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B-2017-1112CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1112 20729 GARDEN CREST CT CUPERTINO, CA 95014-5056 (362 30 057) DONE RIGHT HOME REMODELING INC SANTA CLARA, CA 95050 OWNER'S NAME: NELSON ATSUKO T TRUSTEE & ET AL DATE ISSUED: 07/11/2017 OWNER'S PHONE: 408-504-3773 PHONE NO: (800) 816-0000 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class $ Lic. #1002689 Contractor DONE RIGHT HOME REMODELING INC Date 04/30/2019 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: KITCHEN REMODEL (200 SF) 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. �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 Sq. Ft Floor Area: Valuation: $8000.00 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 36230 057 362 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. Signatur Date 07-11-2017 Issued by: Kim Dunbar OWNER DECLARATION Date: 07/ 11 /2017 -BUILDER 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 fust 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: 07-11-2017 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 s. 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,ons 2550 , 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner or authorized agent: APPL.ICANT CERTIFICATION Date: 07-11-2017 f�L[NG I certify that I have read this application and state that the above information is AGENCY CON TRUCTION 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 07-11-2017 Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 CUPERTINO I (408) 777-3228 • FAX (408) 777-3333 • building cu ertino.OM 11 ❑ NEW CONSTRUCTION ❑ ADDITION E ALTERATION / TI ❑ REVISION /DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS ao a P r�e Y -,C r -e S� (j APN # OWNER NAMEo O h l PHONE G(3 -5U 1/^ T '! i A E-MAIL STREET ADDRESS CA yn CITY, STATE, ZIP O /J FAX CONTACT NAME � V � / / ny PHONE -y G E-MAIL STREET ADDRESS 4 L Vb CITY, STATE, ZIP n C j ^, *�^ FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT ❑ CONTRACTOR It `CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑ DEVELOPER ❑ TENANI CONTRACTOR NAME Dobe (�' FSE revnod cith LICENSE NUMBER oo & q LICENSE TYPE Bl I # I COMPANY NAME O I Ye �M /' E-MAIL V FAX CITY, STATE, ZIP f C /C, r^ STREET ADDRESS I (/ e /V1 c z bl v � �, C� I Y O� PHONE / /' Oma Q o - '1 6 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE DESCRIPTION OF WORK /1 /� t , / / V l, I D� Q !� / l 1� 1 t� O li�et y l Il 'll(f,,l covhter EXISTING USE PROPOSED USE CONSTR. TYPE I # STORIES USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEW FLOOR DEMO TOTAL AREA AREA AREA NET AREA BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA�00 REMODEL AREA PORCH AREA DECK AREAJTOTALDECK/PORCH AREA GARAGE AEA -DETACH EA: DTAC ❑ ATTACH #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 D ION: PLANNING APPL# ❑NO PLANNING APPROVAL LETTER EICHLER HOME? 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 building construe ion. 1 authorize representatives of Cupertino to enter the above -identified property for inspection purposes. Signature of Applicant/Agent: Date: SUPPLEMENTAL INFO ON REQUIRED PLAN CHECK TYPE ROUTING SLIP ❑ OVER-THE-COUNTER ❑ BUILDING PLAN REVIEW _ 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. ❑ EXPRESS ❑ PLANNING PLAN REVIEW 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 MAJOR El SANITARY SEWER DISTRICT submittal of Building Permit application. ❑ ENVIRONMENTAL HEALTH BldgApp 2011.doc revised 06/21/11 \ F L SMOKE / CARBON MONOXIDE ALARMSAu-05 OWNER CERTIFICATE OF COMPLIANCE 01.1, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPEiiTINO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinqAcupertino.orq 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 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 X X the 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 specified below have been tested and are operational, as of the date signed below �,, �j� Address: Os . ,2 ��� �,� ��`�" " / ° Permit No. Specify Number of Alarms: #Smoke Alarms. I CEO I #Carbon Monoxide Detectors. I r I have read and agree to comp! with the terms and conditions of this statement Owner(or Owner Agent's)Name: tri Signature . !u/.. :; C-1-4 7` Date:��p7./. Contractor Name: Signature Lic.# Date: Smoke and CO form.doc revised 09/27/16 WATER-CONSERVING PLUMBING FIXTURES3 (4LO3 $jt0- OWNER CERTIFICATE OF COMPLIANCE 4,1.64 COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildinci cuoertino.orq •Owner Name � v."v ptE�V Permit No. V4-'*— I i- Address Xi2-91G ✓c(e Ores _ C , (ti fl'vi D , eA PERMIT CANNOT BE FINALED AND''`COMPLETED UNTIL THIS CEl;2`TJFICATE HAS B E.1*3 JGNED ANp RF tiiINED.; 'O`TH_ E,BUILDINGaDLVI xoN 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: Date. Ve-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? ❑ 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. Owner' Signature: Date: l 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 Sign below and skip the rest of the form. Owner' Signature: Date. �No Go to Question 4 � I 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 Sign below and skip the rest of the fonn. Owner' Signature: Date: Gr.-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 Refer to the attached. g 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 commercial real property See Civil Code Section 1101.5 On and after January 1,2014,specified building alterations or improvements shall require non-compliant plumbmg fixtures to be replaced with water-conserving plumbing fixtures. SB407 2014.doc revised 03/18/14