B-2017-0199CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0199
1145 STEEPLECHASE LN CUPERTINO, CA 95014-5816 (359 3105 1)
DELTA ELECTRIC
SAN JOSE, CA 95123
OWNER'S NAME: YUSEM STUART I
DATE ISSUED: 02/01/2017
OWNER'S PHONE: 408-857-5830
PHONE NO: (408) 224-0176
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C-10 Lic. #429472
Contractor DELTA ELECTRIC Date 94/30/2017
X BLDG X ELECT _PLUMB
I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing
— MECH X RESIDENTIAL_ COMMERCIAL
with Section 7000) of Division 3 of the Business & Professions Code and that my
license is in full force and effect.
JOB DESCRIPTION:
UPGRADE PANEL (200 AMP)
I hereby affirm under penalty of perjury one of the following two declarations:
_ 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.
Sq. Ft Floor Area:
Valuation: $2650.00
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above
APN Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize
359 31 051
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 EXPIRES IF WORK IS NOT STARTED
may accrue against said City in consequence of the granting of this permit.
Additionally, the applicant understands and will comply with all non -point
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
source reg ations per the Cupertino Municip Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signature Date 02/01/2017
Issued by: Kim Dunbar
Date: 02/01/2017
OWNER -BUILDER DF T RATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE -ROOFS:
following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
t. I, as owner of the property, or my employees with wages as their sole
installed without first obtaining 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)
2. 1, as owner of the property, am exclusively contracting with. licensed
Signature of Applicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 02/01/2017
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
t. 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.
HAZARDOUS MATERIALS DISCLOSURE
2. 1 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 & Safety Code, Sections 25505, 25533, and 25534. I will
permit is issued.
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
3. I certify that in the performance of the work for which this permit is issued, I
Health & Safety Code, Section 25532(a) should I store or handle hazardous
shall not employ any person in any manner so as to become subject to the
material. Additionally, should I use equipment or devices which emit hazardous
air contaminants as defined by the Bay Area Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safety Code, Sections 25505, 25533, and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked. :
Owner or authorized agent: 1 j nJ JZ1 A,
APPLICANT CERTIFICATION
Date: 02/01/2017
1 certify that I have read this application and state that the above information is
CONSTRUCTION LENDING AGENCY
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a construction 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,
judgments, costs, and expenses which may accrue against said City in
Lender's Address
consequence of the granting of this permit. Additionally, the applicant understands
and will comply with all non -point source regulations per the Cupertino Municipal
ARCHITECT'S DECLA ATION
Code, Section 9.18.
1 understand my plans shall be used as public records.
Licensed
Signature Date 02/01/2017
Professional
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
11'11 rl�
110300 TORRE AVENUE - CUPERTINO, CA 95014-3255
CUPERTINO (408) 777-3228 - FAX (408) 777-3333 - buildinq@cupertino.orq MISC
PLUMBING 1 IMFCHANU-M. I PTF('TRir'AT nANIQr1Urr AKM T111
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❑ OWNER ❑ OWNERBUILDERR ❑ OWNER AGENT 11CONTRACTOR A CONTRACTOR AGENT ❑ ARCHITECT 11ENGINEER 1:3DEVELOPER ❑ TENANT
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CONTRACTOR NAME ` bG 1 "
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LICENS TYPE
BUS. LIC #
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ARCHITECT/ENGINEERNAME
LICENSENUMBER
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COMPANY NAME
E-MAIL
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STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF A SFD .r DUPLEX ❑ MULTI -FAMILY
PROJECT INWE.DLAND ❑ YES
PROJECT IN ❑ YES
IS THE BLDG AN ❑ YES
BUILDING: ❑COMMERCIAL
URBAN INTERFACE AREA ONO
FLOODZONE 1431NO
EICHLERHOME?
DESCRIPTION OF WORK
TOTAL VALUATION.
By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf I have read this
application and the information I have provided 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 relatin building construction. I antic6ze representatives of Cupertino
to enter the above -identified property for inspection purposes.
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Signature of Applicant/Agent
Date:
SUPPLEMENTAL INFORMATION REQUIRED
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MEPMiscApp2011.doc revised 06/21/11
CUPERTINO
PURPOSE
SMOKE r CARBON MONOXIDE NOXIDE ALARMS
OWNER, OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT -- BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-32.55
(408) 777-3228 • FAX (408) 777-3333 • building(alcupertino.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 sh-tgle-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:
AREA —��
SMOKE ALARM
CO A ARM
Outside of each separate sleeping area in the immediate vicinity of the
bedroom(s)` (Smoke alarms shall not be located withvn 3 feet of bathroom door)
X
Signature.................................................................. Lic.# ......................................Date:..................
On 'eve welling unit including basements and habitable attics
X —
_
X I
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..
in existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do
not result inn the removal of wall and ceiling finishes or there is no accessby 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 Swing.
As owner of the above -referenced property, I hereby certify that the alarm(s) referenced above has/have been
installed inn accordance with the manufacturer's instructions and ii 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.
C_
Address: % J a e e f It e, A ay -s- e L4j h Q Permit No. r+'QI��
Specify Number of Aiarns: # Smoke Alarms: Lai 4 Carbon Monoxide Detectors: � 9�
l have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Age t'�S) Name:
7 (d N)- Yo se m
................. .............:.................................,........................ Date:
Si nature . ............ p
Contractor Name:
Signature.................................................................. Lic.# ......................................Date:..................
Smoke and CO fornr.doc revised 01/1012017
•
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 • building(@cupertino.org /
Owner Name !° " KuTs I'1 Permit N o. O! �/17
Address l/ q- steep le c i s c )—ev n e
1. Is your real property a registered historical site?
❑_p Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
�J 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.
LTJ No Go to Question -3.
3. Is water service permanently disconnected for your building?
El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
I+J+ 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..
ease check ONE of the following:
d 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-coinpliant 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 following page.
Owner or Owner Agent's Signature: �/p Date: �Lgq I
Upon completing and signing this Certificate, plea46 return it to the Building Division in order to final your building`permit.
SB4072015.doe revised 08126115
CK
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.
SB4072015.doc revised 08126/15
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
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/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB4072015.doc revised 08126/15