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B-2016-3092 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3092 22184 VIA CAMINO CT CUPERTINO,CA 95014-1032(326 46 009) RANDO AAA HVAC INC SAN JOSE,CA 95125 OWNER'S NAME: BERRY HAROLD E AND BEVERLY TRUSTEE DATE ISSUED:11/10/2016 OWNER'S PHONE:408-732-5352 PHONE NO:(408)293-4717 JJCENSF,D CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C43/C20 Lic.#768871 Contractor RAJJDO AAA HVAC INC Date 09/30/2017 X BLDG ELECT X PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9(commencing —MECH X RESIDENTIAL—COMMERCIAL with Section 7000)of Division 3 of the Business&Professions Code and that my license is in full force and effect. JOB DESCRIPTION: REPLACE WATER HEATER(50 GALLON),SAME LOCATION I hereby affirm under penalty of perjury one of the following two declarations: (GARAGE) 1. I have and will maintain a certificate of consent to self-insure forsWorker's Compensation,as provided for by Section 3700 of the Labor Code,for the 02performanceof 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. Sq.Ft Floor Area: Valuation:$2615.00 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 APN Number: Occupancy Type: and state laws relating to building construction,and hereby authorize 326 46 009 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 stands andce the hg this WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally,the applicant understands and will comply with all.non-point source regulation per the Cuperfno •'ci.al Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature �pPI `fir~ 9 Date 11/10/2016 Issued by:PAUL O'SULLIVAN Date: 11/10/2016 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:11/10/2016 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. 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 permit is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the a. 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,Se.i70,s 25505, 5' 3,-and-25 34. Labor Code,I must forthwith comply with such provisions or this permit shall � 40011. be deemed revoked. Owner or authorized agent: ♦i.I • APPLICANT CERTIFICATION Date:11/10/2016 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. I understand my plans shall be used as public records. Licensed Signature Date 11/10/2016 Professional baoI6 . - • r• a ...• _ . , 4 GENERAL PERMIT APPLICATION MEP . to,„..; . COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION f 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 , C UPEI€T#N 3 (408)777-3228=FAX(408)777-3333•bu ldinq(icuperfino.orqMISC , lI PLUMBING Li MECHANICAL 0ELECTRICAL El MISCELLANEOUS PROJECT ADDRESS 2 s.-'21N in t 4 1 1 o GI- 11111L,0 q/P- 04 _. OWNER NAME irg. A �1 1 PHON j I 26, ..:v' ,J E-MAIL STREET ADDRESS ). �I vl g in 1� C. CONTACT NAME ? PHONE E-MAIL A _A., 1 a_ STREET ADDRESS - -_11, / • W' r • . FAX ❑OWNER '❑OWNER-BUILDER 0 OWNER AGENT `CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME Sl I A r n LICENSE NUN,! ����^/ - ° LICENSE T PF 3' .^�w ,i. COMPANY NAME L A A 1---", MAIL FAX 1�s 11A / ftp 1' � •Q c� CLQ AL ''IC9 - ' ) di , �r, STREET ADDRESS n/ •► CITY TATE,Z° A n 12 0 4 0, _.1.�. _.� :....i, X PHONE ARCHITECT/ENGINEER NAME .LICENSE NUMBER BUS.LIC C - ,.'. A COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE USE OF - C SFD or Duplex 0 Multi-Family PROJECT IN MIDLAND -.: PROJECT IN STRUCTURE: 0 CO1DIDEI'CiEI. URBAN INTERFACE AREA 0 Yes 0 NO FLOOD ZONE ,..,❑ Yes 0 No DESCRIPTION OF WORK to ,- ate/ r©� :tr 0 .� �{{� �,A I �} TOTAL VALUATION: l .--- RECEIVED 2 .,,. • I 1 By my signature below,I certify to-. -i 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 lv 'e. z ed is core t. I have read the pescription,ofWork and verify it is accurate. I agree to comply with all applicable Iocal_ ordinances and state laws relating. b, �construch 1. t. rize representatives of Cupertino,to Enter the above-i •nt e-property for inspection.purposes. f i r, Signature of Applicant_/Agent: I �� At IJrite: t r SU" EMENTAL INFORMATION REQUIRED grFl LSA skiLY;; i� O\ER,TI-1>-COTJNTLIe 0 EXPx ss .-.. - o sTANDAR1I ❑,LARGE_ ❑-MAJOR; MEAMiscApp_2011.doc revised 03116/11 , SMOKE / CARBON MONOXIDE ALARMS I OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228•FAX(408)777-3333• buildinq(a�cupertino.orq s At rPERMITiCANNOT BE FINA41)LTNTII.,4T -5 CERTIFICATE HomEE tsei e,0 VLETEIV I ►NI3 ETUR TFrI) 'AF RU IIINP D SI N ffl: 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 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 every level 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 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 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 ofattic,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 been tested and are operational, as of the date signed below. Address: 2t Vtcl Permit No., j Specify Number of Alarms: r # Smoke Alarms: ! "f' I ;1#Carbon Monoxide Detectors: I 2 I I have read and agree to co 'ly with the terms and conditions of this statement 'Owner(or Owner Agents)Name �. , eR,y Signature' no, Date:1! t Contractor Name: dirnQ cto Signature 7 }. ;: Lic.# t Date: IO IN Smoke and COform.doc revised 09/27/16 WATER-CONSERVING PLUMBING FIXTURES AilLe OWNER CERTIFICATE OF COMPLIANCE 4ric.¢, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE^CUPERTINO,CA 95014-3255 tt�°� 32.8• AX t_408)/77-3333• buildinq(cr�.cupertino.orq � � 30 �1. Owner_Name' Permit No. L Address221L- U (.i Cmino 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. KJ/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 fo 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? ❑ No My real property is built and available for use or occupancy after January 1, 199 Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the fo and sign bottom of form. f Yes My real property is built and available for use or occupancy on or before Janua 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three folio ing statements and sign bottom of forni.. 5. Please check ONE of the following: f 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 no -compliant plumbing fixtures to be replaced with water-conserving plumbing fixtures throughout the building.On orb-fore January 1,2017,all non- compliant plumbing fixtures shall be replaced with water-conserving plumbing f itures (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 requir- 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 wi water- conserving plumbing fixtures throughout the building(regardless of whether property un s ergoes 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 requir 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- onserving plumbing fixtures comply with the requirements as indicated in the table on the following page. Owner or Owner Agent's Signature: �-�� � Dater,/. 11!6 Upon completing and signing this Certificate,please return it to the e Building Division in order to final your building permit. SB4072015.doc revised 08/26/15 BUILDING PERMIT CANNO T BE FINALED AND COMPLETED U1TIL THIS � C KTIiFI AT x S S N SIGNED VRI EDT $E�HUILD 6bm, it&. R-;-.110, tekaiiiieW g-12441,1‘ 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 Ch. 4 x 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-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: 05 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 18 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 shown,it is no required to be upgraded. • SB407 2015.doc revised 08/26/15