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B-2017-0335
CITY OF CUPERTINO BUILDING PERMIT • BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0335 23500 CRISTO REY DR UNIT 317D CUPERTINO,CA 95014-6528(342 53 096) BAY AREA ENTERPRISE SAN JOSE,CA 95148 • OWNER'S NAME: BRAUNGER BETTIE B TRUSTEE DATE ISSUED:03/02/2017 OWNER'S PHONE:650-537-1523 PHONE NO:(408)238-5043 LICENSED CONTRACTOR'S DECI ARATION BUILDING PERMIT INFO: License Class i3 Lic.#817817 Contractor BAY AREA ENTERPRISE Date 03/31/2017 X BLDG X ELECT _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: • UNIT 317D-INSTALL(N)RECESSED LIGHTS(6)AND(N)CEILING I hereby affirm under penalty of perjury one of the following two declarations: TRACK LIGHTS(2);(N)LIGHT SWITCHES(2) 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. 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:$1895.00 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: andstate laws relating to building construction,and hereby authorize 342 53 096 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 appli•=nt understands and will comply with all non-point source regulation ler the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. 'Signa'.re Date 3/2/2017 Issued by:Abby Ayende Date:03/02/2017 OWNER-BUILDER DECLARATION 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 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: /23 /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 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 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 shall not employ any person in any manner so as to become subject to the material. Additionally,should I use equipment or devices which emit hazardous 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 Cuper'no Municipal Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Cod tions 255 ,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall { be deemed revoked. 'Owner or authorized age . APPLICANT CERTIFICATION Date:3/2/2017 I certify that I have read this application and state that the above information is CONST R CTION LENDING AGENCY correct.I agree to comply with all city and county ordinances and state laws I hereby affirm that there is a construction lending agency for the performance relating to building construction,and hereby authorize representatives of this city of work's for which this permit is issued(Sec.3097,Civ C.) 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 and will comply with all non-point source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Code,Section 9.18. I understand my plans shall be used as public records. Licensed Signature Date 3/2/2017 Professional �� `_-_7::/:.1.„ CONSTRUCTL N aERW lT AP UCAT1Oh-- COMMUNITY DEVELOPMENT DEPARTMENT e BUILDING DIVISION ! q , 1 ~i 10300 TORRE AVENUE o CUPERTINO,CA 95014-3255 (408)777-3228 a FAX(408)777-3333 e buildine(dcunertino_oro CUPERTINO , ❑NEW CONSTRUCTION ❑ ADDITION kr.: TERATION/TI 0 REVISION/DEFERRED ORIGINAL PERMIT it PROJECT ADDRESS -, 23 00 0r,`5TO P&a17D 312-53...... b41a OWNER NAME r PHONE E-MAIL 5%4.rahY•te.yot 3r°u-n e r B-Q II-(e OE) GP 5D-537- 17-2-3 F•itr{horndFL413b R.SC •C0sn STREET ADDRESS' CITY,STATE Zip• . u FAX 5 b 23a Cvl` � yJ l2 (�et(-- 1/1"6 /Cq- glam`/ ! $$ CONTACT NAMEPHONE E-M1 �>t•e c3 Fe ; St 08 -a3 a -5-003 its e (7 Cof STREET ADDRESS CITY,STATE,ZIP FAX ZI1e' FlaPio s`n mol $5j G4- 4SIVis, 0 OWNER 0 OWNER-BUILDER 0 OWNER AGENT CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTORNA4ME LICENSE NUMBER LICENSE TYPE BUS_ 9 4`5A-- e1R�1�► P.3 .2ga/73 COMPANY NAME E-MAIL FAX { B A ti Ar v tom. -61.14ef-e arr`s req � �'$�--C b it-4 .STREET ADDRESS CITY,STATE,7I PHO p S� / a til 0 tkOrYste4r Sal17- SZI-Ch• q 5708 v7-Jr— 23$- ARCHITECT/ENGINEER NAME GCdb LICENSE NUMBER BUS_LIC F COMPANY NAME E•.MAIL. FAX STREET ADDRESS CITY,STATE,ZIP PHONE � 4 • DESCRIPTION OF WORK I I . Q.o) s Se j (---E r) (7)lnts) 0— aa_N.t) C et(t►�4 traCK f, 1-f 1 , (a) — �I4/ i,,i, sw; Ate1 • EXISTING USE PROPOSED USE CONSTR.TYPE I STORIES USE TYPE OCC SQ_FI'- VALUATION(S) E3USTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA ( REMODEL AREA REMODEL AREA PORCH AREA DECK AREA I TOTAL DECK/PORCH AREA GARAGE AREA: DETACH •ATTACH F DWELUNG UNITS: 1S A SECOND UNIT DYES SECOND STORY DYES I BEING ADDED? ONO ADDITION? ONO 'r. PRE-APPLICATION OYES IF YES.PROVIDE COPY OF LS THE BLDG AN DYES RECEIVEDY /', TOTAL VALUATION: ("I) ,` PLANNING APPL fi 0 NO PLANNING APPROVAL LETTER EICHLER HOME? tk NO ((,',t/. l -M /Q (, s—— By my signature below,I certify to each of the folio%- g: I am the property owner or authorized agent to a on the roperty owner's behalf/I have read this application and the information I have provided is cop- t. I}lava,.+d the Description of Work and verify it is accurate_ I agree to comply with all applicable local ! ordinances and state laws relating to buldine co - +ction. a,. orize representatives of Cupertino to enter the above-ide -tied property for ins.-.tion purposes_ i 7 Signature of Applicant/Agent: 1146. ,Date: ' SUPPLEMENT- INFORMATION REQUIRED PLAN CHECK TYPE ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for 0 OV ER-THE-COUNTER ❑ BEJiL©rNG PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0 EXPRESS D PLANNING PLAN REVIEW Commercial Bld s: Provide a completed Hazardous Materials Disclosure 0 STANDARD 0 PUBLIC WORKS ' — g : p , form if any Hazardous Materials are being used as part of this project. [ LARGE 0 FIRE DEVi _Cagy of Planning Approval Letter or Meeting with Planning prior to ❑ MAJOR 0 SANITARY-SEWER DISTRIC submittal of Building Permit application_ 0 ENVIRONMENTAL HEALTH Bldgflpp ZrJll.doc revised 06/2I/1l PLJRPOlit; SMOKE i 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 • building(a)-cupertino.orq �I r 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 11=here 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 Outside of each separate sleeping area iii 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 emit 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. Irr existing dwelling units, alarms are permitted to be solely battery operated TA7here 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 iviring. 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. t �!� �- Address: _ 6'~ 1 �� Permit 1lTa.�l Specify Number of Alarms: r Smoke Alarms: t Carbon Monoxide Detectors: I have read and agree to compty withfthe terms and conditions of this statement Owner (or wner Agents) Name: .%� Si nature. .,t...�.. / s ..... ...... , Date: ! ...—. ContrabtorName: Si'gnature.................................................................. Lic.#t .......... ............................ Date: ................. N S7770ke and CO fbnn.doc revised 01/1012 017 CUPERTtNO Owner Name 01 4 Address WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • F/ X (408) 777-3333 • building(a)cupertino.org Jr^ l WDPermit No. IZ 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. DO No Go to Question 2. 2. Does your real properly 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. 1�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. 1_90No Go to Question 4. 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ePNo 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 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: 'N 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 noxi -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 nnprovements). 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 Daae. Owner or Owner Agent's Signature: % V_ r—iN� Date: may— 0 y—, Upon completing and signing this Certificatetpfease return it to the Building Division in order to final your building permit. SB407 2015. doc revised 08/26/15