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B-2016-2490CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2490 21685 REGNART RD CUPERTINO, CA 95014-4820 (356 24 039) T R C LANDSCAPE & MAINTENANCE INC SAN JOSE, CA 95125 OWNER'S NAME: CRUSIUS CESAR AND WEIGERT CRISTINA BATE ISSUED: 09/15/2016 OWNER'S PHONE: 408-480-2891 PHONE NO: (408) 271-0510 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C=27 Lic. #784406 Contractor T R C LANDSCAPE & MAINTENANCE INC Date 01/3112017 X BLDG —ELECT —PLUMB COMMERCIAL MECH X RESIDENTIAL 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. JOB DESCRIPTION: NEW RETAINING WALL(59 SY) AND WOOD TRELLIS (410 S.F.) 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 performance of the work for which this permit is issued. i. 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 Sq. Ft Floor Area: Valuation: $50000.00 permit is issued. 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 356 24 039 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 of this permit. Additionally, the appli nt understands and will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR sourceregulati s r the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Sign ure ate 9115/2016 - R Issued by: Kim Dunbar ECLARAT Date: 09/15/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: 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. 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: 9/15/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS 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 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 Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. 3. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the 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 C U,perqY9 Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Se ons 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. (` Owner or authorized agen -_ APPLICANT CERTIFICATION Date: 9/15/2016 I certify that I have read this application and state that the above information is TI4E I hereby affirm that there is &6onstruction lending agency for the performance correct. I agree to comply with all city and county ordinances and state laws of work's for which this permit is issued (Sec. 3097, Civ G.) relating to building construction, and hereby authorize representatives of this city 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, Lender's Address judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands ARCHITECT'S DECLARATION and will comply with all non-point source regulations per the Cupertino Municipal 1 understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 9/15/2016 Professional ❑ NEW CONSTRUCTION CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95094-3255 (408) 777-3228 a FAX (408) 777-3333 • building(cDcupertino.org I; ADDITION ❑ ALTERATION I TI ❑ REVISION / DEFERRED W[(zMLLP uP' :NAL PERMIT #_ PROJECT ADDRESS _ _ APN # OWNERNAME PHONE E-MAIL L�! S'T'REET ADDRESS CITY, STATE, ZIP • j a 100 FAX _! s jj M CONTACT NAME s� /�1 PHON is sk E -M _. "Rr7,F7/ STREET ADDRESS CITY, ST A 5 z- FAX V r 151 ❑ OWNER ❑ OWNER -BUILDER ❑ .OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER Il DEVELOPER ❑ TENANT CONTRACTOR,#AMW& g lhnl< LtCENSE NUMBER p / ,[ `7 L[CENSETYP BUS. LIC # C2J �J IAS// COMPANY NA E • �� E-MAIL FAX ZI VNAh STREET ADDRESS CITY, STATE, ZIP 22 5 PHON Z71 /5516) �. V (/ ARCHITECT/ENGINEERNAME LICENSE NUMBER BUS. LIC #: COMPANYNAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK A s -EXISTINGUSE PROPOSED USE - - CONSTR. TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION {$) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELARP.A REMODEL AREA REMODELAREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH i ATTACH #DWELLINGUNrrs: ISASECONDiUNIT ❑YES SECONDSTORY ❑YES BEIN'G,:ADDEDY []NO ADDTr10N? ONO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑. YES B - - T TAI. VALUATION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER. RICHLER ITOME? NO By my signature below, I certify to, each of the fo wing: I am the property owner or authorized agent act o the property owner's behal . 1 have read this application and the information I have pro s correet.. 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 bui ` . onstruction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of ApplicanttAgent: Date: 4 SUPPLEMENT' NFORMATION R] QUIRED P%AN.CHECYCTYPE ROUIING,SLIP Q OVEIiTH&COU11TdER A/BUILDINGPLANV V 1 ` 4 New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building 1 permit for new building. L7 EXPRESS VPLANNING PLAN REVIEW GFY Commercial Bldgs: Provide a completed Hazardous Materials Disclosure © STANDARD VPVR1JCWORICs form if any Hazardous Materials are being used as part of this project. p LARGE ❑ ADEPT Copy of Planning Approval Letter or Meeting with Planning prior to El MAJOR❑ SANITARY SEWERDISTAICT submittal of Building Permit application. ❑ RNVIRONTMIENTAL HEALTH BldgApp_20 11. doe revised 06121111 rlw- SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - building Mcuoertino:oro 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 907.2.1.1. where no interior access for inspections are required. • I GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smol e Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations, or repairs toe 'sting dwelling units exceeds $1000.00, CRC Section R314 and CSC Sections 907.2.115 and 420,6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: I AREA SMO ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X X On every Ievel of a dmAreMng unit including basements X X Within each Slee in -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 Marshall. Power Supply: In dwelling units with no commercial power supply, alarm(s) In existing dwelling units, alarms are permitted to be solely battery operated i not result in the removal of wall and ceiling finishes or there is no access by in _ space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) re installed in accordance with the manufacturer's instructions and in compliance and California Residential Codes. The alarms specified below have been tested date signed below. r Address: 216 0 5 Specify Number of Alarms: r1.A► ` w1 C"erHn to 44 be solely battery operated. e repairs or alterations do of attic, basement or crawl :rical permit is required for iced above has/have been L the California Building are operational, as of the Permit No. i —2-616-24q0 I have read and agree to comply with the tents and conditions of this statement Detectors: Owner (or Owner Agent's) Name: c�tee n e Signature.. ............ 30 0/3,04 .......................................Date: %G.7�'7+� c►�vsi US .......,. Contractor Name: Signature.................................................................. Lic. ......,..,,....,,.....................Date: Smoke and COforlmdoe revised 09127116 WATER -CONSERVING PLUMBING FIXTU RES , OWNER CERTIFICATE OF COMPLIANCE �i COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION f 3 -`�` f CU'PERTINO 10300 TORRE AVENUE - CUPERTINO, CA 950143255 CZAA j4V vs 8 •FAX (408) 777-3333 • buildinana cuoertino.ora Owner Name J� Permit No. 1J Address 2169S PCEG,NA T RD cvP&7z7"INo cA 9$oiy 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 foand sign bottom of form. XNo 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 Divis on. I$ NoSkip the rest of the form and sign bottom of form. Go to Question 3. 3. Is water service permanently disconnected for your building? I ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the fon and sign bottom of form. IK 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 fo and sign bottom of form. X Yes My real property is built and available for use or occupancy on or before Januar 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three follgwing statements and sign bottom of form.. Please check ONE of the following: jg�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 n to be replaced with water -conserving plumbing fixtures throughout the building. On or compliant plumbing fixtures shall be replaced with water -conserving plumbing i property undergoes alterations or improvements). ❑ My property is a multifamily residential real property. See Civil Code Section 1101.5. On land after January 1, 2014, specified building alterations or improvements shall requ plumbing fixtures to be replaced with water -conserving plumbing fixtures. On nor before January 1, 2019, all non-compliant plumbing fixtures shall be replaced wi conserving plumbing fixtures throughout the building (regardless of whether property i 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 regL plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before January 1, 2019, all non-compliant plumbing fixtures shall be repl; plumbing fixtures throughout the building (regardless of whether property undergoes a -compliant plumbing fixtures fore January 1, 2017, all non- ures (regardless of whether non- compliant water- lergoes alterations or non- compliant d with water- conserving rations 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 accord ce 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: AfVV Upon completing and signing this Cc—pt ficate, please return it to the Building Division in order to final your building permit. SB407 2015.doc revised 08126115