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B-2016-1360CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1360 10206 LOCKWOOD DR CUPERTINO, CA 95014-2600 (342 14 041) WING ON CONSTRUCTION INC' SAN LEANDRO, CA 94579 OWNER'S NAME: DING HAN AND ZHANG YING DATE ISSUED: 06/24/2016 OWNER'S PHONE: 650-866-5815 PHONE NO: (510) 786-8838 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #949206 Contractor WING ON CONSTRUCTION INC Date 06/30/2018 X BLDG _ELECT _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: ONE STORY BEDROOM/FAMILY RM ADDITION (819 SQ FT); KITCHEN REMODEL (245 SQ FT); INTERIOR REMODEL OF i. I have and will maintain a certificate of consent to self -insure for Worker's STUDY/M. BEDROOM/LIVING RM (1331 SQ FT). Compensation, as provided for by Section 3700 of the Labor Code, for the **FIRE SPRINKLERS REQUIRED** performance of the work for which this permit is issued. REV41 - CLARIFY EXISTING AREA (SPRINKLERS ARE NOT I have and will maintain Worker's Compensation Insurance, as provided for by REQUIRED FOR MAIN HOUSE) ISSUED 12/12/2016 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: 819 Valuation: $150000.00 APPLICANT CERTIFICATION 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 and state laws relating to building construction, and hereby authorize APN Number: Occupancy Type: representatives of this city to enter upon the above mentioned property for 342 14 041 Deferred Submittal (R -3),R-3 (Custom) inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. PERMIT EXPIRES IF WORK IS NOT STARTED Additionally, the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 12/12/2016 Issued by: Abby Ayende OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: F ROOFS: RE -ROOFS - 1. 1. I, as owner of the property, or my employees with wages as their sole All roofs shall be inspected prior to any roofing material being installed. If a roof is compensation, will do the work and the structure is not intended or offered for installed without first obtaining an inspection, I agree to remove all new materials for sale (Sec.7044, Business &Professions Code) inspection. 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code).. Signature ,of Applicant: Date: 12/12/2016 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. 2. I have and will maintain Worker's Compensation Insurance, as provided for by HAZARDOUS MATERIALS DISCLOSURE Section 3700 of the Labor Code, for the performance of the work for which this I have read the hazardous materials requirements under Chapter 6.95 of the permit is issued. California Health & Safety Code, Sections 25505, 25533, and 25534. I will s. I certify that in the performance of the work for which this permit is issued I maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the shall not employ any person in any manner so as to become subject to the Health & Safety Code, Section 25532(a) should I store or handle hazardous ' 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 Code, Sections 25505, 25533, and 25534. be deemed revoked. APPLICANT CERTIFICATION Owner or authorized agent: I certify that I have read this application and state that the above information is Date: 12/12/2016 correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives of this city CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance to enter upon the above mentioned property for inspection purposes. p p p y p p p (We) agree of work's for which this permit is issued (Sec. 3097, Civ C.) to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Name judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands Lender's Address and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Signature Date 12/12/2016 Licensed CONSTRUCTION PERMIT APPLICAI W; VISION COMMUNITY DEVELOPMENT DEPARTMENT . BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(@cupertino.org 'fit 1B ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/ TI REVISION /DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 102 V% Lo rkVovd Y)r` APN# Z g f j .. - Q�f �^e' j OWNER NAME )(11V a til .PHONE .(^� f.� G°� J' E MAILf�G�t, f t ed I �-j 'MGA. l� `i STREET ADDRESS ` Cf��^ F CITY,STATE>ZIJP �r.LC SOj FAX aJ ( Vv 1 Vic. CA CONTACT NAME A, i PHONE ® g E-MAIL', UA STREET ADDRESS S CITY STATE, ZIP b FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNERAGENT CONTRACTOR. ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOyR DAME �. LICENSE NUMBER LICENSE TYPE BUS. LIC # COMPANY N,kME- - - -- ® E-�L ® FAX fir" + u� �c M 13 9Yn9 rr,, STREETAD DRE S CI - STATF, ZIP ,�y xxpp I - n ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK / V I al tk EXISTING USE : PROPOSED USE CONSTR. TYPE I # STORIES . USE TYPE OCC. SQ.FTVALUATION ($) EXISTG NEW FLOOR DEMO TOTAL - AREA AREA AREA NET AREA -BATHROOM KITCHEN OTHER REMODELAREA REMODELAREA REMODELAREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: El 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 BLDG AN ❑ YES TOTAL VALUATION: PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO v By my signature below, I certify to each of the following: I am 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 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 buil ' construction. I o>�zesentatives of Cupertino to enter the alw en sed pro� proper( inspecrion purposes. Signature of Applicant/Agent:-2—Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECKTIPE izouMNG SLii _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building ❑' ' OYER -T CCtuNTER ❑ BUH DING r AN itEw permit for new building. ❑ ExPREsS ❑ Pi ANi511G Pi.AN REX I _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ _ PIsLLvvaRxs form if any Hazardous Materials are being used as part of this project. ❑ , LARGE r ❑ F[REDEPZ Copy of Planning Approval Letter or Meeting with Planning prior to submittal Of Building Permit application. ❑ MAJOR , " "' ❑ SANPTARX SEWER DISTRICT . ❑ ' EN VIRON AIENT. HELTI B1dgApp_2011.doc Devised 06121111 CITY OF C PERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-1360 10206 LOCKWOOD DR CUPERTINO, CA 95014-2600 (342 14 04) WING ON CONSTRUCTION INC SAN LEANDRO, CA 94579 OWNER'S NAME: DING RAN AND ZRANG YING \ DATE ISSUED: 06/24/2016 OWNER'S PHONE: 650-866-5718 PHONE NO: (510) 786-8838 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic. # Contractor WING ON CONSTRUCTION INC Date 06/30/2018 X BLDG —ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL (commencing I hereby affirm that I am licensed under the provisions of Chapter (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: declarations: ONE STORY BEDROOMNAMILY RM ADDITION (819 SQ FT); I hereby affirm under penalty of perjury one of the following two i. I have and will maintain a certificate of consent to self -insane for Worker's KITCHEN REMODEL (245 SQ FT); INTERIOR REMODEL OF STUDY/M. BEDROOM/LIVING RM (1331 SQ FT). Compensation, as provided for by Section 3700 of the Labor Code, for the "FIRE SPRINKLERS REQUIRED" performance of the work for which this permit is issued. I Nj "z- 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 Sq. Ft Floor Area: 1638 Valuation: $150000.00 permit is issued. APPLICANT CERTIFICATION 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 342 14 041 Deferred Submittal (R -3),R-3 (Custom) 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 the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 6/24/2 Issued by: Abby Ayende Date: 06/24/2016 0U1DER DEC ARATION { I hereby affirm that I am exempt from the Contractor's License L9w for one of the RE -ROOFS: following two reasons: . I All roofs shall be inspected prior to any roofing material being installed. If a roof is i. 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. 1, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 6/24/2016 I hereby affirm under penalty of perjury one of the following threel declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER i. I have and will maintain a Certificate of Consent to self -ins a for Worker's Compensation, as provided for by Section 3700 of the LaboCode, for the performance of the work for which this permit is issued. i HAZARDOUS MATERIALS DISCLOSURE z. I have and will maintain Worker's Compensation Insurance I 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 mi s. I certify that in the performance of the work for which this ieit 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 makinji 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:26/ 4/2016 I certify that I have read this application and state that the aboveinformation is CONSTRUCTION LEi TNG 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 rep resent ° tives 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 purp ses. (We) agree Lender's Name to save indemnify and keep harmless the City of Cupertino agai 'st liabilities, judgments, costs, and expenses which may accrue against said City in Lender's Address consequence of the granting of this permit. Additionally, the app�icant understands and will comply with all non -point source regulations per the Cu ertino Municipal ARCHITECT'S DECLARATION Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 6/2412016 Professional CUPERTINO ❑ NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOP ENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (40�) 777-3333 • building aQoupertino.org I ' ADDITION ❑SII TERATION / TI ❑ REVISION /DEFERRED } ORIGINAL PERNII PROJECT ADDRESS APN p +2 />j� ^ p I / i I OATi£R NAivIB PHONE B -MAIL STREET ADDRESS CTT ,STATE, ZIP FAX 102-9 f/Tt� o l CONTACT NAME P ONEl� 1 E-MAILR� STREETADDRESS CITY, STATE, ZIP FAX olv'Nm ❑ owIMP.BUILDER ❑ 0Vl'HERAGENT ❑ CO * RACTOR ❑ COXITRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TEIgw,,,; CONTRACTORNAME n LICENSE NUMBER LICENSET11TE Bus. LIC 4 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE ARCHITECr/ENGINEERNAMb f / 'F 1�s ' LELj��� LICENSE NUIVMER BUS. LIC # COMPANY NAME i E-1-LAIL FAX (`^,'�'(Cx_•_ X 1 [ �D Et "s 810-A-.- b C rY. STAT Z,00 Ql O is P ON Z U �� DESCRIPTION RK F( f -to 61W4't 2ev�rrra c��w►�l Yrrt7�M reco vm owd remo�eO (EF) '� 966 EXISTING USE PROPOSED US CONSPR TYPE n STORIES nn USE TYPE OCC. $Q.FT. I VALUATION (i) EXISTG NEW FLOOR DEMO TOTAL _ ©� AREA (/S! © + AREA AREA NET AREA BATHROO14 KITCHENOTHER REMODELAREA REMODELA RFMOD.LAREA - PORCH AREA DECK AREA TOTAL DECK/PORCH AREA G GE AREA: El DETACH •�I A17ACH I # DWELLING UN]TS:IS A SECOND UNIT YES SECO 'D STORY []YES nELACADDED? E]NO ADDI T ION? jgN0 /❑ PRE -APPLICATION ❑ ITS IF YES, PROVIDE COPY OF 1S TH ELDG AN YESjtECEj}7. _ _ �TOTA ; VALUATION: PLANNINGAPPL# ❑NO PLANNn4GAPPROVAL.LETTER EIC-ERHOMIF? NO --_ �' - -- -- _ f By my signatme below, I certify to each of the following: I amt the, property oNvaeKli-authorizeto act on pro , owner's b_e a..., ..,�, Ivao tris application and the information I have provided is correct. I have read the Description of Work and verify it • ac . I agree to comply with all applicable local ordinances and state laws relating to b ' ding consrivcdon. I auth rize representatives of Cupertino to a above-iden$fred property for inspection purposes. Signature of Applicam/Agent: Date: SUPPLEMENTAL INFORMATION REQIRED .i-- ]\Tesl SFD or Multifamily dR ellin,: Apply for demolition permit for -"':r,�r-=-`=->�%:<=�=f.... _....:.__. _..__ ,._._ .: `_�. __.......-,-_.__...,....._.�__,.:_•,_-�..� �. existing building(s). Demolition permit is required prior t issuance of building permit for new building. "� Eaar.> ss y rz a��11G gLANItEt7Fc c —Commercial BId s: Provide a Completed HazardousAaterials Disclosure. .i;::T=:.� w ..ac. _R+t ,Gn_r:: s-sa_:-s: =,:::=: :-- 4-t_r�._ ma :• � .tiff:.,'=.•:-�.�:'.cS:r.;�t^. _..... ._,, .. r -=_- :.`:-. ~� fornz if any Hazardous Materials are being used as part of t Copy Planning Approval Letter Meeting PlaInninQ -Iis project. F;i'T :�c'•. E_>;�T_i; �=_=:.=:-._ :S❑°-;.:sBiA fiStlRsSl ~�aE aATI-R. of orrn with submittal of Building Permit application. __= ITA ; DIt-IES T.I.C_ilT _; :•.,?=�Priorto A `TAT Bldg4pp_2011.doc I-evised 06/21/11 FILE WILSON LAND SURVEYS INC. OVER ssoo Pwmcrs smu iow * CALIFORNIA SMALL BUSINESS #59923 3001 Winchester Blvd Suite 11 • Campbell, CA 95008 • Phone: 408-540-7687 email: kenw@wilsonlandsurveys.com • web: www.wilsoD]andsurveys.com • Mobile: 805-703 -0273 Date: 7 -7 -(-IC Jurisdiction: r�✓�✓`i�'e Subject Address: JO Z06 toctimoOO AO cc'e!;5•y y 15 ' -Pc Wilson Land Surveys Inc. has measured the location of the forms set for the concrete foundation on the above mentioned project. The forms were placed in the following positions: Minimum Front Setback per plans: Minimum Left Side Setback per plans: Minimum Right Side Setback per plans: AM Measured Setback: 00 r Measured Setback: 5-0 4"00" Measured Setback: u� c a is Minimum Rear Setback per plans: Measured Setback: , °oo 44 _ The finish floor- elevation of the building per the plans is g� 9 The measured finish floor elevation is _o' . Sincerely, Ken Wilson Licensed Land Surveyor CAPEX ENGINEERING INC. PO BOX 14198, FREMONT, CA 94539 Tel: (510) 668-1815 Fax: (510) 490-8690 Building Department City of Cupertino / 10300 Torre Avenue Cupertino, CA 95014-3232 Subject: Proposed One-story 2"a Unit and Remodeling at 10206 Lockwood Dr. Cupertino, CA SITE DEMOLITION AND BUILDING PAD G OBSERVATION REPORT Dear Sir: Project No. 10326 July 26, 20 25 CAPEX ENGINEERING INC., has provided observation service for site demolition, primary and final grading of building pad. On the basis of our observation and testing, we concluded building pad, compaction operation were performed. in general accordance with recommendation of soil report and compacted to a minimum of 90% relative compaction. If you have any questions, please contact our office at your convenience. Sincerely, CAPEX ENfilNEERING INC., ary u l .E Principal 9RQ EssloN`�a '10 �ppx HS , F,� CAPEX ENGINEERING INC. PO BOX 14198, FREMONT, CA 94539 Tel: (510) 668-1815 Fax: (510) 490-8690 `Q Project No. 103260 July 26, 2016 Building Department City of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3232 Subject: Proposed One-story 2" a Unit and Remodeling at 10206 Lockwood Dr. Cupertino, CA _ _F_OOTING EXCAVATION (GRADE BEAMS & SPREAD --- FOOTINGS) AND PREPARATION OBSERVATION REPORT Dear Sir: CAPEX ENGINEERING INC., has provided inspection service for footing excavation and preparation. Footing depth and width were excavated adequate in accordance with approved foundation plan and specifications. The exposed soil conditions of excavated foundation are beyond design bearing capacity and acceptable. Any questions, please call our office at your convenience. Sincerely, CAPEX ENGINEERING INC., ar su� .E y Principal 4,�pFtS$Jt,,V �.. CIO: �. W ► ti4�1 �OF C:�.\Pu` j� Wesley Liu Enffineerl 7246 Sharon. Drive, Suite 0, San lose, CA 95 December 12, 2016 Re: Framing WalMeview Ding Residence 1.0206 Lockwood Road Cupertino, Ck 95014 Inc. teI& hx. 408-973-1839 To Whom It May Concern: < As requested, we have made the structural framing walk for the pDroji and rechecked on 12/12/2016. All of the items that we brought up o. our recommendations. Based on our observation, we concluded that the framing was in ge�n plans and specifications. This -review is conceptual and qualitative. I of major structural connections and to identify major deficiencies. ' A and grade of the materials, and similar features of the work were not undertake the guarantee of the construction or relieve the contractor! produce a completed project conforming to the plans. We appreciate the opportunity to have been of service. If you have e information, please feel free to contact us at your convenience. File: 15-081614 C5 m tion a ct m ione oveonll/18120.16 w L the firs walk were addressed per .at conformance with the approved, is intended to verify the presence curacy of the dimensions, type pecked. M� detail. We do not F his primary responsibility to questions or require additional Wes!q Lin Engmeering, Inc. 7246 Sharon Drive, Suite 0, San Jose, CA 95129 Tel & Fa-,,,. 408-973-183! December 8, 2016 Re. Structural Clarification IM Ding Residence a 10206 Lockwood Road Cupertino, CA 95014 To Whom It May Concern, As requested, we provide this letter to clarify the wing f ,n 11owm 1) The wall between garage and living space is d out m Ing r going apply shear wall (type P3)- The plywood is 90mg to shall be nailed to the existing 2x4 stud with 16d at 8 incl of the shear plywood. Also, since this is a P3 shear wall, at plywood joint. Please feel free to call us is you h uestions. Thank you. F ES nj' Sincerely, 570 Wesley Liu, file: 150816.L3 ith 2x2 studs. This wall is also a -tly to the 2x2 studs, The 2x2 studs -s �once�nter prior to the installation minimum 3x stud/post shall be used CUPERTINO CONTRACTOR / SUBCONTRACTOR LIST Building Department City Of Cupertino 10300 Torre Avenue Cupertino, CA 95014-3255 Telephone: 408-777-3228 Fax: 408-777-3333 JOB -ADDRESS: f�� �¢j,�� �Y, PERMIT # OWNER'S NAME: PHONE # GENERAL CONTRACTOR: vi/j, 16C, BUSINESS LICENSE # . ,77-a� ADDRESS: //_3p Ty0 1 t Nt CITY/ZIPCODE: *Our municipal code requires all businesses working in the city to have a City of Cupertino busine4s license. NO BUILDING FINAL OR FINAL OCCUPANCY INSPECTIONS) WILL BE SCHEDULED UNTIL THE GENERAL CONTRACTOR AND ALL SUBCONT CTORS HAVE OBTAINED A CITY OF CUPERTINO BUSINESS LICENSE. ) I am not using any subcontractors: `t-/ f e Signature Date Please check applicable subcontractors and complete the following information: `/ SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets & Millwork Cement Finishing Electrical Excavation Fencing Flooring / Carpeting Linoleum / Wood Glass / Glazing Heating Insulation Landscaping Lathing Masonry Painting / Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock Tile Owner / Contractor Signature Date CUPERTINO Owner Name Address / 0 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (40) 77H7-3?28 • FAX (408 777-3333 - building cupertino.org 1 /► Gi)Dc ,i Var k'k Permit No. 16 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections. 1101.1 through 1.101.8 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. K,I�To 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 fon-n. XNo 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.. Pjease 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-conseiving 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 PlunbimgCode a d California Green Building Standards Code, and manufacturer's installation requirements, and that the water-consenj g plumbing fixtures comply with the requirements as indicated in the table on the following ua2e. / z . F j Owner or Owner Agent's Signature: ; Date: V Upon completing and signing this Q6rf ficate, please return it to the Building Division in order to final your building permit. SB40 7 2015.doe revised 01/05/17 Non-Compliant Water-Conserving Plumbing Fixture PlumbingFixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2016 CPC Ch. 4 2016 CPC Ch. 4 2016 CPC Ch. 4 /Flow Rate 2016 CALGreen Div. 4.3 2016 CALGreen Div. 4.3 2016 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: I 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 60si> . 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 1.8gallons per minute Where faucets meeting @ 6,0 psis the above are unavailable; Where faucets meeting aerators or other means the above are maybe used to achieve unavailable; aerators or reduction: other means maybe" used to"achieve reduction.` ,"