B-2017-1066CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1066
10354 COLBY AVE CUPERTINO, CA 95014-2401 (316 29 03 8)
PURONICS SERVICE
INC
LIVERMORE, CA 94551
OWNER'S NAME: JACK MYERS CONSTRUCTION INC
DATE ISSUED: 07/03/2017
OWNER'S PHONE: 408-813-4020
PHONE NO: (925) 456-7000
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C-M Lic. #92859U
Contractor PURONICS SERVICE INC Date 02/28/2019
X BLDG —ELECT X 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:
(N) INSTALL WATER SOFTENER SYSTEM
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.
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: $2800.00
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
APN Number:
Occupancy Type:
and state laws relating to building construction, and hereby authorize
316 29 038
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
Issued by: JASMINE ARCHBOLD
ER-BUILDER DECLARAT
Date: 07/03/2017
I hereby affirm that I am exempt from the Contractor's License Law for one of the
RF ROOFS:
following two reasons:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
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: 7/3/2017
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.
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
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
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: 7/3/2017
I certify that I have read this application and state that the above information is
CONSTRUCTION L I
correct. I agree to comply with all city and county ordinances and state laws
I hereby affirm that there is a construction nding a cy for the performance
relating to building construction, and hereby authorize representatives of this city
of work's for which this permit is issued
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 7/3/2017
Professional
CUPERTINO
GENERAL PERMIT APPLICATION MEP
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 , B-ZOIj.
(408) 777-3228 - FAX (408) 777-3333 • building aacupertino.org ' S C
❑ PLUMBING ❑ MECHANICAL ❑ ELECTRICAL ❑ MISCELLANEOUS
PROJECT ADDRESS/ ^'3 /' /� L
(f C-rO C/
7r
APN # 1 /J 1
1 (� 0
OWNER NAME l H Y ^ J ^ 0 u'A
j
PHONE / q O ' W ^
E-MAIL
STREET ADDRESS
CITY, STATE ZIP FAX
1,30
CONTACT NAME JEFF RAINEY
PHONE510-427-4260
E-MAIL
Jeffreyrainey@att.net
STREET ADDRESS 1069 EDGEMERE LANE
CITY, STATE, ZIP HAYWARD, CA 945454
FAX510-783-1041
❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT
❑ CONTRACTOR 54 CON'T'RACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT
CONTRACTOR NAME
LICENSE NUMBER 928595
LICENSE TYPE C36
BUS. LIC # 40137
COMPANY NAME Puronics
E-MAIL
�i�� J120,JiC '..wl
FAX 925-456-7010
STREET ADDRESS 5775 Las Positas Rd
CITY, STATE, ZIP Livermore, CA 928595
PHONE 925-456-7000
ARCHITECT/ENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF SFD or DUPLEX ❑ MULTI -FAMILY
BUILDING: ❑ COMMERCIAL
PROJECT IN WILDLAND ❑ YES
URBAN INTERFACE AREA ❑ NO
PROJECT IN ❑ YES
FLOOD ZONE ❑ NO
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
DESCRIPTION OF WORK ' T 67f�,7F_ 1 1
11 `
TOTAL VALUATION: 'Z I g �}� t'TJ
RECEIVED BY
By my signature below, I certify to each of the following:
application and the information I have provided is correct.
ordinances and state laws relating to building construction.
Signature of Applicant/Agent:
I am the property owner or authorized agent to act on the property owner's behalf. I have read this
I have read the Description of Work and verify it is accurate. I agree to comply with all applicable t cal
I authorize representatives of Cupertino to he above -identified property for inspection purposes.
Date: op/
PPLEMENTALf7!5
ION REQUIRED
OFFICE USE ONLY
w
❑ OVER-THE-COUNTER
❑ EXPRESS
U
U
❑ STANDARD
❑ LARGE
4
❑ MAJOR
MEPMiscApp_2011.doc revised 06/21/11
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(a)cupertino.org
PURPOSE
This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for
compliance with 2013 CRC Section R314,2013 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 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)
X
X
On every level of a'dwelling unit including basements
X
X
Within each sleOpirig 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;R3l.4 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 iof 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 operationnl,'as of the
date signed below. I " '
Ad
d s: t 0 3,� raE6Y Avx kw ► Ce q >w `- !O I SPREmit No. 0I7 .`�®6
S 2E '
�� °Alarms
I have read and agree to comply with the terms and conditions of this statement
I-t�1D� r� ,i e..... .. ................ _ ., . :- .
a L........
..................................................................................................................
Contractor Name:
Signature.................................................................. Lic.#.................................... Date:
................................................................................. I
I
Smoke and CO form. doc revised 09/27/16
C.UPERTINO
WATER -CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777- 28 • FAX (408) 777-3333 • building aa)cupertino.org
Permit No. r�C We
1P
Please refer to the attached California Civil Code Sections 1101.1— 1101.8 which are part of this Certification form.
1. Is your real property a registered historical site?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
/Owner' Signature:
No Go to Question 2.
Date:
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.
Sign below and skip the rest of the form.
011/Owner' Signature:
�o Go to Question 3.
Date:
3. Is water service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form.
Owner', Signature:
velx`o'
Go to Question 4..
Date:
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. Sign below and skip the rest of the form.
Owner'. Signature: Date:i
Yes 'My. real property is built and available for use or occupancy on or before January 1, 1994.
Civil Code Sections 110 1. 1 through ,.1101.8 apply. Refer to the attached.
y 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 afte. 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-
conservingplumbing fixtures throughout the building (regardless of whether property undergoes alterations or
improvements): i
❑ My property is la' Cb7ninercial 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.
SB407 2014.doc revised 03118114
1. If the existing plumbing fixture water usage/flotiv rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015.doc revised 08/26/15
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 Usage
2013 CPC Ch. 4
120'13CALGre'en
2013 CPC Ch. 4
2013 CPC Ch. 4'
/Flow Rafe
2013 CALGreen Div. 4.3
Div. 4.3
2013 CALGreen Div. 5.3
Single -Family
Multi -Family
Commercial
Residential I
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
Gallons/flush .
0.5 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 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 Q60 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 psi
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/flotiv rate is equal to or lower than the figure shown, it is not required to be upgraded.
SB407 2015.doc revised 08/26/15