Loading...
B-2016-3266CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PE NO: B-2016-3266 23500 CRISTO REY DR UNIT 211C CUPERTINO, CA 95014-6524 (342 53 045) BAY AREA ENTERPRISE SAN JOSE, CA 95148 OWNER'S NAME: ESKELDSON BETTY M TRUSTEE DATE SSUED: 12/14/2016 OWNER'S PHONE: 408-537-1523 PHONE to: (408) 238-5043 LICENSED ONT TOR' DECLARATION BUILDING PERMIT INFO: License Class 5Lic. # 1 17 Contractor BAY AREA ENTERPRISE Date 03/31/2017 X BLDG X ELECT _ PLUMM I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing X MECH X RESIDENTIAL I COMMERCIAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION: UNIT 211 C; UPGRADE; OUjETS/SWITCHES (37); BATHROOM I hereby affirm under penalty of perjury one of the following two declarations: FANS (2); RECESSED LIGH'T'S (7) 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. 1 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 6F 6 permit is issued. Sq. Ft Floor Area: Valuatio $2600.00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: Occupa Type: information is correct. I agree to comply with all city and county ordinances cy and state laws relating to building construction, and hereby authorize 342 53 045 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 this permit: Additionally, the applicant understands and will comply with all ll non-point WITHIN 180 DAYS�F PERMIT ISSUANCE OR source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM L S' ST CALLED INSPECTION. Signature " Date 12/14/2016 Issued by: MELI Date: 12/14/2016 OWNER-BUTT DER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: All roofs shall be inspected prior tc 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 ani ispection, 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: 12/14/2016 I hereby affirm under penalty of perjury one of the following three declarations: AL • 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. HAZARD US MATERIALS DISCLOSURE 2. I have and will maintain Worker's Compensation Insurance, as provided for by I have read the hazardous mate ials 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 Co le, Sections 25505, 25533, and 25534. I will permit is issued. maintain compliance with the Cu 3crtino 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 15532(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 u e equipment or devices which emit hazardous air contaminants as defined by thb Bay Area Air Quality Management District I Worker's Compensation laws of California. If, after making this certificate of will maintain compliance with thI Cupertino Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Coe, Sections 2550 533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall `� be deemed revoked.O wner or authorized agent: APPLICANT CERTIFICATION Date: '12/14/2016 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 CO�; NS TRC ONLENDINGAGENCY I hereby affirm that there is a co struction lending agency for the performance relating to building construction, and hereby authorize representatives of this city of work's for which this permit is ssued (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 1 understand my plans shall be used as public records. Code, Section 9.18. Licensed SiSignature Date 12/14/2016 9 Professional - 0 CONSTRUCTION PERMIT PP LICAT1 COMMUNITY DEVELOPMENT DEPARTMENT a BUILDING DIVISION 10300 TORRE AVENUE o CUPERTINO, CA 950143255 l (408) 777-3226 o FAX (408) 77T-3333 o buiiding0cuDertino.ora 8' ❑ ADDITION TERATION t TI ❑ REVISION I DEFERRED O GINAL PERMIT #1 PROJECT ADDRESS �g APN# . ' s two L : @ s � €�tA Ni ®� Z-11 c =.„ , OtV2VE$ AAebl£, PHONE £ WIAIL mak! {OYi# M (Te) O #r - 3 - 15-2.3 � d ". ,e to RSC • c6 t% STREET AD R£SS� c - — CITY STATE ZTP i C `�► FAX v,,_ 0 9 d CONTACT NAME •V PHg E q23 _ 3 Eta STREEI'ADDRESS Z110 F PK CTTY,STATE, ZIP F -K Gi S cif 0 OWNER D OWNERBUILDER Q OWNERAGENT Vd CONTRACTOR 000NTRACTORAGENT © ARCHITECT 0 ENGINEER El DEvF-LOPER ❑ TENANT CONTRACTORNAMEjr�}' LICENSE NUMBER TI; ICENSETYPE BUS.LIC# COMPANYNA.IN4£ - e E-MAIL�^,, r� '�Y FAX. 13 a Y,&t� Yt tr v d a' _L 8 STREETADDRESS �. Si Zi CITY, STATE, P 57 a — lo i B , U i �LjLI! ARCIIITEC DENGINEER NAME LICENSE NUMBER BUS. LIC #- COMPANYNA IE E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE 'DESCRIPTION OF NVORK , k d t%9 d 114 S LsS (.� 6Jw 't X f c^2t �'I. ,sem OUSTING USE PROPOSED USE CONSTRTYPE n STORIES USE TYPE OC _ SQ.FT_ VALUATION (S IMSTO N£WFLOOR DEMO TOTAL AREA AREA AREA NECAREA BATHROOM KITCHEN OTHER REMODELAREA REN40DELAREA REMODELAREA PORCH AREA DECKAREA TOTAL DECKIPORCH AREA GARAGEAREA MDETACH OATTACH I & O1vEI J UNITS: ISA SECOND UNIT ©YES SECOND STORY OYES BEING ADDED? ONO ADDITION? ONO PRE -APPLICATION OYES IF YES, PROVIDE COPY OF IS THE BLDG AN AL VALUATION: PLANNINGAP,PLIt ONO PLANNING APPROVAL LETTER EICHLERH06IE? By my signature below, I certify to each of the fo110 ' g 1 am the property owner or authorized agent to roperty mer behalf I have read this application and the information I have provided is co t. I hav d rile Description of Work: and verify it is accurate. I agre to comply with all applicable local ordinances and state laws relating to building con ction.tfirin representatives of Cupertino to enter the above-identifie grope r for inspection purposes. Signature of Applicant(A.gent: SUPPLEMENT INFORMATION REQUIRED PLANCHECKTYPE ROUTINGSLIP ❑ O �CouNTM BUHAING PLAN REVIEW' _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permitfor newbuilding. ©"E3xpx, ss 0 PLANNINGYLANREYILSV .- _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El :STANDARD " " [l PUBLIC WOB_ICS " form if any Hazardous Materials are being used as part of this project, O LARGE 0 FIRE DE": _ Copy of Planning Approval Letter or Meeting with Planning prior to O MAJOR " D SANITARY SEWERDISTRtCr submittal of Building Permit application - 0 WIRONAWNTAL HEALTH B1dgr1PP 2DII.docrevised 06171111 \\ SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION UPEItT tNC� 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 C (408)777-3228•FAX(408)777-3333•buildinq(w,cupertino.orq PERMIT CANNOT BE FINALED UNTIL TINS 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 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: '.3 J`'cto cg({` ,1~gyp'' PA Permit No. ZddC 32.4e, Specify Number of Alarms: #Smoke Alarms: I ( #Carbon Monoxide Detectors: I-1 I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: Signature. Date: Contractor Name: (`(` Signature Lic.# Date: Smoke and COform.doc revised 09/27/16 CUPERTINO Owner Name WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE ® CUPERTINO, CA 95014-3255 ,} (408) 777-3228 A?� (408) 777-3333 • buildinaC�cupertino.org ®-=-- Pear. Address 1. Is your real property a registered historical site? El -yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. ' L 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. '9 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 fonn. IE� 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. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the three following statements and sign bottom of form.. Please 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 noncompliant 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 noncompliant 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 : ing Code and California Green Building Standards Code, and manufacturer's installation requirements, and thate wate - serving plumbing fixtures comply with the requirements as indicated in the table on the followma pane. x s" Owner or Owner Agent's Signature: / �_ ` _ �'� _ Date:,; & (Z Upon completing and signing this{Certificate, please eturn it to the .Building Division in order to final your building permit. SB40 7 2015. doc revised 08126115