B-2017-0037CITY OF CUPERTINO BUILDING PERM
T
BUILDING ADDRESS:
CONTRACTOR:
PERMIT
NO: B-20.17-0037
7398 ROLLINGDELL DR CUPERTINO, CA 95014-5811(359 31041)
7EMiCO LLC
HAYWARD, CA 94544
OWNEWSNAME: MAGELKYAUDREY L TRUSTEE
DTE
ISSUED: 01/06/2017
OWNER'S PHONE: 408-257-1181
PHONE
NO: (866) 420-4109
LICENSED CONTRACTOR' R TION
BUILDING PERMIT
O:
License Class Be C=17 Lic. #972702
Contractor JEM ICO LLC Date 05/31/2018
X BLDG —ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— MECH X RESH)ENT
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 WINDOW (6)
- LIKE FOR LIKE TO MEET EGRESS;
I hereby affirm under penalty of perjury one of the following two declarations:
ENLARGE WINDOW (2);
REPLACE PATIO DOOR (2)
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.
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
Sq. Ft Floor Area:
Valuation:
$26990.00
permit is issued.
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:
01
cupancy Type:
and state laws relating to building construction, and hereby authorize
359 31041
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 EXP
S IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
Additionally, the a ica t understands and will comply with all non -point
WITHIN 180 DAYS
OF PERMIT ISSUANCE OR
source regulatio s per t e Ctu ertino Municipal Cod _9.18.
180 DAYS FROM
LAST CALLED INSPECTION.
Signature Date 1/6/2017
Issued by: AbbyAyende
ER
OWNER -BUILDER DECLARATION
Date: 01/06/2017
hereby affirm that I am exempt from the Contractor's License Law for one of the
All roofs shall be inspected
RE -ROOFS:
prior to any roofing material being installed. If a roof is
following two reasons:
1. I, as owner of the property, or my employees with wages as their sole
installed without first obtain'
g 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)
z. 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: 1/6/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COV
RINGS 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.
HAZARDDUS
MATERIALS DISCLOSURE
z. 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 & Saf
ty Code, Sections 25505, 25533, and 25534. I will
maintain compliance with
he Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
s. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, S
ction 25532(a) should I store or handle hazardous
material. Additionally, sho
d I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
Worker's Compensation laws of California. If, after making this certificate of
air contaminants as defined
will maintain compliance
by the Bay Quality Management District I
ith the Cu rti to unicipal Code, Chapter 9.12 and
E/
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety
Code, ctito s 505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized age
t:
APPLICANT CERTIFICATION
Date- 1Js?1217
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 lawsI
hereby affirm that there i
—ING AGENCY
a cons�tr ction 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,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
TECT's DECLARATION
and will comply with all non -point source regulations per the Cupertino Municipal
ARC
I understand my plans shall
be used as public records.
Code, Section 9.18.
Licensed
Signature Date 1/6/2017
Professional
CUPERTINO
❑ NEW CONSTRUC'T'ION
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building@cupertino.org
❑ ADDITION F-1 ALTERATTON/TT F-1 RT.VTSTCIN/TIFFFRRR (1RTr3TA.TAT T)PI?1 TTTTI
PRO` ADDRESS —] 3 9 � /) 4 j j`� y� �
/� �J
APN #
OWNER NAME
PHONE 25-,- I I
-MAILt,%`�C
STREET ADDRESS -731%
J / C3 f I
f
FAX _
CONTACT NAME
J,t", L,�Se,
PHONE
STREET ADDRESS O S?
CITY, S ATE, ZIP -V
5�f
FAX
r,
❑ OWNER ❑OWNER -BUILDER ❑ OWNERAGINT ,Q -CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITEC
❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
�°ePa /91ytd$fyCGa
ER
L� 10 7-
LICENSE
(j
1
BUS. LIC # 'Jl�
J
COMPANY NAME®`
E_MAQ
FAX
STREET ADDRESS 3 t
CITY, STATE, IPC S i'® `f
PHONE g
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS -
CITY, STATE, ZIP
PHONE
DESCRIPTION OF WORK 2- PA -6o boo a S 4 � J `tvto
dBvt
S
Jj0Vtri\, �10/ 0fid VDfPiYst.S
EXISTING USE
PROPOSED USE CONSTR
TYPE
# STORIES
USE
TYPE
OCC.
SQ.FT.
VALUATION ($)
EXISTG
NEW FLOOR
DEMO
TOTAL
AREA
AREA
AREA
NET AREA
BATHROOM
KITCHEN
OTHER
REMODELAREA
REMODELAREA
REMODELAREA
PORCH AREA
DECK AREA
TOTAL DECK/PORCH AREA
GARAGE AREA: EIDETACH
❑ ATTACH
# DWELLING UNITS:
IS A SECOND UNIT ❑ YES
SECOND STORY ❑ YES
BEING ADDED? []NO
ADDITION? ❑NO
PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF
IS THE BLDG AN ❑ YES
RE EIVED BY..TOTAL
VALUATION:
PLANNINGAPPL# ❑NO PLANNING APPROVAL LETTER
EICHLERIIOME? NO
By my signature below, I certify to each of the following: I am the property owner or authorized agent tl act on the property
owner's behalf. I have read this
application and the information I have rovided 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 ding construction. I authorize representatives of Cupertino to enter the above
-i en ',,tied property for inspection purposes.
Signature Applicant/Agent: Date:
1J /
of
r
SUPPLEMENTAt INFORMATION REQUIRED
PLAN CHECK TYPE
ROUTING SLI P
❑ OVER -THE COUNTER
U-/ BUILDING PLAN REVIEW
New SFD or Multifamily dwellings: Apply for demolition permit for
existing building(s). Demolition permit is required prior to issuance of building
permit for new building.
❑ EXPRESS
g
V-1PLANNLNG PLAN REVIEW
_ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure
ElSTANDARD
❑ PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project.
❑ LARGE
❑ FIRE DEPT
_ Copy of Planning Approval Letter or Meeting with Planning prior to
❑ MAaoR
❑ SANITARY SEWERDISTRICT
submittal of Building Permit application.
❑ ENVIRONMENTAL HEALTH
BldgApp_2011.doc revised 06121/11
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 e building(a)cupertino.org
PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN
COMPLETED, I NED. AND�F I I.� c aid 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 rand 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
CSC Section 420.6 and shall be approved by the Office of the State Fire Marshal.
Trower 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.
"aadr s:
Specify Number of Alarms:
Permit No.A --`03.7
I have read and aaree to comoly with the terms and conditions of this statement
O . er (or Ow er_Agent's_)_NampLs
Signature ... i6ate�r S>7%
—� -- ......................................................
Cont r or ame: C
Signature..................................................................
Lic.#...................................... Date:
Smoke and CO form.doc revised 09/.27116
CUPERTINO
asvner Naive - X
"we
—
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE o CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333
17- ooj
1. Is your real property a registered historical site?
1:1Yes 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 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.
XLNo 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 fonn and sign bottom of form.
`,_ P 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.
C�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 properly. See Civil Code Section -110 1.4.
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 unprovements 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).
UJ 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
installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the
table on the following nage.
Date:,$ -2'-
Upon completing and signing this Certificate; please retutm,,ff to th '&B' uilding Division in order to final your building permit.
SB4072015.doe revised 08126115
1. if the existing plumbing fixture water usage/floe rate is equal to or lower than the figure shown, it is not required to be upgraded.
SE407 2015.doc revised 08/26/15
Non-Compliant _
Water-Conserving Plumbing Fixture
-Plumbing Fixture
(Fixture Complying with Current Code Applicable to 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 1.6Single
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 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/floe rate is equal to or lower than the figure shown, it is not required to be upgraded.
SE407 2015.doc revised 08/26/15
Project name: Audrey Magelky
7398 Rollingdell Dr Backyard/Rear Setback
Cupertino 95014
U -FACTOR: 0.32
SHGC: 0.25
105 PSG D
6/0X6/8
FAMILY
104G
45X35
103DB
37X60
GARAGE
Setback 15
107PSG D
6/0X6/8
106GL M -BED
71X41
BED 1
KITCHEN
BED 1
ENTRY
102PW
12X60
101PW 110GL
45X23 71X41
Street/Front Setback 35FT
Scope of work: 2EA FULL FRAME PATIO DOORS / LATHE AND STUCCO EXT.
3EA FULL FRAME WINDOWS / 3EA LATHE AND STUCCO EXT.
2EA LOWER SILL TO COMPLY WITH EGRESS
SEA REPLACEMENT WINDOWS
CUIIIEIIZ
1,1140 w11
1,30diing Il3ep r irue ue
EEVHE II:�].) F:OIf3 COI: E COM[It,ANCE
Revewea:J ByAoby Ayande
Date: O°U06M.7,
eC1k6VkdUNffe DEVELOPMENT "" CefteTMENT
BUit-DiNG DiViSiON -.. eQ.All' IIIRTpV' O
8AN
5X17APF"IROVED
This s f frR<ws and spsoi icastdo ns BUST be kept at Alis ic.i
site Q:gur ocbn[risaticau'r. It is unlawful to irrnallao irty chainges or
cl[nrnti s on saim, or to deviate ihe efrcrn, v
ifl outapproval
109ANo rn the Building Official,
T"i'm st pan and sWroc.ificati ours 5 I-iAl I. I140T Irc
held penn4 or to be an approval oP the of l ation or ow°ife
povi ,loo of any City Oidin ance ow eta a; L.aw,.
DA flF:
I'f.VallfA i if Cf
ack 8FT