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B-2017-0171CITY OF CUPERTINO BUILDING PERMIT I BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0171 23500 CRISTO REY DR UNIT 406E CUPERTIztO, CA 95014-6531(342 53 155) BAY AREA ENTERPRISE SAN JOSE, CA 95148 OWNER'S NAME: FLIPPEN JAMES H TRUSTEE & ET AL �D-ATE ISSUED: 01/27/2017 OWNER'S PHONE: 650-537-1523 ji PHONE NO: (408) 238-5043 License Class B Lic. #817817 Contractor BAY AREA ENTERPRISE Date 0.3/31/2017 I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. I hereby affirm under penalty of perjury one of the following two declarations: t. 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 BUILDING PERMIT INFO: X BLDG X ELECT X PLUMB X MECH X RESIDENTIAL — COMMERCIAL JOB DESCRIPTION: UNIT 406E - (N) LED LIGHTS (14), (N) OUTLETS 22, (N) LIGHT SWITCHES (14), (1) BATHROOM FANS (2), UPGRADE SHOWER performance of the work for which this permit is issued. 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 y permit is issued. Sq. Ft Floor Area: APPLICANT CERTMC TSI ION 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 relating to building construction, and hereby authorize 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 may accrue against said City in consequence of the granting of this permit. Additionally, the applica nderstands and will comply with all non -point source regulatio the Cu ertino Municipal Code, Section 9.18. Signatu _ _ Date 01/27/2017 hereby affirm that I am exempt from the Contractor's License Law for one of the two reasons: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sce.7044, Business & Professions Code) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sce.7044, Business & Professions Code). $7000.00 APN Number: Occupancy Type: 1342 53 155 I hereby affirm under penalty of perjury one of the following three declarations: z. 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. 2. 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. s. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, atter making this certificate of exemption, I become subject to the Worker's Compensation provisions of the Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. APPI ICANT 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 and state laws relating to building construction, and hereby authorize 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 may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 01/27/2017 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar R&ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant: Hate: 01/27/2017 TO BE CLASS "A" HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintaincomplia celvith the Cu o Municipal Code, Chapter 9.12 and the Hea & Safety C , ectioRV155105, 2 3, and 25534. Owner or auth ized ent: Date: 01/27/2017 JCTIONLENDINGAGENC I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPLICAT101w- - COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISIOCOMMUNITY�. 10300 TORRE AVENUE o CUPERTINO, CA 950W3255 QI P =RT1 5 5 (408) 777-3228 - 777-3333 o buitdingt ctaDertina.ara s t_I NEW' CONSTRUCTION ❑ ADDITi . L RATION { TI Q REVISION i DEFERRED ORIGINAL PERKHT 4 PROJECT ADDRESS APN 3 .L3 3-d%,&✓e°S+{x R®i, /)aP_ d161__- OU NL'ER NAME ' P +®`+� BCf✓�V k PHONE fa b-53 - 15-Z.' E AIAII s •Tk � ruCIL IMA I r 86� C•��Saf°t S•iRE .7 6 1 Yt �� ® aj�j� 7- ErADDRESSr�t, Crfy. sTe ZB' C FAX COr 'TACT NARIEr o PEIONE E=Rt j^ STREET,iDDRESS Jf { t �* G feltIn CFFY,STATE ZIP EAX S,"r-SJ Q O4"TR 0 OWNER -BUILDER Q O\VNERAGCNT 8e7 CownACTOR O rnmTRACTOR AM -WT E3 norm — .. ri ....-...� CONTRACTOR c ia41dE ''y� LICENSE NUMBER 11721 q LICENSETYPE BUS_ LIC a CO1fPANYNAAM -Q �' l� t.9► � g(' �� E-hfAil.. C � � "CJI D •C G - FA.l' STREETADDRESS CrrY,STATE,ZIP 57 ' 67 7 , [1`r l ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS_ LIC 9 COMPANY NAME E NIA11, FAX STREETADDRESS CrrY, STATE; ZIP PHONE DESCR1PI'tO OFtVfl C/` C7'Ye CC.X c r st lcc•e 2 `3ofti r®® -r4'in G�jO yT SGratyc Sic�r U�ue S �r iAla /(S EXISTINGUSE PROPOSEDUSE CONSTR_1YPE =}STORIES I USE TYPE OCC_ SQ_Ff_ VALUATION (S) - EXISTG NEW FLOOR DERIO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODELAREA REN40DEL AREA RERIODELAREA PORCH AREA DECK AREA TOTALDEP-WORCHAREA GARAGE AREA: ODETACH I ❑ATTACH I 9 DWELLING UNITS_ ISASECONDUNIT OYES SECONDSTORY OYES BEINGADDED? ONO ADDITION? ONO PRE -APPLICATION I]YEs tFYESPROVIDECOPY OF ISTHEBLDGAN OYES RECEiVEDBY TOT VALUATION- PLANNINGAPPLn ONO PLANNING APPROVAL LETTER EICHLER HO0 ,M? ONO IBy my signature below, I certify to each ofthe follo ' g: I am the property owner or authorized agent to act on the property owner's behalf. i I have read this application and the information I have provided is coiytet. I haWlead the Description of Work and verify it is accurate. f agree to comply with all applicable local ordinances and state laws relating to building co ction_l a orize representatives of Cupertino to enterthe above -identified property for inspeerion purposes. Signature of ApplicantfAgenC Date: = //2 51 --te/7 SUPPLEMEN16L INFORMATION REQUIREDPLAN cxEaK TYPE New SFD GrMultifamily dsvellinb : Apply for demolition permit for O OVER -TRE -COUNTER existing buitding(s). Demolition permit is required prior to issuance of building permit for new building. Q ExPRESS _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure Ci STANDARD form if any hazardous Materials are being used as part of this project. p LARGE _ Copy of Planning Approval Letter or Meeting -with Planning prior to Q MJOR submittal of Building Permit application. ROUTINGSLIP Q IHJIL DING PLAN REVIEW Q PLAriNRiGPLANRL'VMV ❑ PUBLICIVORKS Q FIRE DEPT Q SANITARY SEWER DISTRICT © ENVtRo.N,&I wALnrALTft B1dgApp 20]Ld©crevised t76l-7I/ll f AotL CUPERTINO Owner Name Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 777-yZ• FAX A08) 777-3333 • building(a)cupertino.org 0, -2--0/> 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. 1NO Go to Question 3. 3. I(ts 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. I�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. ll 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: �G 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 installation requirements, and that the water -conserving plumbing fixtures comply with the requirements as indicated in the table on the followine nate. /^'e Owner or Owner Agent's Signature:( f�A � ��" _ Date:7°-3- e 7 Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB407 2015. doc revised 08/26/15 CUPERTINO 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 - building6a.cupertino.org PERMIT CANNOT I COMPLETED, FINALED UNTIL.THIS,CERTIFICATE HAS BEEN AND HETURNFD TO THE BUILDING DIVISION PURPOSE I'his affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section R314, R315, 2016 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 $1000.00, CRC Section R314, R315, and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed in the following locations: I AREA SMOKE ALARM CO ALARM _ _ _ i _ Outside of each separate sleeping area in the immediate vicinity of the be located feet bathroom door) X X bedroom(s) - (Smoke alarms shall not within 3 of On every level of a dwelling unit including basements and habitable attics_ X X _ Within each sleeping room. _�_ X Carbon Monoxide alarms are not required in dwellings which do not contain fuel -bunting appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply: In dwelling units with no commercial power supply, alarm(s) may be solely battery operated. Ira existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result ii -i the removal of wall and ceiling fuaishes or there is no access by means of attic, basement or crawl space. Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building and California Residential. Codes. The alarms specified below have been tested and are operational, as of the date signed below. 2� Address: Z7$w-U �,��57�. /� T Permit NQF__>15'11 Specify Number of Alarms: # Smoke Alarms: # Carbon Monoxide Detectors: = 1 have read and aqree to comply with the terms and conditions of this statement Owner (or Owner Agent's/)_Name: j6nI L— Signature ........_; .... S Da ..... y........ Contractor Name: Si g n a t ::... ........... ............................ Lic.#...................................... Date:.................. Smoke and CO jor7n.doc 7•evised 01/1012017