B-2016-2860CITY OF CUPERTINO BUILDING PERMIT J
BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-2860
10800 JOHNSON AVE CUPERTINO, CA 95014-3877 (375 31 002) THD AT - HOME
SERVICES INC
ATLANTA, GA 30339
OWNER'S NAME: CHEN HAN-WEN AND BAO MIN
OWNER'S PHONE: 650-296-3298
LICENSED CONTRACTOR'S DF T RATIO
License Class GLAZING Lic. #836021
Contractor THD AT - HOME SERVICES INC Date 04/30/2018
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:
t. 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
f %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 Cupertino Municipal Code, Section 9.18.
Date 10/5/2016
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. L 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 (See.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
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 10/5/2016
ISSUED: 10/05/2016
PHONE NO: (770) 779-1423
PERMIT INFO:
X BLDG —ELECT —PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
REPLACE PATIO DOORS (2) FAMILY ROOM AND BEDROOM - LIKE
FOR LIKE
Sq. Ft Floor Area: I Valuation: $1850.00
"N Number: Occupancy Type:
375 31 002
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
by: AbbLvende
RF 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: 10/5/2016
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, 25533, and 25534..
Owner or authorized agent: _
Date: 10/5/2016
hereby affirm that there is a constr tion g agency for the performance
of work's for which this permit is issue (Sec. 3097, Civ C.)
Lender's Name
Lender's Address
ARCHITECT'S DECLARATION
understand my plans shall be used as public records.
Licensed
Professional
rl�
_-W
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408)777-3333 • building cupertino.org
El NEW CONSTRUCTION. F-1 ADDITION F-1 AT.TF.RATION/TT FI RF:VICT(1N/nFFFRRF:r) nRI( FNAT PPPNn7Ttt
PROJECT ADDRESS } Q f�f� e
tilC
APN #
002
OWNER NAME
P O50 , Z-26 '3 FS
E-MAIL. .. -
STREET ADDRESS /y,, �
10 q00 �of-w5op live
CITY, STATE, ZIP p� /
CJ13(T- G1,JO
FAX
CONTACTNAME JEFF RAINEY
PHONE 10-427-4260
E -MAI LJEFFREY.RAINEY@ATT.NET
STREET ADDRESS 1069 EDGEMERE LANE
CITY, STATE, ZIP HAYWARD, CA 94545
FAX 510-783-1041
❑ OWNER 171 OWNER -BUILDER 1:1 OWNER AGENT ❑ CONTRACTOR :L CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑. DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER.
LICENSE TYPE
BUS. LIC #
836021
B,C39,C13,C17
`
-q l�
COMPANY NAME
E-MAIL
FAX
THD AT HOME SERVICES
510-357-3750
STREET ADDRESS
CITY, STATE, ZIP
PHONE
2456 VERNA COURT
SAN LEANDRO,CA 94577
510-877-4550
ARCHITECT/ENGINEERNAME
LICENSE NUMBER
BUS. LIC #
COMPANYNAME
E-MAIL
FAX
STREET ADDRESS -
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK ` f-7 � /�\ r ! ? A -M I IV �-w t"'p J Q
/ /
-� -� ZL I ( j o 5(� c C
A h A -M
EXISTING USE
PROPOSED USE CONSTR.
TYPE
# STORIES
I
I
USE
TYPE
DCC,
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM -
KITCHEN - -
OTHER -
-
REMODELAREA
REMODELAREA
REMODEL AREA
PORCH AREA
DECK AREA -
TOTAL DECK/PORCH AREA
GARAGE. AREA: CIDETACH
ATTACH
#DWELLING -UNITS:
IS ASECOND UNIT []YES
SECONDSTORY ❑YES
-
BEING ADDED? []NO
ADDITION? []NO
PRE -APPLICATION ❑.YES IF YES, PROVIDE COPY OF
IS THE BLDG AN E] YES
RECEIVED BY,
fiOT_&LUATION: -
PLANNING APPL # ❑NO PLANNING APPROVAL LETTER
EICHLER HOME? ❑ NO
)U—
By my signature below, I certify to each of the following: I am the property owner or authorized agent tA act on t1le property owner's behalf. I have read this
application and the information 1 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 construction. I a resentatives of Cupertino to enter the above -identified property for inspection purposes.
Dater
Signature of Applicant/Agent:
SUPPL E INFORMATION REQ I
PLANICIIECK TYPE
ROUTING SLIP'
`❑: OVER-THE=COUNTER
❑ BUILDINC4LAN REV.IEVV
_ New SFD or Multifamily dwellings: Apply for molihon permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
EXPRESS
' ❑ PLANNINGPIrAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
'STANDARD.
❑ PUTSLIC wORKS
forni if any Hazardous Materials are being used as part of this project.
Q LARGE
❑ FTE DEPT..
Copy of Planning Approval Letter or Meeting with Planning prior to
❑ MAJOR'
ArITRY EwERDsTRICT
❑ubmiA
sttal of Building Per application.
...:
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06121111
Owner Name
I
Address A
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE.,
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
-3228 - FAX (408) 777-3333 - building(d)cupertino.om,
—A-06'sm Ave fLt, ivo
V i
r=A
1. Is yourreafproperty a registered historical site?
F71 Yes Civil Code Sections 110 1. 1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
1A NO -, Go to Question 2.
-
2. Does'
,your real property have a licensed plumber certifying g that, due to the ago 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.
El The licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of faun.
No Go to Question 3.
3. Is water service permanently disconnected for your building?
M Yes Civil Code Sections 1101.1 through 1101.8 donot - apply. Skip the rest of the form and sip bottom of form.
No 'Go to Question 4.
before 94?
4. Is your real property built and available for use or occupancy on January 1, 19:
NoMy 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.
0 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 sip
bottom of form..
5. 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 1, 2014, building alterations or improvements shall require all'llon:-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).
0 My property is a 7nUlti/aMily 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 Nvater-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
finprovements).
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
plumbM"9 fixtures throughout the building (regardless of whether property undergoes alterations. or improvements).
1, as the owner or own I er's-- agent of this property, certify under penalty of perjury -that non; compliant plumbing fixtures will be
Z>
replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1
in I d - '
1101.8, the current California Plumbing Code and California Green Building Standards and manufacturers
installation, requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the
table on the following page.
Dt 117
Owner or OVvnei- Agent's Signature.* ate: f
IM
e ret
TTnnn rnmnlftingr 211d signing this Certificate, 131 ase- urn it to the Building Division in oder to final your building
pei
B4072015,docrevised O8126115
I
SMOKE CARBON MONOXIDE A�ARMS
OWNER CERTIFICATE -OF CO P�IANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILD�NG DIVISION
—Z/,
CUPERTINO 14300TORREAVENUE • CUPERTINO..C_A 95014-325 ,
(408) 777-3228 • FAX (408) 777-3333 -'154ldingOCuperino.orQ ' / •�
PURPOSE ;
TIZis affidavit is a self -certification for the installation of all required Smok and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 9072.11.2 where ho interior access for
inspections are required.
GENERAL INFORMATION
Existing single-family and multi -family dwellings shall be provided with moke Alarms and Carbon
IvIonioxide alarms. When the valuation of additions, alterations, or repairsjio 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 S OKE ALARM CO ALARM
Outside of each separate sleeping area in the immediate vicinity of X X
the bedroom(s)
On every level of a dwelling unit including basements X X
Within each z sleeping room X
Carboni 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 Su ply: In dwelling units with no commercial. power supply, alarm(s) may be solely battery, operated.
Iii existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result:M' the removal of wall and ceiling finishes or there is no access b 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 ownerof the above -referenced property, I hereby certify -that the alarm(5) referenced above has/have been
i -Lstalled in accordance with the manufacturer's instructions and in compliance with the California Build
a11d Cal ifoi -da Residential Codes. The alarms specified below have been tested and are operational, as of the
date sip -Led below.
Address,:
1 f)P0 vi U h -n 5m
Specify Number of Alarms:
I h,-- . —4 „-4
# Smoke Alarms:
#
Permit No.
Monoxide Detectors: I ! f
Owner! (or Owner Agent's) Name:,if
_ ',N,, „uruv,17
5 v7 u77s sraremenr
Signature........ .........................................................Date:
r
............. ...........................................-................................................
e`fitkoI
Contractor Name:
1
Signature..................................................................
_ic.# ......................................Date:
Smoke and CO f07777.doc revi.c(Id 0912711K
M
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure sh vni, it is not required to be upgraded.
i
i
SB407 2015.doc remised 08126115
j
Non-Compliant
Water-Conserving Plumbing
Fixture
Plumbin Fixture
(Fixture Complying with Current Code Applicable
to New Construction)
Fixture �yf
e
Maximum Water Usa
a/Flow Rate
2013 CPC Ch. 4
2013 CPC Ch.
4
2013 CPC Ch. 4
Water Usage
!Flow Rate
2013 CALGreen Div. 4.3
2013 CALGreen
iv. 4.3
2013 CALGreen Div. 5.3
Single -Family
Multi-Fami
y
Commercial
Residential
Residenth
I
Water Closets
Exceed 1.6
Single flush toilets: 1.2
gallons/flush
(Toilets)
Gallons/flush
Dual flush toilets: 1.28 gallons/flush effec
ive flush volume (the composite,
ave-rage flush volume of two reduced
flushes and one full flush
Urinals
Exceed 1.0
Gallons/flush
0.5 gallons/flush
Showerhea s
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 Show
rheads
(A hand-held shower is considered a showerh
ad.)
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 rr
inute
60 psi
Faucets= ;
Exceed 2.2 gallons
1.8 gallons per minute @
1.8 gallons per rr
inute
1.8 gallons per minute @ 60
Kitchen
:1.
per minute
60 psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.
minute @ 60 psi, and must
gallons per minu
e @
default to maximum
60 psi, and must)
1.8 gallons per minute @
default to maxim�m
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 sh vni, it is not required to be upgraded.
i
i
SB407 2015.doc remised 08126115
LEGEND:
® = RETROFIT WINDOW / PATIO DOOR / ENTRY DOOR LOCATION
SCOPE OF WORK: INSTALL (2) RETROFIT VINYL, DUAL
GLAZED, LOW E, PATIO DOORS. NO (N) CONSTRUCTION.
NOTE; WINDOWS / PATIO / ENTRY DOORS;
U -FACTOR = 0.30
SHGC = 0.25
OM TY DEVELOPM
BUS =I .BION
wom
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a raWns on same or to cvit_ the et
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re sta ray g ct i s a[a a if t � E i
9Ir rperr _ or to be an app,� 'a r c
r av sion a y Guy Omdr a _aw
By Abby N
DATE
T NO - F
FIRST STORY (FRONT YARD)
NOTE: FLOOR PLAN JOHNSON AVENUE
1). SMOKE DETECTORS: WHEN A BUILDING PERMIT IS REQUIRED, SMOKE DETECTORS SHALL BE INSTALLED; (a) IN EACH SLEEPING ROOM, (b) OUTSIDE EACH SEPARATE SLEEPING AREA IN THE IMMEDIATE VICINITY OF THE
BEDROOMS, (c) ON EACH ADDITIONAL STORY OF THE DWELLING, INCLUDING BASEMENTS AND HABITABLE ATTICS BUT NOT INCLUDING CRAWL SPACES AND UNINHABITABLE ATTICS. (CRC 314)
2). CARBON MONOXIDE ALARMS: WHERE A PERMIT IS REQUIRED FOR ALTERATIONS,REPAI ONS E.G, lNI9NG DWELLINGS OR SLEEPING UNITS THAT HAVE ATTACHED GARAGES OR FUEL BURNING
APPLIANCES SHALL BE PROVIDED WITH A CARBON MONOXIDE ALARM IN THE FOLLOWING a) Tc t� ING UNIT SLEEPING AREA IN THE IMMEDIATE VICINITY OF THE BEDROOM(S), (b) ON
EVERY LEVEL OF A DWELLING UNIT INCLUDING BASEMENTS. (CBC 420.4, CRC R315). \
(HOME OWNER TO PROVIDE BEFORE FINAL INSPECTION).
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DATE 09.28.16
SCALE NTS
DBAWNBY DKW
ADB 9564283
SHEET
A-1