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B-2016-2879 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2879 18610 STARRETT CT CUPERTINO,CA 95014-3863(375 26 029) EAGLE PLUMBING INC SAN JOSE,CA 95148 OWNER'S NAME: FLANIGAN MARK ET AL DATE'ISSUED:10/06/2016 OWNER'S PHONE:408-313-2387 PHONE NO:(408)270-2279 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class QW Lic.# 9$ 1Q$ Contractor EAGLE PLUMBING INC Date 08/31/2018 X BLDG —ELECT X PLUMB— — _MECH X RESIDENTIAL_COMMERCIAL 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: (N)PROPERTY LINE CLEANOUT(SUNNYVALE SANITARY) 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. 5ZN2. A 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: Valuation:$2400.00 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 26 029 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. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all non-point source reg ion u ertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Date 10/06/2016 Issued b Date: 10/06/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RF-ROOFS: following two reasons: All roofs shall be inspected prior to any roofing 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. 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:10/06/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER 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. 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. Health&Safety Code,Section 25532(a)should I store or handle hazardous a. 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 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 er unicipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Co e,,Sections 2 505,25533,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: 10/06/2016 CONSTRUCTION GYAGENCY I certify that I have read this application and state that the above information is 1 hereby affirm that there is a construction"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 relating to building construction,and hereby authorize representatives of this city t 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 DECLARATION I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date 10/06/2016 Professional GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION •10300 TORRE AVENUE CUPERTINO,CA 95014-3255 CUPER€ NO (408)777-3228 FAX(408)777-3333•building(cDcupertino.org MISIC 13t- 0006w2e3 PLUMBING ❑MECHANICAL ❑ELECTRICAL []MISCELLANEOUS PROJECT ADDRESS' G - APN# � S- � —: ,— �- �3 C.� 2- -f OWNERNAME PHONE E-MAIL, STREET ADDRESS CITY,STATE,ZIP FAX CONTACTN Z r PHONE!!P�1' 4'A& 613 r E-MA STREET ADDRESS s 1 CITY,STATE,ZIP FAX q ^¢y ❑OWNER ❑ OwNER-BUIIAER ❑ OWNERAGENT CONTRACTOR ❑CONTRACTOR AGENT ❑ ARCHnFCT ❑ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMELICENSE NUMBER LICENSE TYPE BUS.LIC# �' 9L 16-0,K 36 COMPANY NAMEG _ E-MAIL � FAX ;X0W1WAffd ago-tag STREET ADDRESS 21 CIT ,STATEZI , PHONE .rz L.0 CA 951 ajo-as ARCEITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY;STATE,ZIP PHONE USE OF ❑SFD or DUPLEX MULTI-FAMB,Y PROJECT IN WILDLAND ❑ YES PROJECT IN ❑YES IS THE BLDG AN ❑YES BUILDING: ❑COMMERCIAL URBAN INTERFACE AREA --EJ-" FLOOD ZONE ❑NO EICHLER HOME? ❑NO DESCRIPTION OF WORK - ---_-. _ o TOTAL VALUATION: �� =RECE By my signature below,I certify to each of the following: I am the property owner or authorized agent to ac e pro e this application and the information I rovided 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 rela to tri I authorize representatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMV,TTAT,INFORMATION REQUIRED USE ONLi " ` YER-TFa COCJNTE$ �� STANDARD LARGE' —77777— ©y MA:IOIt- MEPMiscApp 2011.doc revised 06/21/11 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE F Igo JE COMMUNFTY C3EVE10PMENT DEPARTMENT m BUILDING DIVISION UPERT]N 0 103130 TORRE AVENUE-CUPERTINO,OA 95014-3255 i?$)777=3228-PAX�408)777-3333.building l]cuper ino org ,OwnerNam 1'ernit N.o Address C _e,"Z;y f 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 11=01.13 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. tl "oto 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? El Yes Civil Code.Sections 11"01.1 through 1101.8 do not apply. The licensed plumber's certification has been provided to the Building Division. � Skip the rest of the forth and sign bottom of form. R'14'o Go to Question 3. 3. Is water service permanently disconnected for your building? El 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? O 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. 3-les 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: 9-Myproperty 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). ❑ 1vlyproperty 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-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). 1,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-conservirtg-plum—bing fixtures comply with the requirements.as indicated in the table on the following page. a d Owner or Owner.Agent's Signature.i " Date Upon completing and signing this Certificate,please retain it o the Building Division in order to final your building permit. SB407 2015.doc revised-08/26/1'5 SMOKE / CARBON MONOXIDE ALARM'S OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION FILE cupeRTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 f' (408)777-3228•FAX(408)777-3333•_building a.cupertino.oM ��� ����ERMIT GANNOT BE-��AI��D VI�T�I,THIS�GERT�CATE HS_B�+lat1� 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 8314 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 v cindty of X X the bedroom(s) On every levol of a dwelling unit including basements X X Within each fs!leeping room X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do not have an atiached 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:Indwelling units with no comunercial 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 must be connected to the building wiring. X As owner of the above-referenced property,I hereby 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 specified below have been tested and are operational, as of the date signed below. Address `r c? L",ev, ill y'SP.2/ Permit No..- ~6 e`dP6 f � i yea Specify Number of Alarms: #Smoke Alarms:- #Carbon Monoxide Detectors: l have read and agree to comply w't. •he terms and conditions of this statement Owner(or Pwner Agents)Name: 'lf�t Gyr'. Signature �c �r�sL ' "�" !�/' / ...Date: ......... ........ ............. ..... .....,.. ........... ... ..... . . ..... ......... ... Contractor Name: _ Signature..................................................................Lic.# ......................................Date: Siiioke and COform.clot t-evised 09l'17116