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B-2016-2520 CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: _ CONTRACTOR: PERMI NO:B-2016-2520 10481 JOHNSON AVE CUPERTINO,CA 95014-3862(375 17 047) DELSUR CONSTRUCTION ENTERPRISES SOUTH SAN FRANCISCO,CA 94083 OWNER'S NAME: KUSHNERANNEDORE BATE ISSUED:08/16/2016 OWNER'S PHONE:650-450-8009 PHONE o:(415)305-7638 LICENSED COMI—RACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lie.#932UI Contractor DELSUR CONSTRUCTION ENTERPRISES Date 05/31/2017 X BLDG X 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: UPGRADE PANEL(200 AMP);SAME LOCATION;REWIRE FOR 40 I hereby affirm under penalty of perjury one of the following two declarations: OUTLETS;16 SWITCHES;20LIGHTS 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 in t",'", performance of the work for which this permit is issued. 1 Jl 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: Valuatio :$15000.00 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 375 17047 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 this permit. WITHIN 180 DAYS F PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all ll non-point sourcregulations per the Cupertino,MuKiic pal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Si .,�� "`�� ,.�"'",.�:•�..-,�--'--...v-m-•-- { gnature �- Date /18 6/2016 Issued by:Abby A e �`' Date:08/16/2016 OWNER-BUILDER D -"ATTON R - I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: All roofs shall be inspected prior to any roofmg 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:8/16/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERING 3 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 ATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance,as provided for by I have read the hazardous mater als 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. 1 will permit is issued, maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the s. I certify that in the performance of the work for which this permit is issued,I Health&Safety Code,Section 2 532(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,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:8/16/2016 1 certify that I have read this application and state that the above information is CON TRU In DtLENDIN-aAJ N Y 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 Code,Section 9.18. 1 understand my plans shall be used as public records. Signature Date 8/16/2016 Licensed rWGENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION M E 10300 TORRE AVENUE• CUPER T INO,CA 95014-3255 cuPl*ATrNa. (408)777-3228 FAX(408)777-3333•buildino(alcuoertino.oro MISC PLUMMING ❑ VELECTRICAL ❑N SCELLANIEOUS PROJECT.ADDRESS i # 0 O\V^,�,ER NA-HE PHONE STREETADDRESS r r„L1 6 f \ w:— I CITY,STATE:ZIP � FAX CONTACT NAVE � PH0\7- �R - l I E-Mi4IL STREETADDRESS 3 { CITY,ST�TE PT -P f D ,5- FAX r°u, C�k ,�/ T �r�,.ri r `j� 71 O@rna ❑. OR-'.\-.R.BbnzER ❑ ONiNERAGENT N CO'..TRSCTOR ❑CONMICTORAGEN7 ❑ fu2C-rIIT£CI ❑m,'Gp\EzR ❑ DEVELOPER ❑ TE IUNT CONTRACTOR NAWM ii^ �' I LICENSE NUbO3ER � i I LICKS£ME I BUS.LIC', t C) COMP.ANYN:11E E-iJAIL I FAX STREET ADDRESSI C TY,STATE,ZIP K PHONE ARCHITECT/E1\'GL'\EERN.-.A;E LICENSE NU7A8 R I BUS.LIC COMPA?Y NANE E-ALAIL FAX STREET ADDRESS CITY,STATE,ZIP I PHONE USE OF VSFDxDUPLEx ❑ PROTECT M wILDLAND ❑ 1'Es PROJECT IN ❑YES 1S THE BLDG AN -❑ %Es BU-ILDn1G: ❑CO?KERCIAL i,YBANNTERFACEAREA ".0 FLOOD ZONE ❑ O EICHLERHOME? ❑.No DESCRIPTION OF WORK in e- v� TOTAL VALUATION: y By my si_nature below,I certify to each of the follo%ving: I am the property owner or authorized agent to act on the propc rty owner's behllf. I hake read this application and the information I have provided is correct. I have read the Description of Work and veiiffy it is accurate. I agree to comply with all applicable local ordinances and state laws relating to>Pild=co struction. I thorize re ese;tit o to enter the above yp-ide tified property for inspection purposes. Signature of Applicant,ARent: Date: � ! SUPPLENIENTA I'�FOR.A6ATI N QUIRED OFFTCE USE:DI\L1 .•y: 5 NEWNRCI THF COU\TFR:+ ❑,E3 PRESS U ❑ ST. �33aRD " z , 3 7 IAJ0R fi EPM,7c.,�p 201]:Voc revised 06121111 WATER-CONSERVING PLUMBING ,FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERT NO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3,f228• FAX(408)777-3333•building(tupertino,org Owner Name `r't k" c` Permit No. X6 z Addresscolt 1. Is your real property a registered historical site? Y s 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 forma No Go to Question 3. 3. Is water service permanently disconnected for your building? 11 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. r 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, Ye 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: I My property is a single family_resid�ntial real property. See Civil Code Section 1101.4. Ori 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-co 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 w o e g plumbing fixtures throughout the building(regardless of whether property undergoes alterations or s). 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. Owner or Owner Agent's Signature: Date: 6 Upon completing and signing this Cerfficate,please return it to the Building Division in order to final your building permit. SB407 2015,doc revised 08/26115 B Ngo D +,.,....,.,- -.,,._..,.,,e. �....:'-� _�.-.,, x z s_ L� - "' " �"'��'%r rr, �1 . mac„ '•xr 1�, f ; ,aa. T"' ,,,,�,£ _. !Von=Compliant ( ! Water-Conserving Plumbing Fixture Plur§in Fixture (Fixture Complying with Current Code Applicable to New Construction) Fixture Type MaXlmum Water sa a/Flow hate Water Usage 2013 CPC Ch.4 2013 CPC Ch.4 I 2013 CPC Ch,4 /Flow Rate 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3 Single-Family Multi-Family Commercial Water Closets Exceed 1,6 Residential Residential f (Toilets) Gallons/flus! Single flush toilets: 1.28 gallons/flush l Dual flush toilets: 1:28 gallons/flush effective flush volume(the composite, Urinals avera e flush volume of two reduced flushes and one full flush 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 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 exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time, Faucets— Exceed 2.2 gallons l`^aximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute v l minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8minute per allons g p @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public l use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute Faucets— F s f 60 psi xceeo 2.2 gallons ; e.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Kitchen per minute i 60 psi @ 60 psi psi Faucets May temporarily increase May temporarily j 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 crater usageAftow gate is equal to or lower than the figure shown,it is not required to be upgraded. 1SB407 2015.doc revised 08126115 SMOKE 1 CARBON MONOXIDE ALARMS PA OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUP RTII' O 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333 building(d)cupertino.org _ Permit No. 2 C?(� z b :address � �� of"t 5��n� #of Alarms Smoke: Carbon Monoxide: PERNIIT CANhTOT BE FINALED SND COMPLETED UNTIL.THTSCERTIFICATE 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 bedroom(s) Ori every level of a dwelling'uni.t including basements X _X Within each sleeping 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 ttery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs r Iterations do not result in the removal of gall and ceiling finishes or there is no access by means of attic, as ent or crawl space.Refer to CRC Section 8314 and CBC Sections 907.2.11.4 and 420.6.2.An electrical per t 's r quired r 4 alarms which must be connected to the building wiring As owner of the above-referenced property,I hereby certify that the alarm(s)referenced abov a a been installed in accordance with the manufacturer's instructions and in compliance with the Cali r Buil in- and California Residential Codes.The alarms have been tested and are operational,as of the date signed below. I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: a Si nature........ 7 /� �� ..............Date: ..(J. .r? .....: o f-a(✓ ... Contractor Name: �t l� Signature.....f. .... ::...... Lic.#.......,.. ........Date: Smoke and CO form.doc remised 03/18/14