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B-2016-3131CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: 10400 PLUM TREE LN CUPERTINO, CA 95014-2019 (316 33 021) CONTRACTOR: THD AT - HOME PERMIT NO: B-2016-3131 SERVICES INC ATLANTA, GA 30339 OWNER'S NAME: LOW BETTY TRUSTEE DATE ISSUED: 11/16/2016 OWNER'S PHONE: 707-217-6022 PHONE NO: (770) 779-1423 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B. C39. C13, C17 Lic. #836021 Contractor THD AT - HOME SERVICES INC Date 04/30/2018 X BLDG _ELECT — 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: I hereby affirm under penalty of perjury one of the following two declarations: REPLACE 8 WINDOWS & i (ONE) SLIDING GLASS DOOR (TO MEET EGRESS/TEMPERED WHERE REQUIRED BY CODE) 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. 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: $6191:00 APPLICANT RTIFI ATION 1 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 316 33 021 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. Additionally, the applicant understands and will comply with all non: o. WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, S 180 DAYS FROM L INSPECTION. Signature's Date 11/16/2016 Issued by: LISSAN Date: 11/16/2016 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: 11/16/2016 I 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 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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. 1 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 3. I certify that in the performance ofthe 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 Worker's Compensation laws of California. If, after making this certificate of 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 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:-' APPLICANT CERTIFICATION Date: 11/16/2016 certify that I have read this application.and state that the above information is �constru�� fore correct. I agree to comply with all city and .county ordinances and state laws I hereby affirm th re is 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 Lenders 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'SDECLARATION Code, .Section 9.18. 1 understand my plans shall be used as public records. Signature Date 11/16/2016 - Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 - buildingCc�cuoerfin, or ® NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PR07ECTADDRESS ,may +�,y s jAPN AJL OWNERNAME PHONE ,Z E-MAIL 7 tJ 1 p�( t �?c�� d 7 -�6fq� Z2 S: ® Lf 00ADDRESS '1 ICi 6M f tt+��{ /.�C�' CI%TACa27lN°® �"I% FAX CONTACT NAME ,BEEF PHONE 510-427-4260MAILIEEFREY.RAINEY@ATT _NET STREET ADDRESS 1069 EDGEMERE LANE CITY, STATE, ZIP HAYWARD , CA 94545 FAX 510-783-1041 El OWNER ❑ OWNER -BUR DER ❑ OwNERAGENT ❑ CONTRACTOR `L! CONTRACTOR AGENT ❑ ARCHrrECT 13 ENGINEER 0 DEVELOPER 13 TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS. LIC # Q 836021 B,C39,C13,C17 _q tV COMPANY NAME E-MAIL FAX THD AT HOME SERVICES 510-357-3750 STREET ADDRESS CITY, STATE, ZIP PHONE 2456 VERNA COURT SAN LEANDRO,CA 94577 510-877-4550 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME I E-MAIL I FAX STREET ADDRESS I CITY, STATE, ZIP i PHONE nES� xu ncYN 01, c iixx /V / Vi l I 1` �I nJ ' i1 -,>&JA) Til N�/ d ��flO e_�f A-,t)'r1k E__) I I I i I USE I TYPE I OCC. I SQ.FT. I VALUATION (S) 'AREA G I AREA R AREA I NET AREA REMODELAREA I REMODEL.AREA 1 REMODEL AREA ATTACH #DWELLING UNITS: IS A SECOND UNIT a YES SECOND STORY U YES BEING ADDED? []NO ADDITION? rJNO PRE -APPLICATION n YEs IF YES, PROVIDE COPY OF IS THE BLDG AN ` TOTAL VALUATION: PLANNING APPL 9 rlNO PLANNINGAPPROVAL LETTER EICHLERHOME? _NO By my signature below, I certify to each of -the fbllowing: I am the property owner or authorize " ent to act on the property owner's behalf: l "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 constructio esentatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: I _New SFD or Multifamily dweIImg_s:"Xp_p_1y for dri&olition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. 201 Ldoe revised 06121111 PURPG't; 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(a7cupertino.org 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 oxide -ala- rms: 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 the bedroom(s), X X On every level of a dwelling unit including basements,*,, X X Within each sleeping room X Carbon Monoxide alarms are not required-' dwellings which do not contain fuel -burning appliances and that do not have an attached garage.' Carbon xriorfoxide 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 of attic, basement or crawl space. Refer to CRC Section R3f4 and CSC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for -- ,alarms which must be connected to -the 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: !1:00G Permit No ,, . Specify Nu F have read and agree to comp With the ms and nditions of, is stateme am e: _ - s Signature .Date: Ow er Corer Agent's) N Co� r or'Na Ce:P n -, ignature Lic.# ................................................................ .....,< ...............................Date: Smoke acid CO form.doe revised 09/27/1 b WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION Ct R 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 408) 77T-3228 • FA)C 408) 777-3333 • building(a�cupertino.org Owner Name f Permit No: Address \ 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 11.01.1 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. 11 The licensed plumber's certification has been provided to the Building Division. Ship -the restsignthe form azid sign bottom—of form; \$(No 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? El No ' My real property is built and available for use or occupancy after January 1, 1994. XYCivil Code Sections 1.101.1. through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. es My real property is built and available for use or occupancy on or -before January 1, 1994. Civilbode Sections 1101.11 through 1101.8eapply. Check one of the three following statements 'and sign. "bottom of form.. 5. Please check ONE of the following: 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, 20.1', 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,_201, specif ed 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 comrner-dal 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-cornpliant 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'agexit of this property, c rtify under penalty --of pedury that non-compliant plumbing fixtures will be replaced -,prior to'date specified- above with wafer -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; anththat the water -conserving plumbing fixtures comply with the `r eq e �t�s a„s i�;&gated the table on the followin�ge. , i j , ' _ , i � A Owner or Owner Agent's Signature: / l Date: Upon completing and signing this Certificat64,Mase rdturn it tot e Building Division,in order to final your building pe it. SF4072015.doc revised 08/26115 � CUP R� �oENT GOMEsU NGEp \/1510 iw►s+oN AP P RpV E�u gT be kept at 0 n6 specifications ke ar INS set o1 plans a It is unlawful '10 devia' construcCron. s�R e or to (ob site during � _ging o(iicl Iterations on ; ohan9os ora Prov om th` H.ALi therefrom, vvitri Spk e vola' ZheSta Sof Eh?r (o n a'''r v 5ta'.el eid to pF.FZtv1II K — LEGEND: SCOPE OF WORK: INSTALL (8) RETROFIT VINYL, DUAL GLAZED " ! M = RETROFIT WINDOW / PATIO DOOR / ENTRY DOOR LOCATION LOW E, WINDOWS & (1) PATIO DOOR. NO (N) CONSTRUCTION. (SH) = SINGLE HUNG WINDOW (XO) SLIDER WINDOW FAMILY ROOM FAMILY ROOM BEDROOM 2 BEDROOM 3 NOTE; WINDOWS / PATIO / ENTRY DOORSLO C) WINDOW (XO) PATIO DOOR WINDOW (XO) WINDOW (XO) U -FACTOR = 0.30 Li l 4711w x 2811h 96' w x 8111h 4711w X 6211h 47"w x 2,811h SHGC = 0.25 -nom-r—.-_--A-LIJ BEDROOM 2 5 - FAMILY ROOM BEDROOM 3 m m C) ua ED `2 CD M p W x KITCHEN o b cn}' WINDOW (XO) KITCHEN BEDROOM m w C 48"w x 30 BEDROOM 1 BEDROOM A � -0 WINDOW (X n .P•s �n 4 rn 47°wx28"h 0 r I r CTD a 0.: BEDROOM 1 ®' o ENTRY WINDOW (XO) U L Q A7"wx28"h O U +D F= LIVING ROOM Cil r LIVING ROOM z--,Ia (2) WINDOWS (x0) GARAGE U -A I- o CL Z 47'w x26% !a0 Q � m clDI te 0 °n FIRST STORY (FRDNTYARD) CD a w. FLOORPI.AN PLUM TREE LANE, o t� NOTE: - 1), SMOKE DETECTORS: WHEN A BUILDING PERMIT IS REQUIRED, SMOKE DETECTORS SHALL BE INSTALLED; (a) IN EACH SLEEPING ROOM, (b) OUTSIDE EACH E SLEEPING AREA IN THE IMMEDIATE VICINITY OF THE IATC 11.09.18 BEDROOM$, (0) ON DWH ADDITIONAL STORY OF THE DWELLING, INCLUDING BASEMENTS AND HABITABLE ATTICS BUT NOT INCLUDING CRAWL SPADES AND UNI NABfTABUrATTtOB,(ORO 814) eca� NTS 2). CARBON MONOXMF ALARMS: WHERE A PERMIT IS flEOWRED FOR ALTERATIONS, REPAIRS OR ADDITION$ EXCEEDING $1,000.00, EXISTING DWELLINGS OF SLEEPING UNITS THAT HAVE ATTACHED GARAGES OR FUEL BURNING o'%w"' DKW APPLIANCES SHALL BE PROVIDED WITH A CARBON MONOXIDE ALARM IN THE'.FOLLOWINI;i LOCATIONS; (a) OUTSIDE OF EACH SEPARATE DWELLING UNIT SLEEPING AREA IN THE IMMEDIATE VICINrrYOFTHE BEDROOM(S), (b) ON 9681927 EVERY LEVEL OF A D74ELLING UNIT INCLUDING EASEMENTS, (CBC 420A, ORO Hal 6). (HOME OWNER TO PROVIDE BEFORE FINAL INSPECTION). siiEr A-1