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B-2017-0219
CITY OF CUPERTINO BUILDING P ! RMIT BUKDINGADDRESS: CONTRACTOR: PERMIT NO: B-2017-0219 7938 CRANBERRY CIR CUPERTINO, CA 95014-4923 (362 03 015) A R S AMERICAN RESIDENTIAL SERVICES OF j CALIFORNIA INC MEMPHIS, TN 381'd 11 OWNER'S NAME: YOSHINAKA KIYOSHI AND JOAN S ( i DATE ISSUED: 02/07/2017 OWNER'S PHONE: 408-910-7369 PHONE NO: (901) 271-9700 LICENSED CONTRACTOR'S DECLARATION BUILDING PE I !i T INFO: License Class C-36 Lic. #765155 ContractorA R S AMERICAN RESIDENTIAL SERVICES OF CALIFORNIA INC X BLDG _ ELEC.T _ MECH X RES! X PLUMB �ENTIAL _ COMMERCIAL Date 07/31/2018 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 JOB DESCRIPTT N: license is in full force and effect. INSTALL 2WAY C !'LN OUT - BUILDING 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. 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 Sq. Ft Floor Area: Valuation: $2800.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: r Occupancy Type: information is correct. I agree to comply with all city and county ordinances 362 03 015 and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for j inspection purposes. (We) agree to save indemnify and keep harmless the PERMIT VPIRES IF WORK IS NOT STARTED City of Cupertino against liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. WITHIN 180" DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non-point 180 DAYS OM LAST CALLED INSPECTION. source regulations per the Cupertino Municipal Code, Section 9.18. F i Issued by: Kim Duhbar Signature Date 02/07/2017 Date: 02/07/2017' OWNER-BUILDER DECLARATION RE-ROOFS: I hereby affirm that I am exempt from the Contractor's License Law for one of the All roofs shall be its installed without first "�ectcd prior to any roofing material being installed. If a roof is obtaining an inspection, I agree to remove all new materials for following two reasons: 1. I, as owner of the property, or my employees with wages as their sole inspection. compensation, will do the work, and the structure is not intended or offered for ! sale (Sec.7044, Business & Professions Code) Signature of Applican :1 2. I, as owner of the property, am exclusively contracting with licensed Date: 02/07/2017 contractors to construct the project (Sec.7044, Business &Professions Code). I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOT COVERINGS TO BE CLASS "A" OR BETTER 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 WZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the ha !ardous materials requirements under Chapter 6.95 of the 2. 1 have and will maintain Worker's Compensation Insurance, as provided for by California Healti I& Safety Code, Sections 25505, 25533, and 25534. I will Section 3700 of the Labor Code, for the performance of the work for which this maintain compliagc (with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. Health & Safety, de, Section 25532(a) should I store or handle hazardous s. I certify that in the performance of the work for which this permit is issued, I material. Addition y, should I use equipment or devices which emit hazardous Bay Area Air Management District I shall not employ any person in any manner so as to become subject to the air contaminants , will maintain comp defined the Quality ance with the Cupertino Municipal Code, Chapter 9.12 and Worker's Compensation laws of California. If, after making this certificate of the Health Safety Code, Sections 25505, 25533, and 25534. exemption, I become subject to the Worker's Compensation provisions of the t Labor Code, I must forthwith comply with such provisions or this permit shall, Owner or authoriz II agent: be deemed revoked. Date: 02/07/2017 l APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is I hereby affirm that 111 of work's for which t ere is a construction lending agency for the performance is permit is issued (Sec. 3097, Civ C.) 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 Lender's Name to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against liabilities, Lender's Address p judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands I understand my pla U ARCHITECT'S DECLARATION is shall be used as public records. and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. ',; Licensed CUPERTINO GENERAL PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildina(@cuperth LUNIBING ❑]MECHANICAL ❑ELECTRICAL mist; a21C7 ❑ MISCELLANEOUS PROTECT ADDRESS I AP?�r 7 A, � 3 05r � A �YU C � MAINERNANM �.r C�/► PHONE11C� �Q -g , r / (� �1p- l E -M -AIL STREET ADDRESS 0 FAX CIT, STATE, ZIP93-Cm„� 6irg5-6 ®pQIIII CONTACT NAME r- PHONEE-MAIL rQ STREETADDRESSCITY, 93d� G�rn STATE, ZIP i l ? �. a �'� 3 FAX ❑ owNER ❑ OWNER-BLiIIDER ❑ OWNERAGENT ❑ CONTRACTOR ❑ CONTRACTORAGENT ❑ _ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CON' RACTORNAI\ffi LICENSECENSE TYPE BUS. LIC . r COMPANY NAME �Ej, tI koR q f E-MAIL FAX STREET ADDRESS ,(r- q.�^ CITY, STATE, ZIP `� ARCHITECT/ENGIJ,TEER. NAME I LICENTSE NUMBER BUS. LIC COMPANY NAME _ E-MAIL. I ill III FAX STREET ADDRESS CITY, STATE, ZIP I I' PHONE LL� USE OF aFD or DLTPLEX ❑ MULTI-F.4-30LY I PROTECT IN WILDI-AND ❑ YES PROTEC �N ❑ YES BUII-DLN0:❑COA9\4ERrLAL I URBAN INTERFACE ARA DNO FLOOD iQNE ❑ NO .. IS THE BLDG ANT ❑ YES EICHLERHOME? El NU DESCRIPTION OF WORK �/ _ J t/ � -- , Y O - - II u V �I II I IIID TOTAL VALUATION. By any signature below, I certify to each of the following: I am the property owner or authorized agent to a;! on the property owner's behalf. I have read this application and the infornation I have provided is correct. I have read the Description of Work and verify it, �s accurate. I agree to comply with all applicable local ordinances and state laws;ra..t�ing to buction. I au rize re resentatives of Cupertino to entae above -identified property for inspection purposes. Signature ofApplicant/Aff Dat :I L SUPPLEMENTAL INTF0RM4 T D II I OFFICE USE ONLY.,, {� O1 ER TFIE COLIi\TEI2 U - ❑- STAi�DARD ' 11 A1EPR1fisc,4pp_2011.doc revised 06121111 11 II ' CUPERTINO SMOKE / CARBON MONOXIDE ALARMS OWNER, CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (40 8) 777-3223 • FAX (40 8) 777-3333 • bui[ding (a.cupertino.orq PURPOSE 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 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 ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) - (Smoke alarms shall not be located within 3 feet of bathroom door) X X On every level of a dwelling unit including basements and habitable attics _ X X Within each sleeping room I X —i - 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 ivith 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 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 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 «Tiring. 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. Address: 7"!5? (_'Mn 1Y\J C Permit No. 15 oROI-7.- Qa)'2k Specify Number of Alarms: # Smoke Alarms: - # Carbon Monoxide Detectors: I have read and agree to comply, with the terms and c9nditiony of this statement Owner (or Owner Agent's) Name: �,o " 1 7 .. Si nature .. ....... .... .... ...........f ........................................ Date:.................. Con actor Name: `TTiV �.'(.... Signature..,-,'� ... .... .............`Lic.#...................................... Date:...`....... [y0 Smoke and COfo7-777.doe revised 0111012017 CVPERTINO Owner Name Address WATFR.-CO,KSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408)�7 -32E8, • FAX 408) 777-3333 • buildinala.cupertino.ora 11 ---_ 1 ( Permit No. `-O(U r ©x19- 1. Is yo realproperty a registered historical site? s Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. F1 '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. No Go to Question 3. 3. Is water service permanently disconnected for your building? V❑ es 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. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ N My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.7 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 fonn.. 5. Ple e check ONE of the following: My property is a single fancily 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 ncultifanidy 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-conseiving 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 concncercial real properly. 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 Plumb' g Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the wat -conserving plu rtures comply with the requirements as indicatedin the table on the followiniz page. � sf �/ f Owner or Owner Agent's Signature: // 4J 4�4 v a 4-� Date: f Upon completing and signing this ifi ate, please retuyXto the Building Division in order to final your buildin permit. SB4072015.doc revised 08126/15 BUILDING PER112IT CANNOT B,E FINALEI3 AND COMPLETED, UNTIL THIS CERTIIH IC TE Hr S BEEN A1�D I T�7RIVED Tfl THE BiJILDiNG:' '; CVISIt31�T .M 1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shoe/, it is not required to be upgraded. SB407 2015. doc rerised 08126115 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 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 shoe/, it is not required to be upgraded. SB407 2015. doc rerised 08126115