The URL can be used to link to this page

B-2017-0930O� CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-0930 20224 NORTHGLEN SQ CUPERTINO, CA 95014-0518 (316 41 053) THRASHER TERMITE & PEST CONTROL INC 17427 FARLEY ROAD WEST LOS GATOS CA OWNER'S NAME: HOGAN JOSHUA N DATE ISSUED: 06/12/2017 OWNER'S PHONE: 650-996-0025 PHONE NO: 408-354-9944 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class Lic. #1ZZfS Contractor THRASHER TERMITE & PEST CONTROL INC Date X BLDG —ELECT —PLUMB MECH X RESIDENTIAL COMMERCIAL 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. JOB DESCRIPTION: TERMITE DAMAGE - REMOVE FUNGUS/REPLACE WOOD I hereby affirm under penalty of perjury one of the following two declarations: MEMBERS; REPLACE GUARD RAIL - LIKE FOR LIKE t. 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. z. 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 Sq. Ft Floor Area: Valuation: $9485.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above Number: Occupancy Type: information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize 31641 053 316 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 regulatio s per the Cupertino Municipal Cod , Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Sign re Date 06-12-2017 VT Issued by: Kim Dunbar OWNER-BUILDER DECLARATION Date: 06/12/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS: All roofs shall be inspected prior to any roofing material being installed. If a roof is following two reasons: t. 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: 06-12-2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER t. 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 z. 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 material. Additionally, should I use equipment or devices which emit hazardous shall not employ any person in any manner so as to become subject to the 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, #ctions 25505, 25533 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner authorized aCnt- APPLICANTCERTIFICATION 6- Date: 06-12-2017 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 06-12-2017 Professional CUPERTINO CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildingaculperflno.or LJ NEW CONSTRUCTION LJ ADDITION LJ ALTERATION / Ti LJ REVISION / DI ERRED ORIGINfrL ARMIT # PROJECT ADDRESS 1Z0a:a APN # / /„ / /� D OWNER NAME`PHONE �s Co CnaJ7o}{ , STREET ADDRESSj�L ITHTZIP FAX90X�jAVo��LL/V�LifnNO950f CONTACT NAME PONE E-MAIL STREET ADDRESS CITY, STATE, ZIP I FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACT R N �,r LICF LICENSE TYPE BUS. LIC # COMPANY NAME E-MAII. FAX ' 2 cr f -z K!3i C�Oti' T72D� 0 SECOND STORY LJ YES STREET ADDRESS f� CIS , ZIP r ONE i C PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF 5. } _ _ ARCHITECT/ENGINEER NAME T TIQ�I: LICENSE NUMBER EICHLER HOME? E]NOE2, BUS. LIC # COMPANY NAME 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 MAIL ordinances and state laws relator ing construction. I thorJ7wMreVntatives of FAX STREET ADDRESS Date: CITY, STATE, ZIP PHONE DESCRIPTION OF WORK ,. ROUTING SLIP- P /I /1 I I . - . _ ... , I .-, _ /I VCADI(1."_ i�J JCS. LVat) aum i�e_7�, EXISTING USE PROPOSED USE CONST& I YPE I # STORIES USE TYPE OCC. SQ.FT. VALUATION (S) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA ATTACH k DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY LJ YES BEING ADDED? []NO ADDITION? E] NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YESRE T TIQ�I: PLANNING APPL # E]NO PLANNING APPROVAL LETTER EICHLER HOME? E]NOE2, S ,�-- 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 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 relator ing construction. I thorJ7wMreVntatives of upertino to enter the above -identified property for inspection purposes. li Date: Signature ofApplicant/Age SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TYPE ,. ROUTING SLIP- _ New SFD or Multifamily dwellings: Apply for demolition permit for ❑ ovER T coUNTER ❑B iLDINGP, .AN REyirw - existing building(s). Demolition permit is required prior to issuance of building permit for new building. El'. EXP: itESS INc Pi iN REV1Ety� _ Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD ❑' PUBLIC WORKS form 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 El MA TOR • , ❑ SANITARY SEWER submittal of Building Permit application. ❑.ENVIRONMENTALHEALTH B1dgApp_2011.doc revised 06/21/11 i SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildinga()cuaertino oro PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN COMPLETED, SIGNED, 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 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) 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. ( q Address: 11 NO a rk 6 `C�1 9C1144yu, U P ER 40 Permit No. ; LJ//7 Specify Number of Alarms: # Smoke Alarms: ET # Carbon Monoxide Detectors: a Smoke and COform.doe revised 0111012017 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (4031777-.13228,- AX (408) 777-3333 • bulldinoQcuoertino.org / Owner Name _ � � t sl (?i Nennit No. % � Address 1f) 7 s7JA ),, ` I h t 4l n .. 10 t 1. Is your real property a registered historical site? res Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. Go to Question 2. 2. Does your real properly 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. M 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. QKNo 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 110I.8 do not apply. Skip the rest of the form and sign bottom of form. IN 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: 19""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 conrmercial 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 i nprovernents). 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 followine nage_ ,?. i I / Owner or Owner Agent's Signature: o 1� Date: 16 tT0.e 2.o t7 Upon completing and signing this Certifrc e, please return it torthe Building Division in order to final your building permit. SB40 7 2015. doc revised 01x'05/17