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B-2016-2532CITY OF CUPERTINO BUILDING PERMI BUILDING ADDRESS: 11615 OAK SPRING CT CUPERTINO, CA 95014-5140 CONTRACTOR: PER HT NO: B-2016-2532 (366 52 072) F W H ACQUISITION CO LLC BOTHELL, WA 98011 OWNER'S NAME: XU YI AND DING XIAOFANG DATE ISSUED: 08/17/2016 OWNER'S PHONE: PHO E 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 _ PL ` ME I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing MECH X RESIDENTIA L _ CO1M VIERCIAL 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: WATER HEATER REMOV & REPLACE 50 GALLON WATER 1. 1 have andwill maintain a certificate of consent to self -insure for Worker's HEATER 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. Sq. Ft Floor Area: Valuf tion: $1654.00 APPLICANT CERTIFICATION certify that I have read this application and state that the above APN Number:. Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 366 52 072 representatives of this city to enterupon 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 PERMIT EXPIRE IF WORD IS NOT STARTED 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 regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date Issued by: Patricia Garcia Date: 08/17/2016 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 prioi 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 firstobtaining a i 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. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: I hereby affirm under penalty of perjury one of the following three declarations: 2. I have and will maintain a Certificate of Consent to self -insure for Worker's ALL ROOF COVERINGS T O 1;E 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. 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 ode, 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, Sectio rh 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 Worker's Compensation laws of California. If, after making this eel tificate 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 file the Health & Safety Code, Cupertino Municipal Code, Chapter 9.12 and 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 G.) 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 ARCHIT ECT'S DECLARATION Code, Section 9.18. I understand my plans shall be ised as public records. Signature Date Licensed Professional - _.--'-- _- _ Zvi. COMMUNITY DEVELOPMENT DEPARTMENT # BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3,255 VWPERT'INO' (409) 777-3228 •FAXJ406) 777-3333 • bu�unertin_o � .PROJECT ADDRES ELECTRICAL M / APN 0 OWDtER NAME `^ • PHONE ' I E M STREET ADDRESS CJ TATE C/ �r CONTACT NAME v:%Wa PHON® STREET ADDRESS pM I CITY, STATE, Zip L7 ON'NBIt © OWNER-BUILDBk 0 OWNpRA0sNT Jar ACOMRACTOR 000NTRACTORA08Nr CONTRACTOR NAble�p 13ARCNITBCT LLCeNSB COMPANY p NU&MER GICEN9 TiLI+� -�L, � 1, lJ NAME M1 , ,, s 5TBBHT ADDRESSq G 'C�✓ S l:G / 1 ARCHITECT/BNOWBHR NAME LICBF1Sti NUMEER COMPANY NAME EMAIL STREET ADDRESS CLTY, STATE, Zip USILD( SFD-DUFLBx 0 MULTr-FAMILY PROr9CTINWEDLAND BrnOMOr �COIvlivmRCtAL 13Y99 PROUBCTIN - 4 YBs DESCRIPTION OP WORK URBAN INTSRFACBAREA I' NO FLOODZONB ❑ NO \)C ()\)C 11-10-P n 1Z Y1 041/003 M-1. S C Jr?nT rc PAX FAX t ❑ 013WL4D MR 0 TENANT BUB. LIC OA PAX W-(�q36 =QOS7 BUS. GLC M FAX PHONE IS The BLDG AN © YES BICHLIKHOW? 0 No TOTAL VALUATION: 13y my signature below, I artily to each of the following; [ em the property owner or authorized agent to act on the property o er's behalf. !have tend this ardinan es and the information I have provided Is correct. f have rend the Descriptio n of Work and verify it Is accurate. I afire to comply wish all applicable local ordinances and stole laws relating to building conatru ion. I authoria.e representatives of Cupertino to enter the above•identlfe Signature of Appllcant/Agent: I C f ProParty for inspection purposes. Date: !_2411,doc revlsecf 06!21/( ( Address SMOKE I CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION i 10300 TORRE AVENUE - CUPERTINO, CA 95014-3;255 I (408) 777-3228 - FAX (408) 777-3333 - of Alarms Smoke: 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 917.2.11.2 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 repain to existing 'dwelling units exceeds $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 requiie that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA ( SMOKE ALARM CO ALARM Outside o-f---a-ch-sepa-rate-Tsleeping-area in the-iminediat6vici.-fty-of the X -X bedroom(S) I On every level of a dwelling unit including basements X X Within each sleeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-bu I i appliances and that rrung do not have an attached garage. Carbon monoxide alarms combined wiih smoke alarms shall comply with CBC. Section 420.6 and shall be approved by the Office of the State Fire Nfarshal. Power Supply: In dwelling units with no commercial power supply, alari,n(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 i 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 alai installed in accordance with the manufacturer's instructions and in com and California Residential Codes. The alarms have been tested and are below. the fnrmo =nd CO s) referenced above has/have been ince with the California Building rational, as of the date signed of this statement i na v& i uuu u, lu a 1cc to t wit -L Owner (oT-Owner,Agent's) -Name:-- J- ------ Signature ....... V.7 -Z-771 .............. I ......... ................ Date: Contractor Name: I Signature.............................................. ................ ; ... Lic.# ...................................... Date:................... t Smoke and COform.doc revised 03118114 CUPERTINO Owner Name Address WATER -CONSERVING PLUMBING1 FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDI G DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 '(408) 777-'3228 - FAX (408) 777-3333 - building ZD_cupertir o.orq P MM 1. Is your real property a registered historical site? 13 Yes Civil Code Sections 1101.1 -through 1101.8 do not apply. Skip the rest of the form and sign bottom o£ 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? 11 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. 0 The licensed plumber's. certification has been provided to the Building Division. Skip the rest of the form and sign bottom of form. Go to Question 3. 3. Is water service permanently disconnected for your building? I , M 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? El No My real property is built and available for use or occupancy after January 1, 1994. Civi Code Sections I ; ki th r s 1 the form anti - I - Yfl_ _ _ n5 -.1101.1 -through+10-L 8 do not y .- S p c. e t I of a igrybattorn 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.. /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 I; 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). El 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. I On or before January 1, 2019, all lion -compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). 0 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). 1, as the owner or owner's agent of this property, certify under penalty of p_erju�t4tnon-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 Buildilng Standards Code, and manufacturer's I installation requirements, and that the water -conserving plumbing 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, please return- 7io the Building Division in order to final your building permit. SB407 2015.doc revised 08126115 1. if the existing plumbing fixture water usage/tlow rate is equal to or lower than the shown, it is not required to be upgraded. SB407 2015.doc revised 08/26/15 Non -Compliant Water -Conserving Plumbing Fixture Plumbi ng Fixture/ (Fixture Complying with Current Cgde Applicable to New Construction) Fixture Type Maximum Water; Usa a/Flow Rate 2013 CPC Ch. 4 2013 CIPC Ch. 4 2013 CPC Ch. 4 Water Usage /Flow Rate 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi I'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 Gallons/flush 0.5 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 sho�verhead.) 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 onlyone shower outlet to be in operation.at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 11.5 gallons psi Faucets 0.8 gallons per minute @ per minute �@ 60 psi; 20 psi minimum 0�8 gallons per minute I@ 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 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 tempo arily 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 rr aximum 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 unavailablet aerators or reduction. other mean's maybe used to achieve reduction. I 1. if the existing plumbing fixture water usage/tlow rate is equal to or lower than the shown, it is not required to be upgraded. SB407 2015.doc revised 08/26/15