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B-2016-2291
CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-2291 21321 COLUMBUS AVE CUPERTINO, CA 95014-4921 (362 04 001) S & B CONSTRUCTION SUNNYVALE, CA 94087 OWNER'S NAME: NARAYANAN SUNDARARAMAN AND SRINIVASAN SANGE OWNER'S PHONE: 408-505-4840 LICENSED CONTRACTOR'S DECLARATION License Class ]a Lic. #893195 Contractor S & B CONSTRUCTION Date 03/31/2017 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. 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. �/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. 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 Cupertirl6 Municipal Code, Section 9.18. ignature� Date 08/17/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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(Sec.7044, Business & Professions Code). ISSUED: 08/17/2016 ' PHONE NO: (408) 529-1818 BUILDING PERMIT INFO: BLDG _ ELECT X PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: CONSTRUCT ONE STORY ADDITIONS (859 SQ FT); KITCHEN REMODEL (112 SQ FT); BATHROOM REMODEL (122 SQ FT); OTHER INTERIOR REMODEL (740 SQ FT); INSTALL (I) FURNACE AND WATER HEATER. Sq. Ft Floor Area: 859 1 Valuation: $95000.00 APN Number: Occupancy Tape: 362 04 001 1 Deferred Submittal (R -3),R-3 (Alternate Materials) PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: Kim Dunbar 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: 08/17/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL 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. 1 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. 3. 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. �f 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 08/17/2016 TO BE CLASS "A" 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, 25 33, and 25534. Owner or authorized agent: Date: 08/17/2016 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction 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 CUPERTINO' NEw CONSTRUCTIO N CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE . CUPERTINO, CA 95014-3255 (408 777-3228 • FAX 408 777 33 3 • b 3ulldIncl tc?cuDertrno:ora Z�o `6 e, l_r✓Jinwni: -ADDITION I I ALTERATiiTT n RP11reinNtFi♦unn r ,;nnrrrrnir ncn�xrmu PROJECT ADDRESS w W t 1 b e- Cup ew� Yz 77 APN # z ( [JJ OV�NERNA E � ! l+riV 0� a 4I7 2 { ;HON t OS 505 C7 E-MAIL 1 STPRET ADDRESS f, _ G; trL CITY, STATE, ZI 1 Yl (� lit�k I F - CONTACT AME Stx n r�I fn, F ONE _ a &MAIL a>j -eta: to[ STREET ADDR $ �1 CITY, STATE ZIP / rw CA 1.5b IQ FAX I11"OWNER ❑ OWNER-BUJLDER ❑ OWNERAGENT ❑ CONTRACTOR CONTRACTOR AGENT 11 ARCHITECT 0 ENGINEER IJ DEVELOPER ❑ TENANT CONTRACTORNAME ,c LICENSENUMSEis { LICENSE BUS. LICq!^ v COMLf PO NgAM(��, ! - - E-MAIL FAX STRET ADDRESS G ITY,ST 1! PHONE ARCIIITECTIENGINEERNAME�� B IJC/t.L6,cO4 LICENSE NUMBER BUS. LIC# COMppP,�A,,NYNAMP [r Covina e t Vt Cit E-MAIL FAX STREET ADDRESS l CITY, STATE, ZIP PHONE A W t9 - Ca -D&SieRIPTfAid - -- 0 A -A t G– Cf:—:: Cal �C i�[ QUI 4rC.�_ 3" 00 /;Y, EXISTING USE PROPOSED USE - CONSTR. TYPE N STORIES - - USE TYPE OCC. SQ,PT. VALUATION ($) EXISTG NEWPLOOR DEMO TOTAL AREA 2_`-3 LIS IAREAREA. A py- �Q NETAREAjr!G C9. / ✓ BATHROOM KITCHEN OTHER - REMODEL AREA RE•MODELAREA REMODEL AREA PORCII AREA DECK AREA TOTALDEMPORCH AREA GARAGE AREA: -DDETACH _ [� 1�'f`TACIi I i1DWELUNGUNITS: ISASECONDUNIT I]YI? SECONDSTORY []YES - ` BRINGADDED7 []„D3t ADDITION? [1.Nc` PRE -APPLICATION ❑YES IF YES, PROVIDE COPY OF ISTHEBLDGAN []YES - ALVALUA'rION: PLANNING ADPL# LINO PLANNING APPROVAL LETTER EICHLER HOME? ©a;r0 - By my signature below, I certify to each of the following: I am the property owner or authorized agent tc on the pro Gw s behalf. 1 have read this application and the information I have provided is correct 1 have read the Description of NVork and verify it is accu e to comply with all applicable local ordinances and state Iaws relating to building tioll. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes, �conshv Signature of ApplicanUi Agent' /iixlVV Date: ` f SUPPLEMENTAL INFORMATION REQUIRED =-:::: : - -:::::: _ ._... P.LL�TCHECKTYPE':::..:':::•. ..._... :.,_ROUTII+IGSLLP (� oviR rH CouxTEa ❑ I3i1tLDING rLAn RE1'IE�v New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s)., Demolition permit is required prior to issuance of building permit for new building. Q CXPRESS ❑ . P1 ANNING Pi 4N REVIIs1i Commercial Bldgs: Provide a completed Hazardous Materials Disclosure. sTAi�`DARD ❑ PUBLTc�ioRxs For—in if any Hazardous Materials are being used as part of this project❑ -LARGE :; Copy of Planning Approval Letter or Meeting w %ith Planning prior to - :_ C.b1AJ0R;-__-._..,::. ;- :' CI ;SANITARYSEtiERDISTRICT submittal of BuildingPermit a application. ........ .,. ::'::. .. _.:.-,...:.•:.::: ...:. :`.Si'.%.;::;_':-:�:::':;�:::`Eh'1iIRONd4ENTAC B1dgApp_2011.doc revised 06121111 A " WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERT[NO 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(-cupert! no.org Owner Name 10An 9Permit No. 1 I Address. 21;21 Lo Lu n 6, tAo M -� 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. IXNo 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. C,No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 110 1. 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. Ciyil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 2/yes My:re.al 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: 2'00'My'property is a single-family resid2ntial 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 i;plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My,propertyis 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 properly 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 owner1,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 11018,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: 2 Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB407 2015. do revised 08126115 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to tie upgraaea. SB407 2015.doc revised 08/26/15 Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture/ (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4' Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 /Flow Rate Single -Family Multi -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 0.5 gallons/flush 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 Maximum 1.5 gallons per Within units: 0.5 gallons per minute @ 60 Lavatory per minute minute @60 psi; minimum Maximum 1.5 gallons psi 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 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 temporarily 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: may be used to achieve reduction. 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to tie upgraaea. SB407 2015.doc revised 08/26/15 CUPERTINO Address SMOKE / CARBOWMONOXiDE ALARMS sE �t OWNER CERTIFICATE OF COMPLIANCE f: COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 FAX (408) 777-33331 building(a-cupertino.org Z f 32.1 C&(jLMb GjD fW e- # of Alarms Smoke: D Carbon Monoxide 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 bedroom(s) X X On every 1'evel of a dwellin unit including basements X X Witlun 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 coiYply 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'mustbe connected to the building wiring. As owner of the above -referenced property, Ihereby 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 & _.._ ...., 1 ,..,.J ...ti 11 #^ nn 11/ Iciifh fhc forme anri rnnrlitinn.S n€ this statement 1110vu luau a�.�u uy�..v w --j" Owner (or Own er Agent's) Name: Si nature ...........:......... .... ........................................................................ Date: ................. [Contra!,ane: " Signature...................................................................Lic.4...................................... Date: ................... Smoke and CO for ni.doc revised 03118114