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D-2017-0021CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: 10510 STOKES AVE CUPERTINO, CA 95014-1235 (326 48 002) OWNER'S NAME: CHOUAARON C AND CHEN CHIOULIEN TRUSTEE OWNER'S PHONE: 408-221-6436 LICENSED CONTRACTOR'S ARATION License Class B Lic. #1008838 Contractor HUEY CONSTRUCTION INC Date 11/30/2017 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: 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. 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 Cvpre6rtino Municipal Code, Section 9.18. Signature Date 04/27/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the following two reasons: 1. 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). 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. Signature Date 04/27/2017 CONTRACTOR: PERMIT NO: D-2017-0021 HUEY CONSTRUCTION INC SAN JOSE, CA 95148 DATE ISSUED: 04/27/2017 PHONE NO: (408) 623-5724 BUILDING PERMIT INFO: BLDG —ELECT —PLUMB MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: DEMO SWIMMING POOL (600 SF) FOR LANDSCAPE PURPOSES ONLY Sq. Ft Floor Area: I Valuation: $1200.00 APN Number: Occupancy Type: 326 48 002 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: 04/27/2017 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. s Signature of Applicant: Date: 04/27/2017 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, Sections 5505„25533, and 25534. Owner or authorized agent: - 1,1,q1V Date: 04/27/2017 (/ 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 SWIMMING POOL / SPA PERMIT APPLICATION COMMUNITY ,.. BUILDING D • 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building@cupertino.org 'fSP Si+hnPool 1pp_2011.doc revised 03116111 PRO]ECTADDRESS _ /,�® eI ` (1� APN 2, )o2, OWNER NAME PF ON �d yp�6 3� E -MAL STREET ADD ESSc CITY, STATE, LIP PAX OV T-NAMEPHONEADDRE F " 1, " e %tea -'TT�Wip W "t, ,/� .''F`1ta FAX ❑ OWNER ❑ ONvNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARC'FIITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACT R 4ME C LICENSE NUMBER E LICEN. � 'PE BUS. �l>p l/, COMPAN ' ATME E-MAIL FAX STREET.4DDRESS �� .J „y CITY, STY1,11W •J PII :1RCHITE-CT.ENGINEERNAMEL LICENSENUMBER 103 COMPANY NAME E-MAIL FAX STREET ADDRESS CITY. STATE, ZIP PHONE -DESCRIPTION OF WoRx POOL- — 11in ,4- fA USE OF ❑ SFD or Duplex ❑ Multi -Family TYPE MATERIAL TYPE (CODE) AREA (SQ. PT.) VALUATION (S) STRUCTURE: ❑ Commercial POOL POOL/SPA ND TERIAL TYPE CODES: SPA V -- VINYL -LINED DEMO '�t/ K4 �60G F FIBERGLASS ... GUNCIE Vt RICEtVLDBY- TOTAL VALUATION: P PREFABRICATED By my signature below, I certify to each of the following: I am the property owner or authorized agent to act on the property owner's behalf. I have read this application and the information I have provided is corrzl;Irhave read the Description of work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building constr ction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY PLAN CHECK TYPE ROUTING SLIP Commercial or Multi -Family Buildings with Public Swimming Pools: Department of Environmental Health approval required. © OVER-THE-COUNTER ❑ BUILDING DEPT ❑ EXPRESS ❑ PLANNING DErr ❑ STANDARD ❑ PUBLIC WORKS DEI -r ❑ LARGE ❑ ENVIRONMENTAL HEALTH ❑ MAJOR ❑ SAN#TARY SEwFR D#STRICT Si+hnPool 1pp_2011.doc revised 03116111 SMOKE 1 CARBON MONOXIDE ALARMS OF COMPLNA pICE OWNER CERTIFICATEoN COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING 5 10300 TORRE AVENUE • CUPERTINO, CA 95014 3325 cupertino.ory I=RTiNfl 408 777-3333 , buildinaC� U P 777-3228 • FAX ( ) y 40 PURPOSE on for the installation of all required Smoke and Carbon Monoxide Alarms or This affidavit is a self-certlficatr where no interior access r 2016 CRC Section 8314; R315,,2016 CBC Sections 420.6 arid 907•_.11. . compliance with for inspections are required. GENERAL INFORMATION Multi dwellings shall provided with Smoke Mar, s and dwellinCarbon u�-� exceeds Existing single-family and Monoxide alarms. When the valuation of additions, alterations, or repairs to existing $1000.00, CRC Section 8314, 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: SIviOKE ALARM CO ALARM AREA X I ediate vicinity of the Outside of'each separate sleeping area in the imrn feet of X X — (Smoke alarms shall not be loc' nems and habitable ttics door) bedroom(s) unit includingbasem X On every level of a dwelE119 ' Within each slee inc'roen1 appliances and that not require in dwellings which do not conined ch ke alarms hall comply with Carbon Monoxide alarms areq SMO of have an attached garage• Carbon Monoxidefficeaof he Stat Fre Marshal. don roved by the CBC Section 420.6 and shall be app 1 alarm(s) maybe solely battery operated. units with no commercial power Supp y, 0 Power Supply: In dtivelling s are permitted to be solely battery oiler b do eat of attic, basement oOr r crawl In existing dwelling units, alarm P ermit is required for result in the removal of wall and ceiling finishes tions 907.2-11.4 and 420 6.2. An electrical p not r CBC Se space. Refer to CRC Section R314: and. alarms which must be connected to the building wiring• ms referenced above has/ -have been instructions and in compliance with the California Building As owner of the above -referenced property, I hereby certify that the alarm( operational, as of the installed in accordance �•irith the manufacturer's ins ' dential Codes. The alarms specified below have been tested and are and California Residential pernut No �j/��C�U� r date signed below -C ry Address* � Carbon Monoxide Detectors: Specify Number of Alarms: _ r Smoke Alarms: mply with the terms and conditions of this sfate I have read and agree to cmen oI Da e�l �.[•�.: owner (or Owner Agent's) Name: I ' r .......... Contractor Name: ........ Lic.#........................................ Date; .................. I Signature........................................................... Smoke and COform.cloc revised 01/I0,•'<01; WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE . COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION cuprz I 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 FAX (408) 777-3333 • buildinacugertino.ora '3 Ca Owner Name , /-kP 0 A 1 0 Permit N o Address . U fi /A-- n- C-0 f V, 1. Is your real property a registered historical site? ❑—Yes Civil Code Sections 1101.1 through 1.1:01.8 do not apply. Skip the rest of the form and sign bottom of form. ,'L1 ---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. 7�. 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 fonn and sign bottom of form. ANo 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. l�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 fonn.. 5. Please check ONE of the following:. -2' My property is asingle 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-conseiving plumbing fixtures (regardless of whether property undergoes alterations or improvements). ❑ My property is a niultifawily 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). ❑ Mypropertyis a convnercial 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 Daae. Owner or Owner Agent's Signature: ��? .�„ `` ' 1 - ,, o� _ Date: Upon completing and signing this Uertrrrcate, please return it to the.Building Division in order to anal your building permit. SB4072015.doc revised 01,'05/17 T (0j/1) S7-0KF5 AOF � J,� r?- C/ ji cq W-� k, f 0,) E )r- UOMPE_IANCE ,3T o Kb s ii �� +t7tUl�f p�'p �'y [�(���+ ry II�� Af f`�fi�✓�:/EO: ^;s set ')f ,off 5ice i�.,rinc s e kepi at!r& eta .c ion. It is .i to rr.,;' nges orj,rl{a atinns on s 3. I or to deviate, re`s `rom, approval Iran +' , r Ding ofiCial. J ?;� an;f sP(' SHALL NOT �E held t0 r< be an cap r ` `':l` i'f ttl? VIO1ai!?r� of any P� �r ,far, Cky Ore r; ,_Ince or State l.aty_ BY DATE