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B-2017-0133
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CO:TNRACTOR: ]PERMIT NO: B-2017-0133 7611 KIRWIN LN CUPERTINO, CA 95014-4356 (359 21 012) F WCQUISITIONCOBOL, WA 98011 OWNER'S NAME: KIMBERLIN STEVEN R AND KATHLEEN L TRUSTEE OWNER'S PHONE: 408-219-6096 LICENSED CONTRACTOR'S DECLARATION License Class C-36 Lic. #987398 Contractor E W H ACQUISITION CO LLC Date 10/31/2017 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: 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 i Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. APPLICANT CER11MATION 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. Date 1/25/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. 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: r. 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. 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 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 1/25/2017 DATE ISSUED: 01/25/2017 PHONE NO: (425) 636-7078 BUILDING PERNIT INFO: BLDG —ELECT X PLUMB MECH X RESIDENTIAL _ COMNIERCLAL JOB DESCRIPTION: (N) 38 GALLON WATER HEATER -GARAGE Sq. Ft Floor Area: l Valuation: $1480.00 APN Number: Occupancy Type: 359 21 012 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Ayende RE -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: Date: 1/25/2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Seed ns i05, 25533, and 25534. Owner or authorized agent: Date: 1/25/2017 CONSTRUCTION LENDING AGENCY Y 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 01/24{2017 TUE 13:50 FAX Fact WahOr HOa'h*r C.r1{ -.0l _� c cii�tr KJG►c, r= KIVII I AtItIl_H.;A, I IUIV In COMMUNITY DEVELOPMENT DEPARTMENT,, BUILDING DIVISION 10300 TORRE AVENUE: P CUPERTINO, CA $5014-3255 CI(498) 777.3228.• FAX (409) 777-333.3 * bulIdIQ aup ' o,om ��Ueb� UMHINCI MECIIAMCAL ELECTRICAL —LISCELLANT PROJECT Abba ES j y AflN M%q 1 i� ttWNHR NAMIt ` s NiI V-.ty,(r ( s^MM AtI. r.. --►—•—'r STREET ADDRESS I r �� "'A 1 l^ r _� FAX CONTACT NAME ( I !�`fAX0 PHONE (, �(J B -MAIL tiTItHET ADARHSB "�1 t _ n ( �i ` 1 CITY, STATE, ZIP U3002/008 WW0 .M.1'' 11 OWNER d OWNE"UMDER © OWNERACWT CONTRACTOR NAMII3 r COMPANY NAME ftj I FAX ©CON`MACT0A Aa9NT CI AWMTKT ©ENOINEeR. 0 DIVHLOFER 07WMT SIR, n t\ 1 LIMSI1."PE . r *% ARCIRTHCT/EINANHER NAME LICIINSH NUMUR CCWPAN'Y NAME R-fiiIAIL STREET ADDRESS CITY, STATE, ZIP U88 OF 8FD.,DUPt.HX © 1.avuT1-VAWIHMY PK=CT E14 W PLAND M Y98 81TALDINQ Ij COMORCIAL t URBAN INTEMPACE AREA T9 NO D.BSCRIPTIONOF WMK I A- CQ)0&1 PROMT IN ❑ YES FLOWZONH D NO .0fo, BUS. LIC 4 FAX PROM IS TFX BIDG AN © Ya; HICFIII.HR Roan? © NO TOTAL. YALUATrON! IU l�1'' BY MY signature below, I aettify La each of the following. I Am the property owner or authorized $gent to ant on the property owner's behalf. I have read this application and the information I have provided is correct, (have read the Deacripdon ofWork and verity It Is accurate, I agree to comply with all applicable local ordinances and state lawn relating to building constrtic n. I authorize representativea of Cupertino to enter the above•identifle property for Ilns ectlon purposes, Signature of Applimt/Agent: Date: �_� MEPHiscApp 20 r i.doc revised 0612 1/11 a jCUPERTINO PERMIT l'sll'i TiT, PURPOSE SMOKE / CARBON MONOXIDE ALARMS OWNER.CERT[FICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a_)cuperiino.org This affidavit is a self -certification for the installation of all required Sm, compliance with 2016 CRC Section R314, R315, 2016 CBC Sections 420.6 for inspections are required. and Carbon Monoxide Alarms for 1907.2.11.2 where no interior access 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 $10Q0.00, CR Carbon Monoxide Alarms be installed.in the following locations: -- (require that Smoke Alarms and/or _C_Sectio1 R4 31�R315, and CBC Sections 907.2.11.5 and 420.6 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 including basements and habitable attics X X Within each sleeping room X _ J Carbon Monoxide alarms are not required in dwellings wluch 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, alae-n(s) may be solely battery operated. In existing dwenag units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling f rdshes or there is no access by means of attic, basement or crawl space. Refer to CRC Section 8314 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.<5zr j Address- rC1, Permit No. _2. 017— Specify Number of Alarms:, # Smoke Alarms: # Carbon Monoxide Detectors: l have read and agree to ccPmply with the termq anti r nnrYitfnn.c of th;� ..Qtatern, nt Owner (or Owner Agent' )Name: ev—l4t Si na%ir................................ ... ........................................ Date:.. . . �. Contractor Name: Signature.................................................................'. Lic.# ......................................Date:.................. Smoke and COfonn.doc remised 01/1012017 r �N WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ' CUPERTI NO 621-10 (408) 777-3 AX (408) 777 333 > b Odin u ertino or Owner Name JT�%'G%/� rytee 0( -+L �� ` 1 [ii Permit N o j -7-0/33 Address ` 17,411 j y1__ tj (VI L lit 6I asw'( lGI 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. ANo 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. No Go to Question 3. 'Is water service permanently d sconriected-for y&d build ng? ` `` ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest or the form and sign bottom of form. K 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.. 5. 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-l; 2019—,all-non--compliant pimmbing-fttures� shall be=replacc�d-with w tey-- -- — - - 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 wat -conserving plumbing fixture comply with the requirements as indicated in the table on the following_age. -- j % Y A/ I Owner or Owner Agent's Signature:-�%'�-^ Date: Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit. SB4072015.doc revised 08126/15 SB407 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 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 CALGreen Div. 5.3 Water Usage /Flow Rate Single -Family Multi -Family Commercial Residential Water Closets Exceed 1.6 (Toilets) Gallons/flush Residential Single flush toilets: 1.28 gallons/flush Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite, Urinals Exceed 1.0 average flush volume of two reduced flushes and one full flush Gallons/flush 0.5 gallons/flush 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of Showerheads Exceed 2.5 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 Faucets — Exceed 2.2 gallons allow only one shower outlet to be in operation at a time. Maximum 1.5 gallons per Within units: Lavatory per minute 0.5 gallons per minute @ 60 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 — Kitchen Exceed 2.2 gallons minute 1.8 ,gallons per minute @ 60 1.8 gallons per minute 1.8 gallons per minute @ 60 Faucets per psi May temporarily increase @ 60 psi May temporarily psi 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