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B-2017-0288CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0288 22276 HARTMAN DR CUPERTINO, CA 95014-1020 (326 13 086) MIKE COUNSIL PLUMBING INC SAN JOSE, CA 95131 OWNER'S NAME: FROLICH ROSALYN A TRUSTEE DATE ISSUED: 02/21/2017 OWNER'S PHONE: 408-245-3243 PHONE NO: (408) 272-4900 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C36 Lic. #879261 Contractor MIKE COUNSIL PLUMBING INC Date 04/30/2017 X BLDG —ELECT X PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: REPLACE GAS LINE THROUGHOUT SFD FROM METER FOR ALL I hereby affirm under penalty of perjury one of the following two declarations: OUTLETS 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. z. 1 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: $15000.00 permit is issued. APPLICANT CERTIFICATION A 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 326 13 086 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. WITHIN 180 DAYS OF PE ANCE OR Additionally, the applicant understands and will comply with all non -point source regulation per the Cupe ino Municipal Code, Section 9.18. 180 DAYS FR CALLED ECTION. Signature . Date 02/21/2017 Issued by: MELISSA N�4R-BUILDER DECLARATION Date: 02/21/201 I hereby affirm that I am exempt from the Contractor's License Law for one of the REPROOF All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: 1. 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. I, as owner of the property, am exclusively contracting with licensed Signature of Applicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 02/21/2017 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 performance of the work for which this permit is issued. HAZARDOUS MATERIALS DISCLOSURE 2. I 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 maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the permit is issued. a. I certify that in the performance of the work for which this permit is issued, I Health & Safety Code, Section 25532(x) should I store or handle hazardous 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 exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Sections 25505, 25533, and 2553 Labor Code, I must forthwith comply with such provisions or this permit shall - be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 02/21/2017 CONSTRUCTION LE ING 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 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, 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 02/21/2017 Professional GENERAL PERMIT APPLICATION �MEP COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERT[NC3 (408) 777-3228 • FAX (408) 777-3333 • buildina(cDcupertino.ong m Ist; , T3- Z- 6 ? - PLUMBING NIECHANICAL. F�ELECTRICA.L 7MI5;CELLANE0i7C PROJECT ADDRESS�y AP -N' � OWNER NAME t o PHONE(465) ,5-3Z t I E-1`4AII STREET ADDRESSG j 5- `q FAX levl�s CITY, STATE_ C L �� Y�'i -A CONTACT NAME! I j ` PHOIBy Z ®r 3� Eq5-01q -MAIL STREET ADDRESS CITY, STATE, ZIP FAX ❑ OWNER ❑ OWNER-BL7LDER ❑ OW!\TRAGF.Nr. ❑ co=-ACTORCO\TRACTORAGLTT ❑ ARC=CT ❑ ENGL\TER ❑ DEVELOPER ❑ TEKA.NT CONTIRACTORM,LME , , ke. LICENSE NUMBER +1 LICENSE TIME ,s^ y f C✓ S BUS. LIC r COMPANY NAME f➢ ( �� E r 1 p���� FAX �� A",k C STREET ADDRESS . "� GJ CITY, STATE, ZIP G g 5 L I PHON 2 pY�C ! J �l i �, . ARCIUTECT/ENGWEER. NANIE LICENSE NUMBER BUS, LIC CONIPANY NAME E-MAIL FAX STREET ADDRESS I CITY, STATE, ZIP f PHONE USE OF FD or DUPLEX ❑ MULTI-F.ANCLY PROJECT IN A=LA2\,D- ❑ YES PROJECT IN ❑ YES _ IS THE BLDG AN ❑ 'YES BUILDING:❑M.BERCLAL _ I U7tBANIT'TFt2FACEAR'r,.A ❑. NO FLOODi;ONE ❑ NO .. I EICHLERHUME? El P7U DESCRIPTION OF -WORKq f� j�V V 2-1 �r TOTALVALUATIOh.'; [ O - By my signature below, I certify to each ofthe following: I am the property owner or autho Q t to a e property o a ve read this application and the information I have provided is correct. I have read the Description of Work and verify it is acclu _ licable local ordinances and state laws relatin.- to building construction. I authorize re resentatives of Cupertino to enter the above -identified property for inspection p Signature of Applicant/Agent: te: SUPPL'EMORMAT QUIRED o.FFicEtisE,orL_.,, r, ,;;,.,_, :,.. >.❑:.©LER THE-Cfli3ATER, :::, -:.• ._ �- TRESS T. h7EPA1flscgpp_2011.d0c remised 06/21/11 SMOKE / CARBON MONOXIDE ALARMS OWNERCERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 (408)777-3228 •FAX(408)777-3333•buildinq(a cupertino.orq >.:• h PERMIT CANNOT BMJ 1'I ALED T.a+THIS CERT33'ICAT r S BEE 1 - ,CO LETED,SIG D,AN])ET +D T O T $ LDING-DIVISION 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 X X bedroom(s)-(Smoke alarms shall not be located within 3 feet of bathroom door) 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 andthat 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 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 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 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 below. Address: 22-216 I ( *- -t a r-. &u?Q rf("1 Permit No. -g-Z-43 n'" Specify Number of Alarms: #Smoke Alarms: #Carbon Monoxide Detectors: 3 j I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: 1?-05a/L n 113•eG Signature .,(4, Date:0 'l17 Contractor Name: 41, d10 / Signature Lic.# Date: Zl2 q 4111111110 • Smoke and CO fonn.doc revised 01/10/2017 WATER-CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE r, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION . N 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPER (408)777-3228•FAX(408)777-3333•buildinca(a)cupertino.orq Owner Name es —OS t.„ crot tc- Permit No. _1-0 11 --o2-S� Address '7-1.1--/, !-I e( r 1-' n • "<. C...--t-41-1-r'1"B Kq 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 form. 64 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. lit 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. g.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 fonn. 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 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: ,9Date: 2—ZZy—il Upon completing and signing this Cei i.fl ,please r rn it to the Building Division in order to final your building permit. SB4072015.doc revised 08/26/15 BUILDING PERMIT CANNOT BE EINALED AND..COMPLETED..UNTIL TIIS ( RTIIi KATE HAS BEEN SIGNED'ANDJ2ETUI NED TO TIlL BUILDINGDIVISION g q>FF .M . : . • Non-Compliant Water-Conserving Plumbing Fixture Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch.4 2013 CPC Ch. 4 2013 CPC Ch.4 Water Usage 2013 CALGreen Div. 4.3 2013 CALGreen Div.4.3 2013 CALGreen Div. 5.3 /Flow Rafeate 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. SB407 2015.doc revised 08/26/15