3255 Telephone:408-777"-3228` C O P E RT I N O Fax:-408-77-7-3333 CONTRACTOR/SUBCONTRACTOR LIST JOB ADDRESS: ® ," PERMIT# e) dl6 -A�/9 OWNER'S NAME: ' PTIONE# 10 � GENERAL CONTRACTOR: A. BUSINESS LICENSE#_4/0 _ ADDRESS: /0 ,,, CITY/ZIPCODE:_ .ZS elf *Our municipal'code.requires a 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 Date Please check applicable subcontractors and complete the following,information SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets&Millwork Cement Finishing �t1 2' Electrical z l Excavation Fencing Flooring/Carpeting Linoleum/Wood Glass/Glazing, Heating Insulation Landscaping Lathing - `/ Masonry fc,,� "�` ZG386 Painting/Wallpaper Paving Plastering Plumbing Roofing Septic Tank - Sheet Metal Sheet Rock .4 6A61A, Tile 7/ Owner/Contractor Signature Date WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDINGDIVISION CIJPERTIN4 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FM((408)777-3333•buitding(@_cupertino.org {Owner ame K Pvi ri P-{ to �Li I—Ty— Permit No e 1 ddress _ 206 1�,�f^l�t V1Lin a CE 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. No Go to Question 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? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. El The licensed plumber's certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. JK 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. No Go to Question 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. K 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.. (5D 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 mpliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. 10 On or before January 1,2019,all non-compliant plumbing fixtures shalfbe replaced with wat - , conserving plumbing fixtures throughout the building(regardless of whether property underg s improvements). ❑ My property is a commercial real property. See Civil Code Section1101.5. On and after January 1,2014,specified building alterations or improvements shall require non om t 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 er- 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 110 1.1 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. ( wner or Owner Agenf's igna ure: a e: 5 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 ITIII,IIG OT HE FOALED ANI? GONPLETED'gT1YTIL THIS CE 'I'IFI��T'E IIA.S BEEN � NED 7D I2ETLTRIVED T4 THE BUIIDING,DI'VISTON IQlon Compliant Water-Conserving Plumbing Fixture Plumbingfixture l ' (Fixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Water Usage/Flow Rate Water Usage 20.13 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, i Urinals Eaverage flush volume of two reduced flushes and one full flush xceed 1.0 Gallons/flush 0.5 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 op 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 ac;lieve 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 08/26/15 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPRTiiO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•building aakupertino.org q �j j (PermitNo. m-o a�Smoke:) rca—io—n monoxides 2. ! PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE k as HAS SEEN SIGNED AND RETURNED TO THE BUILDING DIVISION 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 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 bedroom(s) On every level of a dwelling unit including basements X X 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 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 alterati s o, not result in the removal of wall and ceiling finishes or there is no access by means attic,basemen o ca space.Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2.An e tri a p m g's r u+ r alarms which must be connected to the building wiring. `; V As owner of the above-referenced property,I hereby certify that the alarm(s)refere c. Bove ha ve been installed in accordance with the manufacturer's instructions and in compliance with t California Building and California Residential Codes.The alarms have been tested and are operational, as f the date signed below. I have read and agree to comply with the terms and conditions of th" st ement Owner or Owner Agent's ame: Rpo in `�� ...va e: 4/t /..' v� (Si nes ure........ (Con rac or ame: (Si natur.................................................................tl iG)......................................Gate:)................... Smoke and COform.doe revised 03/18/14