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B-2016-0340CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0340 10993 NORTHSKY SQ CUPERTINO, CA 95014-0540 (316 40 004) EKIM PAINTING - NORTH INC CUPERTINO, CA 95014 OWNER'S NAME: LOPES JOAN D DATE ISSUED: 03/01/2017 OWNER'S PHONE: 408-996-3897 PHONE NO: (408) 996-3897 LICENSED CONTRACTOR'S R TION BUILDING PERMIT INFO: License Class a Lic. #623665 Contractor EKIM PAINTING - NORTH INC Date 07/31/2017 X BLDG —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: BALCONY REPAIR AND REBUILD GUARD RAIL TO CODE 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. z. I have and will maintain Worker's Compensation Insurance, as provided for by Section 3700 of the Labor Code, for the performance of the wor for which this Sq. Ft Floor Area: Valuation: $2000.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 316 40 004 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 PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non-point source regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. �. _-- Signature Date 03/01/2017 Issued by: Kim Dunbar OWNER-BUIY DER DECLARATION Date: 03/01/2017 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 _ 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 maf&ials for compensation, will do the work, and the structure is not intended or offered for inspection. sale (Scc.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: 03/01/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS.TO BE CLASS "A" OR BETTER 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. HAZARDOUS MATERIALS DISCLOSURE z. 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 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 eta s 2550 , 25533, and 25534. ' Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 03/01/2017 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the phrformance 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, 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 R TION and will comply with all non-point source regulations per the Cupertino Municipal DECL ARCHITECT'S be used I understand my plans shall be used as public records. Code, Section 9.18. Licensed Signature Date 03/01/2017 Professional CUPERTIN"O [ 0 NEW CONSTRUCTION CONSTRUCTION" PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildin-gcDcupertino.org Q: ADDITION ❑ ALTERATION/TI El REVISION/DEFERRED oPjoiNALPERMIT# PROJECT ADDRESS 10993 Northsky Square, Cupertino, CA APN # 3 j(pL@00 OwNERNAME c/o Wauhab Realty PHONE(L I0 ( ,,?Bq,'I E=MAIL pinkie@wauhab.com STREET ADDRESS 4024 Bay Street CITY, STATE, ZIPll// Fremont, CA 94538 FAX" CONTACT NAME Butch Brisbin PHONE (408) 996-3897 E-MAIL ekimconstruction@gmail.com STREET ADDRESS 10200 Imperial Ave CCtY.STATE, ZIP Cupertino, CA 95014 FAX (408) 996-3897 ❑ OWNER 13 OWNER -BUILDER I2 OWNER AGENT CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Ekim Painting - North, Inc LICENSENUMBER 623665 LICENSE TYPE C33 B BUS. L1" 6197 CONIPANYNAME E-MAIL FAVI Ekim Painting -North, Inc ekimconstruction@gmail.com (408 ) 253-9527 STREET ADDRESSlO2OO Imperial Ave CrrY,STATE,ZIP Cupertino, CA 95014 PHO\E (408) 996-3897 ARCHITECTlENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E b1ATL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK Like for like exterior construction repairs; to include balcony repairs and rebuild of balcony rail to bring railing up to current building codes. EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES" residence same 2 USE TYPE OCc SQ.FT." VALUATION (S) EXISTG NEW FLOOR DEMO i TOTAL AREA AREA n/a AREA NET AREA - BATHROOYI KITCHEN 'OTHER REMODELAREA REMODEL AREA RENIODELAREA 'PORCH AREA "DECK AREA '_" TOTALDECKIPORCHAREA :GARAGE AREA: ATTACH ❑ ATTACH" #DWELLING UNITS: ISASECOND UVIT L] YES SECOND STORY :OYES" " BEING ADDED? NO ; ADDITION' ®NO - PRE -APPLICATION [IYES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YES RETE D BY: TOW VALUATION: PLANNING APPL# []NO PLANNING "APPROVAL LETTER ; EICHLER HOME? - ONOi Cku By my signature below, I certify to each of the following: I" am the property owner or authorized agent to act on the �roperty owner's behalf 'E 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 nomply witli all applicable'local ordinances and`state laws relating to nI ing construct ia, "author a i! preseritatiues of Cupertino to enter the above=identifi%ed pr/operty for inspection purposes. Mgnature_ofApplicant/Agent: s Date: 'SUPPLEMFINTAYINFORMATIGNN REQUIRED PLAN CFIECKTvpE . IiouTlNcsLr._ , New SFD or Multifamily dwellings: Apply for demolition pem-dt for ❑ ovER rFi Cou vTER " ❑ "suu DIVG PLAN REVIEW ' ex_isting building(s). Demolition permit is required prior to is of building pen -nit for new building... ❑ EXPRESS: Q OANNi\GPLANREVIEW _ Commercial Bldgs: Provide a completed. Hazardous Materials. Disclosure ❑ STANDARD - ❑`--PUBLiCWORIts: - - form if any Hazardous Materials ,are. tieing used as part of this project. ❑LARGEFi>ii ,DEPT .. Copy of Planning. Approval Letter or Meeting with Planning prior to MAJOR Q savtTnRY sEwEiIDISTRICT submittal.Gf Building Permit application: ❑ ENVIRONMENTAL HEALTH Btdg"App 2011Aoc revised 06121111 Address EESMOKE 1 CARBON MONOXIDE ALARMS F LE OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 7 CUPERTINO 10300 TORRE AVENUE • CUPERTINO. CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinatMcunertinn ora PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section 8314, 2013 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 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) X X Can every level of a dwelling unit including basements X X Within each sleTing 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 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 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 have been tested and are operational, as of the date signed below. 1 have read and agree to comDfv with the terms and conditions of this statement Own2!rSpr OwnerAgent's) Name: -ame— f^F1 G/ 5 Signature........ . Date:. / ..t ... Contractor Name: Sinature..........-•------------------•--.................................. Uc.#...................................... Date:.................,. Smoke and COform.doc revised 03118114 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO10300TORREAVENUE -CUPERTINO,CA95014-3255 (4Q8) 777-3228 - FAX (408) 777-3333 - buildinakEDcuoertino org e, .. Owner- Name '\�l�?eZ ��©�3,0 Permit No.b0"1,p C Address 1. Is your real property a registered historical site? El 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 2. 2. Does your real property have a licensed plumber certif rdng 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. �R,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. Vf 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 an. 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.. S. 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, 20I7, all non- compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). D 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 11015. 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 i nprovements). 1, 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 110 1.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the «N ter -conserving plumbing fixtures comply with the requirements as indicated in the table on the following page. ,I „ I , Owner or Owner Agent's Signature: Date.r/f8 �,z 1 Upon completing and signing th Ccrtificate, please returrr it to the Building Division in order to final your building permit. SB407 2015.doc revised 08/26115