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B-2016-2493I CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2493 19975 PEAR TREE CT CUPERTINO, CA 95014-2318 (316 30 088) SEARS HOME IMPROVEMENT PRODUCTS INC LONGWOOD, FL 32752 OWNER'S NAME: GRANT TERRY TRUSTEE DATE ISSUED: 08111/2016 OWNER'S PHONE: 408-257-3189 PHONE NO: (407) 551.6000 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C10, B C6. C36 tic. #721379 Contractor SEARS HOME IMPROVEMENT PRODUCTS INC Date 04/30/2018 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. 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 4 erformance 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. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct, t agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 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 accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all nqa.- eirrt'' source regulations per the Cupertino Municipal Code, Se aorf-9.18. Signatu Date 08/11/2016 OWNER -BUILDER DECL ON I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons:. r. I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (See.7044, Business & Professions Code). BLDG _ ELECT — PLUMB MECH X RESIDENTIAL _ COMIIIDRCIAL JOB DESCRIPTION: HALL BATH; REMODEL; M.E.P.'S (45 S.F.) Sq. Ft Floor Area: I Valuation: $10537.00 APN Number: Occupancy Type: 316 30 088 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST INSPECTION. Issued by: MELISSA N Date: 08/11/2016 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Date: 08/11/2016 hereby affirm under penalty of perjury one of the following three declarations: I ALL ROOF COVERINGS TO BE CL"ASS "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. 2. 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. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. 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 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 accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 08/11/2016 HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sections 25505, 25533, and 25534. Owner or authorized agent:-- Date: gent Date: 08/11/2016 N TI NEN I hereby affirm that there is a construe on lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 building(@cupertino.org 2-0 1-6 ZTn U NEW CONSTRUCTION UADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT i# PROJECT ADDRESS � ( � //�� p APN# l S7 U Q OWNER NAME—P-H7 -,,,I ev I E-MAIL SECONDSTORY ❑YES STREE ADDRESS CITY, STATE, ZIP FAX CONTACT NAME i [��r�p PHONE 1�7�C 2-" f �J EMAIL PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF STREET ADDRESS CJ/iq e7 ! l� r � c I CITY, �`%TigZIP i1 0 FAX ❑ OWNER ❑ OWNTER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANTS CONTRACTOR NAME 17 LICENSE NUMBER -7 �e� / LICENSE TYPE BUS. LIC COMPANY NAME L N�L- HcDe 1 !n/i r c?nl�J-C E-MAIL FAX STREEI ADDRESS ( E , A-, GJ A� r S1 � CITY, STATE, ZIP GL ti'1e/E.2vtA G c7 t PHONE � ARCHITECT/ENGINEER NAME Signature of Applicant/Agent: LICENSE NUMBER BUS. LIC # COMPANY NAME �ROUTINGStiIP p ovER TiiE couN?Z R E-MAIL FAX STREET ADDRESS r� x CITY, STATE, ZIP PHONE DESCRIPTION OF WORK �� c? t6---fi rnf lc �fi �' 4 `j1--- '13 EXISTING USE - PROPOSED USE CONSTR. TYPE # STORIES - - USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL - - AREA. AREA AREA NET AREA BATHROOM KITCHEN OTHER- REMODELAREA Lf REMODELAREA REMODELAREA PORCH AREADECK AREA I TOTAL DECK/PORCH AREA I GARAGE AREA: DDETACH - BldgApp_201 1. doC revised 0621/11 ❑ ATTACH DRPELLING UNITS: - IS A SECOND. UNIT ❑YES SECONDSTORY ❑YES BEING ADDED? ❑ NO ADD ION? '❑ NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ Y ' TOTAL VALUATION: PLAN'NINGAPPL,", NTO. PLANNING ❑ EICHLERHOME? X iv '5317 -- By my signature below, I certify to each of the following: I am the property owner or auth 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 Desc W Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building construction. I authorize re ntatives of Cupertino to enter the above -identified property for inspection purposes. a� 1 ) 1(0 Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMAT s S.PLAII�CHECKTIPE _ -_ �ROUTINGStiIP p ovER TiiE couN?Z R ❑ suILDmG 'PLANREVIEW olition permit for _ New SFD or Multifamily dwellings:�qp existing building s). Demolition penmi to issuance of building r� x permit for new building. RESS F TLAN31INC' PLAN REVIE'V1 _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure L7 sTANmaRv ❑ UBLIC1�oRxs ' form if any Hazardous Materials are being used as part of this project. L LA RGD = �:, FIRE'D Copy of Planning Approval Letter or Meeting with Planning prior to � � ❑ � '' submittal of Building Permit application. D?.�JOR. SANITARYSE�3�ERDISTRICT BldgApp_201 1. doC revised 0621/11 Assessor's Parcel Number: 3 (b/�U 6$i� Name of Owner: %ZIP tt (/( ( ,4,J T p r Contact Person: ! Gr?—,,J i t`- YO-7ffr5e_ni Phone: Project Address: 1 CIT7S Scope of Work: \ cq� Code Editions: 2013 California Residential Code 2013 California Plumbing Code 2013 California Mechanical Code 2013 California Electrical Code 2013 California Energy Code Mechanical Notes: CUPERTINO Building Department 1. Bathroom vents shalifermInate not less than 3 feet from operrngs and property lines. IONIC .504, 1) REVIEWED FOR CODE COMPLIANCE 1 , ' All Permanerman EnergyCode ory Measures: �t entlyliulaledhigh ef6cacyluminaires shall besw'itchedseparately from low efficacy luminaires (150(x)(7)) Reviewed BY 2. Permanency Installed luminaires in bathrooms shall be high eMoacy luminalms OR are controlled by an occupant sensors(s) certified (o comply with Section 119 that does not turn an automatically or have an always on option. (150(x)(10)) I i �� 1_ �� AUG i OFFICE Copy �cr.,ntt Nl - BUILDINCi ,t VI�t._ �r;Tr"J01E1vT APPROVED Ws set of Pin s - `, s eci§cafior, n ';T 90 site dun, c" r3lfuction. If is e kPpl at the es or rl to make any thong a,tarations on herefrcm, wiln:w` approval !;om r tt:v:°r' to deviate The StarrT in rlding Official. p r"an-1d spec ;; 0r-, bti held to per nnf ar to be an �^ oval ctSiSeFlotNOT la ion or any proeisio ,- r rn.ance or State Law. ATE- -- _ PERMIT # EXISTING BATHROOM FLOOR PLAN Plumbing Notes: 1. Watarclosats shall have an average were, consumptlon of not more than 1.28 gallons per effective flush. (CPC 403.2) 2. Shower heads shall have a water flaw not exceed 2.0 gallons per minutes @ 60 pal. (CPC 408.2) 3. FaucetsInlavatories shall have a watertlow not exceed 1.6 gallons per minutes @ 60 psi and shall not be less than :6 gallons per minutes at 20 psi, (CPC 403.6) 4. Shower stalls shall have aclear Interior gnlsh area of 7.1 sq.1t. and be able to accommodate a minimum 30 Inch circle at the threshold level, These clearances shall be maintained uplo a height of 70 Inches able the shower draln. (CPC 408.0) S. Shower compartments and walls above bathtubs with installed shower heads shall be finished with a smooth, nonabsorbent surfecs to a height not less than 72 Inches (6ft). (CRC R307.2) 6, The maximum hot water temperature discharging from the bathtub, shower and whirlpool bathtub I',Iler shall be limited to 120 degrees Fahrenheit. The water heater thermostat shall not be considered a control for meeting this provision. (CPC 409.4 & 408,3) 7, Weller closet shall be set minimum 15 Inches from its center to a side wall or obstruction and 24 Inch clearance In front of water closet. (CPC 4024) Electrical Notes: 1. The installation of smoke alarms In all ofthe following areas shall be provided; (R314.3) a. On the telling or wall outside of each separate sleeping area in the Immediate vicinity of bedrooms, b. In each room used for sleeping purposes, c. in each story within a dwelling unit, including basements but not Including crawl spaces and uninhabitable attics, 2. Approved carbon monoxide alarms shall be installed outside of each separate sleeping area In the Immediate vicinity of the bedrooms and on every level Including basements In dwelling units that have fuel -fired appliances or attached garages. (CRC R315.1) 3. At least one 20 amp branch circuit shall be provided to supply bathroom receptacle outlets. Such clrcuils shall have no other outlets. (CFC 210.11(C)(3)) 4. All receptacles In bathroans, garages, accessory buildings, outdoors, crawl spaces, unfinished basements, kitchens (where receptacles serve countertop -surfaces), laundry, utility, well bar sinks (within 5 feet of the edge of the sink), shall have ground -fault circuit Inarrgpter (GFCI) protection. (CEO 210.8) 5. In ell .,.as specified In 210.52, all 120 -volt, 15 -and 20 -ampere receptacles shall be listed tamper-resistant receptacles. (CEG 406.11) 1711 —� tJ auI 4"'j. sf�d� r�tr G"Iti M i& I IF =y oov�,ev CQ1111 5uvrotaJ 41— �ie 7 �00t PROPOSED BATHROOM FLOOR PLAN i CUPERTINO Address _ 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 . buildingaC�cuoertino.org _ (113 PEItIlIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN S GN ANll RETUR_N1 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 i Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s) On eve level of a dwellingunit includingbasements X X Within each sleeping room 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 have been tested and are operational, as of the date signed below. I have read and agree to Owner with the terms and conditions of this statement Date: /1./. ........................................Lic.#...................................... Smoke and COform.doc revised 03/18/14 CUPERTINO WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(.a-)cugertino.org Owner Name d Y L A A Al Z- Permit No. � - Z� l 1p - Z�i°r 3 Address9 1 ;� /� !-�� ' ZTZAffe `:) 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. �k No Go to Question 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 110 1. 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. 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. r 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.. Please check ONE of the following: My property is a single-family resid6ntial real property. See Civil Code Section 1101.4. Oil 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. 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 -conserving plumbing fixtures comply with the requirements as indicated in the table on the following page. I , Owner or Owner Agent's Signature: 2. n4 4W 7—, Date: 7/� 7/1 Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB407 2015.doc revised 08/26115