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B-2016-3149
} t i 1 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2016-3149 10171 E ESTATES DR CUPERTINO,CA 95014-3303(369 08 004) DENNIS W CHIVERS f SAN JOSE,CA 95136 r OWNER'S NAME: FLESHMAN STEVEN G AND RITA K TRUSTEE&ETA DATE ISSUED:11/21/2016 OWNER'S PHONE:408-690-7361 PHONE NO:(408)267-3355 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: I License Class a tic.#434820 Contractor DENNIS W CHIVERS Date 02/28/2017 X BLDG _ELECT _PLUMB i 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 FILL IN FIREPLACE(48 S.F.)-FAMILY ROOM 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 l 'e performance of the work for which this permit is issued. cl"- ,1.2I 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 i permit is issued. Sq.Ft Floor Area: Valuation:$5600.00 APPLICANT CERTIFICATION I I l 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 369 08 004 representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the 1' 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. Signut ec Date 11/21/2016 Issued by:.Abby Ayende Date: 11/21/2016 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:11/21/2016 } I hereby affirm under penalty of perjury one of the following three declarations: ALLROOF COVERINGS TO B1E CLASS"A"OR BETTER a. I have and will maintain a Certificate of Consent to self-insure for Worker's Compensation,as provided for by Section 3700 pf the Labor Code,for the I 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 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&Safe Code,Sections 25505,25533, •,' 5534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date:11/21/2016 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 ofthis 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 11/21/2016 Professional 1 1 -L60 - 1qC/ CONSTRUCTION PERMIT APPLICATION if/ COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION r.rrgr' 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinc0,cupertino.orq CUPERTINO ❑NEW CONSTRUCTION ❑ ADDITION 1X I ALTERATION/TI ❑ REVISION I DEFERRED_ ORIGINAL PERMIT of6_# #.2... PROJECT ADDRESS %-- �•- ' N t 7/ irpts. ceet OWNERNAME ..i.....,.. .1__ ' , , ' PHONE]0. _f &O_ ( i E-MAIL 11110 STREET S7j ( r ' S A P FAX CONTACT NAME O akive ^ovi PHONE E-MAIL cItyi { STREET ADDRESS CITY,STATE,ZIP FAX ❑OWNER ❑ OWNER-BUILDER 0 OWNER AGENT tI CONTRACTOR ❑CONTRACTOR AGENT 0 ARCHITECT ❑ENGINEER 0 DEVELOPER ❑ TENANT CO CTO N`ME F LICENSE;E-MAIL:Et2520 LICENSE TYPE BUS.LIC# COMP NAMEFAX bNYutt. v, STREET U ,f• ... ya <a. CI'I'�%r ..T -t�jtC F _ F-c--t a' PqP v n- lJ .' ,,.�y-`/0 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS,SS,,,LIC# COMPANY NAME FAX 6-2--c? S� ISTREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WO' "IP y cam' 0 i` s 4.i_✓ '%� • ti. R �.' ? � (! C� C y EXISTING USE PROPOSED USE CONSTR TYPE #STORIES USE TYPE OCC. i SQ.FT. VALUATION(.$) EXISTG NEW FLOOR DEMO TOTAL , AREAAREA 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: ISA SECOND UNIT ❑YES SECOND STORY El YES BEING ADDED? ❑NO ADDITION? ❑NO I PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES C<'EI ,EDD j s'/ tx �`" TOTAL VALUATION: PLANNING APPL# 0 NO PLAN NING APPROVAL LETTER EICHLER HOME? 0 NO :a 1 �# a '�^l'r3 By my signature below,I certify t0 each of the following: I am the property owner or authorized agent'o act one 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 re./se if,tives of Cupertino to enter the above-id Milled pro „for inspection purposes. Signature of Applicant/Agent: �Af, j✓ - Date: x SUPPLEMENTAL INFORMATION REQ IRED P% Iv CPE' W.yy.;RoUTING sLIP , New SFD or Multifamily dwellings: Apply for demolition permit for ❑ GyER, C(3IINTEl2 © IBTIILDINGFLANREVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. I- REss ❑ :,",-,NG zNG PLANREVIE W Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARpy l y DPUBLIC WORKS form if any Hazardous Materials are being used as part of this project. Q LARGE, ❑,,1 IRE,DEPT, Copy of planning Approval Letter or Meeting with Planning prior to MAJOR ❑ 'ShNI'TARY SEwERDISTRICT.. ; submittal of Building Permit appliElcation. El ,ENVIRONMENTAL HEALTH Bldgiipp_201Ldoc revised 06/21/11 i i 1 SMOKE / CARBON MONOXIDE ALARMS FEEsE OWNER CERTIFICATE OF COMPLIANCE 44;4x,rsttCOMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 �. (408)777-3228•FAX(408)777-3333• buildinq(a cupertino.olg. PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN COMPLETED,SIGNED,AND RETURNED TO THE BUILDING DIVISION 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 vps _ 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 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 been tested and are operational, as of the date signed below. Address: /2/ 7/ � �e �� /�. Permit No D/ /7f Specify Number of Alarms: # Smoke Alarms: Wan #Carbon Monoxide Detectors: } I have read and agree cornpy.W_iffitlpe t msoan�d:• editions of this statement Owner(or Owner Agent's) ame: Signature Date:. 4eae/Y fir% rn4W , ' )'/6 Contractor Name:.' Signature Lic.# Date: Smoke and CO form.doc revised 09/27/16 \\\ /Y. WATER-CONSERVING PLUMBING FIXTURES til OWNER CERTIFICATE OF COMPLIANCE %i44DEPARTMENT COMMUNITY DEVELOPMENT •BUILDING DIVISION �L-?-0 ��ERTINO 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 C (408)/p-77-... 408)7 3228•FAX(408)777-3333• buildingna•cupertino.orq „q f� Owner Name c t c,if G'S A,ri✓0 Permit No. �c —)/ _Z/ ' Address/0/ 2/ �C �.5 ,/2 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. 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. 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, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Yes My real property is built and available for use or occupancy on or before January 1, 1994. f Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of foini,. 5. P ease 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 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 fixtures comply with the requirements as indicated in the installation requirements,and that the � . � ti�1rvmg . �� � p y q table on the following page. } / Owner or Owner Agent's Signatu rt, Date: -` 0 / Upon completing and rgn s ertificate,2 ease return it to the Building Division in order to final your building permit. SB4072015.doc revised 08/26/15 BUILDING PERMIT CANNOT BE FIN:0EDND COIVII'EETED UNTIL THIS CERTIFICATE HEIS BEEN SIGNED A�TD J ETURNED TO'THE BUI IDI1NG.DIVISION F a:' Non-Compliant Water-Conserving plumbing Fixture Plumbing Fixture/ (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch. 4 2013 CPC Ch. 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-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 shovverhead.) 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 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 not required to be upgraded. SB407 2015.doc revised 08/26/15