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B-2017-0686CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0686 22396 BALUSTROL CT CUPERTINO, CA 95014-3948 (356 03 020) S D BOWYER CO SANTA CLARA, CA 95051 OWNER'S NAME: REED JAMES W AND KAREN L TRUSTEE OWNER'S PHONE: 408-255-2398 LICENSED ONT A TOR' D A TION License Class t3: C-33 Lic. #358917 Contractor S D BOWYER CO Date 09/30/2017 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: I have and will maintain a certificate of consent to self -insure for Worker's C6mpensafion, 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 pert ® pertino nrcnf pal Code, Section 9.18. Date 5/1/2017 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. s. 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 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. be deemed revoked. Signature Date $/1/241.7 DATE ISSUED: 05/01/2017 PHONE NO: (408) 247-7217 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: 1 ST FLOOR MASTER BEDROOM BATHROOM REMODEL (49 S.F.) Sq. Ft Floor Area: I Valuation: $10000.00 APN Number: Occupancy Type: 356 03 020 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. by: Abby A_)Lende RE -ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove all new materials for inspection. Signature of Al Date: 5/1/2017 tl A I1 HAZARDOUS MATERIALS DISCLOSURE I have read the hazardous materials requirements under Chapter 6.95 of the California Health & Safety Code, Sections 25505, 25533, and 25534. I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Section 25532(a) should I store or handle hazardous material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the Bay Area Air Quality Management District I will maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the Health & Safety Code, Sectio 21;505, 2� f-Aad25534. Owner or authorized agent: / Date: 5/1/2017 I hereby affirm that there is a construction lending agency for the performance of work's for which this permit is issued (Sec. 3097, Civ C.) Lender's Name Lender's Address ARCHITECT'S DECLARATION I understand my plans shall be used as public records. Licensed Professional s 16-Wa-CSW COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildinga-cupertino.ora ❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT # PROJECT ADDRESS 3 oz— <S U APN# 5S9v P e OWNER NAME PHONE lC11 i Q Z f fd,2 ZEN fJ E-MAIL �$g STREET ADDRESS .14 CITY, STATE, A �� ® FAX CONTACT NAME rmj d �A✓' PHONE ,/? ,6S P 1 E MAIL&A. STREET ADDRESS CITY, STATE, IP FAX ❑ OWNER ❑ OWNER-BUMDER ❑ OWNERAGENT❑ CONTRACTOR ❑CONTRACTORAGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTR Jyle- NAME l .fl� %�_� LICENSE NUMBER �/ LICENSE TYPE F BUS. LI'C `' �3 \' COMPANY NAME EMAIL 'goo v p# FAX ) STREET ADDRESS a �+0'� CITY, STATE, �p�Cm � PHONE /1V W 6-:01 ARCHITECT/ENGINEER NAME LICENSE NUMBER l �"O fl BUS. LIC #p r COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORKO 0 % EXISTING USE PROPOSED USE CONSTR. TYPE # STORIES USE TYPE OCC. SQ.FT. VALUATION (5) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM �i/; KITCHEN REMODEL AREA t-}Vl REMODEL AREA OTHER REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: DETACH []ATTACH # DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY []YES BEING ADDED? ❑NO ADDITION? ❑NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF PLANNING APPL # ❑NO PLANNING APPROVAL LETTER IS THE BLDG AN ❑ YES EICHLER HOME' ❑ NO■♦-y�} . RECEIVED BY - _-_ - T TAL VALUATION: w 1 10; �! By my signature below, I certify to each of the following: I am the property owner or authorized agent lo act on e property owner's behalf. I have read this application and the information I have provided is cog9ct. I have read the D seEiption of Work and verify it is accurate. I agree to comply with all applicable local ordinances and state laws relating to building Mnslrycction. I authonz epee aCVes of Cupertino to enter the above-ident`s edI'r`opryerty for inspection purposes. Signature of Applicant/Agent: Date: `� / ✓ / SUPPLEMENTAL INFORMATION REQUII F� "` PLAN CHECKTYPE ROUTING SLIP EI OVER-xiM-COUNTER suu.DING PI.ANREVIEW _ New SFD or Multifamily dwellings: Apply for demolition permit for existing building(s). Demolition permit is required prior to issuance of building permit for new building. C3 EXPREsS ❑; PLANNINGPLAN REYSEW .' Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD _ , _ , D PUBLIC woxxs for_m if any Hazardous Materials are being used as part of this project. LARGE- ❑ .FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to ❑ IKAxoR_ ° " snrrTnRYSEWEIi DISTRICT submittal of Building Permit application. ENVIRONMENTAL HEALTH BldgApp 2011.doc revised 06121111 SMOKE I CARBON MONOXIDE PL AN E pncuir5 �� °�� .rfl: OWNER CERTIFICATE OF CO ,_;,r • COMMUNITY DEVELOPMENT DEPARTMENT •BUILDI G DIVISION ��-r9,, , 10300 TORRE AVENUE•CUPERTINO cu ertmo o� CUPERTINO (408)777-322B•FAX(408)777-3333•buddmoC� p { x< $g Y ' OfggRataaWtangigaigOIWAOWWWWWWWAiptagg n u- at r err ,,,fix ,# i n s k. * �.� BV i'xua-?, E.4,PAI 3a , ass? ., atm SIGI�`RD�ply -- ate' d t4sNyhi . saMgail �,= � �� . amts for ��SY PURPOSE for the installation of all required Smoke and Carbon rb 2 ere Monoxide interior access This affidavit is a self-certification R314;R315,2016 CBC Sections 420.6 and compliance with 2016 CRC Section for inspections are required. GENERAL INFORMATION shall be provided with Smoke Alarms and Carbonexceeds and multi-family dwellingsdwellingndrb isting single-family alterations,or repairs to existing Monoxide alarms. When the valuation of additions, CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or $1000.00,CRC Section R314,R315, and Carbon Monoxide Alarms be installed in the following locations: SMOKE ALARM CO ALARM AREA X X immediate vicinity of the I • Outside of'each separate'sleeping area in the X bedroom(s)_ Smoke alarms shall not be located withind feet of bahattics door) ( dwelling unit including basements OnW every level eoa oo Within each slee•m room' . 1111111111111 Carbon Monoxide alarms are not required in dwellings which do notona fuel-burningappliances and that at n h ms do not have an attached garage. Carbon monoxide alarms combined ke hall comply With by the Office of the State Fire Marshal. CBC Section 420.6 and shall be approved be solely battery operated. dwelling units with no commercial power supply, alarm(s)may Power Supply:Ingpermitted to be solely battery operated whereof pairsor aor crawl Qiinits,alarms are Inn t result s dtit7ee re elns of al attic,basement is required fol inthe removal of wall and ceiling finishes 90��11.4 and 420.6.2.Anss by e space.Refer space.Refer to CRC Section connected to the buildingo�ring• alarms which must b eferenced property,I hereby certify that the alarm( s)referenced above has/have been the;above-referenced ) As owner of manufacturer's instructions and in compliance with are California al foio operational, of the installed in aia Resider tial-witthe .The �a.2017• asof 0z g g • Residential Codes.The alarms specified below have been tested an and California R permit • No. date signed below: S4L ary�6G 6/ 2�23i� _ Address:' #Carbon Monoxide Detectors: . ' #Smoke Alarms: , Specify Number of.Alarms: _ I have read and agree to comply with the terms and conditions of this statement .2 11112111 �� ' .. , me: Kum Date:or Owner Ag • ......................................... / Owner( ♦ ®--- Agent's/� / ' 1 Si•nature.............. ..: �.. Contractor Name: .. ...... Signature .... Smoke and CO form.doc revised 01/10/201: n FE WATER-CONSERVING PLUMBING FIXTURES Flux5cf, OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 �.. 1408)777-3 28•Ea(408)777-3333• buildincq(a cupertino.orq 15-2a/7-06,4 Owner Name . —I i4�=s �;�r.4 Permit No. Address Z Z 3/6 8AGUcfrAFiL t 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. fNo 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? 0 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? El Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. C o 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 fonn and sign bottom of fonn. ;IcesMy 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: O'CMy 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). I,as the,owner or owner's agent of this property,certify under penalty of peijury 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 page. Owner or OwnerAgent's Signature: -WO/Lc. / e.-e/\ Date: Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit. • SB407 2015.doc revised 01/05/17 • " Tw � pg 'x` • ."i e � — i T giB it�sbPE61171c1 �Oi aiba eMti�rsaana T$i$t L : ' .vim =t becka*'. . "7-: R ,, : tel: om h a z ,m ' ti" 1 ,re-wf - - W RTi I IHASSBEE SJ IDD �ED T B g 1N DJWo 1, �� e fir t.,s * gy -v-fs • • 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 • • 2016 CPC Ch. 4 . 2016.CPC Ch. 4 2016 CPC Ch. 4 /Flow.Rate Usageate 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 fllush-toilets: 1:28-gallons/flush effective flush volume (the composite, - average flush volume-of tw6.4re6uced flushes and one full flush) Urinals Exceed 1.0 - Gallons/flush 0.5 gallohs/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 gallon's per minute. ,.,60t si . . R Faucets— • Exceed 2.2gallons 1:8 a g. Ilons 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,jand must— '1.8 gallons per minute_@, default to.inaximum • F 60 psi,. 18gallons per minute Where faucets meeting ..: ,@},.60 psi'; the above Ora-unavailable, Where faucets meeting . aerators or other means the above are maybe used to achieve unavailable;aerators or 'reduction r 7 r�';4 othe�'means may be`'� r-,..--,,,,,,,_„,,,,,,,•___,,,5 ,, Air 5 .r .ax:.r `..' 3 Z t,. ?Y 1. { .t f used to achieve{ t S t t r - s+ .�. �� _� _., 1.,.�: � .,reduction wxE_,. .� >,=• 1 If the existing plumbing fixture water usage/flow rate'isyequal to,orlower than the figure shown ,rt is not required to be upgraded r a • Y ' ;y } ' �. ' Bn � sg iFer g t � x. 0lolt t 3 At S 1 t " "4dl r' x :61 " tx4 } rt09 t#5F5 .-ii 'S: S :' i t f 5 z 5 'Arx - . . r_ ,r , t i" ( " r7fa. FF '. i # ..._. t . fit'i 1$)kI 1'� '...( 41 i n,, t hF 4 c t ht :o.k L f,1.. 11',Itf.1;:ki c N!- -af,c F'�)'$s. z. ti.. 'i p#1 14 7} •' 1'4 ., '.r y3_at , .1 r t{ i }., � t,(1 7 ' . "t`. 'rf,x 4-' try' `'`` x`�tr' L" • . .. SB4072015.doc revised 01/05/17 Abby Ayende 05/04/17 05/04/17 B-2017-0686 Abby Ayende