Loading...
B-2017-0333 i CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0333 . ' 23500 CRISTO REY DR UNIT 511H CUPERTINO,CA 95014-6535(342 53 250) BAY AREA . ENTERPRISE • SAN JOSE,CA 95148 OWNER'S NAME: MOHR J HENRY TRUSTEE&ET AL DATE ISSUED:03/02/2017 OWNER'S PHONE:650-537-1523 PRONE NO:(408)238-5043 i ICENSED CONTRACTOR'S DCLARATION BUILDING PERMIT INFO: , " License Class GENERAL BUILDING CONTRACTOR Lic.#817817 - Contractor BAY AREA ENTERPRISE"Date 03/31/2017 X BLDG X ELECT PLUMB X MECH X RESIDENTIAL_COMMERCIAL - I hereby affirm that I am licensed&nder 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 511H-INSTALL(N)LED RECESSED LIGHTS(7);REPLACE I hereby affirm under penalty of perjury one of the following two declarations: BATHROOM FANS(2);REPLACE OUTLETS(23);REPLACE LIGHT 1. I have and will maintain a certificate of consent to self-insure for Worker's SWITCHES(14) Compensation,as provided for by Section 3700 of the Labor Code,for the performance of the wor cl�for which this permit is issued. rz y`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 rfr— permit is issued. . Sq.Ft Floor Area: Valuation:$3000.00 - 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: and state laws relating to building construction,and hereby authorize 342 53 250 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 e Cupertino unicipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. f-1 ((Signature . Date 3/2/2017 Issued by:Abby Ayende • '- F -- 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:3/2/2017 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 s. 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 Cupertino Municipal Code,Chapter 9.12 and ' exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code - fns 255 , 33,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. .Own r or authorized agent: APPLICANT CERTIFICATION ®ate:3/2/2017 I certify that I have read this application and state that the above information is CONSTRUCTION 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 -1 -- CONSTRUN'-TION PERMIT APPLICATION--' - 1 -015 _t19 COMMUNITY DEVELOPMENT DEPARTMENT o BUILDING DIVISION B . ;SSS,, ,. 10300 TORRE AVENUE 0 CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228-FAX(408)777-3333-buildinaecuoertino.orq 0 NEW CONSTRUCTION 0 ADDITION aTERATION/11 D REVISION/DEFERRED ORIGINAL PERMIT if IPROlECI'AL 3 DDRESO at S� CUR • APN �'7 e 5--y� I OWNER NAME I PHONE E-MAIL T1%!Fort',}A ; rt -f' • Cf 1. ie VI 1/- ( 9 gAitt(111 ( 1E I VSD-537- 152.3 Frecihernan.4.90 RSC •e6c� STREET ADDRESS C liI Ie n p� I I rt CITY,STATE,ZIP 517) ri-0-�! -e ricl— n 'O/ FAX CONTACT NAlvIEPHONE E-MAIL Gre 5 Fe ; s . I/DS -2.3 a -sb4L3 8,AeceiviiC DIM STREET ADDRESS CITY,STATE,ZIP FAX Z 11 C> Tia Kb t`n W e,. / _ 5 Tj r4- 9,S1 SL$ ❑OWNER 0 OWNER-BUILDER 13 OWNER AGENT rG1 CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTORNAME LICENSE NUMBER LICENSE TYPE BUS.LIC GiPa 9 Fe,•5}-- ►irtso I ig. e2 fr73 COMPANY NAME E-MAIL FAX 3 a 1..3 A.r.e c_ Ev►4er-1,ri'se r'elM� 154-.Cor-4 STREET ADDRESS CITY,STATE,ZIP PHO 2-i.I © t1 �1 O.V4- I.40‘ iLI a S's 1 c 4k- q e Yat— Z3 8—$7J9131 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS.LIC E COMPANY NAME E-MAIL FAX STREET ADDRESS +++��� CITY,STATE,ZIP - PHONE DESCRIPTION OF fRK L_7 �- wew LED e.ec.ess¢d ii vets. 8a+t1 Room ,tt.. Z 3g (Li p3 de_ 4:"leei�t`ce. (out-lei-3 wt}kTP- ),. _ ! T C s. er a I& 1t' ill-sw r k S , EXIS ITP SE PROPOSED USE CONSTIL fSTdRPl�S - • - • • ----- ` --- --� USE TYPE OCC_ SQ.FT. VALUATION(S) — EXISTG NEW FLOOR -DEMO TOTAL AREA AREA AREA f NET AREA - BATHROOM KITCHENI OTHER REMODEL AREA REMODEL AREA REMODEL AREA i ', PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑DETACH 0 ATTACH, P DWELLING UNITS: IS A SECOND UNIT ©YES SECOND STORY ©YES BEING ADDED? ONO ADDITION? 0NO PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS THE BLDG AN ❑YES RECEIVED BY: TOTAL VALUATION �- PLANNING APPL& ©NO PLANNING APPROVAL LETTER EICHLER HOME? 0 F NO y� 01�`3 , (1/40-'" 'Yid 149 3, irin - - By my signature below,I certify to each of the follow' g: I am the propertyowner orauthorized agent to ct on the property owner's behalf. I have read this a application and the information I have provided is co I ha,e;ead the Description of Work and verify itis accurate. i agree to comply with all applicable local ordinances and state laws relating to building cons ction_ I a a�jLN'onze representatives of Cupertino to enter the above-identitie property foruinspection purposes. Signature of Applicant/Agent �7 Coate 2/7 35 -2-0/7 SUPPLEMENTINFORMATION REQUIRE!) PLAN CHECK TYPE I ROUTING SLIP New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW existing building(s). Demolition permit is required prior to issuance of building permit for new building. 0 EXPRESS 0 PLANNING PLAN REVIEW _Commercial Bldgs: Provide a completed Hazardous Materials Disclosure 0 STANDARD 0 PUBLIC WORKS form if any Hazardous Materials are being used as part of this project ❑ LARGE 0 EIRE DEPT _Copy of Planning Approval Letter or Meeting with Planning prior to © MAJOR 0 SANITARY SEWER DISTRICT submittal of Building Permit application. 0 ENVIRONMENTAL HEALTH BldgApp 2011.doc revised 06/21/11 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 • build ing(a)cupertino.org 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 OFof each separate sleeping area in the immediate vicinity of the bedroom(s) - (Smoke alarms shall not be located withiva 3 feet of bathroom door) X X On every level of a dwelling unit including basements and habitable attics X X—_j jvWithin each slee ing room. _ _ X Carbon Monoxide alarms are not required in dwea-igs wlai.ch 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: Ira 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 pen -nit is required for alarms which must be connected to the building wiruag. 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: `e 'j '` r 1—Te 1Z r 11 Permit No. 2- 011 r g w Specify Number of Alarms: " Smoke Alanlns: :E Carbon Monoxide Detectors: 1 have read and agree to comply with the terms and conditions of this statement O r Owner Agent' Name: �f ............................................................. Date ./.......... Si...:................. ....... nat ..........�� Contractor Name: Signature.. ................................................................ Lic.#...................................... Date:.................. Smoke and COform.doc rerised 01/1012017 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT; BUILDING DIVISION CUPE NO I 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408 777-3228 • FAX (408) 777-3333 • buildingocupertino.org Owner Name,� Permit No "`'0 (7 C)- ✓f Address i� 1 -5, , a A e�'� � *311 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. 4P 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. 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. tR 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 Januaiy 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: I - My property is a single family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or iinprovements 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 iinprovements). ❑ Myproperty 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-coinpliant 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 imae. ., Owner or Owner Agent's Signature: ,�/d a_ ! Date: Upon completing and signing this Certif e&4t 'please return it to the Building Division in order to final your building permit. SB4072015.doc7•evised 08/26/15