B-2017-0124CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0124
22345 CARTA BLANCA ST CUPERTINO, CA 95014-1008 (326 13 057) ECONOMY ROOTER
INC
SANTA CLARA, CA
95055
OWNER'S NAME: CUTLER GREGORY M AND MAI H
OWNER'S PHONE: 408-425-1236
LICENSED CONIRACTORISD ('TARATION
License Class C-36 Lie. #8 04
Contractor ECONOMY ROOTER INCDate 05/31/2018
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:
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. 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.
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
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 pplicant understands and will comply with all non -point
source regulati n per the Cupertino Municipal Code, Section 9.18.
Signature Date 01/24/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
following two reasons:
1. 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 (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
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.
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.
3. 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, after 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.
APPLICANT CERTIFICATION l
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 01/24/2017
DATE ISSUED: 01/24/2017
PHONE NO: (408) 249-4922
BUILDING PERMIT INFO:
X BLDG —ELECT X PLUMB
_ MECH X RESIDENTIAL _ COMMERCIAL
JOB DESCRIPTION:
REPLACE; 50 GAL WATER HEATER - GARAGE
Sq. Ft Floor Area: Valuation: $950.00
APN Number: Occupancy Type:
32613 057
PERMIT EXPIRES IF WORK IS NOT STARTED
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
180 DAYS FROM LAST CALLED INSPECTION.
Issued by: Kim Dunbar
Date: 01/24/2017
RF 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 ofApplicant:
Date: 01/24/2017
ALL ROOF COVERINGS 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 maintain compliance with the Cup 'no Municipal Code, Chapter 9.12 and
the Health & Safety Code, S ti ns 25505, 25533, and 25534.
Owner or authorized agent:
Date: 01/24/2017
CONSTRUCTION LENDING AGENCY
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
CUPERTIISIO
GENERAL PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333-buildina(a)cupertino.org misc
I(/IurTTKMrnTr- F7 =-.----.---. r—'
PROJECT ADDRESS
I 11VllZl&bLLANt,UUS
OVTNER NAME
PHON
/Z36
E-MAIL
STREET ADDRESS
a� t3Z� Ne,4
CITY, STA, ZIP FAX
q ywcl
CONT CT NAME
OIZG£ �i y`?�
PHO Z ��} �{�l ZZ
EMAIL
STREET ADDRESS
� u t
CITY, STATE, ZIP/�1ti"L+0N
5-� �,�- 3ti
AX
F �/�6OWNER 9
❑ OWNER-BUB.DER ❑ OWNERAGENT.
-—T
❑ coNTRACTOR dCONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPA'!
CONTRACTOR NAME
LICENSE N-UMBE ,,,)
LkJ Z
LICENSE lY3 / BUS.
Fa
LIC #.
303 6
COMPANY NAME
'�..,` co
E -nom
�OIYK o ✓� iyv+
FAN
08 0 0 ((ZgO
STREET ADDRESS //
/d bJf�
CITY, STATE, ZIP
PHONE
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC 4
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or DUPLEX ❑ MULTI-EAMILY PROJECT INWILDLAND ❑ YES PROJECT IN ❑ YES
BUnl)LNG: ❑ comAuRCLAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO
IS THE BLDG AN ❑ YES
I EICHLER HOME? ❑ NO
DESCRIPTION OF WORK
TOTAL VALUATION:
V U
By my signature below, I certify to each of the following: I am the property owner or authorized agent to a t on the property owners behalf. I have read this
application and the information I have pr 'ded 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 bui g construction. I authorize representatives of Cupertino to enter the above' iden ified property for inspection purposes.
Signature of Applicant/Agent: Date: o7 Z Y—/
SUPPLEMENTAL INFORMATION REQUIRED
oic usE oNzY
Oti ER-TIiE-COiJ1�TER
.
{fl EJ,PI2ESS
STANDARD .,.,.
LARGE
0 RiAJOR
h1EPR4iscApp_2011.doc revised 06/21/11
CUPERTINO
PURPOSE
SMOKE / CARBON MONOXIDE ALARMS
OWNER.CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPER'TINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(a.cuoertino.org
This 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
Nloz oxide a iif is: VVeff �fhzeg�valu-d61-of-ad`di t10ris,-alae ions,�or repair to-ezis Yng-dweffiy
$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:
AREA
SMOKE ALARM
CO ALARM
Outside of each separate sleeping area in the immediate vicinity of the
X
X
bedroom(s) - (Smoke alarms shall not be located within 3 feet of bathroom door)
On every level of a dwelling unit includin basements and habitable attics
-
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 firzdshes 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 wiz=iru3''u` coilnectd io Ehe buildup '�vfr- _- - _
As owner 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 hastructions 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. 9,11
fn
Address: t.l*rLA [)ACS � / � it � tJ ��/ Permit No.
Specify Number of Alarms: # Smoke Alanlls:' # Carbon Monoxide Detectors: 71
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owne Agent's) Name:
d •A /
Si nature' .. .. ...... .. ...... � ......................................... ........ Date: /.. `/h
Contractor Name:
I ,
Signature.................................................................. Lic.#...................................... Date:..................
I_
Smoke and COfonn.doc revised 01/1012017
WATER-GONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
28 • FAX (408) 777-3333 • buildingCa.cupertino.org
Owner Name
Address
2 7-
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.
/ o _-Gates i Miijcm: - -
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.
1(7
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..
5. 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
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 following pace.
Owner or Owner Agent's Signature: i.X? Z 111,&4 1 A Date: 1/ 51 1 <
Upon completing and signing this Certificate, please return it to the Building Division in order to final your blildinj permit.
SB4072015.doc revised 08126115
BUILDING PERMIT CANNOT BE TINALED.Al\TD COMPLETED UNTIL THIS
CERTIFICATE HAS BEEN SI(T i ANIS RETIJRNED T(4 THE BUILDINGS , NISI+
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
Non -Compliant
Water -Conserving Plumbing Fixture
PlumbingFixture
(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 1.6
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 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/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