B-2017-0565CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-0565
7611 HOLLANDERRY PL CUPERTINO, CA 95014-5070 (362 26 065)
PLUMBING TECH
REPIPE SPECIALISTS
INC
SAN JOSE, CA 95131
OWNER'S NAME: CUI GUOQI AND YANG MINGTAO
DATE ISSUED: 04/11/2017
OWNER'S PHONE: 408-391-8921
PHONE NO: (408) 237-6207
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C3_Q Lic. #1016448
Contractor PLUMBING TECH REPIPE SPECIALISTS INCDate 07/3112018
X BLDG _ELECT X 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:
REPLACE BUILDING SEWER & SANITARY SEWER; INSTALL
I hereby affirm under penalty of perjury one of the following two declarations:
FOUNDATION & PROPERTY LINE CLEANOUTS
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.
V2. /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: $5000.00
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
362 26 065
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.
'cant
WITHIN 180 DAYS OF PERMIT CE OR
Additionally, the ap understands will comply with all non -point
source regulation the Cupe ' M cipal Code, Section 9.18.
180 DAYS F
Signature / Date 04/11/2017
Issu y: MELISSA
Date: 04/11/2017
O R -B T1H D RDE RATION
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 notintended or offered for not.
sale (Sec.7044, Business & Professions Code)
2. I, as owner of the property, am exclusively contracting with licensed
Signature ofApplicant:
contractors to construct the project (Sec.7044, Business & Professions Code).
Date: 04/11/2017
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
quient or devices which emit hazardous
material. Additionally, shoulAtherti
air contaminants as defined ba Air Quality Management District I
Worker's Compensation laws of California. If, after making this certificate of
will maintain compliance wito Municipal Code, Chapter 9.12 and
exemption, I become subject to the Worker's Compensation provisions of the
the Health & Safetys 25505, 2553 34.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized agent
APPLICANT CERTIFICATION
Date: 04/11/2017
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
CONSTRUCTION LENDING AGENCY
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.
1 understand my plans shall be used as public records.
Licensed
Signature Date 04/11/2017
Professional
CUPER." INO
GENERAL PERMIT APPLICATION
COMMUNITY DEVELOPMENT. DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • buildino()cupertino.org
allMBING . I (MECHANICAL F�ELFCTR1C.AT
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PROJECT ADDRESS
APN #
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CITY-, STATE, ZIP FAX
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r71 OWNER ElOwNER-BUILDER ❑ OwNERAGENT
CONITRACTOR ElCOA'TRACTORAGEr ❑. ARCHITECT ❑ ENGINEER 13 DEVELOPER ❑ TENANT
CONTRACTOR NAME t J
LICENSE NUMBER //
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LICENSE TYPE�i
BUS. LIC # ` D
COMPANY NAA
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ARCHITECVENGINEER NAME
LICENSE NUMBER
BUS. LIC
COMPANY NAME
E-MAIL
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STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF . . ❑ SFD or DUPLEX ❑ MULTI -FAMILY
BUILDING: El COMMERCIAL -
PROJECT IN WtLAND ❑ •YES PROJECT IN ❑ YES
URBANINTERFACEAREA ❑ NO FLOOD ZONE ❑ NO
IS THE BLDG AN ❑ Y -ES
EICHLERHOME? ❑ NO
DESCRIPTION OF WORK
/ ®�
df?2jh
TOTAL VALUATIONT:
ETVED. '
By my signature below, 7 certify to eac of the foll -ing: I ain the property owner or authorized agent to act on the property ow s behalf. I h read this
application and the information I have ided i orrect. I have rea of Work and verify it is accurate. I a e to c m I all applicable local
ordinances and state laws relating t uildin tructi orize representatives o pertino to enter the 0 abo -fig e inspection purposes.
Signature of Applicant/Agent: Date: (may
SUP EMENTAL
ATION REQUIRED
'
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AlEPAlliscApp_2011.doe revised 06/21/11
V
CUPERTINO SANITARY DISTRICT
o�S`�o skbirAy`o��P
20863 Stevens Creek Blvd #100, Cupertino, CA 95014
Tel (408) 253-7071 • Fax (408) 253-5173 Fs,PBtISNE019�� cUPanrt4
SANITARY DISTRICT PERIdIT LETTER
Cupertino Sanitary District has adopted Resolution No. 1263.
Building Permit Request
(Over -the -Counter)
Single Family Project ❑ Multi -Family Project. ❑ Commercial Project
Project Address:
Permit Number:
Scope of Work:
v
Owner/Applicant Name: M
Date: Prepared By:
Phone:
City Authorized Representative
1, as property owner or authorized agent, acknowledge that all Cupertino Sanitary District requirements
will be met and all required fees will be paid prior t the approval of final inspection for proposed project.
Date: —t Signature:
Owner / Authorized Agent
CUPERTINO SANITARY DISTRICT OFFICE USE ONLY
❑ Pre -inspection RequiredFinal Inspection Required
Date Scheduled: 19
Date: — — Conditional Approval By:
Authorized Hepresentative
Cupertino Sdnitary District
District will notify owner of the required fee within 5 days after Pre -Inspection has been completed and cc
City of Cupertino.
M Inspection Fee Paid Date Paid: L
Connection Permit Fees:
❑ $350/unit - Single Family Residential connecting to existing lateral (CCN & inspection
included)
❑ $650/unit - Single Family Residential connecting with new lateral (CCTV & inspection
included)
❑ $100/unit up to 4 units & $65 above 5 - Housing (Multiple, hotel, condo, living units, etc.)
$500/connection - Commercial & Retail (Permit only. CCTV and inspection not included)
❑ $200/each – Disconnect Permit
Inspection Fees:
$250/unit - Single Family Residential already connected, but new cleanout required
(CCN & inspection included)
❑ $150/unit - Single Residential already connected w cleanout (CCN & inspection
included)
Date: Final Approval By: '��:'
Authoriz Representative
Cupertino Sanitary District
•
PERM]
PURPOSE
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.or4
13 -�tc7 c 5 - 6s
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, 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 in the immediate vicinity of the
X
X
bedroom(s) — (Smoke alarms shall not be located within 3 feet of bathroom door)
Signature...................................................................... Lic.#........................................ Date:...................
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.
NAddress: c ei a, rr �% Permit No.
Specify Number of Alarms: # Smoke Alarms: = # Carbon Monoxide Detectors:
I have read and aqree to comply with the terms and conditions of this statement
Owner Owner Agent's) Name:
P6? / C (%
Signature .................................. ................................................................................ Date:6..�/i0111.fl�
Contractor Name:
Signature...................................................................... Lic.#........................................ Date:...................
Smoke and CO form.doc revised 0111012017
CUPERTINO
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
b__)612--�5�6
408) 777-322$ • FAX (408) 777-3333 • building(Dcupertino.org 5
Owner Name�'�G'� t C 0 / Permit No.
Address �Z 611 p Z
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 fonn and sign bottom of form.
�<No Go to Question 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 fonn.
WINo 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 fonn and sign bottom of form.
YNo 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 fonn.
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..
PI ase 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, 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 iinprovements 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 110 1. 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 age.
Owner or Owner Agent's Signature: Date: rlllilht 77
Upon completing and signing this Certificate, please return it to the Building Division in order to final vour building permit.
SB407 2015. doc revised 01105117
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015. doc revised 01105117
Non -Compliant
Water -Conserving Plumbing Fixture
Plumbing Fixture
(Fixture Complying with Current Code Applicable to New Construction)
Maximum
Water Usage/Flow
Rate
Fixture Type
Water Usage
2016 CPC Ch. 4
2016 CPC Ch. 4
2016 CPC Ch. 4
/Flow Rate
2016 CALGreen Div. 4.3
2016 CALGreen Div. 4.3
2016 CALGreen Div. 5.3
Single -Family
Multi -Family
Commercial
Residential
Residential
Water Closets
Exceed 1.6
Single flush toilets: 1.28 gallons/flush
(Toilets)
Gallons/flush
Dual flush toilets: 1.28 gallons/flush effective flush volume (the composite,
average flush volume of two reduced flushes and one full flush
Urinals
Exceed 1.0
0.5 gallons/flush
Gallons/flush
Showerheads
Exceed 2.5
2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of
gallons per minute
U.S. EPA WaterSense Specification for Showerheads
(A hand-held shower is considered a showerhead.)
For multiple showerheads serving one shower, the combined flow rate of all
showerheads and/or other shower outlets controlled by a single valve shall not
exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to
allow only one shower outlet to be in operation at a time.
Faucets —
Exceed 2.2 gallons
Maximum 1.5 gallons per
Within units:
0.5 gallons per minute @ 60
Lavatory
per minute
minute @ 60 psi; minimum
Maximum 1.5 gallons
psi
Faucets
0.8 gallons per minute @
per minute @ 60 psi;
20 psi
minimum 0.8 gallons
per minute @ 20 psi
In common and public
use areas: 0.5 gallons
per minute @ 60 psi
1.8 gallons per minute
60 psi
Faucets —
Exceed 2.2 gallons
1.8 gallons per minute @
1.8 gallons per minute
1.8 gallons per minute @ 60
Kitchen
per minute
60 psi
@ 60 psi
psi
Faucets
May temporarily increase
May temporarily
up to 2.2 gallons per
increase up to 2.2
minute @ 60 psi, and must
gallons per minute @
default to maximum
60 psi, and must
1.8 gallons per minute @
default to maximum
60 psi
1.8 gallons per minute
Where faucets meeting
@ 60 psi
the above are unavailable,
Where faucets meeting
aerators or other means
the above are
may be used to achieve
unavailable, aerators or
reduction.
other means may be
used to achieve
reduction.
1. If the existing plumbing fixture water usage/flow rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015. doc revised 01105117