The URL can be used to link to this page

B-2017-0343CITY OF CUPERTINO BUILDING PERMIT BUILDINGADDRESS: CONTRACTOR: PERMIT NO: B-2017-0343 20218 NORTHWEST SQ CUPERTINO, CA 95014-0546 (316 40 015) EKIM PAINTING - OWNER'S NAME: ORTEGA DANIEL OWNER'S PHONE: 408-930-8649 LICENSED CONTRACTOR'S DECLARATION License Class B: C-33 Lic. #623665 Contractor EKIM PAINTING - NORTH INC Date 07/31/2017 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. I hereby affirm under penalty of perjury one of the following two declarations: t. 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 permit is issued. I certify that I have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances 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 liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Date 3/1/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: t. I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec.7044, Business & Professions Code) 2. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). hereby affirm under penalty of perjury one of the following three 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. 2. 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. s. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. If, after making this certificate of 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 be deemed revoked. 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 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 liabilities, judgments, costs, and expenses which may accrue against said City in consequence of the granting of this permit. Additionally, the applicant understands and will comply with all non -point source regulations per the Cupertino Municipal Code, Section 9.18. Signature Date 3/1/2017 NORTH INC CUPERTINO, CA 95014 DATE ISSUED: 03/01/2017 PHONE NO: (408) 996-3897 BUILDING PERMIT INFO: X BLDG —ELECT _PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REPAIR BALCONY & REBUILD GUARDRAIL TO CODE Sq. Ft Floor Area: I Valuation: $8000.00 APN Number: Occupancy Type: 316 40 015 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Ayende Date: 03/01/2017 RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Applicant:, Date: 3[1/2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, e tions 25505, 25533, and 25534. Owner or authorized agent: Date: 3/1/2017 / CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 110300 TORRE AVENUE 1- CUPERTINO, CA 95014-3255, (408) 777-3228 - FAX (4081777-3333 - buildinq(a)-cupertino.oLg CuPERTINO [ - 3 Ej NEW CONSTRUCTION El ADDITION QALTERATION /T1 0 REVISION /DEFERRED ORIGrNALPLVT�t PROIECT ADDRESS 20218 Northwest Square, Cupertino, CA APN # (31 0-1� OWNERINAME Dan Ortega I PHONE (408) 930-8649 E-MAIL dan.ortega@comcast.net STREET ADDRESS same CITY, STATE, ZIP Cupertino, CA 95014 FAX CONTACT NAME Butch Brisbin PHONE (408) 996-3897 E-MAIL ekiTnconstruction@gmail.com STPEETADDRESS 10200 Imperial Ave CITY, STATE, ZIP Cupertino, CA 95014 FAR (408) 996-3897 n OWNER 13 OWNER -BUILDER El OWNERAGENT CONTRACTOR 13 CONTRACTOR AGENT 0 ARCHfTECT 0 ENGINEER .13 DEVELOPER Q TENANT .CONTRACTOR NAME Ekim Painting - North, Inc L . ICENSENUMBER. 623665 7CENSETYPE C33 B BUS. Lie , # 6197 CO1%IPANYNAME Ekim Painting - North, Inc E-MAIL ekiinconstruction@g'mail.com FAX (408) 253-9527 STREET ADDRESS 10200 Imperial Ave trrysTATEzip Cupertino, CA 95014 PHONE (408) 996-3897 ARCHIfECTIENGINEER NAME LICENSE NUMBER BUS. Lie # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK Like for like exterior construction dry rot repairs and re -build of existing balcony; to include bringing existing balcony rail and any/all materials up to current building codes. EXISTING USE PROPOSED USE CONSTR- TYPE #STORIES 2 USE TYPE OCC. SQ.FT. VALUATIONS) residence same EXISTG NEW FLOOR DEW TOTAL AREA AREA n/a AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA H AREA GARAGE AREA., DETACH I [ # DWELLING UNIT& ISA SECOND UNIT EIYES SECONDSTORY []YES BEFNGADDED?, , ®.NO ADDITION? [ONO PRE -APPLICATION [3YES IF YES, PROVIDE COPY OF ISTHE BLDG AN 0 YES DBY- kTION; PLANNINGAPPL# [3NO PLANNING APPROVAL LETTER FICHLERHOME? Ea N�O Ej QA XWO .on1tho property owner's Is By my Signature below, I certify to each of the following: I am theprqpqrty owner or authorized agentko act behalf. IhaVereadrtbi - , y iI a to with all applicable local application and the infohnatiOulhav- r-ovidediscorrect. Jhave read the PescriPtiQri of Work and verify it s accurate: agree 0 mPly ' ordinanbes and -State laws gelatin . bu Iding const remitatives of Cupertino to enter the ahove4deatified property for inspection purposes. Signature ofApplicantfAgeitt: Date: ,9-1-17 SUPPLEMEINFORMATION REQUIRED PLANCHECKTYPE kOUTWGSLTP' 0 OVER-THE'COUNTER' --BUILDING PLAN REVIEW - New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance, of building ' Y *A permit for new building. El EXPRESS PLANNIN6IPLAPI - 9 Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 1:1 STANDAIRD PUBLIC11YORKS form if any Hazardous Materials ate being used as part of this project. 0 LARGE FIRE DEPT Copy of Planning Approval Letter or Meeting with Planning prior to0 MAJOR D SF&NITARYSENVEjiDISTRICT submittal of Building Permit application. El FNVTRONMENTAL HEALTH BldgApp__2011.docrevised O6l2ll.]I SMOKE i CARBON MONOXIDE ALARMS B---d-ef7-03 O NER CERT[FICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION L t 10300 TORRE AVENUE •CUPERTINO, CA 95014-3255 CUPERTINO 10: W 7 el (408)777-3228 •FAX(408)777-3333•buildinci cupertino.orq PERMITCANNO .'BE> 1NALE D ITINTTI I,THIS CERTIFICATE.BIAS BEEN tOlO tgTED A1i I):,ill\ , ET I T.L'SJ. O-T OW SJWiTO SIO 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 $1000 00, CRC Section R314,R315, and CBC Sections 907.2.11.5 and 420 6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installed.in the following locations. T AREA SMOKE ALARM j CO ALARM Outside of each separate sleeping area in the immediate vicinity of the I X X bedroom(s)-(Smoke alarms shall not be located within 3 feet of bathroom door) On every level of a dwelling unit including basements and habitable attics X X I L"Within each sleeping room ,X Carbon Monoxide alarms are not required in dwellings which do not contain fuel-burning appliances and that do not have an attached garage. Carbon monoxide alarms combined with smoke alarms shall comply with CBC Section 420.6 and shall be approved by the Office of the State Fire Marshal. Power Supply In dwelling units with no commercial power supply, alarm(s)may be solely battery operated. In existing dwelling units, alarms are permitted to be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic,basement or crawl space.Refer to CRC Section R314 and CBC Sections 907.2.11.4 and 420 6.2.An electrical permit is required for alarms which must be connected to the building wiring As owner of the above-referenced property,I hereby certify that the alarm(s) referenced above has/have been installed in accordance with the manufacturer's instructions and in compliance with the California Building , and California Residential Codes.The alarms specified below have been tested and are operational, as of the date signed below �+' Address 2 0 21$ IQ0t:114W 6,r Same- (.,{et,401 )0, C 150 11Permit No Specify Number of Alarms 4 Smoke Alarms I 3 #Carbon Monoxide Detectors 73-1 I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: / VA-1J 16L- Otr�t c k Signature . `f �� Date:1 bb3/2bti Contractor Name: Signature Lic.# Date: Smoke and COform.doc revised 01/10/2017 i WATER-CONSERVING PLUMBING FIXTURES (7 (.),,i, -'- v.- OWNER CERTIFICATE OF COMPLIANCE .... COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION _i 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 /0-17-17 Qj CUPERTINO (408)777-3228•FAX(408)777-3333• buildinq(a�cupertino.orq Owner Name DAA lL 0(2_,-M.‘A Permit No. Address 1(22-Vg' f2Q„iii'IIJ 4, 6?.UAA - S CP -P,T1Nv) CA 615014 0544 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. 1E/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. V No Go to Question 3. 3. Is water service permanently disconnected for your building? O Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 'u'No Go to Question 4. 4.' Is your real property built and available for use or occupancy on or before January 1, 1994? 0 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. Cj 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. Pl,ea se check ONE of the following: My property is a single-family residential real property. See.Civil Code Section 1101.4. 1 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 i 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. j� Owner or Owner Agent's Signature: Lv�� Date: i&113 12441 Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. SB407 2015.doc revised 08/26/15