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B-2017-1072CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1072 10657 AMULET PL CUPERTINO, CA 95014-1303 (326 43 067) WILLOW GLEN ELECTRIC INC SAN JOSE, CA 95155 OWNER'S NAME: BUTT NINA AND CHANG EDWARD K OWNER'S PHONE: 408-230-1132 LICENSED CONTRACTOR'S DECLARATION License Class C'-10 Lic. #591918 Contractor WILLOW GLEN ELECTRIC INC Date 04/30/2018 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: 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. 2. I have and will maintain Worker's Compensation Insurance, as provided for by AA 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 upertino Municipal Code, Section 9.18. Signature Date 07-06-2017 LIVA71191 DOM UN 191 IJ 34 If t -M DATE ISSUED: 07/06/2017 PHONE NO: (408) 289-9725 BUILDING PERMIT INFO: X BLDG —ELECT —PLUMB _ MECH X RESIDENTIAL _ COMMERCIAL JOB DESCRIPTION: (N) EV CHARGING STATION (30AMPS) - GARAGE Ft Floor Area: I Valuation: $1490.00 APN Number: Occupancy Type: 326 43 067 PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180 DAYS OF PERMIT ISSUANCE OR 180 DAYS FROM LAST CALLED INSPECTION. Issued by: Kim Dunbar Date: 07/06/2017 I hereby affirm that I am exempt from the Contractor's License Law for one of the RE -ROOFS: following two reasons: All roofs shall be inspected prior to any roofing material being installed. If a roof is 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 ofApplicant: contractors to construct the project (Sec.7044, Business & Professions Code). Date: 07-06-2017 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. 1 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 1 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 07-06-2017 ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 Quali Management District I will maintain compliance with the Cupertino Munici Code, Chapter 9.12 and the Health & Safety Code, Sections 2550 5 nd 25534. Owner or authorized agent: Date: 07-06-2017 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 CUPERTINO ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buildinlX1$QWuart�hy, P-2 - - ja 3-o Twa. PROJECT ADDRESS I �/_ /1.n w , l /� ! 1 I� _•PH APN # 3 —D • OWNERNAME ! /�i H 'V �'W D� D130's/( E-MAIL j I,I tb tgy✓I' Q' ..&/ Db -L •!j ' STREET ADDRESS -P _, „ _ ( (r CITY, STATE,ZIma � qlw/q FAX CONTACT NAME Mark Londre PIIIIONE (408)289-9725 E-MAIL office@williowcLlienelectric.com STREET ADDRESs f O. Box 8430 CITY, STATE, ZIP San Jose, CA 95155 FAX (408)289-9725 1:1 OWNER ❑ OWNER -BUILDER 11a OWNER AGENT >�I CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME Mark Londre LICENSE NUMBER 591918 77NSETYPE ^-1 O BUS. LIC # 15897 COMPANY NAME Willow Glen Electric, Inc. E-MAIL office@willowglenelectric.ciom FAX (408)289-9725 STREET ADDRESS P O. Box 8430 CITY, STATE, ZIP San Jose, CA 95155 PHONE (408)289-9725 ARCHITECT/ENGINEER NAME NSA LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ Multi -Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes ❑ NO PROJECT IN FLOOD ZONE ❑ Yes ❑ No ❑ SOLAR PANELS I it ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS. NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: 11 ' + "F , / q� DESCRIPTION OF WORK � Electric Vehicle Charging Circuit: 1 -a 2 AJIC6 { r- JDJ C-4- C. (1)40V ZDj<"P J4�b 1 - Ct' -ur w m ewA i- 5 a l`t b e AR-A6-it__7 %`b 7-eFsZA S . RECE D BY• 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 building const ru Iz � s Ives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: 1K Z Date: SUPPLEMENTAL INFORMATION REQUIRED OFFICE USE ONLY W ❑ OVER -THE COUNTER ❑ EXPRESS fr ❑ STANDARD ❑ LARGE ❑ MAJOR PVApp_2011.doc revised 03/16/11 pocuSign,Envelope ID:F9F47CD6-83C9-4942-8148-C1681 FF343F3 SMOKE/CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE ,;- a ,I11 ,/4.„1"15%, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300;TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq a cupertino.orq Permit No.B-2017-1072 Address 10657 Amu 1 et P1 ace #of Alarms Smoke: 4 Carbon Monoxide: 1 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE • HAS BEEN SIGNFD 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 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 X X bedroom(s) On every level of a dwelling unit including basements 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 have been tested and are operational,'as of the date signed below. 1 have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: e—Docusfgned by: Nina Butt Signature...ie,...i..yk„, tG� j Dat .X3/14/2017 Contractor Name: %,-72CFD758CB9C476.. Signature Lic.# Date: Smoke'and CO fann,doe revised 03/18/14 DocuSign Envelope ID:F9F47CD6-83C9-4942-8148-C1681FF343F3 !// i• WATER-CONSERVING PLUMBING FIXTURES AVA OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq(a cupertino.orq Owner Name Nina Butt Permit No. 3-2017-1072 Address 10657 Amulet Place, Cupertino, CA 95014 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SIGNED AND RETURNED TO THE BUILDING DIVISION 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: DocuSignedby: Date: 8/14/2017 ❑ No. Go to Question 2. /� ( �c�jL 72CFD75BCB9C476... 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. DocuSigned by: /20.1 7 Owner'Signature: Date:8 O/-I A 1`F 1 O No Go to Question 3. /-. ( (/tA Idly 72CFD75BCB9C476... 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: DocuSignedby: Date: 8/14/2017 ❑ No Go to Question 4. ( rut c�ly 72CFD75BCB9C476..• 4. Is your real property built and available for use or occupancy on or before January 1, 1994? O 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. DocuSigned by: Owner'Signature: ( y Yes ilat: Date:8/14/2017 ❑ �. IMc5I My real property i �xgsniritle for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. O 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). O 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. SB407 2015.doc revised 02/04/15 fDocuSigti Envelope ID:F9F47CD6-83C9-4942-8148-C1681 FF343F3 R. 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). 1/We,the owner(s)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-conservirtvritinibing fixtures comply with the requirements as indicated in the table below. .8/14/101/ Owner's(or Owner Agent's)Signature' /.. tr.lit Date: 8/ Upon completing and signing this Certificate,please return it to the Building Division in order to final your permit. Non-Compliant Water-Conserving Plumbing Fixture Plumbing Fixture1 (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch.4 2013 CPC Ch.4 2013 CPC Ch.4 Water Usage 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013. CALGreen Div.5.3 /Flow Rate 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 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 @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 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/flow rate is equal to or lower than the figure shown,it is not required to be upgraded. SB4072015.doc revised 02/04/15