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B-2016-2139CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 21914 GRANADAAVE CUPERTINO, CA 95014-2818 (357 16 137) CONTRACTOR: PERMIT NO: B-2016-2139 RANDO AAA HVAC INC SAN JOSE, CA 95125 OWNER'S NAME: LUYUCHUNGAND CHIAJENG DATE ISSUED: 06/15/2016 OWNER'S PHONE: 408-398-2575 PHONE NO: (408)293-4717 LICENSED CONTMCTOR'S DECLARATION A_RATION BUH DING PERMIT INFO: License Class C-43�-?n Lic. #7 71 Contractor RANDO AAA HVAC INC Date 09/30/2017 X BLDG —ELECT X PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (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 75 GALLON WATER HEATER i. 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 of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $2346.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above ATN 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 35716 137 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 may PERMIT EXPIRES IF WORK IS NOT STARTED 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 regular ns er the Cuperti o Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signatur Date 6/15/2016 Issued by: Abby Avende f rs ql OWNER-B Til DER DECLARATION Date: 06/15/2016 &W I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS.- E-ROOFCfollowing followingtwo reasons: All roofs shall be" inspected prior to any roofing material being installed. If a roof is 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 for compensation, will do the work, and the structure is not intended or offered for materials 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 (Sce.7044, Business & Professions Code). Date: 61152016 I hereby affirm under penalty of perjury one of the following three declarations: 1. I have and will maintain 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. 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. 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 exemption, I become subject to the Worker's Compensation provisions of the will maintain compliance with the Cupertino Municipal Code, Chapter 9,12 and Labor Code, I must forthwith comply with such provisions or this permit shall the Health & Safety Cod Se�,25 25534. be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 6/15/2016 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 6/15/2016 Professional CUPERTINO F-1 NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408) 777-3228 FAX (408) 777-3333 • building(a cupertino.Org y�� F- ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT #_ PROJECT ADDRESS y t APN # OWNER NAME Vd un A PHONE E-MAIL N / A f l..FAX STREET ADDRESS /� 1 1" fd� `�p n. /' �\ V l CITY, STATE, ZIP(� `1� �' nD rh �(�,hVl `JOU (�E-MAILL CONTACT NAME PHONE STREET ADDRESS CITY; STATE, ZIP FAX ❑. OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEJ U' V_n f)d o LICENSE NUNIBERI LI ENS TYPE BUS. # COMPANY NAME E-MAIL a CITY, STATE, IP r �� U ///LIC FAX( r PHONE 1 �Y ✓ I n y� STREET ADDRESS Sfi - �p `/ r, ' 1 I�Q ]/��p .'t( v [/t I l/ ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK - 11b offlDn wt Q - EXISTING USE PROPOSED USE - CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA. NEW FLOOR - AREA DEMO _ AREA TOTAL _ NET AREA BATHROOM REMODEL AREA _ ..KITCHEN _ - REMODEL AREA :.OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA -. GARAGE AREA DETACH ❑'ATTACH # DWELLING UNITS: IS A SECOND UNrr El YES BEING ADDED? ❑NO SECOND STORY []YES ADDITION? [:]NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL #. ❑ NO PLANNING APPROVAL LETTER IS THE BLDG AN ElYES EICHLER HOME? ❑ NO FhI1 D_BY TOTAL VALUATION: By my signature below, I certify to each of the following: I am the property owner or authorized agent to act DAhe 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* construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQU RE New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. Pi;4iatcHECI'>TYPE. ,: ziou ING:, 6P-., .: [] ovGR TiIE COTiIITER Q ] XP12ESs Cl sTANAARD (] T nRCE 1VIAJOR E';BrIH.DIPiGPLANI2EYiEw I� Pi AIXNIN PL ANiRkmw �i .PUIiTICvvolzT�s ;e ��EI) AT 4 Q SANITAItYSEWERDiSTRICT uII20[MENTAL HEALTH.,' BldgApp_2011.doe revised 06/21/11 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(okupertino.org PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN COMPLETED, 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 bedroom(s) X X 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 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 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: &YOAA (A AVC )-k4I e.C 014' Permit No. fy-2Ch l (� - 2,17 57 Specify Number of Alarms: # Smoke Alarms: # Carbon Monoxide Detectors: I have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: l Signature.............../.....<..................................................................................Date: I ................................................................................................................................. Contractor Name: Signature.................................................................. Lic.# ......................................Date: Smoke and COform.doc revised 09127116 CUPERTINO Owner Name WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (4Q8) 777-3228 • FAX (408) 777-3333 • building a.cupertino.org Address C_o n 0�a �ve Ltd( IL[- nkpr rt(no (A .Q 00 A --�2Dt6_Zl3 `7 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THISCERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION Please refer to the attached California Civil Code Sections 1101.1 — 1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: ISL No Go to Question 2. Date: 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. Sign below and skip the rest of the form. Owner' Signature: No Go to Question 3. Date: 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Q No Go to Question 4. Date: 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ie!!A 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. Sign below and skip the rest of the form. Owner' Signature: Date: ❑ 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. Refer to the attached. 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. SB407 2014.doc revised 03/18/14 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). UWe, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures have been replaced 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 c9giply with the requirements as indicated in the table below. Owner's (or Owner Agent's) Signature: Date: 71 13 /Zo 17 l Upon completing and signing this Certiticate, please return it to the Building Division in order to tinal your permit. I. 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. SB40 7 2014. doc revised 03/18/14 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 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 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, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 0.5 gallons/flush 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 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. I. 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. SB40 7 2014. doc revised 03/18/14