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B-2016-2383CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2383 10245 LEBANON DR CUPERTINO, CA 95014-2679 (342 14 036) WILLOW GLEN ELECTRIC INC SAN JOSE, CA 95155 OWNER'S NAME: GOSWAMI MOUSHUMI AND NATH HEMANGAR DATE ISSUED: 07/26/2016 OWNER'S PHONE: 408-861-0651 PHONE NO: (408) 289-9725 LICENSED CONTRACTOR'S DECLA_RATION BUILDING PERMIT INFO: License Class C=10 Lic. #391918 Contractor WILLOW GLEN ELECTRIC INCDate 04/30/2018 X BLDG —ELECT _PLUMB I hereby affirm that Lam 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: (N) EV CHARGING (50 AMPS)- GARAGE I hereby affirm under penalty ofperjury 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 of the work for which this permit is issued. vz� �performance i have and will maintain Worker's Compensation Insurance, as provided for by C/ Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Sq. Ft Floor Area: Valuation: $1390.00 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 342 14 036 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. Additionally; the applicant understands and will comply with all non -point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulatio s per the Cupertino unicipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 'Signa ure Date 7/26/2016 Issued by: AbbyAyende OWNER-BUILDERDECLARATION Date: 07/26/2016 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 (See.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed Signature ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code), Date: 7/26/2016 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 AL1, ROOF COVERINGS TO BE CLASS "A" OR BETTER Compensation, as provided for by Section 3700 of the Labor Code, for the performance ofthe 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 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, Se ons 25505, 25 33, and 5534 Labor Code, I must forthwith comply with such provisions or this permit shall / be deemed revoked.�� •Owner or authorized agent: Date: 7/26/2016 APPLICANT CERTIFICATION 1 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 7/26/2016 Professional CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777.3228 FAX (408) 777-3333 • buiidin ala eriin r PROJECT ADDRESS /00-445- 00-44 ' „ OWNER NAME PHONE //0 (dT //r )65-11 EMAIL STREET ADDRESS,, 5 CL- O/ v �� C T Z77iVV CA FAX CONTACT NAME. Mark LOndre PHONE (40v0)2y9-9725 / y .7 —7office@willowalenelectric.com E-MAIL. STREET ADDRESS R O. Box 8430 CITY, STATE, ZIP San Jose, CA 95155 IFAx (408)289-9725 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME Mark Londre LICENSE NUMBER 591918 7 LICENSETYPE ^-10 BUS.LIC# 15897 COMPANYNAME Willow Glen Electric, Inc. E-MAIL office@willowglenelectric.com FAX (408)289-9725 STREET ADDRESS P. 0. BOX 8430 CITY, STATE, ZIP San Jose, CA 95155 PHONE (408)289-9725 ARCHITECT/ENGINEER NAME N/A LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE Use OF If SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ No PROJECT IN FLOOD ZONE ❑ Yes ❑ No ❑ SOLAR PANELS I I ELECTRIC VEHICLE CHARGING STATION El SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELSIUNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: _ S 4 0 DESCRIPTION OF WORK Electric Vehicle Charging Circuit: F EA)I- i (" fN�i3f L �j� � t V P 73 D l') A VO V -6 ED K e. r -' ,oc` le- n RECEIVED>IIY: f ((�`p !�� 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 to building cotis1ruct, an onze r resentatives of Cupertino to enter the above -identified prope for inspection purposes. Signature of ApplicantlAgent: !' i"' p�// Date: SUPPLEMENTAL INFORMATION REQUIRED oltE.ixSU)Y .,. , • W OVER THE-CO04, gp, �` ❑ E�Yi'ESS hip LARGE G) MAJOR PV4pp_2011.doc revised 03/16/11 8/3/2016 Scan plj peg (2550x3300) SMOKE I CARaON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIA14CE lag COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION CUPERTI .. 0 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-32Z8 - FAX (408) 777-33,33 - buiIdinq6-cuuertt=orci ca"Hancevitli,2013CR9. inspections are required. GENERAL INFORMATION k05- fk:AdK- 14 Monoxide alarms. Wien the valuation of additionsf alterations, or repairs to existing di I il 0,00 CRC Section R314 and CBC Secl:Jons-907.2.115 and 420.6 reeuire th t.';-mok Monoxide Alarms be installed M* the following locations: AREA SMOKE AL AFJ 4 CO ALARM Outside of each separate sleeping area in the irrunediate vicinity of the bedroorn(s) X X On every level of a, cl!yn unit including basements X X Within each sleepiLig room X ,; appliances and that shall comply with M LL ell ULLits,id=s-are I ",stived L& be s&IX rate re re -pi 57271-7- -0-54-17 OF "J.'M It 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 have been tested and are operational, as of the date signed below. / haves rpad aM atyran to mmn1v wM thr, farms and Wnditions of thISF M ff 3? MIM 7?.Trt Smoke an4 CoformWoc revised 03118114 https://s3.amazonaws.com/closeio-emaiIlaftachment/f87be3eO6OOd3ef3elb676fOObd6blIe2lf3b981al307bO4edl8f6afe551dbe4/Scan%20pl.jpeg 1/1 Smoke an4 CoformWoc revised 03118114 https://s3.amazonaws.com/closeio-emaiIlaftachment/f87be3eO6OOd3ef3elb676fOObd6blIe2lf3b981al307bO4edl8f6afe551dbe4/Scan%20pl.jpeg 1/1 8/4/2016 Page 2.j peg (2550x 3300) i' r - . ri - J! rid ::. i. L % a ' - � o • � ! � s r. k" it , 1 1,► $ 9 e l L Please refer to the attached California Civil Code Sections 1101..1 — 1101.8 which are part of this Certific ition form. 1. Is your real property a registered historical site? 13 Yes Civil Code Sections! 101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature: Yate: 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? Q yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber'scertification has been provided to the Building Division. Sign below and skip the rest of the form. Owner' Signature: Date: No Go to Question 3. 3. Is water service permanently disconnected for your building;? Q yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest ofthe form. Owner' Signature: Date: ( 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. J7� Civil Code Sections 1101.1 1101.8 do not apply. Sign below and skip the r t of t� fber .r"` Owner' "Signature: Date: �-{} F yes My real property is bu` available for use or occupancy on or before January 1, 9 4. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. , 0 My property is a single-family residential real property. See Civil Code Section MIA' On and after January 1, 2014, building alterations or improvements shall require all n -compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. C in 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). 0 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 I, 2019, all nota -compliant plumbing fixtures shall be replaced with w., tter- conserving plumbing fixtures throughout the building (regardless of whether property underoes alterations or improvements).. d Mypropertyis a commercial real property See Civil Code Section 1101.5. tin and after January 1, 2014, specified building alterations or improvements shall requirere n> compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. 2015.doc revised 02104115 https://s3.amazonaws.com/closeio-emaiI/attachment/c33d49beO44687dae539d6b6f4dOe7c2407e76bb3dl788f5e3599d5a96l ed946/Page%202.jpeg 1/1 8/3/2016 Scan p3.jpeg (2550X3300) On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced wi water- conserving plumbing fixtures throughout the building (regardless of whether properly under oes alterations or improvements). Y w e, me Owners) of this property, certify under penalty of perjury that non-compliant plumbingfixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Cade 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 waster-conservin i4g s c2MIy with the requirements as indicated in the table bel w. owner's (or Owner Agents) Signature; EOatB C� f� Upon completing and signing this Certificate, please return it to the Building Division in order t final your permit. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it isl not required to be upgraded. revised 02104115 https://s3.amazonaws.com/closeio-email/attachment/d455ef8l5l848669b6cld38a7e4303927834453a2970dd6ebd6a05e8a�6ab072/Scan%20p3.jpeg 1/1 Non -Compliant Water -Conserving Plumbing Fi urs _PlumbingFixtures (Fixture Complying with Current Code Appilcable . to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 GPC Ch. 4 2013 CPC Ch. 4 2013 GPC Ch. —4— : Water Usage /Flow Sate 2013 CALGreen Div. 4.3 : 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3. Singld-Famlly Multi -Family Commercial esidential Residential Water Closets Exceed l.6 Single flush toilets: 1.28 gallon ski (Toilets) Gallonslflush dual flush toilets: 1.28 gallons/flush effective flush v fume (the composite, avera a flush volume of two reduced flushes aid one full flush Urinals Exceed 1.0 _ Gallons/flush 0.5 gallons/flush ShowePheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the pe.r brmance criteria of gallons per minute U.S. EISA WaterSense Specification for Showerheads (A hand-held shower is considered a showerheads) 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, lir the showers all 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, C.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons rsi 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 18 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 Maytemporarily 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 maybe used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it isl not required to be upgraded. revised 02104115 https://s3.amazonaws.com/closeio-email/attachment/d455ef8l5l848669b6cld38a7e4303927834453a2970dd6ebd6a05e8a�6ab072/Scan%20p3.jpeg 1/1