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B-2017-0150CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRE SS: CONTRACTOR: PERMIT NO: B-2017-0150 10144 PARKWOOD DR APT 1 CUPERTINO, CA (326 27 037) THERMAL OWNER'S NAME: AVERY GLENBROOK LP OWNER'S PHONE: 650-961-8330 LICENSED ENSED ONTRA TOR'S DECLARATION License Class C10, C20, C36, C38 Lic. #256052 Contractor THERMAL MECHANICAL Date 01/31/2018 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. hereby affirm under penalty of perjury one of the following two declarations: s. 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. Oli4ection have and will maintain Worker's Compensation Insurance, as provided for by 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 applicant understands and will comply with all non -point source regulations per tbe.QADertino Municipal Code, Section 9.18. Signature f Date 01/31/2017 SANTA CLARA, CA 95054 ISSUED: 01/31/2017 PHONE NO: (408) 988-8744 BUILDING PERMIT INFO: X BLDG X ELECT X PLUMB X MECH X RESIDENTIAL — COMMERCIAL JOB DESCRIPTION: BLDG 25MMT 1; ADD (N) A/C; REPLACE FURNACE, SAME LOCATION; (l) WASHER AND DRYER HOOK UPS; (I) ELECTRICAL SERVICE (70 AMP); (N) GAS LINE FOR STOVE; (N) RECEPTACLE OUTLETS; (N) LIGHT; (N) BATHROOM EXHAUST FANS Sq. Ft Floor Area: ( Valuation: $20000.00 APN Number: Occupancy Type- 32627037 ype:32627037 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. ` IIssued by: MELISSA'NAMES Date: OU3112017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: z. 1, 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. 1, 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. 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 CERTIFI ATION 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 01131/2017 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: OI/31/2017 ALL ROOF COVERINGS TO BE CLASS "A" 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 5,25 3, a d 25534. owner or authorized agent: \ _ Date: 01/31/201 A 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 N CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 121 10300 TORRE AVENUE * CUPERTINO, CA 95014-3255 CUPERTINO (4018)),777-3228 - FAX (408) 777-3333 - building@ -nig z7VA C= -A -1 6- V A-117 I Tn'MnXT M A nVIVIT111T r -X1 I I ID &InM ITT F PVVT'Q1I-)-W I nFRF?PP Rn r)VIrUM4,V PVR MIT a PROJECT ADDRESS 10144 Parkwood DR, BLDG 25, Unit #1 APN#1 OWNER NAME Avery Glenbrook LLC PHONE 650-961-8330 avery@pacbell-net STREPTAIDDRESS 130 East Dana Street CITY, STATE, ZIP Mt. View, CA 94041 FAX 650-961-0571 CONTACT NAME Rob Moyer I PHONE 408-593-8115 1 E-MAILrmoyer@thermalmech.com STREETAIDDRE&S 425 Aldo ave. CITY, STATE, ZIP Santa Clara, CA 95064 1 PAX 408-988-0233 El OWNER 11 OWNFR-BUILDER El OWNERAGENT IR CONTRACTOR El CONTRACTOR AGENT 171 ARCHrrECT El FMOINEER 0 DEVELOPER 0 TBNANT CONTRACTORNAME Thermal Mechanical LICENSE NUMBER 256057 LICENSH TYPE C-4 10,20,36.38 BUS. LIC fi 299 com"ANY"Amp Thermal Mechanical F-MAILrmoyer@thermaimech.com FAX 408-988-0233 8TRFffrADDRESS 425 Aldo ave. CITY, STATE, ZIP Santa Clara, CA 95054 FHONF 408-988-8744 ARCHrrECVsNCuNuBR NAM 6 LICENSE NUMBER BUS, LIC fi COMPANYNAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK add new AC, replace furnace in same location, (N) washer/dryer hook ups, (N) electrical panel (70 AMP), (N) gas line for stove, (N) electrical outlets, (N) light, (N) bathroom exhaust fan EXISTING USE PROPOSED USE CONSTR.'r)0B it STORIES USE TYPE OCC. SQ'FT. VALUATION FXISTG NEW FLOOR DEMO TOTAL ARBA AREA AREA N9rARBA BATHROOM KITCHENR =DBLARFA REMODELAIWA REKODBLARRA -p0--RCvAA-AEA±DECK AREA TOTA DECK(PORCHARBA GARAGEAREA: DNIACH n ATTACH # DWELLING UNITS; IS A SECOND UNIT BEINGADDED? []NO SECONDSTORY UYES ADDITION? [3NO PRF -APPLICATION DYES IF YES, PROVIDE COPY OF ISTID. BLDG AN El YESTOTAL. VA UATION: PIANNINO APPL It []NO PLANNING APPROVA L LKITER, EICHLER HOME? El NO By my signature below, I certify to each of the following: I am the property owner or auth tzed a eat to act The owner's behalf 1 have read this and the information I have provided is correct I have road the Description of Work and verify i Ovate, I agree to comply with all applicable local application ordinances and state laws relating to build' autlVilze representatives of Cupertino to enter the above-identifi5d property or inspection purposes. io,I Date: Signature of Applicart/Agent: SUPPLEMENTAL WINFORMATION REQUIP&D -�* PLAN CHE 1 77777 j BMI)jNcPL N`RKVI8NY.!:.;--.:-,-.-'-..-. New SFD or Multifamily dwellings; Apply for demolition permit fior existing building(s). Demolition permit is required prior to issuance, of building permit for now building. 1=1 ace>iss Comcaercial Bldgs-. Provide a completed Hazardous Materials Disclosure S NDA" form if any Hazardous Materials are being used as part of this project. F= -DEPT Copy of Planning Approval Letter or Meeting witli Planning prior to submittal of Building Permit application R ALTR Bldg,41)1�_2011.doo reviser! 06/21111 SMOKE / CARBON MONOXIDE ALARMS OWNER C'.ERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION CUP ERT j N0 10300 1 U KKE AVENUE- • CUPERTINO, CA 95014-3255 PURPOSE '11zis -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 ulterior access for inspections are required. ENERAL INFORMATION Existing single-family and multi -family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When the valuation ofadditions, 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 Ivfonoxi.de Alarms be installed in the following locations: AREA -- Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) Can every level of a dwelling unit including basements Within each sleepi.na room SMOKE ALARM X X CO ALARM. Al Carbon Monoxide alarms are not required in dwellings which dont contain fuel -burning appliances- and that do not have an attached garage: Carbon monoxide alarmscombined with smoke alarms shall comply, with CBC Section 420.6 and. shall be approved by the Office of the State Fire Marshal. 'ower Supply: In dwelling units,with no commercial power supply, alarm(s) may be solely battery. operated. Tn 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 arld 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 bQlow. Address:.. f61 0 Specify Number. of Alarms:. Permit No,f- Z()I ? -6 1-90 # Smoke Alanms: I have read and agree to Owner (or Owner Agent's) Name: ,I-4/14Ef �� /��r�LD I Signature...... am e: 90 ( ��tf,�,�� Signature;..... with the .=Ls and conditions of this ..................................................................................... Date: ............................................................I..............:.............. 0.01 ......- ....... Z �( .....-�Lic.# ...............Q. fir. .......Date: V7 0 C777nZ_P and ('n 7e)7-771 dnr —vicod n9/77/l{, CUPERTINO Owner Name Address WATER -CONSERVING PLUMBING FIXTURES. OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildina(a)-cuoertino ora Permit No. f.3 -Z017- O t 3—t) I. Is your real property a registered historical site?' K❑ 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 lumbing, 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 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 No Go to Question 4. 4. Is your real property built and available fo'r 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 fonn. �x`�Yes My real property is built and available for use or occupancy on or before January 1, 1994. Cavil Code Sections -1101.1 through 11,01.8 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 he replaced with water -conserving plumbing fixtures throughout the building. On or before January 1', 2017, all non- compliant plumbing fixtures shall be replaced w_ ith 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 followinu naQP 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 buildilig permit. SB407 2015. doc revised 08/26/15