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B-2017-1007CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1007 7771 ORION PL CUPERTINO, CA 95014-5078 (362 18 045) F W H ACQUISITION CO LLC BOTHELL, WA 98011 OWNER'S NAME: LEE CHIN -PING AND CHANG CHI -LAN ISSUED: 06/26/2017 OWNER'S PHONE: 408-219-0353 1 1 PHONE NO: (425) 636-7078 License Class C-36 Lic. #987398 Contractor F W H ACQUISITION CO LLC Date 10/31/2017 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 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 Cuper�i�Municipal Code, Section 9.18. Signature Y' ��55 )) Date 6/26/2017 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). BUILDING PERMIT INFO: X BLDG —ELECT X PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: REPLACE 50 GAL WATER HEATER - SAME LOCATION Sq. Ft Floor Area: I Valuation: $1412.82 APN Number: Occupancy Type: 362 18 045 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Abby Ayende Date: 06/26/2017 RE -ROOFS: All roofs shall be inspected prior to any roofmg 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: 6/26/2017 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. 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 6/26/2017 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 25505, 25533, and 25534. Owner or authorized agent: Date: 6/26/2017 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 06/19/2017 MON 14:04 Fax Fant water Heater U003/018 96313 GENERAL PERMIT APPLICATION MEP COMMUNITY DEVELOPMENT DEPARTIVICNT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3256 misc CUPERTINO (4013)777.3228*FAX �408}777-3333-I�ulitilnt IruDDfllnDara KI h1.l vanlv4CI r_1 mprtr-jic r 17-114 1:'r kIr Al 17-1 x4mi'm I &mrr I1R "Ik'wFr'T AfJuRF99 7771 ORION PLACE APN p 19 1nwrnNAW CHANG, CHI -LAN "HO' 4082990353 r'"""L - fTRFFTADDRLSS 7771 ORION PUKE CITY, VNPQ1 lip CUPERTINO CA 95014 �>>x ------ CONTACT NAME Katy Kehle FAST Water Heater rDONE 4255-636-7084 °'I''"'tK ehle astwaterheatersom AIRrrrAIDIDA Ss 11715 N Creek pkwy S, C-106 CITY. s' IAT¢.1fP Bothell WA 96011 FAx ❑ 0WHEA 0 ON'NLRd1ULLDPR ❑ WAKA0P07 COVDIACIOR ❑COIFJR^CIOk A011NT, 0 ARC11111:0 11 BUMMER Q ntvIII-0 -0 13 71''144;11 CONTRACrORKAIR6 FAST Water Heater LIC'L•NsLNUMBLR 987398 1.1crNSL IVI'I: C36 FAST Water Heater KKehIg0fastwaterheater_c m Aus,l.ac, L-tL_1,52; `1-L TAS 425-636-7085 srFA°a;rAt>Itar-� 11715 N Creek Pkwy S, C-106 CITY,Bothell WA 98011 PI(('NE425-636-7084 II°TT'4A,CIP'I'JI:YUI\LIiJI?f�113 --- ---•� ItIC:7srsrlun7DLl1.__�— ANY VAMP' Sit J ;s3 - C!ITY,$'IArI;.%IP r ---•- 91s. u(, "y PAX 51D�11 _7 Otr oSI°crl.kX ❑ AIL11t1d'APALY Us@ Um�u IIUILION0, [j MWILWAL Y'NOMFC11OWMIN.AKIt Q 17, UKbAN1�L1111tPAl'rl ALMA C7 KO 1'I147nulDj 15 vuIxTIIBUIJNInN PLO[)UYONE ❑ NO ❑ vu DESCR111'1r0N Ur WORY Oil TOTAL VALUATIUH: $1,412-82 @.[CI!IPPD RY: d, fly I>tiy YISpUU4>' bQk)w. I l'ettlry W t4TG11 urlhc rnllowing; I um Qlc plulrity ownor or oulhOrlud It vik to nrt all the prDI).Ay owncr'S lWhn1[ I Imvt: scud thls nL1llfLCn11011 nlld d>n IIl'�nlll►yLltaTl l hplti plLVitlal is COIYCLI. I Imve 1Ynd ilio 1 ewriprion of Wnik Apfl Y'CIiQ' it tD nuem Acc. I uiVec 10 caml)ly With nil 11"IIIjcol le (uvol oidli1911m 3nij Sltile Irl',as reInfilL]l IO1111 Iltb'010111199 IIS �I uli Il'lL' Icln'ep.Stllnli5'OJ UrCl1I7Cfiiw t0 univi 1hC above-Ountinctl pivli �y 1h9 (NxP00kNIl I)IJrNWCS. stgnntulvur>111pucnutEngctl+',_,..,..c��Ct__�� ------ L)nlc:--'--. 6/19/2017 SUPPI.ElvIENTAL INFORMoVI'lON REQUIRED 01`11(1 u4KONL.Y Clt-121t-Y11►:-C011l�i'k',k G I..I I;fil9tlx9 ST:4A11AHD —•---- a *1AJOR 1lfi /� L}rseApl,`2D 11. doe 1z l lsed 06/21111 CUPERTIA40 SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 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 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 - = - atarm&-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. 11'1 Address: 9 ( ermit No. f Specify Number of Alarms: # Smoke Alarms:F6 6 # Carbon Monoxide Detectors: I have read and agree to comply with the terms and conditions of this statement Owner(or Owner/Agent's) Name- �Oate,.'0/2 � CrXGf Signature ..........ZZ ................................................................................ Contractor Name: �7 Signature...................................................................... Lic.#........................................ Date:................... Smoke and CO form.doe revised 0111012017 CUPERTitI' O 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_-3333 o building(akupertino.org — /_a, n-- % ran ---3. PP, -m 0 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. .KNo 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= f-ffie�oi-in and sign --b ottom-0 f form: y' o 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. XX 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.. 5. Please 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 f turesYo be replacedw wafer-conservuig plumbing Aures. 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 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-conseiving plumbing fixtures comply with the requirements as indicated in the table on the following nage. � s51 ® _ 0 _ I 1 Owner or Owner Agent's Signature: /�s��i� (g=I Date: e14L12V Upon completing and signing this Certificate, please return\to th4 Building Division in order to final your building permiitt. SB40 7 2015. doe revised 01/05/17