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B-2016-1811
CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: ; PERMIT NO: B-2016-1811 10270 NPORTAL AVE CUPERTINO, CA 95014-2361 (316 29 001) ROYAL POOLS OF,, SANTACLARA 1 SAN JOSE, CA 95124 OWNERISNAME: OLIVER JEFFREY LAND DENISE A DATE ISSUED: 04/21/2016 OWNER'S PHONE- 408-569-2669 PHONE NO: (408) 371 -8000 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-53 Lie. #2ZO4 t2. Contractor RQYAL— POQLS OF SANTA CLARA Date 12131/2016 X BLDG XELEICT PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing NECH X RESIDENTIAL _, COMMERCIAL I with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect, JOB DESCRIPTION: CONSTRUCT (N� TN -GROUND SWIMMING POOL AND SPA; NEW I hereby affirm under penalty of perjury one of the following two declarations: 200 AMP PANELi 1. 1 have and will maintain a certificate of consent to self-insuro 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 fet which this Sq. FtFloorArea: Valuation-. $48000.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN Number: j Occupancy Type: Information is correct. I agree to comply with all city and county ordinances 316 29 001 and state laws relating to building construction, and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against I bililles, judgments, costs, and expenses which PERMIT EXPIRES IF WORK IS NOT STARTED may accrue against sai Ci In consequence of the granting of this permit. WITIIIN 190 DAYS OF PERMIT ISSUANCE OR Additionally, the applf rri 11dersta an HI com with all non -point I 'pal Section 9.18. I 180 DAYS FROM LAST CALLED INSPECTION. source regulations p r t supe o - C , Signature Date Issued by. Phuong Devx1es Date: eit Aj#Al ON. I hereby affirm that I am exempt from the Contractor's License Law far ono of the BE All roofs shall beinspected prior to any roofing material being installed. If a roof is following two reasons. installed without firs" obtaining an inspection, I agree to remove all new materials for 1. 1, as owner of the property, or my employees with wages as their s ole inspection. compensation, will do the work, and the structure is not intended or offered for sale (Sco.7044, Business & Professions Code) 2. 1, as owner of the property, am exclusively contracting with licensed Signature ofApplicai t: contractors to construct the project (Soc.7044, Business & Professions Code). Date,. I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERING$ TO BE CLASS "All OR BETTER i. I have and will maintain a Certificate of Consent to setf-insure for Worker's Compensation, as provided for by Section 3700 of the Labor Code, for the DISCLOSURE ATTERLAL4DISCLOSUP1E performance of the work for which this permit is issued. 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, 1 will with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. maintain compliance Health & Safety Code, Section 25532(a) should I store or handle hazardous I I certify that in the performance of the work for which this permit is issued, I material. Additionally, should I use equipment ces which emit hazardous shall not employ any person in any manner so as to become subject to the air contaminants as, defined by the Day Aroal Qu iy Management District I Worker's Compensation laws of California, If, after making this certificate Of will maintain compliance with the. cupertin Mun teat Co , 9apter 9.1 d exemption, I become subject to the Worker's Compensation provisions of the the Realf & Safety Code, Seeti s 2. 5, 2553 "TTS634. Labor Code, I must forthwith comply with such provisions or this permit shall be doomed revoked. owner or noldhor d agent: ,APPLICANTCERMC I certify that I have read this application and state that the above information Is Date: C ON LEN GA Iherebyaffir that there Is a cg6struction lending agency rthaperformance correct. I agree to comply with all elty and county ordinances and state laws of work's for Whichis permit Is Issued (Sec. 3097, CIV C,) 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 judgments, costs, and expenses which may accrue against sold City In -------- consequence of the granting of this permit. Additionally, the applicant understands ARCHITECT'S DECLARATION and will comply with all non -point source regulations per the Cupertino Municipal I understand my plans shall be used as public, records, Code, Section 9.18. Licensed Signature Date Professional, SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • build! nq(a)cupertino.ora SP a � 2/�[A _ c.711 SivhnPoo7App_2011.doc revised 03116111 b" I PROJECT ADDRESS �j APNIi OWNERNAME PH y �2� ! �t� E-MAIL STREET ADDRESS S a7 •�� %` j CITY, STATE, p 9 le) Cvf G -C Lei ��&1 ' FAX i - !A�✓6? . %^/ i IV G I . CONTACT NAMEh rvrZC 6�%�� PHON g _MA�1& apL� c STREETADDRESS CITY, STATE, ZIP �+ a� _C. FAX ® OWNER ❑ OWNFR-BUILDER ❑ OWNBRAGENT CONTRACTOR ❑ CONTRACTOR AGENT © 1RCI•nTECT "❑ ENGRQFFP. ❑ IDEVELOPER ❑ TENANT CONTRACTOR NAMEL Ca �„ LICENSE NUMBER � LIdENSE TYPE ;? S� BUS. LIC q COMPANY NAME E-MAIL FAX STREETADDRESS %% .S : �a•Gi AL141 CITY, STATE, LIP - Off 6� PHONE ARCHITECUENGINEER NAME LICENSE NUMBER IMUS. LIC tl COMPANYNAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP I PHONE ' DESCRIPTION OF WORK n a i I j USE; or, SFD or Duplex ❑ Multi-Faulily TYPE MATERIAL TYPE (CODE) AREA (SQ. FT.) VALUATION (S) S'I'RUCI'URE: ❑ 6011illlerCial POOL J �- " T POOLISPA MATERIAL TYPES CODES: SPA V - VINYL -LINED F - FIBERGLASS DEMO G - GUNITE " P - PREFABRICATED KECEiVE BY: _ -' ` TOTAL 'PION: By my signature below, I certify to each oft a folio mg: I am`th , rape lel or all I rized agent to act on the property owner's behalf. I have read this application and the information I have pro v ded is orreeL I havteed• a escript p ark and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to buil " tg struetion. 1, i h0. . resents' .a of Cupertino to enter the above-ident 'Vied properfor inspection purposes. Signature of Applicant/Agent: .� a �- Date: SUPPLEIv1FNT INFORMAYbN R15QbTRWI al'FI F_[JSE,ONLY . PLAN CIIECKTYPE - ROUTING SLIP' Commercial or Multi -Family Buildings Widl Public Swimming Pools: Department ":; "'+".. ©OV I "�-_•.: . lE1 Of Environmental Health approval required. RTIIE C}UNTF.R . __;�;, BiJILDINGDEPT ❑ EXPRESS':...: '❑."PLANNLI'GDEPT .. - .." A STAND:IRD .' ❑" PUBLICIYORKS DEPT.:::::'.::.:.;:'. •.;". ❑ :LARGE.;;``. ❑ `IENVIROVNICN'TAL RFALTH '`. IVL4JOR ❑.r -&S NUARYSEWFRD.IT: T SivhnPoo7App_2011.doc revised 03116111 b" r"V, PERTI.."10 PURPOSE CO"MMMUNITY'DE,,VELrOP,MEN'T�D,EP,A,R,TtMENT- BUILDING 10300 TORRE AVENUE 4 CUPERTINO, CA 95044-3255 (408) 777-3228 - FAX'(408) 777-3383 *!bujt1d1ryqfq)rcupedino,.( 11iis affidavit is a self -certification for the installation of all required Smoke anh Carbon Monoxide Alarms for compliance with 2013 CRC. Section R814,21013 CBC Sections 420.6 and 907.2.11]-2 where no interior access for inspections are required. G -M' MAL INVORMATION P - , ti-.� - � " - I. f --d mu dwellings shall be provided with. Sm 66 Alarms and Carbon -ge� amily an Iti-family dwe �X �m sm Moi ,oxide alafms. When the valuation of additions, alterations, or repairs to e-�Sclating dw ellirig units exceeds $1,000.90, CIBC Section R314 and CBC Sections 907.2.11.5 and 420.6 require thaIl Smoke Alarms and/or Car*6,on. Mbn,oxide Alarms be installed in the following locations: ARRA S, MW 01k, E At ARM C01 AtAkM Outside of each, separate sleeping. area in the immediate vicinity of the X 7- X Mi Oh eY(4,y level el of a d1welliq&-unit ftwludiilgjs serft- e nds WidNin, eactit, sleep �,00ift, X, Carbon Miortvxide alllarmms- are not required in dwelfirig-s- which do riot contain4uel-bu. m�ing appal ia, nces and that do�rLqffna,ve,mattac,lriedg-ar,a,g,e. Carbvn, Monoxide alarms, conibined with, smokeI alarms sTrila,11 cam -ply with C"OC Section, 470.6 and, shall be approved by the Office of the State Fire Marahhki. Power Snpplyw Ink, welling un is with na commercial power supply, alarm(s) inay- be solely beffnewy operated. In ex&,&,wg, dwe'0&ng, mriiftg, alarms air, e permi, iitted, to be solely battery oper, akfed #here repairs, or ailltteratlows, not res-aR In the: removal, of wal' aind ceik-, tg, finishes or there is into access by n� I ea ns, o)f antic, Nage-ment or crawl space.. Refer to, CRC SediloiLi R3341 wrtd CBC Sectiorts, 9OV.2-1 11.4 and 420.62. An,elecbd eal per mu; t is-, reqginedl for alarms, which m.. ust, be eoLmt,,ectedl to, thebull.di ng wirkil- cr, I As. owner of the above -referenced property, I hereby certify that the, aliarrnm(s) installed' in, accordance with the mmanuf actur er's instm ctiorls, aft2d i na eumpfian and- Cafi-ifon,,da, R--esiderttial Codes. The: alarms: is, have been test -ed, airtd are opera b;elow., w1th., the. above has//have beezt w "t y Th- the Caldiur CF7 mall,, as, of, tike- dilate signed thin s tote, mi -,an; ti.� ..................... ....... WATER -CONSERVING PLUMBING ;FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPS TINO I 10300]TTORRE AVENUE • CUPERTINO, CA 95014-3255 Jane i i7ff28) 777-3333 • buildinaCa cupe F 1. Is your real property a registered historical site? I ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest ¢f the form and sign bottom of form. LJ No Go to Question 2. Ili 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. E`i N -No Go to Question 3. 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. 4. Is your real property built and available for use or occupancy on or before January 11, 1994? ❑ No My real property is built and available for use or occupancy after Januar 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. t J�-Yes My real property is built and available for use or occupancy on or beforJanuary 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Check one of the thfee following statements and sign bottom of form.. " I, 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 requi e 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). I ❑' My property is a multifamily residential real property. See Civil Code Section 11101.5. On and after January 1, 2014, specified building alterations or irnprovernents 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 realproperty. 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 4 replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property underlgoes alterations or improvements). I, as the owner or owner's agent of this property, certify under penalty of penury 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 Buildii ig Standards Code, and manufacturer's installation requirements, and that the water -conserving plumbing fixtures comply ith the requirements as indicated in the table on the following naize. �Z/ I f" / Owner or Owner Agent's S Upon completing and signing this Certificate, please return i'f4o the Building Division in order to final your building permit. SB4072015.doe revised 08/26/15