The URL can be used to link to this page

B-2016-2668CITY OF CUPERTINO BUILDING PERMIT 19631 DRAKE DR CUPERTINO, CA 95014-2433 (316 32 027) OWNER'S NAME: BOTTENFIELD CHESTER LAND CARRIE H TRUSTEE OWNER'S PHONE: 408-996-8605 LICENSED ONTRA TOR' DECLARATION License Class QM- Lic. #794890 Contractor ALL VALLEY PLUMBING INC Date 02/28/2017 hereby affirm that I am licensed under the provisions of Chapter 9 (commencing pith Section 7000) of Division 3 of the Business & Professions Code and that my cense 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 CONTRACTOR: PERMIT NO: B-2016-2668 ALL VALLEY PLUMBING INC PREMONT, CA 94539 DATE ISSUED: 09/07/2016 PHONE NO: (510) 661-9095 BUILDING PERMIT INFO: BLDG —ELECT X PLUMB M ECH X RESIDENTIAL _ COMMERCIAL DESCRIPTION: LACE 50 GAL WATER HEATER Compensation, as provided for by Section 3700 of the Labor Code, for the erformance of the work for which this permit is issued. 2ave 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: $750.00 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 regulation per the Cupertino Municipal Code, Section 9.18. Signature' Date 09/07/2016 OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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). I hereby affirm, under penalty of perjury one of the following three 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. 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 09/07/2016 "N Number: Occupancy Type: 316 32 027 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM L S� CC-A�L�D� ECTION. Issued by:MELISSAN S Date: 09/07/2016 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: 09/07/2016 ALL ROOF COVERINGS TO BE CLASS "A" OR 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 theCu ertino Municipal Code, Chapter 9.12 and the Health & Safety Co e, S tions 25505, 25533, and 25534. Owner or authorized agent"/ Date: 09/07/2016 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 ARCHTTECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408)777-3333 • buildinaOcupertino.org k jgfLUMBING Fj?1AFrunTnrAT I IrT Vf--rDT!` MEP MIS -C 1 IxAro�rr r PROJECT PROJECT ADDRESS q & Dr " %[ • - V OWNER NAME . ` . 1 Pld _ r EMAIL _ STREET ADDRESS�311 � CITY, S r TE, ZIP f } q' FAX 1 CONTACT NAMEC. I }� PHONE S��®�� E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑. OWNERAGENT ® 'CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME - _7 LICENSE NUMBER `) y SC2 0 LICENSE TYPE C 3 BUS. LIC # COMPANY NAME ALL P s E-MAIL FAX - t-404 - STREET ADDRESS - I� tT Q CITY, STATE, ZIP x)r eA 13 1-f 53 07 PHONE s-, 0-4,40,1-17 o r - ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL - FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF ❑ SFD., DUPLEX ❑ MULTI-FAMII,Y BUILDING: 0 COMMERCIAL PROJECT INWILDLAND ❑ YES URBAN INTERFACE AREA. ❑ NO PROJECT IN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK TOTAL VALUATION: wx CE By my signature below, I certify to each of the following: I am the property owner or authorized agent to a pe o 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 c uction. I author resentatives of Cupertino to enter the above-identifiedpropertyfor inspection purposes. Signature of Applicant/Agent: Date: �y SUPPLEMENTAL INFORMATION REQUIRED ; 6 ME USE_ONiY w ' OVER-THE-COUNTER. 6 " ' ❑ EXPRESS ❑:. STANDARD d a . ❑'. LARGE: c ❑: itRAJOR< MEPMiscApp_2011.doc revised 06/21/11 CV PE.RTINO Add7r-ess= PURPOSE 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 • building(a)cupertino.ora Dr; PERMIT -CANNOT BE FINALED AND COMPLETED UNTIL TMS CERTIFICATE HAS BEEN'90—D AND R a'.TiTRNRiD TO THE SLTII,DIIVG DIVISIiIN 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. - GEIVERAL 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 level of a dwelling unit including basements X X Within each sleeping room IX 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:4-i the-removal-of-.wall_and=ceilin:g-.f niches -or there is�,pa:access by-means-of=attic,-basezrent-or,crawt space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alanns 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 he manufacturers instructions and in cornipliance 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 comply with the terms and conditions of this statement Owner (6_FU,Wner Agent's Name; / CL Bot t�h�`IC¢�� Si nau `� ...............�............ :..... G+ -- __7_ i7 ..... .......................................:.Date: ;. -Contractor-Name:A H ,/,, 1� ��tn n b� 1_n Si nature............................................................... c. _}................................... fDate: }.................. Smoke and CO form.doc revised 03/18/14 WATER -CONSERVING PLUMBING FIXTURES DI OWNER CERTIFICATE OF COMPLIANCE r�¢ COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE . CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinala�cuoertino.ora Owner Nam C' h�st� � � �i rl4� i-floll"e-A l 61� 'ircz�i� Permit No , B Ul%-0. (e 6 F Address QJ 12'03 1-2 t - L, Dri I. 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. 9 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. :.ice_�No— - _Go to Question -- 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. 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: E P' 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 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 before7Januaryl; 2Qr9, -all=no-n-e"ompiiant-plumbing fixtures shall=-b-e-repiaced-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. Owner or Owner Agent's- Signature- ? Date: 63-67- ®f'7 -. 1 _ IJ rJVll L 11,VI0L111b' d11U Jlb'lllllg LIUN %_r11 L lWaLe, piease return it to the tjurramg llrvrsron in order to tinal your building permit. SB407 2015. doc revised 08126/15