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B-2016-2953CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESSp CONTRACTOR: PERMIT NO: B-2016-2953 10265 PARKWOOD DRAPT 8 CUPERTINO, CA 95014-1509 (326 27 036) THERMAL MECHANICAL SANTA CLARA, CA 95054 OWNER'S NAME: AVERY GLENBROOK LP OWNER'S PHONE: 650-961-8330 7 T11 NQri T rVlx7rn.A rlmAnfv "VL . T ♦TT(ll i License Class C-4. 10.20.36.38 Lic. #256057 Contractor THERMAL MECHANICAL Date 01/31/2018 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: 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 / ection 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 regulationse Cupertino Municipal Code, Section 9.18. hereby affirm that I am exempt from the Contractor's License Law for one of the ving two reasons: 1. 1, 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 DATE ISSUED: 10/20/2016 PHONE NO: (408) 988-8744 BUILDING PERMIT INFO: X BLDG X ELECT X PLUMB X MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: BLDG I I/UNIT 8; ADD (I) A/C; REPLACE FURNACE, SAME LOCATION; (I) WASHER AND DRYER HOOK UPS; (I) ELECTRICAL SERVICE (70 AMP); (I) GAS LINE FOR STOVE; (I) 9 RECEPTACLE OUTLETS; (N) 1 LIGHT; (I) BATHROOM EXHAUST FAN Sq. Ft Floor Area: I Valuation: $20000.00 "N Number: Occupancy Type: 326 27 036 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Aygnik Date: 10/20/2016 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. 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: 10/20/2016 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. 2. 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. s. 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 10/20/2016 ALL ROOF COVERINGS 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, SeStionV25505, 25533, and 25534. Owner or authorized agent: Date: 10/20/2016 CON IR1156TIOLLENDINGA 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 Professional C P RTINt CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 FAX (408) 777-3333 building((-cupertino.orq 0 NEW CONSTRUCTION 0 ADDITION 0 ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 10265 Parkwood DR, BLDG 11, Unit #8 1J OWNERNAME Avery Glenbrook LLC PHONE 650-961-8330 E-MAIL Avery@pacbell.net STREET ADDRESS 130 East Dana Street CITY, STATE, ZIP Mt.. View, CA 94041 FAX 650-961-0571 CONTACT NAME Rob Rob Moyer 408-593-8115 E-MAIL rmoyer@thermalmech.com STREET ADDRESS 425 Aldo ave. CITY, STATE, ZIP Santa Clara, CA 95054 FAX 408-958-0233 ❑ OWNER ❑ OWNER-BUIME'R ❑ OWNERAGENT IX CONTRACTOR D CONTRACTOR AGENT ❑ ARCHITECT 11 ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME - Thermal Mechanical LICENSE NUMBER 256057 LICENSE TYPE BUS. LIC # 299- C-4,10,20,36,38 coMPANYNAME Thermal Mechanical E-MAILrmoyer@thermalmech.com FAX 408-988-0233 STREET ADDRESS 425 Aldo ave. CITY, STATE,z'P Santa Clara, CA -95054 PHONE 408-988-8744 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE - DESCRIPTION OF WORK. - r� Apartment renovation=Jz�jt�,t<��6� bet-, EXISTINGUSE - - PROPOSED USE CONSTR. TYPE' # STORIES - - N USE TYPE OCC. SQ.FT. VALUATION ($) F,XISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN - OTHER REMODEL AREA RIMODEL AREA REMODEL AREA - PORCH AREA DECK AREA TOTAL DECK/PORCH AREA -GARAGE AREA: DETACH- ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? ONO ADDITION? []NO PRE -APPLICATION F1 YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES ............ TOTAL VALUATION: PLANNING ADPL # [:]NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NOave f By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on e property owner's behalf. I ha e 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 bui " ' ons cti a•f a5110>e representatives of Cupertino to enter the above -d for inspection purposes. /operty `j ® `M Signature of Applicant/Agent: c Date: SUPPLEMEN AL INFORMATION REQUIRED Q _ New SFD or Multifamily dwellings: Apply for demolition permit for ©; tix»rrlCct3Ul�ti' „ ItUtLDINt�REtli existing building(s). Demolition permit is required prior to issuance of building permit for new building. ,Ei I Iss CI) ArlNttt pLAt tusvu ' Commercial Bldgs: Provide a completed Hazardous Materials Disclosure C{, C Pulls Wt?itl5 form if any Hazardous Materials are being used as part of this project. V �� CIARI � ` F#RI bF _ Copy of Planning Approval Leiter or Meeting with Planning prior to �� p SNI`rARy WER nlTtt [off <` submittal of Building Permit application. BldgApp 2011.doc revised 06/21/11 hrr R-A WATER-CONSERVING PLUMBING FIXTURES, _CI OWNER CERTIFICATE OF COMPLIA CE �yi •t, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildln. • cu.ertino.or• - Owner Name ‘ick5 M L- I)c, a-1 t e+ Permit No. 2 0i 6 2-9 ' 3 Address I 0 2-175 NY'kwa v 4 b — eB: 1. Is your real property a registered historical site? ' 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. ii‘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. 0 No Go to Question 3. 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 fonn. 1, No Go to Question 4. 4. Is your real property built and available fo'r use or occupancy on or before January.1, 1994? 0 No My real property is built and available for use or occupancy after January , 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of e form and sign bottom of form. A-Yes : My real property is built and available for use or occupancy on or before anuary 1, 1994. Civil Code Sections.1101.1 through 1101.8 apply. Check one of the thre following statements and sign bottom of form.. 5. Please check ONE of the following: • 0 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. I n or before January 1,2017,all non- compliant plumbing fixtures shall be' replaced with water-conserving plumb, g fixtures (regardless of whether • J\ property undergoes alterations or improvements). My property is a multifamily residential real property. See Civil Code Section.11 6 1.5. 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 replac;d with water- conserving plumbing fixtures throughout the building(regardless of whether prop-rty undergoes alterations or improvements). . 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 eplaced with water- conserving plumbing fixtures throughout the building(regardless of whether property underg es alterations or improvements). • I,as the owner or owner's agent of this.property,certify under penalty of perjury that on-compliant plumbing fixtures will be replaced prior to date specified above with water-conserving plumbing fixtures in acc rdance 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: 7:364 PC/l'rile"o) Date: Upon completing and signing this Certificate,please return it to the Building Division l'n order to final your building permit. SB4072015.doc revised 08/26/15 • BUILDING PERMIT CANNOT BE FINALED AND COMPL TED UNTIL THIS (.i RTIFICATE HAS BEEN IGNED`AN )RETURNED`TO TH"UILDING DIVISION Non-Compliant Water-Conserving Plumbing Fixture Plumbing Fixture1 (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch.4 2013 CPC h. 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-Fam ly Commercial Residential Residents 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, average flush volume of two reduce flushes and one full flush) Urinals Exceed 1.0 Gallons/flush 0.5 gallons/ ush Showerheads Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certifie 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 con rolled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or th shower shall be designed to allow only one shower outlet to be in operatio 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 @ 6 psi; 20 psi minimum 0.8 gal ons per minute @ 2 psi In common and ublic use areas: 0.5 allons per minute @ 60 psi 1.8 gallons per inute @ 60 psi Faucets— Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per nJiinute 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 inute Where faucets meeting @ 60 psi the above are unavailable, Where faucets eeting aerators or other means the above are may be used to achieve unavailable, aer tors or reduction. other means ma 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 be upgraded. SB407 2015.doc revised 08/26/15 SMOKE / CARBON MONOXIDE ALARMS :V. OWNER CERTIFICATE OF COM-LIANCE r . ' COMMUNITY DEVELOPMENT DEPARTMENT• BUI DING DIVISION CUPERTINO 10300 TORRE AVENUE. CUPERTINO,CA 95014-32.5 (408)777-3228. FAX(408)777-3333. buildincacupzrEino.orq iMURFORii,416,0105VPMFAMMINing,PIVatiniet MFAMTION,q:gA: 4:i1;1:: :*4 piDiMgKrA*__L,tr;VkpaiLate4RCYMLAN;'e•Seika.Vi'ft CANNOTVad"Aigg:WKIXBE VNTItiq4tinFPVCogaVligM'AWOOEN DIVISION 4, Ap..,,AidagowfaimAwkiwys:A. I§,a2L,4g*Arag., , ftv3,046k.5,44s04,..14,:440;r..,'-:9: Co yuriegETunri , - iq. FURNEWD:$r) REB ,le 0..1 IN,. ozblom 4i Aiwi:hivii.77,5v,f7ma DPIRE aisiu:,,,f,,,,,,,el'';) .,,1,ag'ie•14't'i., -.V,t' '!:',1141i.,'•X:,'' l''' I'vki• VAredifeag"4.s'l PURPOSE This affidavit is a self-certification for the installation of all required Smo e and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 947.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing single-family and multi-family dwellings shall be provided wi Smoke Alarms and Carbon Monoxide alarms. When the valuation of additions, alterations,or repas to existing dwelling units exceeds S1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 reque that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: AREA '.MOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of .A. X the bedroom(s) _ ' On every level of a dwelling unit including basements 0 X X Within each sleepier room X 1 -- Carbon Monoxide alarms are not required in dwellings which do not co tam n fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined wi h smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire arshal. Power Supply:In dwelling units with no commercial power supply,alar (s) may be solely battery operated. In existing dwelling units,alarms are permitted to be solely battery oper ted where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access y means of attic,basement or crawl space.Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6i.An electrical permit is required for alarms which must be connected to the building wiring. • As owner of the above-referenced property, I hereby certify that the alar (s) referenced above has/have been installed in accordance with the manufacturer's instructions and in comp]lance 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: ID 21 CP 5 P a r ktic,te,(1 ()r Permit No. 1))"2-°1 6- z953 Specify Number of Alarms: #Smoke Alamis: ) 3 I #Carbon Monoxide Detectors: 1 I I have read and agree to comply with112212.=. nd concltions of this statement Owner(or Owner Agents)Name: , .74440 P4 /egezo Signature Date: Contractor Name: ., ,„ ,... __— , . L. z-5 6a 5 7 Date: Plerfrt-4,( 1-1 4 ee,_.01,11„ Signature ..... . . ic.#