B-2016-2145 i
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2145
10313 BONNY DR CUPERTINO,CA 95014-2905(359 13 006) RANDO AAA HVAC
INC-
SAN JOSE,CA 95125
OWNER'S NAME: STOECKERT EDWARD D AND MARY J TRUSTEE DATE ISSUED:06/16/2016
OWNER'S PHONE:408-253-5296 PHONE NO:(408)293-4717
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO:
License Class C-43,C-36.0-20 Lic.#768871
Contractor RANDO-AAA HVAC INCDate 09/30/2017 XBLDG —ELECT X PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 4(commencing —MECH X RESIDENTIAL—COMMERCIAL
with Section 7000)of Division 3 of the Business&Professions Code 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: REPLACE 50 GALLON WATER HEATER
1. 1 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.
Loozs' 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:$2188.00
APPLICANT CERTIFICATION
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 13 006
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 ap fl ant understands and will comply with all non-point
;source regul on er the Cu i nicipal Co ,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
nat 6/16/2016 tissued by:Abby yende �n
Date:06/16/2016 -
0WNER-BUI DER DECLARATION e
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 j
L 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
inspection.
compensation,will do the work,and the structure is not intended or offered for
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:6/1612016
I
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
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
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 Municipal Code,Chapter 9.12 and
exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Codf,Se d 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent.
APPLICANT CERTIFICATION Date:6/16/2016
I certify that I have read this application and state that the above information is CONSTRUCTIONLENDINGAGENCY
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 6/16/2016 Professional
I
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO, CA 95014-3255
CUF'ERTIPEa
(408)777-3228•FAX(408)777-3333•building(Dcupertino.org
❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ❑ REVISION/DEFERRED ORIGINAL PERMIT#' j
PROJECT ADDRESS (� O�I(��+ y J APN# _
OWNER NAME \N 1 f PHONE�-\� ..G - E-MAIL...1�. -
STREET ADDRESS CITY, STATE,ZIP y^ q�o F i'
nJ r' j v p ry �11
CONTACT NAME I(�(� -nd -. PHONE 0 J/ ►E-MAIL I C VI nARY l
11,
STREET ADDRESS M/,^ �t7 CITY,STATE,ZIP jolt
/612 FAX , (�.
fl
El OWNER ❑OWNER-BUILDER 11 OWNER AGENT 'qk, CONTRACTOR ElCONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER.✓❑TENANT
CONTRACTOR NAME J I ,. �a LICENSE NUMBER % (A J G!)_`!� LICENSE TYPE BUS.LIC# � J�
COMPANY NAME. � ,/ - n E-MAIL
STREET.ADDRESS
1 ^ v CITY,STATE,ZIP -. y� PHONElAI1Ih),1��
LCA 0026
ARCHITECT/ENGINEERNAME.. G LICENSE NUMBER ' f BUS.LIC+'9 L
COMPANY NAME E-MAIL FAX
STREET ADDRESS CITY,STATE,ZIP PHONE.
DESCRIPTION OF WORK
1
i
EXISTING USE PROPOSED USE CONSTR.TYPE - #STORIES - - - -
USE TYPE OCC.. SQ.FT. VALUATION($)
EXISTG NEWFLOOR DEMO TOTAL - - - -
AREA AREA AREA NET AREA
BATHROOM KITCHEN - •OTHER. -
REMODEL AREA REMODEL AREA REMODEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA I GARAGE AREA LIDETACH - - - - -
ATTACH
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY ❑YES - - -
BEING ADDED? ONO ADDITION? E]NO
PRL-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES TOT VALU TION:
PLANNINGAPPL# E]NO PLANNING APPROVAL LETTER EICHLERHOME? NO
By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on th property owner's behalf. I have read this
application and the information I 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 build'ng cons ction. I authorize representatives of Cupertino to enter the above-id e tified property for inspection purposes.
Signature of Applicant/Agent: Date: /
SUPPLEMENTAL INFORMATION REQ
U pyAri ciEcicxYr RoNG$t Ir
_New SED or Multifamily dwellings: Apply for demolition permit for ❑ `bvEx TIS cQUNx ❑ si7D7NcriaN7R �Iw
existing building(s). Demolition permit is required prior to issuance of building
permit for new building. ❑ EXPx>ss=' ❑ PL 1NNRVG PI AN RErVIEyI
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ sTANDAiin ❑ rvsrrc v4ORTt
form if any Hazardous Materials are being used as part of this project. ❑ BARGE ❑*IIREDEP2
_Copy of Planning Approval Letter or Meeting with Planning prior to
submittal Of Building Permit application. p ox ❑ sATARY SEVER nzszlucT "
C1.HNVIROI±IMENT'ALHEA]t T I
BldgApp_2011.doc revised 06/21/11
i
SMOKE / CARBON MONOXIDE ALARMS 5
OWNER CERTIFICATE OF COMPLIANCE ~�
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
U 'I `1Cdt 10300 TORRE AVENUE o CUPERTINO, CA 95014-3255
(408)777-3228•FAX(408)777-3333 buildin_@cupertino ora
I
Address D . Permit No.
of Alarms Smoke: Carbon M noxide:
PERMIT CAL�NOT BR FINALED AND COMPLETED IJ L _ -
�
PURPOSE
This affidavit is a self-certification for the installation of all required Smoke and Carbon Monoxid Alarms for
compliance with 2013 CRC Section R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interioi 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 un Its exceeds
$1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms an
Monoxide Alarms be installed in the following locations: /oz Carbon
AREA SMOKE ALARM COALARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s) X
On e ery level of a dwellin unit including basements X
Within each sleeping room x
X _1
Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning applian es and that
do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall corr ply 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 alter tions do
not result in the removal of walland ceiling finishes or there is no access by means of attic,basemel it or crawl
space.Refer to CRC Section 8314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical permit is re 4uired 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 ave been
installed in accordance with the manufacturer's instructions and in compliance with the California l3uilding
and.California Residential Codes.The alarms have been tested and are operational, as of the date sigmed
below.
i
- [have read and agree to comply with the terms and conditions of this statement
Owner(or Owner Agent's)Name;'
Znd Si nature. .. ... .. D {e: ...
Con for Name: ......
JIM Pan d d
Si nature, _........
Da te:
Smoke and COfonn.doc r ised 03/18/14
i
WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE _
f
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
CUPS Tmo 10300 TORRE AVENUE• CUPERTINO, CA 95014-3255
(408)-777-3228•FAX 408)777-3333•building cupertino ora
Owner Name PermitNo. �� 5
AddressmQ) Y S
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 f form.
No Go to Question 2.
2. Does your real property have a licensed plumber certifying that,due to thea e or configuration of the property
plumbing,installation of water-conserving plumbing fixtures is not technically feasibler its
❑ 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 forth.
)<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 o'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 o form.
es 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 plumbinj fixtures
to be replaced with water-conserving plumbing fixtures throughout the building.On or before January 1,2017all 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 improvemeits).
I,as the owner or owner's agent of this property,certify under penalty of perjury that non-compliant plumbing fixi ures will be
replaced prior to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sec 'ons 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 indical ed in the
table on the following page.
Owner or Owner Agent's Signature: Date:
Upon completing and signing this Certificate,pl se return it to the Building Division in order to final your bAildinj permit.
SB4072015.doc revised 08126115
BUILDING PERMIT CAlNO B
FINALEU rill GUMPLPTP�UNTIL THIS
CER�IP�� �I'E�:��BEAN
y t
Non-Compliant
Water-Conserving Plumbing Fixture
Plumbing Fixturel (Fixture Complying with Current Code Applicable to New Const ucton)
Fixture Type Maximum Water Usa�e/Flow Rate
Water Usage 2013 CPC Ch. 4' 2013 CPC Ch.4 2013 CPC Ch.4
/Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div, 4.3 2013 CALGr en Div. 5.3
Single-Family Multi-Family Com ercial
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,
average flush volume of two reduced flushes and one full flush
Urinals Exceed 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 hall 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: '
Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons P gallons nute @ 60
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 ninute_@60
Kitchen per minute 60 psi @ 60 psi si
Faucets May temporarily increase May temporarily p
up 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 achieve 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 i pgraded.
. 1
SB407 201 S.doer wised 08/26/15
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