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D-2016-0400 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:D-2016-0400 7593 DUMAS DR CUPERTINO,CA 95014-4310(359 25 027) DIG&DEMO INC SAN RAMON,CA 94583 OWNER'S NAME: SHEN JEFF YAND JANE S TRUSTEE DATE ISSUED:08/04/2016 OWNER'S PHONE:408-888-2645 PHONE NO:(925)933-4448, LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class A,G-21 Lic.#993947 Contractor DIG&DEMO INC Date 06/30/2018 —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: POOL DEMO(396 S.F.)-LANDSCAPE PURPOSE ONLY I hereby affirm under penalty of perjury one of the following two declarations: 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. (� zJ . 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:$10000.00 APPLICANT CERTIFICATION certify that 1 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 25 027 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 Cupertin Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. V'Signature Date 8/4/2016 Issued by:AbbyAyende Date:08/04/2016 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 r. 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) i. I,as owner of the property,am exclusively contracting with licensed Signature of Applicant: contractors to construct the project(Sec.7044,Business&Professions Code). Date8/412016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. HAZARDOUS MATERIALS DISCLOSURE z. 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 ofthe the Health&Safety Code,Sections 2550 25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. 1j'� r"Owner or authorized agent: APPLICANT CERTIFICATION Date:8/4/2016 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 ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal Code,Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 8/4/2016 Professional SWIMMING POOL f SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION UR' 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228• FAX(408)777-3333•building(cr�.culavrtino.org CUPERTINOOD- 7'0v�- - PROJECT ADDRESS 7 593 'Dttiy,%^s 'bAPN# q M OWNER NAME PHONE IM s Q va u��. .�O y E-MAIL STREET ADDRESS-7S!,7 'b rN ib< CITY, TE;Z1P G•` n i FAX CONTACT NAME6,,,; „ .5 PHONF^Z..) .'% 7 U E-✓SAIL q STREET ADDRESS CITY,STATE,ZIP ' FAX call G ❑OWNER ❑ OWNER-BUILDER ❑ OWNERAGENT XCONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT CONTRACTORNAMEI,); Cha t LICENSE NUMBER a�2b/J� LICENSETYPE� G��. BUS.LIC 4 COMPANY NAME- E-MAIL II 77_/(( /j' FAX _S ?)t-,rd- STREET t-,� STREET ADDRESS1 ', � CITY,STATE, ( PHONE ARCHITECVENGINEER NAME r LICENSE NUMBER 7 BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK \ C e Cl) d , a 4 e- o e ( �,e-- holes i n ahm k LwJ Pf bd res�*te, a r-& -6 Do' i n0,/ t Cdc a? o 4,( m;4 A}-i'ce, (ya s -t I�7 Ie—, (-) USE OF -9 S`FD or Duplex ❑ Multi-Family TYPE MATERIAL TYPE(CODE) AREA (SQ.FT.) VALUATION(S) STRUCTURE: ❑ Commercial POOL ' POOL/SPA MATERIAL TYPE CODES: SPA V - VINYL-LINED .. - F - FIBERGLASS' DEMO 00 5G '- GUNITE V P - PREFABRICATED RECEIVED B3. TO :y�TAL VALUATIONSeco p By my signature below,I certify to each of the following: 1 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 I ize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL 1NFORMAT ON QUIRED "OFTTC [JsoilL , PLAN CI3ECK:TYPE„`�, Y RQYTPvG SLIP _Commercial or Multi-Family Buildings with Public Swimming Pools: m Department of Environmental Health approval required. `OVER�xE cauNTi R ❑ BVH ❑ nlNc DPTz ❑�.EXPRESS ❑ Pi-;ANIvING DEPT ❑4 STNDAAD ❑ PUBLTCVORhSsDEP2 .. ❑s LARGE, _F ❑ E3YVIRONMENTt1LI3EALTH ;. ❑,'.;t7A,iOR."' ? ❑, SA?1ITAR1�SDVkE.R,D7STR1'GT.:, f',;' SwimPoolApp_2011.doe revised 03116/11 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE , COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUP TING 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 x(408)777-322 •FAX(40777-3333•building(a.cupertino.org Owner Name Permit No. l AddressY- , C vt4 C 1 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 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. 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 of form. No Go to Question 4. z 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.. 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 plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building. On or befor January 1, 2017, all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing frxtur s (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 req •e o oliant plumbing fixtures to be replaced with water-conserving plumbing fixtures. On or before January 1,2019, all non-compliant plumbing fixtures shall be replaced wit t conserving plumbing fixtures throughout the building(regardless of whether property ungoes al e ations 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 Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements, and that the water-conserwkgialurribing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: Date: Upon completing and signing this Certificate, ease,r it to the Building Division in order to final your building permit. SB407 2015.doc revised 08126115 B ANG-MOM iC40W W., f fid e NoramGornpliant Mater-Conserviri8 Plumbing Fixture PlumFixturel (Fixture Complying with Current Code Applicable to New Construction) Fixture TypeMaximum Water t3sa a/Flaw Rate Water Usagei 2013 CPrICh.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 MultipFamily 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, rShowerheads nals average flush volume of two reduced flushes and one full flush Exceed 1.0 Gallons/flush 0.5 gallons/flush ::: 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 i showerheads and/or other shower outlets controlled by a single valve shall hot I exceed 2.0 gallons per minute @ 80 psi,or the shower shall be designed to allow oniy one shower outlet to be in operation at a time. Faucets— Exceed 2:2'gallons i Maximum 1.5 gallons per Within units: 0.5 gallons per iniinute 60 Lavatory per minute I minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets i 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 gallop 3s 11.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minut @ 60 kitchen per minute 160 psi @ 60 psi psi Faucets May temporarily increase May temporarily up to 2.2 gallons per increase up to 2.2 min'Ute @ 60 psi,and must gallons per minute @ default to maximum 60 psi,and must 1 8,gallons per minute e7 default to maximum o . I _. sG ps: 7 SMOKE / CARBON -MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUP RT'I NO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333-buildingCaD_cupertino.org rmit No. )-Z,4-6 Address 15gsyyooy w C � t�v #of Alarms Smoke: Carbon Monoxide: PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THTS�CERTIFICATE w "� � � ` C�1tLIAND TO�EF.�BUILDIN�k T�ISI�ON �� $AS BEE 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 X X bedrooms) On every level of a dwelling unit including basements X X Within each sleepin 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 per t' rea e 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 ab e ave b en' installed in accordance with the manufacturer's instructions and in compliance with the C rni uilding and California Residential Codes.The alarms have been tested and are operational, as of t e date signed below. I have read and agree to comp4ekyith the terms and conditions of this statement Own r(or Owner Agent's)Name: J QM e P Si nature...... ........ Date. /211 Contractor Name* ,,j ��9�7 f� Si nature...: ..... ..:....... ...1:�/ Lic.#.... Date Smoke arad CQ forimdoc revised 03118114