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B-2016-3087CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: J CONTRACTOR: PERMIT NO: B-2016-3087 20225 NORTHGLEN SQ CUPERTINO, CA 95014-0517 (316 39 006) SHAW CONSTRUCTION SARATOGA, CA 95070 OWNER'S NAME: HOLSINGER ROY W TRUSTEE DATE ISSUED; 11/22/2016 OWNER'S PHONE: 925-284-7026 - PHONE NO: (408) 205-9606 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class a Lic. #799336 Contractor SHAW CONSTRUCTION Date 09/3012017 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: DECK REPAIR AND GUARDRAIL REPLACEMENT (138 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: 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: $3000.00 APPLICANT CERTIFICATION I certify that 1 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 316 39 006 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 unde�tands a9d will comply with all non-point WITHIN 180 DAYS OF PERMIT ISSUANCE OR source regulations per the'cupertino - nicipai Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. f Signature f ��/ pi Date 11/22/2016 Issued by: Kim Dunbar W i r OWNER-BUILDERDECL ION Date: 11/22/2016 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(See.7044, Business & Professions Code). Date: 11/22/2016 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 1. 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. HAZARDOUS MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous materials retluirements 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 Ma ement District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with the Cupertino Mu 'cipal Co Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the _ the Health & Safety Code, Sectio 5, 255331 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: 11/22/2016 1 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 TRXJ—N ° GEN-V 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'SDE #TION Code, Section 9.18. I understand my plans shall be used as public records. Licensed Signature Date 11/22/2016 Professional CONSTRUCTION PERMIT A PPLICAT[ON '>Ml✓iUNTY DEVELOFh4ENT DEPARTMENT • BUILDING DIVISION I 03u,,i T ORRE AVENUE • CUPER T INO, CA 95014-3255 r CU?l=t�TEt�tO (408) 777-3228 • FAX (408) 777-3333 • buildinoQcuDerlino.org ❑ NT7\ %CONSTRUCTION ❑ ADDITION 11+1'.-:7_TFRAT)n1KT; TI n r> �;tc�nwt inter �� E1dJ Z0.P_2011.doc revised 06121 `11 PROJECT ADDRESS I 3N� ry v Q �j��fg O\\NP NAME P(-�� A� �} +� ^� I E -I TAIL STP T,=JDF.ESS I CITY. STAT -E; Zip s e-�t G G CONTACTNAJMEEI yyW OLS UVG P:HO\'= E_Tr STREET?DDRESS I CITY, STATE, ZIP F?3 IZI61"�c?. ❑ ov.,=-B-u-, DER ❑ ov,,\m kGTT ❑ CONFRACTOR ❑ CO.117RACTOR AGT? ❑ A-RCHFIECT ❑ ?Gr, ❑ - DE\-.APi=R E) CONTRAC;j R\fiJ,4E I LICENSE I`7ulls It I LICENSETYPE I BUS. LIC s C01\9'1t.YNAJ4E _ zA TL PAX STREET ADDRESS 'TY, STA t... ZIP- . r10'�L Dom/ ?.RCHIECT/ETGPKEER' Al,<E ( LICENSE NU? /BER BUS. LIC I C01TANY\":" E I E hLAIL FAX STREET ADDRESS I CIT Y, STATE, ZIP I P'A0NE — t _-ZESCRIPTIONOFWORx � , I ' EX1S l LAG USEI PROPOSED 7.;,S: CONSTR. T?TE =STORE'S ... USE I Ti PE occ. I SQ FT. VALUATION csi ISTG NEW FLOOR DEh40 TOTAL ' AREA I AREA ( P3.EA (. NE AIREA 1 BATHROOM KITCHEN OTHER R-hODrLAP.E.A I REMOD L.A A REMODELAPEA PORCH,LA DECD i+.RE— 1OT_.ZD_ECKTORCH GAP.AGE AREA: DETACH I ATTACH (. D,+ILL:•GUNITS: 1SASECOADUNIT []Y=S SECOND STORY ❑YES - I BEL'*G.ADDED?rte'" NO ADDITION? ❑I:0 PP` L1C,ATIC'' 171 =S E YES: PRO V DE COPY OF PLt\N1Gpapt . o._ -T ❑NO :LtYNNGAPPROVALLEt_ER IS THE BLDG N ❑ - S r EICEL-RHOME? ❑�:O r ., -*fi - h / e - TQ L\ !DATION: _ 20 FIAT By my signature. below, I ce,tit;' to each of the follov L -t_: I zn The property owner or authorized <<e;?t Lact on the broperty owner's b,,ha'sf. I _n V-.ead rl,Is application and the information I have provided is correct. I have read uhe Description of \York and v.:r_'j+ it is accurate. I Ltee to complywith- all applicable local ordinances and state Jaw s :.lasing t b , ,-a n- . c ion. I authome representatives of Cuae:tino to enter the above -id ,tifted property for L�>pect' proposes. Sign2tilie Of ?I7pliCani� aeni: Date: ft° t •' i �- SUPPLE' IENTA __ T_ RMA T I0\1 REQUIRED PL :CHECKTIPEF: ''--: POLTI G5rI Ne -,v S1 -D Cr Mul i ainfly dwellings: Apply for demolition D ri,iit for I �.... 1�_oz _-..� n-.�s tc Ise ��*I or ��-Ici__Q DEnol p... 7 is ..QL '; i -s. ^, ... O\ $R TIS COL�TEn -- BLi DI1C PL�� RE\ ESi r e mit for new building. EIPRE c ;. .. I FLA NL GPI _Col, :]?tic C421 ;51e_S: Provide- a con Dle:e3 FTazarjous 1via4ci?_1S D+SC10cu-e >] cTsiD RD i I )MjB IC1; 0R c _ bel L_ea ..._ forl,iar�-r rdcu_' �..-:ali=ve :,,-i OT z_0=�-t Jy ' ❑ T'RGE LIRE DEPT Copy ofPlans ina spprovaI Le aer ot-Meeting „with Planning ,prior to ❑ \L JOR C. subm,«al or Building Penult application. S t1T�R1 cE\jrRDt� TRICT E1dJ Z0.P_2011.doc revised 06121 `11 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 whore 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 8314 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 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. Iri 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 8314 and CBC Sections 90,7.2.11.4 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 witK the California Building and California Residential Codes. The alarms specified below have been tested and are operational, as of the date signed below. Address: Specify Number of Alarms: Permit No. AW ::i368 I # Carbon Monoxide Detectors: I have read and agree to comply with the terms and conditions of this statement Owner (or Owner Agents) Name: Signature........ t (�%*� ..... ......... .................. ............................ Date: Contractor Name: i Signature :...... ........... Lic.# ......... Date: 'p .............................. g... r. # .� Smoke and COfo»is.doc revised 09/27/16 Wzu�• Owner Name Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3333 • build ingCa_cupertino.org 1. Is your real property a registered historical site? D Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 0' 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? tt' Yes Civil Code Sections 110 1. 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 jsign bottom of form. n leo 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. ''' Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the forma and sign bottom of form. N/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.. i Pleas heck 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-1compliant 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, 20.14, 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-conservin plumbing fixtures comply with the requirements as indicated in the table on the following age. Owner or Owner Agent's Signature: *''A Date: Upon completing and signing this return it to the Building Division in order to final your building permit. 'SB40720J5,doc revised 08/26/15 i 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 O8/26/15 Non -Compliant Water -Conserving Plumbing Fixture PlumbingFixture l (Fixture Complying with Current Code Applicableto 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%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 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 compined 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 i 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 O8/26/15