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B-2016-2982CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO.: 10334 JUDYAVE CUPERTINO, CA 95014-3525 (375 10 008) G K W CONSTRUCTORS CAMPBELL, CA 95008 OWNER'S NAME: SCHERP RALPH S OWNER'S PHONE: 408-838-9194 I pill -e- - 1 1, t_ 1 : _ 1IYARAINVIlleg Class 5 Lic. #1001525 for G K W CONSTRJ JCTCRSDate 02/28/2017 hereby affirm that I am licensed under the provisions of Chapter 9 (commencing ith Section 7000) of Division 3 of the Business & Professions Code and that my cense is in full force and effect. 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 DATE ISSUED: 10/25/2016 PHONE NO: (408) 315-2125 BUILDING PERMIT INFO: BLDG —ELECT -PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REPAIR WATER DAMAGE - BATHROOM Compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. y'2i I have and will maintain Worker's Compensation Insurance, as provided for by j1 Section 3700 of the Labor Code, for the performance of the work for which this W permit is issued. Sq. Ft Floor Area: Valuation: $2000.00 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 regulations pA the Cupertino Municipal Code, Section 9.18. Date 10/25/2016 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 (Sec.7044, Business & Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: x. 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. 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. 3. 1 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 10/25/2016 APN Number: Occupancy Type: 375 10 008 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby A e�nde Date: 10/25/2016 RF,RROO. C: 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 ofApplicant: Date: 10/25/2016 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 Cuperti unicipal Code, Chapter 9.12 and the Health & Safety Code, S ons A5505,25533, and 25534. Owner or authorized agent: /< Date: 10125/2016 N hereby affirm that there is a construction lending agenKy 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 CUPER.T INO. CODS TR TION PERM APFLIGAT[ON COMMUNITY DEVELOPMENT DEPAR T MiiENT • BUILDING DIVISION 110300 TORRE AVENUE CUPERTINO, CA 05014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildino(bDcuDFrlino org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/E ❑ REVISION / DEFERRED ORIGIN r L PERh1IT 1 �rR niFrr enno rec i ICYJU�y A -VS 4PNr 3mss- to - 00`6 OWNER N. hti�At/PH S cHe-IMP PHO? 4-oc6 -5 3 f5-cj tq4 E -AVAIL —9 SrHeA-PO � STRMADDRESS - �% 33 %+ U 0-4 a�V y� CITY, STATE, ZIP CU V --n N O LA q Sbi B� T FAX CONTACT '.Ns \�E r -p0 N " ®N C;i I PHONE -f®'b E-MI---iL I C�lo"ON WOIN &L(';�C� `m mei O 1 O MC(AIANLI I- -N I CITY: STATE, ZiP c STR T.SDDRESS - tr/�fAPBELL ( 9SoD FAX I 0 M%N-R ❑OVA rlt-3L DER ❑ ORh RAGE T ❑ CONTRACTOR ❑ CO?eACTORAGENT 91 ❑ A-RCHITECT MM GL,\ -F ❑ DEvZ-LOPER CONTRACTOR NAbS G O poo N W G N 4a LICENSE N MMER (00192-5 LICENSE TYPE � I BtiS. LiC r,/ g nsG� C0AQ.;1 yT'A-"m w c.A sriu► LTd �S I E-Ia IL - F .X ®e -DN A +IIT STR T.-DDRESS I CITY, STATE,Z P '4-I o E 1M C,C-j t i,,f �t P HONE E fl Tv0 5 �t Q7e UT ARCraiEC7/E GINEERNAA4E &OVDC>N g�� y�l EN LICZNSLT,B-R �la� I n - '6+TASFAX I BL;S.LIC' Ag -C4 tT �---(.'1" S C-ic ON IOW a N CaC�G-t W CN 1T T.S ( iY1 �" _ STREET ADDRESS I CITY, STATE, ZIP P' ON '7-1. o SU N W (,R -N -* 1 o + $ o>, DESCRIPTION OF \3'ORK - A-CEV- /{-!'YIA-&l E Td BM WA-l.G eiz&z<m `5A4< SC—H Cryo S4"p_K, EXISTING USE - PROPOSED USE CO\STR. P -'PE =STORIES y VALUATION (S) fj C1 �L �(05115t( (i I I USE TIDE I ,OCC. SQ=T. EXISTG '\'EWFLOOR DEI,O TOTAL AREA I AP.EA AREA NET.4�.EA 13.6T} -3,00M KITCHEN 0Tr_ER REA ODEL AREA Sir RE\20DEL AREA / I RE1,40DEL AREA / PORC!"APEA DECK AREA TOTAL D=_CK•PORCH AREA GARAGE P.REA: ❑ cT hCH _ [9TTACH I DWELLING L" MTS: I IS A SECOND L" SIT ❑ '-S BEING ADDED' � SECOND STORY ❑�,Y� S ADDITION? M�`O PRE -APPLICATION L7) -S IF -Es: PROVIDE I L-- COPY OF ❑NO PLA2,,'�L�G.�.PPROV.SLLETTER r ❑ IS 1t5 EICHLERHOIIE? ❑?gip ;: Ry EjA ED BY c J T LJVALL1L,ATi0\: __r J ,�.- (,awl! By MN si_enata+e blow, I certif�to each o _ roflowing: I am the prop T owner or authorized agent ?o act OA the 'Dropertt, owner's behalf I have read this application and h.. information I hav -ovid is correct. I have read <he Description of'Wo-lk and verify it is accurate. I a -z ee to complywith all applicable local ordinances and state Ia\vs relat ng' uildi- construction. I authorize representatives of Cnpe, Lino to enter the above -identified p oriel,y for inspection purposes. Sig-natureofApplicant/Agent: Date:. /0- SUPPLEMENI INFORMATION IIIRED PLS\ CHECi.TIPEMI _ _ I e,t� S D Or Mul ifalnily d �,�elln_�s Appl\% for de volition permit for POUII G SLIP _ e isuna buildinR(S). Demolltio_I p.,i.rlit 7� reQuired prior C 5SC27Ce 0: IJuildlnQ O\ ER Tl F COLTER BLILDI\G PLA RB\TECi pern;itfor new building. - - c 11PRt S PLA\L�GPL4\ RE\ IE1! Co .jn;erc al BIdas: Provide a completed Hazardous Materials Disclosure — - \D RD L7;LI 9r m ,f any Hazardo''s 1\1'Fte ials are being used as jJu i o I this project. 7 RGE FIR£ DEPT Copy of Pla uaing App: -oval Letter or l i eeting with Planning prior to S ,btnittal of Building Permit application. L4d0R _ rIAFl SEjiERDi�TRICT IRON"4IE'iTAL IiE:ALT"ii Bldg�,�pp_2011.doc revised 06/21/11 CUPERTINO 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.org This affidavit is a self -certification for the installation of all required Smoke and Ca compliance with 2013 CRC Section R314; 2013 CBC Sections 420.6 an&907.2.11.2 w inspections are required. GENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alan Monoxide alarms. When the valuation of additions, alterations, or repairs to existing, $1000.00, CRC Section R314 and CBC Sections 907.2.11.5 and 420.6 require that Smoke Monoxide Alarms be installed in the following locations: Monoxide Alarms for no interior access for is and Carbon welling units exceeds klarms and/or Carbon AREA SMOKE ALARM 2010 CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) X Contractor Name: X On every level of a dwelling unit including basements X Signature.................................................................. Lic.# .....................................Date: ................................................................... . ........... X WitIdn each sleeping room X 4 OP 90%miz6 g.090,6or�a -Pr_rEcroa-s Carbon Monoxide alarms are not required in dwellings which do not contain fuel do not have an attached garage. Carbon monoxide alarms combined with smoke CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no corrunercial power supply, alarm(s) may be In existing dwelling units, alarms are permitted to be solely battery operated where ri not result in the removal of wall and ceiling finishes or there is no access by means of space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420„6.2. An electric alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referen installed in accordance with the manufacturer's instructions and in compliance with and California Residential Codes. The alarms specified below have been tested and i date signed below. Address: 14 I Specify Number, of Alarms: '� r # Smoke Alarms: # Carbon / have read and agree to comply 14th the tergps and 6onditions of this appliances and that shall comply with lely battery operated. airs or alterations do tic, basement or crawl permit is required for d above has/have been e California Building operational, as of the -mit No. --)J 6 de Detectors: Owner (or Owner Agent's) Name: 2010 .p j'� Signature... . . . ............................................. I ........................... Date: Contractor Name: Signature.................................................................. Lic.# .....................................Date: ................................................................... . ........... r Smoke lied CO for i. doc revised 09'-27/10 i WATER -CONSERVING PLUMBING FIXTURES_' OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION �r +UPitTtIVC? 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3 •FAX (408) 777-3333,® building a().cuperEino.org Owner Name _� C Permit No. Address 11) 3 3q al)& A\)&-- 1 . \)&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 form and sign bottom of form. 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. Xk,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 ign bottom of form. >,�'No _ Go to Question 4. i 4. Is your real property built and available for use or occupancy on or before January 1, 1994? 1 ❑ No My real property is built and available for use or occupancy after January 11 1994. 1 Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of fonn. Yes My real property is built and available for use or occupancy on or before January 1, 1014. Civil Code Sections 1.101.1 through 1101.8 apply. Check one of the three following statements and sign 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 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 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 properly undergoes alterations or improvements). 04 I, as the owner or owner's agent of this property, certify under penalty of perjury that non-compliant replaced prior to date specified above with water -conserving plumbing fixtures in accordance wiT plumbing fixtures will be 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 -cone g plumbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: Date:-Ati/atz ! Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB4072015.doe revised 08/26115 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shoxni, it is not required to be upgraded. SB407 2015. doc revised 08/26/15 Non-Compliant Plumbing Future 1Water-Conserving PlumbingFixture (Fixture Complying with Currenf Code Applicable to New Construction) Fixture Type Maximum Water Usage/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 Div. 4.3 2013 CALGreen Div. 5.3 Single -Family Multi-Family Commercial Residential Residential ; Water Closets Exceed 1.6 Single flush toilets: 1.28 gallons' lush (Toilets) Gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0 Gallons/flush 0.5 gallons/flush ' Showerheads 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 Showerheads (A hand-held shower is considered a showerhead.) 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 1 use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 psi Faucets — Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 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 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 shoxni, it is not required to be upgraded. SB407 2015. doc revised 08/26/15