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B-2017-0436CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0436 7634 KIRWIN LN CUPERTINO, CA 95014-4357 (359 22 014) BROTHERS HOME IMPROVEMENT INC ROCKLIN, CA 95765 OWNER'S NAME: APPANNAGAARI NARESH AND NALLUR RACHANA I I DATE ISSUED: 03/16/2017 OWNER'S PHONE: 408-532-3225 I I PHONE NO: (916) 791-9170 WFON7�. _ 1 g t 1 �_i• License Class ,C-1 7 Lic. #699009 Contractor BROTHERS HOME IMPROVEMENT INCDate 11/30/2018 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 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL DESCRIPTION: ACE LIKE FOR LIKE TO MEET EGRESS (17 WINDOWS) (1 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. Sq. Ft Floor Area: Valuation: $10944.00 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 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 regulates per the Cupertino Municipal Code, Section 9.18. Date 03/16/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 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) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.7044, Business & Professions Code). I 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. 3. 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. Date 03/16/2017 APN Number: Occupancy Type: 359 22 014 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 03/16/2017 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: 03/16/2017 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 Coil (Sections 25505, 25533, and 25534. Owner or authorized agZ�LL Date: 03/16/2017 V 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 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPER.i,INO (408) 777-3228 • FAX (408) 777-3333 • buildin cu erlin 'O"W ElNEW CONSTRUCTION n AnniTTf)1T n 11 T =� A IT—T — n _ _ u rcLVIZIORIGINAL PERMIT# PROJECT ADDRESS APN # ' 2 � r PHONE,vYy ►, q E,Mpn OWNER NAME Kw ��� G _T STREET ADDRESS www 1pmt_ CITY, STAT, ZIP f1AJOW FAX CONTACT NAME ^� E-MAIL PHONE �f �� 7,� ®V 74 (ZIP STREET ADDRESS CITY, STATE, / A n -,. FAX ,,��®® 13 OWNER 13OWNER-BUILDER❑ OWNER AGENT 117 CONTRACTOR CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICENSE NUMBER Oft LICENSE TYPE Q s /j I BUS # COMPANY NAME j Ae _MAIL FAX STREET ADDRESS T O [� n ,�2 .moo CITY, STATE, ZIP 17 N® /{ A r PHONE 7 l ARCHITECT/ENGINEERNAME LICENSE NUMBER - BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK 4 An, oi ® I� .., EXISTING USE PROPOSED USE CONSTR. TYPE #STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM KITCHEN REMODEL AREA - REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: U DETACH ❑ ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ONO ADDITION? []NO PRE -APPLICATION OYES IF YES, PROVIDE COPY OF PLANNING APPL # []NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME? ❑ NO RE EO j' T TAL VALUATION: A By my signature below, I certify to each of the following: I am the property Owner or authorized jIgent to act on the property owner's behalf. I 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 comply with all applicable local ordinances and state laws relating to 'lding ion. I authorize representatives of Cupertino to enter the above-identifiedroperty for inspection purposes. Signature of Applicant/Agent Date: �OltGf` SUPPLEM&LTAL RMATION REQUIRED _PLAN CHECK TYPE'.,, RouTnv�sl Ir — New SFD or Multifamily dwellings: Apply for demolition permit for ©`ovE>r cico[)NTER ©xllu nING PLATFiLEVtEw existing building(s). Demolition permit is required prior to issuance of building permit for new building. EXPRESS Commercial Bldgs: Provide a completed Hazardous Materials Disclosure STANDARIJ '' ;:.;. -" 0, pI3BLie`WgRKs form if any Hazardous Materials are being used as part of this project. © L9RGE TIREDEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ©.MAapR ©.SA1IITARYSEWER INSTRICT,.,: - ..,...:._.,. _EI-vlRailEAr:Tn "..... . B1dgApp_2011.doc revised 06/21/11 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 40300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 e FAX (408) 777-3333 • building(llcupertino.org PERMIT CANNOT BE 1F'INALED UNTITL THIS CERTIFICATE HAS BEEN COARLETED, SIGN- E1�3 AND RETURNED TO THE BUILDING 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 j SMOKE ALARM CO ALAR Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) - (Smoke alarms shall not be located within 3 feet of bathroom door) ; X X 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 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: 70 1A� _ Permit No. Specify Number of Alarms: # Smoke Alarms: I 1 # Carbon Monoxide Detectors: I have read and aaree to comply with the terms and conditions of this statement Owner (or Owner Agent's) Name: Signature........................................................................................................................ Date:.��.7�.1.} Contractor Name:yys/,,��,,��jj Signat Lic.# .....L..[..w....(.......... Date: Smoke and COform.doc revised 01/1012017 • Owner Name Address -% WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777 kl KW I N /1% r_1 Lao N 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. 04o 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. L 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. 6' 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 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.. Please check ONE of the following: . 0% -/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). 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 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 -oaae. a, 1) IOwner or Owner Agent's Signature: Date: DI /11 / Upon completing and signing this Certificate, please return it to the Building Division in order to nnai your nutiaing permit. SB4072015.doe revised 01/05117