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B-2016-2442 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2442 22515 KINST CT CUPERTINO,CA 95014-3900(342 51 010) F W H ACQUISITION CO LLC BOTHELL,WA 98011 OWNER'S NAME: CHAN YIU F AND STELLA H TRUSTEE DATE ISSUED:08/02/2016 OWNER'S PHONE:408 219 6020 PHONE NO:(425)636-7078' LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class PLUMBING Lic.#987398 Contractor F W H ACQUISITION CO LLC Date 10/31/2017 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: WATER HEATER 40 GALLON REMOVE/REPLACE I hereby affirm under penalty of perjury one of the following two declarations: 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. 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 permit is issued. Sq.Ft Floor Area: Valuation:$1344.00 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 34251 010 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 Issued by:Patricia Garcia Date:08/02/2016 OWNER-BUILDER DECLARATION 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 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) 2. 1,as owner of the property,am exclusively contracting with licensed Signature ofApplicant: contractors to construct.the project(Sec.7044,Business&Professions Code). Date: 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,S&tion 25532(x)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 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: 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 ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18.. I understand my plans shall be used as public records. Licensed Signature Date Professional 07/29/2916 FRI 10t Q9 FAX FaSt water Heater ISGlvvc,( wvj UENERAL PERMIT APPLICATION Irl h p COMMUNITY'DEVELOPMENT DEPARTMENT-BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 950'14-3255C**" (406)777-3228 FAX(406)777-3333-b 'I u e I W ,L/ MI-sc •CUPERTINO. LUMDINO El MECHANICAL PLECTRICALMiSCELLAfYE0U5 -Lfq2 c -2 -CIII j PROJECT ADD S � n � 1� .. APN a Owl IBR NAMY ` ' P NE E MAIL V STREBT ADDRESS `C ` 1- f�TY, to ,ZIP FAX CONTACT NAME VL&"CV1FRONS E-MAIL STREET ADDRESSi ` ,� CITY,STATE,ZIP V rax ❑OWNER ❑ OWMMR-191JUDR d OWNER AORW A1<05NTRACTOlk 13 CONTRACTOR AUENT ❑ ARCIjiTECr ❑ENGIN9EB ❑ WIVALOPBR ©TENANT ..CONTRACTOR NAbW ^ LICENCy BUS.LIC la(1 M. COMPANYNANM V1LWYl'O� `_ O( FrMAt,� p�xa�--bab�oS ISTREET ADD RE55 � CITY•STA ,2TP Q O(, I Pt•Io _ q yl\D RCHITECT/ENOINEEtt NAME LICENSE NUMBER (� Y Bus,1•IC a At COMPANY NAME P.MAIL FAX STREET ADDRESS. CITY,STATE,ZIP PI1nNe USE OF SFD or DUPLEX ❑ MULTG.PAMILY PROJECT IN WnALANO ❑ YE9 PROJECT IN 0 YES IS THE 111-170 AN ❑YH9 DUILDINO: COMMERCIAL URBAN INTERFACE AREA r] NO FLOOD ZOND. Q NO E GMER HOMO ❑NO DESCRIPTION OF WORK / TOTAL VALUATION: , Ma Y�' 'i I i I �. By my signature below,i certify hr each of the f0110Wing: 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 hove provided Is correct, I have read the Description of Work and verlfv it is accurate, I agree to comply with all applicable local ordinances and state laws relating to buildin construction I authorize representatives of Cupertino to enter the above-idtlfledlpr pony for inspection purposes. 5ignatuivofAppllcan�Aoent: Date: -'Xl SUPPLEMENTAL INFORMATION REQUIRED I .r MEPM1scApp_,2011.doc revised 06/21/!f r �'OKE--f AA BU KERCEF r~~ m COMMUNITY DEVELOPMENTQEPARTMENT-BUILDING DIVISION CtV, FRATIM0 10300 TORRE AVENUE,;CUPERTINO;`CA 95014-3255 (408) 777-322-8 w FAX, '-('4G$)777-8333.,bualdirwo. cuperlino orw fts I _ Thzs affidavit is a self-certific'atio'n for the installation of all required Smoke and Carboni Monoxide Alarms for compliance wifh 2013 CRC S�ctibn R314,2013 CBC Sections 420.6 and 907.2.11.2 where no interior access.for uzspectrains 01I5 -required GEN-9RAL]ENIV011,MA7[I existing;single=famrly andrn66JE4 airady dwellings shall be-provided with Smoke Alarms and Carbon Mono=xide alarms W,hen.the valuation of additions, alterations,or repairs to existmng dwelling units exceeds $1000'0'0 CRC Section 1314 and CSC S'E,!Ctlolls 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carban , Mono�icle Alatrms be install'e�d in the following locatois: ATMA S,1V10` ALARM IG CO1 ALA ODUMe of each separate seep ng area inn the immediate vicinity of the X X Ori every leveli of a dwelli>i unit hftgWdin_ basements x Wfthirik each 0--eiii= room" Carbon +on© rd.e alarms are not retqpired,in dwel li- ':s Which` : " , < < t, , =t,t , g i h do not contain feel burning appilianc es,and =�.afi do notlnawe an all ached Barge , Carbon monoxide alarms corrtl3ned wifh s=t orke alarms s1na�II c© IyrtI CBC Sec i a 42'0'.6 aild slta�Il e�axppxoved by the Office of the Stale Fire MlarshaI. 1 O'Wer SU i l hr,dwel1kr *fits w1t1L'X150 C©E11t1�er =t = 1'p Y g> coal power supFly,alarzn(s)matyEe s;©lely b =ttery, operated z Zn exisfni�g dwelling u�Zits aI�arns are per-mrtled ro be soler btalt�ery o6peraledt vhere repa�rs�or alleraror={s:`,`o } - ziQt r,esuli �the removal[ 4 wall and cei inIg,fuushes m there is ruo access by me.i}s;of"atfsc,boase-menor crawll space,..Defer to=CRC Section,AM4 acid CBC Sections 90 2.11.4 and 420.6.1,Aa,eTedficall per,f}.t is required,for Alan, w 1ich,must b_e eormecte-d to the building,v.,ig,. As owner of the above refexe2lcd iro pert l 1`' y,I hereby certify that the alarm(s)referenced above has;/have beein instal>ledl in,, accordatnce witlhi,'the _artufactureT.'s instrue alldl in com=3l�ance wzfih the Cal�ornia p Buildup=a azld Cal f£onua=,Resicleztit�=al Clod st. the ala=rnls lave I eei�tested . 1d are operatzo all as,of the dale s g1nedE below.. i and°a ree to com;;G wrtt�.fhe ferm,s a:nd condttlons;of'fhis;sfemenf fr WSN! U Sf Marra- 2—zi f ` 4Ltc. .. Date` F »y d !4 WATER-CONSERVING PLUMBING FIXTURES OVIINER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION U�'ER"1"i NCS 10300 TORRE AVENUE•CUPERTWO, CA 95014-3255 ( 10 3)77 -3228 FAX(408)777-3333-building(u�cupertino.orq Owner Name - t iti;G Permit No !S f 2- Address Address �� r- _i �jl 1�` �, CL194 no 1. Ts your real property a registered historical site? Civil Code Se6tions 1101.1 through 1101.8 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. �' 3.No Go to Question " �- -_ -- - — 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. -P—No Go to Question 4 I 4. Is your real property built'and,'I available for use or occupancy on or before January 1, 1994? El Y p p rtY. January No M real ro e ' is built and available for use or occupancyafter Janua i, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. es My real property is uilt and available for use or occupancy on or before January 1, 1994.. Civil Code Section's 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. 5. Plead check ONE of the fpllo ng: EZ/My property is a singly 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 P -3 - lumbin frxtures-to-be-re laced-w th water--corns umb fixtures. On or before January 1. 2019;all hon-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 throtkghout the building(regardless of whether property undergoes alterations or improvements). 1,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 Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements, ind that the water-conser4g plumbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: i ? Date: 7 ,,/2D I Upon completing and signing fic this Cert 0 p se return it to the Building Division in order to final your building permit. i SB407 2015.doc revised 08126115 .. - 1 311 V �' " g ,v' r i r IVon-Comlpliar9t Water-Conserving Plumbing Fixture Plumbing Fixture (f=ixture Complying with Current Code Applicable to New Construction) Fixture Type Maximum Water Usage/Flow Rate Waterisage 2013 CPC Ch.4 2013 CPC Ch.4 2013 CPC Ch..4 /g=low ate 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3 { Single-Family Multi-Family Commercial j 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 20 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 i exceed 2.0 gallons per minute @ 80 psi, or the shoyyvver shall be designed to allow only one shower out to be in o eration at a'time. Faucets— Exceed 2.2' allons 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 j 0,.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons 1 per minute @ 20 psi { In common and public I use areas: 0.5 gallons per minute @ 60 psi ' 1.8 gallons per minute 1 -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 r 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 1 Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are maybe used to achieve unavailable, aerators or C reduction. other means may be used to achieve jI reduction. 1. If the existing plumbing fixtare water usage/flow rate is equal to or lower than the figure shown,it is not required to be upgraded. if i 1 I I SB4072Q1S.docrevised 08/26/I5 i I