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B-2016-2929CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2016-2929 22350 MCCLELLAN RD CUPERTINO, CA 95014-2771 (356 04 040) JEFF L YANG SARATOGA, CA 95070 OWNER'S NAME: WONG TING-WAH AND WENYI WENDY TRUSTEE DATE ISSUED: 11/09/2016 OWNER'S PHONE: PHONE NO: (408) 439-9732 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic. #1014072 Contractor JEFF L YANG Date 05/31/2018 X BLDG —ELECT —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: TO CLEAR CODE CASE; REPAIR FRONT & REAR DECKS DUE TO I hereby affirm under penalty of perjury one of the following two declarations: DRY ROT 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 REV#2 - REPLACE 6X12 DRY ROT BEAM WITH (N) PT 6X12 BEAM. performance of the work for which this permit is issued. ISSUED 5.18.17 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 tpa Sq. Ft Floor Area: Valuation: $5000.00 permit is issued. APPLICANT CERTIFICATION I 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 04 040 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 regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature '� Date 5.18.17 Issued by: SEAN HATCH Date: 11 /09/2016 OWNER -BUILDER DECLARATION 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: t. 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 (Scc.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: 5.18.17 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE z. 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 & Saty Code, Sections 25505, 25533, and 25534. 1 will Safety permit is issued. maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the 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 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 Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: c _ APPLICANT CERTIFICATION Date: 5.18.17 I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit 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 Code, Section 9.18. 1 understand my plans shall be used as public records. Licensed Signature Date 5.18.17 Professional CUPERTINO fc✓ �2 CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino.org ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI 'In REVISION / DEFERRED ORIGINAL PERMIT # L� 20 (, " Z� � � PROJECT ADDRESS 22-3s-0 j (a" �ot� APN # � � � � J J f� C e , ?v _7E OWNER NAME w 0 tNq ±1144 W A6 L PHONE -MAIL STREET ADDRESS ��pp 2,_,,Ivl�t (C�vt CITY, STATE, ZIP FAX CONTACT NAME G/Y�a2 G — PHONE E-MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT yC. CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAMEJG T� L �/(w I r /" `I v LICENSE NUMBER l c) 22 LICENSE TYPE BUS. LTC #46 7 COMPANY NAME E MAII' aaL�(� 2 l� /} G ,C, O (� M FAX STREET ADDRESS j 2 qq q , 61&Wq'e,, r v vF- CITY, STATE, ZIP I ,. ?- // 3 PHONE ZIP,?i ARCHITECT/ENGINEER N,�"1(AMEj LICENSE NUMBER BUS. LIC gf�/d COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK LQ V w Int Qfi vA O lX.. 4 EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NETAREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECKIPORCH AREA GARAGE AREA: DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEINGADDED? []NO ADDITION? EINO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RECEIVED B� TOTALTI PLANNING APPL # ❑ NO PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have 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 building construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. _/ Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLANT CHECK TYPE ROUTING SLIP VFR-THE-COUNTER y BUILDING PLAN REVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building !/ permit for new building. ❑ 'EXPRESS ❑ PI ANNINGPLAN REVIEW _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑ PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT, _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR ❑ SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp_201 1. doc revised 06/21/11 CITY OF CUPERTINO BUILDING PERMIT ' BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-2929 22350 MCCLELLAN RD CUPERTINO,CA 95014-2771(356 04 040) JEFF L YANG SARATOGA,CA 95070 OWNER'S NAME: WONG TING-WAH AND WENYI WENDY TRUSTEE DATE ISSUED:11/09/2016 OWNER'S PHONE:408-439-9732 PHONE NO:(408)439-9732 TJCENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class GENERAL BUILDING CONTRACTOR Lic.#1014072 X BLDG _ELECT _PLUMB Contractor JEFF L YANG Date 05/31/2018 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: TO CLEAR CODE CASE;REPAIR FRONT&REAR DECKS DUE TO I hereby affirm under penalty of perjury one of the following two declarations: DRY ROT ` 1. I have and will maintain a certificate of consent to self-insure for Worker's REV#1-REMOVE PLACEMENT OF GUARDRAIL FROM SCOPE- Compensation,as provided for by Section 3700 of the Labor Code,for the ISSUED 2/28/2017 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 5119 permit is issued. Sq.Ft Floor Area: Valuation:$5000.00 APPLICANT CERTIFICATION I 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 356 04 040 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 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 regulations per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. .40 1,• Signature �' Date �� 7Issued by Abby yen8e �, _ f Date: 11/09/2016 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-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: I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER i. 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 Cupertino Municipal Code,Chapter 9.12 and ' exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall -_- be deemed revoked. -' Owner or authorized agent Afre'1 APPLICANT CERTIFICATION Date: I certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit 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, 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 ARcifincr&DEELARATEff and will comply with all non-point source regulations per the Cupertino Municipal I understand my plans shall be used as public records. Code,Section 9.18. Licensed Signature Date Professional CONSTRUCTION PERMIT APPLICATION .!°&.. COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVI'SI'O VISIO #N Td .1B .1 • 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildini(acupertino.orq CUPERTINO •' /(Q 2-9 2_q . ❑NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION/TI ' REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 2-u S--(-) ® M c,Cit"e4 f ct 0 act,(,_ APN# OWNER NAME ' . 1 PHONE o g_21 O (24, E-MAIL STREET ADDRESS CITY, STATE,ZIP yw-t-iiy,k-r. �'iLO� t12. FAX CONTACT NAME +T-E L: PHONE 8- 36i 7 3� E-MAIL 8J� 4-Q i el k , STREET ADDRESS I294q 'c3 .(e✓4 c'C, CITY,STATE,ZIP FAX ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT pl CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER ❑ TENANT CONTRACTOR NAME L t=C .F L - y y>,_ LICENSE NUMBER 6.to 2_ LICENSE TYPE Is BUS.LIC# 4 ,?s@ 9 COMPANY NAME /S6 V E-MAIL FAX 6 `�` t}"tc`vljc20044 a'Ctau.c$.c, , STREET ADDRESS9 (evx et , CITY,STATE,ZIPS AY-A _ . e� ",)C7� (Pal-cog ' c� T PHONE( a -cZ�g-79), ARCHITECT/ENGINEER NAME LICENSE NUMBER / BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK T,eivtio:),)e, -C--,1,', ,,,,,,A - - n ��n -6-yi 2 d6ofI ! - EXISTING USE PROPOSED USE CONSTR.TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: 0 DETACH 0 ATTACH #DWELLING UNITS: IS A SECOND UNIT ❑YES, SECOND STORY ❑YES BEING ADDED? ❑NO ADDITION? ❑NO A in /J/yJ ��,'�y/p� /J PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES IEDP i ��t : g TOTAL VALUATION: PLANNING APDL# 0 NO PLANNING APPROVAL LETTER EICHLER HOME? 0 NO {,-6 dd By my signature below,I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have 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 relatin to building construction. I authorize representativesseof Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: °�- -e Date: ,- )4-7 /v SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for lvf OVER-THE-COUNTER Q BUILDING PLANREVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0 EXPRESS ❑ PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD I=1PUBLIC WORKS form if any Hazardous Materials are being used as part of this project. ❑ LARGE ❑ FIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑ MAJOR 0 SANITARY SEWER DISTRICT ❑ ENVIRONMENTAL HEALTH BldgApp_2011.doc revised 06/21/11 i ' CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2016-2929 22350 MCCLELLAN RD CUPERTINO, CA 95014-2771 (356 04 040) JEFF L YANG SARATOGA, CA 95070 OWNER'S NAME: WONG TING-WAH AND WENYI WENDY TRUSTEE I I DATE ISSUED: 11/09/2016 I I,OWNER'S PHONE: 408-218-1842 I I PHONE NO: (408) 439-9732 License Class $ Lic. #1014072 Contractor JEFF LYANG Date 05/31/2018 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 Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT NT RTIFI ATION 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 11/9/2016 I hereby affirm that I am exempt from the Contractor's License Law for one of the following 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 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). PERMIT INFO: BLDG —ELECT _ PLUMB MECH X RESIDENTIAL COMMERCIAL 3 DESCRIPTION: CLEAR CODE CASE; REPAIR FRONT & REAR DECKS DUE TO Y ROT Sq. Ft Floor Area: I, Valuation: $5000.00 APN Number: Occupancy Type: 356 04 040 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: AbbLyende 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. Signature of Applicant: Date: 11/9/2016 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. 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. 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, theapplicantunderstands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 11/9/2016 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. 1 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 agentaf-- Date: 11/9/2016 CONSTRUCTION TENDING AGENCY 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 ST€ UCTION PERMIT APPLICATIC N ,.. COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 r (408) 777-3228 • FAX (408) 777-3333 - building@ougertino,orcl I r , CUP ERTIN ❑ i,,EwC01';STRUCTioN ❑ ADDITION ❑ ALTERATIONITI ❑ REVISIONIDEFFRRFT'T nRi(;TNW T)t u1„rr-r- PROJECT ADDRESS / 2 3t o ,��(% C% �� 1� I' ?.?N R 3k6 - o 4l - C7 4 c) OWNUXAME oaav PHONEE-D4AIL 71x STREETADDRESS CITY, STATE, ZIP 223 0 -fie z�> 6 : &p- CONTACT I.Aa,tE I PTiD1tE t© 29' F-4 I q TsC-. 1 I x e@rrt c `cwt c' . uary ST}tEETADDRE$Sgt,CITY, STATE, $IP FAX 17 O%V."MR El O1An' kBLI.DER Q OV,RtERAGm\r ❑ COh-m&cPOR M cmrpACTORA.Wr ❑ ARCHITECT t5'Q DEVELOPER .0 TEh/-VT -tG�2�t-'U' COT'7R9CTORNAME i { LICENSFIVU1,4BER L10ENSETYPE Y ` BUS.LICK etor L —44-1 COMPAh'YMAME E-1,WL h U GCUI '200 I FAX STREET ADDRESS CITY, STATE, ZIP I PHONE ppr� ARCHITECT,ENOrNEERKALIOE T5 LJCENSEhUNMER 5, � BUS. LIC y COMPANY NAME r�t��GY-�*4L�. 1.�(� • E•h44]L g �5�.t�F9't•� LtvIGC.`GyIG' FAX STREETADDRESSn 210 �t�%7 76 CITY, STATE,7,1P�n• 7 1�c �! e.4+"T� PHOItE lti �QlL�-� -�v DESCRIPTIO? OF WORK a;P- -06(6?#T - EXIST", USE - PROPOSEDUSE CONITIL TYPE R STORIES USE TI'PE OCC, I SQ.FT. VALLATTU?` (S) EXIST ;�°EA' FLOOR D32,10 'TOTAL AREA AREA ARt A I NTET AREA BATHP.00M _ KITCHEN OTHER - - REMODELAREA RB40DEL-AREA REMODELAREA I PORCH AREA DECK AREA TOTAL DECK?QRCH AREA GAMGE AREA: DETACH - - © ATTACH DA'ELLNG L:'iTTS: IS A SE• COxn UXIT ❑YES SECOND STORY [] YES - - BEING4DDED? [3 No ADDITION17 I EINO PRE-ATPLJCA71 10\1 ❑YES IFYES, PROVIDE COPY OF]S THE BLDG AN DYES "ICHLEREOME? � t � � s TOTAL VALUATION: PLAA7,'LA'GAPPLR ©gel PLAT.NNGAPPROV.ALLETTER By my signature below, I certify fo each of the following: I a4u the property owner or authorized agcn{at roperq+ ovrnet''s behalf. I have read this application and the information I barn provided is correct I have read the Description of Work and verify it is accurate. I agree to comply v+ith all applicable local ordinances and state latus relating to building/tt1, ction. I authorize representatives of Cupertino to enter the above -identified proper+ for inspection purposes. SigratrneofApplicantrAgent: — Date: SUPPLE1,10\1TA L P\1FORlt ATION REQUIRED •.R0-IJT ; I]rr4i New SFD or lvlultifarr ily d-wellings: Apply for denloliticii pennit for existing building(s). Demolition pennit is required prior to issuance of building DeI7IIit for new building. Ex otNTi 1FTO,in.GPt�n RIEt� 3 ComnTercial :Bldgs: Protide a completed hazardous Materials, Disclosure '] PLBLIC �S OR3.S - form if any Hazardous hieterials are being used as pat of this project y L RGE FIfiE Copy.ofPlanning Approval Letter orkmeting with Planningpriorto�M v DEPT �� _ submittal ofBuildingPermitapplication.IMA- © inJ°R s�tri�It1sEz�TRnl�rlticr 3 n _ Mum- ED 'Off "I�iE'�TAG 13E+1LT3r .,�.- yL: Bfdl-,lpp_2011.doc revised 06121111 FRANK -LEE A$.,SQq-1 .5 ID ),676 - 5 8 5 9, i. D Q-j;eirftb _qqp 17 Wendy Mong- 22 j_S`Q Mcclellain Aoad, C Calllf-Or.n, 9`50Fl 4 su, JWT., FOUNDAT-TON, T: 7N INS ?% ZION qlip�rtfnoe 'Califbmia -D Th�tt'O that. vie: h�' -ayl�.inspected I exo,a tor: the grapsi id d (3a4ervatmon cated that . the b" tr t -Y agr eement with:the CT approvedplans ' I � g re bascl.. The. Aqi7 cond.i:pion t Proposed, de.ck re e gppreci ate the, O.'PpOrt,Unit.y, tea work with you on ouae any.' 5u we 0 -an be qt"ani nit heojt4te to, 11 : Thank yoi� 70 ' t4ulyv Ylourlsl 88 . L i '849ilae'er 149'S -e fouadation 1, sitee Our ev a,. ur., adequate: Tdr iect - if servige, rote rand Structural Engineering Et Design January 10, 2017 City of Cupertino Building Division 10300 Torre Ave. Cupertino, CA 95014 Project Address: 22350 McClellan Re: Structural Observations This is to certify that our office, as the project engineer of record, was retained to perform visual structural observations on the above referenced project. We have provided structural observations for the following item(s): ❑ Foundation excavation ❑ Rebar cage installation To the best of our knowledge, the observed work was completed in general conformance with the approved construction plans and specifications, and applicable workmanship provisions of the California Building Code. If you have any question, or if we may be provide further assistance, please do not hesitate to contact our office at 510-299-7520. Sincerely, Lisa Tse, S.E., LEER AP Integrand, Inc. LE • .:. SMOKE / CARBON MONOXIDE ALARMS LbS 9 ° ` OWNER CERTIFICATE OF COMPLIANCE • i` COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION • �SK�rss, CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq c(�cupertino.org i' `;IVWA.EP.OW*bVf3t LINA` EDt 3�t T'IL THIS CER IsEICA'1+E HAS BEEN n`, ' , + • t rx ,R `�-�'C uM ,3 r •'d m t*}r'�'-�`�' -irREVW - i o d ,;.v ry r 165** COMBEE FjMMTNEn'.VA •RRTA RWII5roklatE1314M II�G,D$EVIS>ON fi� 0, { Y u >d 2 ante "- }y.�u - rav6r _-3r .''�+T'".� if,. `j 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 dwellingunits 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 • SMOKE ALARM CO ALARM Outside of each,separate sleeping area in the immediate vicinity of X X the bedroom(s) On eveiylevel of a dwelling unit including basements X X Within each sleeping room X _— Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do riot have an attached garage. Carbon monoxidealarms combined with smoke alarms shall comply with CBC Section 42016 and shall be approved by the Office of the State Fite Marshal. Power Supply:In dwelling units with no commercial 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. 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 beein tested and are operational, as of the date signed below. c,� Address: 2 Z 350 `&//c'-cwt dJ r C14p• '1 . Permit No.$3' 16 . 2T 2 y' Specify Number of Alarms: - # Smoke Al. s: tom► ' # Carbon Monoxide Detectors: 5I 1 have read and agree to co r. Wit the terms an c, di ions of this statement Owner(or Owner Agent's)Name: © Signature.... � )vii"/G.. .... ... ... 11 Date: 3/:).07 Contrac r Name: /, n Signature © .... rM Lic.# I t 4 0 l 2--Date: q4f `1 Smoke and COforni.docc revised 09/27/16 rn� \' / WATER-CONSERVING PLUMBING FIXTURES � 9 9 i+ OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION �,ERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777x3228 FAX(408)777-3333•buildings icuoertino.orq • ac 21 Owner Name T'Ak nck1/1,r (IVO Permit No. Address 09-0135-0 ' !"'lGtrel1ctvt T �. CtkA ,11-D 1. Is your real property a registered historical site? f ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. CR 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. ❑ 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 form. X No : Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? Cl 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. I.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 sign bottom of form.. 5. Please check ONE of the following: X My property is a',single fainily residential real property. See Civil Code Section 1101.4. On and after Jarivary 1, 2014,building alteration's 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 undergoesialterationsor improvements). ❑ My property is al 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 t'6 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:cornmercial 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). 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 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-conserving plumbing fixtures comply with the requirements as indicated in the table on the following .age. _ Owner or Owner Agent's''Signature: ; ,at7Z. - r j� Date: g 7i' >0'f1 Upon completingand signing this Certifica e,please return it to the Building Division in order to final your building permit. SB407 2015.doc revised 08/26/15 Z .• 33a�t BUILDING PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE TIAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISI011T, Non-Compliant Water-Conserving Plumbing Fixture Plumbing Fixturel (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch.4 2013 CPC Ch. 4 I 2013 CPC Ch. 4 Water Usage 2013 CAL.Green Div.4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3 _ /Flow Rate Single-Family Multi-Family Commercial Residential Residential Water Closets Exceed 1.6 'Single flush toilets: 1.28 gallons/flush' (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 0.5 gallons/flush 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 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.ar'e 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 shown,it is not required to be upgraded. SB4072015.doc revised 08/26/15