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B-2017-1035CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1035 20177 NORTHBROOK SQ CUPERTINO, CA 95014-0501 (316 39 029) STEVE PERRON MOUNTAIN VIEW, CA 94040 OWNER'S NAME: YAMADA LLOYD S AND SUZANNE K TRUSTEE DATE ISSUED: 06/29/2017 OWNER'S PHONE: 408-888-9834 PHONE NO: (408) 966-8275 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class a Lic. #934132 Contractor STEVE PERRON Date 06/30/2019 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: DECK REPLACEMENT - LIKE FOR LIKE (48 S.F.) I hereby affirm under penalty of perjury one of the following two declarations: r. 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. I have and will maintain Worker's Compensation Insurance, as provided for by 09 Section 3700 of the Labor Code, for the performance of the work for which this Sq. Ft Floor Area: Valuation: $5000.00 permit is issued. APPLICANT CERTIFICATION I certify that I have read this application and state that the above APN 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 31639 029 316 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 regulations per the Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature Date 6/29/2017 Issued by: Abby Ayende OWNER-BUILDER DECLARATION Date: 06/29/2017 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: 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 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: 6/29/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER t. 1 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 a. 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 material. Additionally, should I use equipment or devices which emit hazardous 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, Sections 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPLICANT CERTIFICATION Date: 6/29/2017 1 certify that I have read this application and state that the above information is CONSTRUCTION LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws 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 6/29/2017 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building(a)cupertino.org 3 -Zoic- [o35 ❑ NEW CONSTRUCTION ❑ ADDITION [?r ALTERATION / TI ❑ REVISION / DEFERRED ORIGINAL PERMIT n PROJECT ADDRE) o /� J' , r a APN # 2 - O �l A 9WNERN PHONE -MAIL 11 G y - 4ina J Go•y, t S ET RESS STATE, ZIP FAX c) k �da'¢.1i,.� g o CONTACT NAME'� R riv� PHONE E-MAIL n e,ii - it - G✓c- STREET DRE S 6 �, � 4 CITY, STATE, ZIP V1 is r% V ICA'a O C/ J FAX ❑ OWNER ❑ ORT'ER-BUIIDER ❑ OWNER AGENT P CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME LICE4ElNUMBER?- LIC 'SE TYPE BUS. LIC #402 4 I �I COMPANY NAME IN E-MAII „.s . . c-,.�-, FAX STREET ADDRESS `/O .(!4 CITY, STATE, ZIP oc." hi-'? J tw 9yJ L u P ONE ARCHITECT/ENGIN-EER NAME LICENSE NUMBER BUS. LIC n COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK EXISTING USE PROPOSED USE CONSTR. TYPE *STORMS USE TYPE OCC. SQ.FT. VALUATION (S) E)USTG AREA NEW FLOOR AREA DEMO AREA TOTAL NET AREA BATHROOM KITCHEN OTHER REMODELAREA REMODEL AREA REMODEL AREA PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: UDETACH ATTACH k DWELLING UNITS: IS A SECOND UNIT ❑ YES SECOND STORY ❑ YES BEING ADDED? ❑NO ADDITION? []NO PRE -APPLICATION ❑ YES IF YES, PROVIDE COPY OF - IS THE BLDG AN ❑ YES -:-RECE D: TOTAL VALUATION: PLANTING ADPL k ❑ NO PLANNING APPROVAL LETTER EICHLER ROME? ❑ NO . �� 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 relating to bufldlin& construction. I authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFORMATION REQUIRED PLAN CHECK TIPE ROITFINGSLI P ❑ ONTER-TEL-COUN-rER ❑ BUILDING PLAN REN%IEW 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. ❑ ExTREss ❑PLANNLNGPLAN RD«W Commercial Bldgs: Provide a completed Hazardous Materials Disclosure El STANDARD ElPU'BLIC R'ORKS _ form if any Hazardous Materials are being used as part of this project. ❑ LARCE ❑ FIRE DEPT _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. ❑ I,IA.TOR ».,: ❑ SANITARY SE\E'ER DISTRICT .❑� ENVII2oNniENTALHEALTH. BldgApp_2011.doc revised 06121111 CUPERTINO 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 • building(olcugertino.org �3-�or7tra35� PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2016 CRC Section 8314, 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 I 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 hasihave 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. `1 II-_ Address: �� 10 1 b1. L C t/�11�y� IF7�� Permit No. Specify Number of Alarms: # Smoke Alarms: I `_1 # Carbon Monoxide Detectors:�� 1 have read and agree to comply with the terms and conditions of this statement Owner or Ow' r Agent's) ame: Si natur .. .................................................. Date: 7 ..... �... Contractor Name: Signature...................................................................... Lic.*........................................ Date:................... SJ77oke and COform,doe revised 01/10/2017 1. If the existing plumbing fixture water usage/tlo,�, rate is equal to or lower than the figure shown, it is not required to be upgraded. SB4071015.doc remised 08/16115 Non-CompliantWater-Conserving Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) —PlumbingFixture Maximum Water Usa a/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CPC Ch. 4 2013 CPC Ch. 4 (Flow Rafe 2013 CALGreen Div. 4.3 2013 CALGreen Div. 4.3 2013 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 considereda 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 si 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/tlo,�, rate is equal to or lower than the figure shown, it is not required to be upgraded. SB4071015.doc remised 08/16115 Owner Name Address 2.0 -1 WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (4 8) 777-32 8 • FAX (408) 777-3333 r building(Qcupertino.or4 `1 AVS k Pen -nit No. 1. Is.your real property -a registered historical site? ❑ Yee Civil Code Sections 110 1. 1through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. C'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? El Yes Civil Code Sections i 101.1' through 1101.8 do not apply. ❑ The licensed plumber's .certification has been provided to the Building Division. Skip therest`of the form and sign bottom of form. Er No Go to Question 3. 3. Is water service permanently disconnected for your building? ❑ Yds Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 0' 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 fon-n. Myreal 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: ❑ IVIy property is a"single fancily residential real property. See Civil Code Section 1101.4. I On `and after�Jahuary-1, 2014; building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced w th`water-conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non- cbrnpliant pl rinbing;i fixtures, shall be replaced with water -conserving plumbing fixtures (regardless of whether i .property undergoes alterations orpTrovements). 21, M' yproperty is a' inult family residential real property. See Civil Code Section 1101.5. " On and after 7anuary_1, 2014; specified building alterations or improvements shall require non- compliant l plurnbing fixtures'; t6 -!be replaced with water -conserving plumbing fixtures. On or before'Jarivary 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- ' `conerving pluinbingg' fixtures throughout the building (regardless of whether roperhundergoes alterations or nuprovements).' ❑ ,1VIylproperty is.a conl7nercial 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. I',Qn 'or, before January 1, 2019; all non-compliant plumbing fixtures shall be replaced with water- conserving i' plurnbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). I, ' si the owner or owner's agent of this property, certify under penalty of perjury that non-cornpliant 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 talile,on the following Daae. 0 ., n A ► I I Owner or, OwnerAge'nt'si Signature: Date: V2.711-1, I' Upon completi:6g,p signing this Certifica , please retu it to the Building Division in order to final your bifildind permit. SB4072015.doc revised 01/05/17 &5017 V- T A, GO .ogle Maps 20177 Northbrook Square le ;orrento NW Square z i m agej peg_2-j pg etR6 KA. z 0 :L fc NW Square Northbrook Square NW Square ?2Dt77 Hartfiprook SQ -4 I I niji � 4 li r. e , ii PP Pw Go 4e NW Square z 0 M Map data 02017 Google 50 ft, L WCX SAL- C OWY LZ R AJ.4� 41 4- N OR TH 4- 2& -1 1 .. %. I WOTE�: THOROUC-iH LY CA-ULK k. —=PERTINO Buildin-q Department V D FGffff A e, Y4 2 DPJ'17�`-' ' 06/a4L,/17 IEV' C-�) I K E FO;��. L I K evieWj`e�Y:Abb7 e 20177 C-'UPERZLJ!�., � C t\\ �. F—Z , 1\1 T S r 55 T• 12" Barnes Paps --. r" • *0 ow$*OWN-�` �* f — 5oalkpM bps 0VW rnium paw WOW Bi ) q � u _ 1 �Plra 7C) �Jq J1 T 4" 1 O , C_ TSD U.) 01 S ". 411 C.0 a RQvul ~I,i j�V I i r,l 0 - �p . ISI s�� 3 1 I:r� T 001. .�---� SCOFF 0f::� OIz UCa./L 07- E:F_LP4_&_MC__jv Ll Irl 14.a CUPERTINO Building Department X 12 " 7n i S7 I J 1 JX 5 I D( F• _P:F, TO 1167 @_ 16'x' "C'. COMMUNITY DEVELOPMENT DEPARTME BUILDING DIVISION—CUPERTINO APPROVED This set of plans and specifications MUST be kept at the ob X I it q dcri r� tsOru ion. It is unlawful to make any change or a terations on same, r to deviate therefrom, without approval from the Building Official. The stamping of this plan and specifications SHALL NOT be held to permit or to be an approval of the violation of an provision of any City Ordinance or State Law. BY DATE PERMIT NO 06/30/17 3) a"-x6"a NEDAJ r I�� L��.?� �EVIEWC� C DE COMP6FAiVCE ; r— _ � 1 � DE''Rev ewed � : bb�r y rr�E=- , l,_e 2071-7 7 �� _ Date- - 06/30/17 ---- CUA �?�i I ��'� , C'_ �.�� I L+ - --