B-2017-0232CITY OF CUPERTINO BUILDING PERMIT
BUILDINGADDRESS:
10167 DENISON AVE CUPERTINO, CA 95014-2426
CONTRACTOR:
PERMIT NOS B-2017-0232
(316 28 024)
A & H HEATING & AIR
CONDITIONING
SERVICE INC
SAN JOSE, CA 95110
OWNER'S NAME: DORAISWAMY SRIDHAR AND ARUGAKEERTHY CHITRA
DATE ISSUED: 02/08/2017
OWNER'S PHONE: 408-725-9725
PHONE NO: (408) 279-0722
LICENSED CONTRAC'TOR'S DECLARATION
BUILDING PERMIT INFO:
License Class S --M Lic. #304472
ContractorA & H HEATING & AIR CONDITIONIN0 INCDate
X BLDG —ELECT _PLUMB
X MECH X RESEDENTLAL _ COMMERCIAL
-ZERVICE
Q5/31/2017 I
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 DESCRIPTION:
license is in full force and effect.
REPLACE FURNACE (SAME LOCATION); INSTALL (N) AC UNIT
I hereby affirm under penalty of perjury one of the following two declarations:
WITH 220V;
1. I have and will maintain a certificate of consent to self -insure for Worker's
NOTE TO INSPECTOR - VERIFY ASBESTOS ON DUCTS OTHERWISE
Compensation, as provided for by Section 3700 of the Labor Code, for the
HERS TESTING REQUIRED
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
permit is issued.
Sq. Ft Floor Area: Valuation: $8500.00
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
316 28 024
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
PERMIT EXPIRES 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 FROM LAST CALLED INSPECTION.
source regulations per the Cupertino Municipal Code, Section 9.18.
Issued by: Abby Ayende:
�gnatur —�-7 r ate 2/8/2017
OWNER
Date: 02/08/2017
-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RE-RQOFS:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
following two reasons:
installed without first obtaining an inspection, I agree to remove all new materials for
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 Applicant:
2. I, as owner of the property, am exclusively contracting with licensed
Date: 2/8/2017
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
1. 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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials requirements under Chapter 6.95 of the
2, I have and will maintain Worker's Compensation Insurance, as provided for by
California Health & 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 compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
Health & Safety Code, Section 25532(a) should I store or handle hazardous
3. I certify that in the performance of the work for which this permit is issued, I
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
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
the Health & Safety Code, Sections 25505, 25533, and 25534.
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 �;Ow"
ner or authorized agent: _
be deemed revoked.
Date: 17
APPLICANT CERTIFICATION
CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city and county ordinances and state laws
of work's for which this 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 Address
judgments, costs, and expenses which may accrue against said 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 2/8/2017
Professional
T
GENERAL PERMIT APPLICA I ION
1',11 COMMUNITY DEVELOPMtENT DEPARTMENT, BUILDING DIVISION
10300 TORRE AVENUE - CUPERTINO, CA 95014-3255
C1 (408) 777-3228 - FAX (408) 777-3333 - buildingAguOerting.org
UPERTIN0
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each the following I am the property owner or authorized agent to act�on the property ovAer's bAalf. I have read this
By my sigmature below, I certify to ea
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and IS ate. I agree to comply with all applicable local
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application and the information I have pr0%12-dCd CqF4ect lhave read the Description of)W-k . y
-n�ifed property for inspection Purpol-
ordinances and state laws relatin.-to representatives of Cupertino to enter the above -i&
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Signature ofApp1icantJ-k-evLt:
STj-PPLEMENT,kL D,rFORMATION REQ IRED W,
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hIjEPM'iscApp_.2011.doc revised 06121112
CUPERTINO
"SMOKE / CARBON MONOXIDE ALARMS
OWNER, CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX {408) 777-3333 a buildina(d)cupertino.org
PURPOSE
'I11-iis affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarmus .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, 8315, 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 I
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)
v
On every level of a dwelling unit including basements and habitable attics
X
X
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.
Iii 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 «Thich 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 uistructions 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: 10 1 L'+ _DP_ Nr_.S0nl A -UE, CCfGP_ i r NO - g,!�b % Permit No. A2c1�- 023
Specify Number of Alarms: r Smoke Alarms: = # Carbon Monoxide Detectors: =
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owner A\gent's) Name:
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X2.214 Pro. ] )Q -�c�i
Si nature....................................°---.......................................................................Date: �
Contractor Name: '
�. __.. __
Signature.................................................................. Lic.# .................................... ,.Date:..............,.
S777oke and COf01-777.doc revised 0111012017
CUPERTINE3
Owner Naive S R"11
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE FILE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(@.cupertino.om
Permit No ^ 201-T - 0232—
Address fVT _S,0rJ A -if Ca___ P7i NO, CA -��p 14
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 fonn.
N"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?
WYes Civil Code Sections 1101.1 through 1101.8 do not apply.
WThe licensed plumber's certification has been provided to the Building Division.
Skip the rest of the form and sign bottom of form.
tl 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.
H 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 foam 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 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 connnercial 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 followine Daae. n (Z'�- r
Owner or Owner Agent's Signature: 1 °. t� ��-- Date: '
Upon completing and signing this Certiticate, please return it to the Building Division in orcler to nnai your ourramg permit.
SB407 2015. doc revised 08126115
BUILI
CERTIFI(
ER)
1. If the existing plumbing tixture eater usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015. doe remised 08126/15
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbing Fixturel
(Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usage/Flow Rate
Fixture Type
Water Usage
2013 CPC Ch. 4
2013 CPC Ch. 4
2013 CPC Ch. 4
(Flow Rafe
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 galfons/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 tixture eater usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015. doe remised 08126/15
m
0
CUPERTINO
Building Department
Lo FEB o 8 2017
REVIEWED FOR CODE COMPLIANCE
Reviewed By:
I'S
PARTIMLN-T
RTINO
PLOT PLANS PHEC , KE"Y
DATE
PLANNING n4p-i
CU" " j1n r n P Y- CUPERTINO
,U
"4i;q!nHAL L REMAIN ON
REVI EWT+ffic,t9011ATLAALILL TIMES DURING
Reviewed ByAbbyeMSTRUCT16N'
Date: 02/08/17
RECEIVED
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Ce 'Kept a,, the
cJon It Is u .1 to rr.ake any
to deviate
cnangaS Or
_jtjoils or sa:�
SHAI,-L NoT
Violation
be held to
anyC-1Ofdr.,,ce or State Law,
cf any
pvrs
By
ti
DATE
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2—
R;'IT#T #
PLOT PLANS PHEC , KE"Y
DATE
PLANNING n4p-i
CU" " j1n r n P Y- CUPERTINO
,U
"4i;q!nHAL L REMAIN ON
REVI EWT+ffic,t9011ATLAALILL TIMES DURING
Reviewed ByAbbyeMSTRUCT16N'
Date: 02/08/17
RECEIVED
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