B-2017-1201CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1201
10488 CHACE DR CUPERTINO, CA 95014-1010 (326 13 078)
AFFORDABLE WATER
HEATERS AND
PLUMBING INC
28358
CONSTELLATION RD
VALENCIA, CA 91355
OWNER'S NAME: KLAGES DONALD N AND DEANNE A TRUSTEE
DATE ISSUED: 07/24/2017
OWNER'S PHONE: 408-746-3799
PRONE NO: (855) 345-9087
LICENSED .DCON T A TOR'C D . • RATION
BUILDING PERMIT INFO:
License Class C-3ii Lic. #627368
AND PLUMBING INC Date
X BLDG X'PLUMB
Contractor AFFORDABLE WATER HEATERS
09/30/2018
— _ELECT
— 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
JOB DESCRIPTION:
license is in full force and effect.
(N) 50 GAL WATER HEATER - GARAGE
I hereby affirm under penalty of perjury one of the following two declarations:
i. 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
4 Section 3700 of the Labor Code; for the performance of the work for which this
Sq. Ft Floor Area:
Valuation: $2489.00
permit is issued.
APPLICANT NT RTIFICATION
I certify that I have read this application and state that the above
Number:
Occupancy Type:
information is correct. I agree to comply with all city and county ordinances
32613 078
3 26
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
PERMIT EXPIRES IF WORK IS NOT STARTED
City of Cupertino against liabilities, judgments, costs, and expenses which
WITHIN 180 DAYS OF PERMIT ISSUANCE OR
may accrue against said City in consequence of the granting of this permit.
Additionally plicant understands and will comply with all non-point
180 DAYS FROM LAST CALLED INSPECTION.
source reg ti per he Cupertino Municipal Code, Section 9.18.
Issued by: Kim Dunbar
Signa®r Date 07/24/2017
Date: 0 /24 201
-111"D R DECLARATION,RE-ROOFS:
I hereby''affirm t at I am exempt from the Contractor's License Law for one of the
All roofs shall be inspected prior to any roofing material being installed. If a roof is
installed without first obtaining an inspection, I agree to remove all new materials for
following,two reasons:
t. I, as owner of the property, or my employees with wages as their sole
inspection.
compensation, will do the work, and the structure is not intended or offered for
sale (Sec.7044, Business & Professions Code)
Signature of Applicant:
2. I, as owner of the property, am exclusively contracting with licensed
Date:, 07/24/2017
contractors to construct the project (Sec.7044, Business & Professions Code).
I hereby `affirm under penalty of perjury one of the following three declarations:
ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER
i. 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
HAZARDOUS MATERIALS DISCLOSURE
performance of the work for which this permit is issued.
I have read the hazardous materials, requirements under Chapter 6.95 of the
z. I have and will maintain Worker's; Compensation Insurance, as provided for by
California Health & Safety Code, Sections 25505, 25533, and 25534. I will
Section 3700 of the Labor Code, for the performance of the work for which this
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
Health & Safety Code, Section 25532(a) should I store or handle hazardous
s. I certify that in the performance of the work for which this permit is issued, I
material. Additionally,: should I use t or devices which emit hazardous
air contaminants as definV��'rQuality Management District I
shall not employ any person in any manner so as to become subject to the
will maintain compliance nicipal Code, Chapter 9.12'and
Worker's Compensation laws of California. If, after making this certificate of
the Health & Sa05, 25533, and 25534.
exemption, I become subject to•the Worker's Compensation provisions ofthe
Labor Code, I must forthwith comply with such provisions or this permit shall
Owner or authorized ag
be deemed revoked.
Date: 07/24/2017APPLICANT
CERTIFICATION
I certify that I have read this application and state that the above information is
A ECY
I hereby affirm that there is a onstru tionlending agency for the performance
'
I to comply with all.city acounty ordinances and state laws
of work's for which this permit is ue (Stec. 3097, Civ C.)
correct. agree
relating to building construction, and hereby authorize representatives of this city
Lender's Name ,
to enter upon the above mentioned, property for inspection purposes. (We) agree
to save indemnify and keep harmless, the City of Cupertino against liabilities,
Lender's Address
judgments, costs, and expenses which may accrue against said City in
consequence of the granting of this permit. Additionally, the applicant understands
ARCHITECT'S DECLARATION
and will comply with all non-point,source regulations per the Cupertino Municipal
I understand my plans shall be used as public records.
Code, Section 9.18. p „
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 ^ building cupertino.or4 MISC
CUPERTINC? Q
.UMBING ❑MECHANICAL ❑ELECTRICAL ❑MISCELLANEOUS
PROJECT ADDRESSG
APN# 324(4p
OWNER NAME PHO O
STREET ADDRESS (
1 FAX
CIT ST ZIPC/A cis D
CONTACT NAME P O 99...+(Pt^�pUn
6 V
E-MAIL
STREET AD S
CIT TATE 0
(/�
FAX
❑ OWNER ❑ DOWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ,ARCHITECT ❑ ENGINEER ❑ DEVELOPER U TENANT
CONTRANM
LJE P
BUS. LIC #NUMBERE
COMANY
FAX
STREET ADDRESS2UUCITY, STATE, ZIP q
PHONE
ARCHITECTIENGINEER NAME
LICENSE NUMBER
BUS. LIC #
COMPANY NAME
E-MAIL
FAX
STREET ADDRESS
CITY, STATE, ZIP
PHONE
USE OF ❑ SFD or DUPLEX ❑ MULTI -FAMILY PROJECT IN WILDLAND ❑ YES PROJECT IN ❑ YES
BUILDING: Q COMMERCIAL URBAN INTERFACE AREA ❑ NO FLOOD ZONE ❑ NO
IS THE BLDG AN ❑ YES
EICHLER HOME? ❑ NO
DESCRIPTION OF WORK
C�
TOTAL VALUATION: L
RECE ED
By my signature below,'I certity to each o e wi T 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 p v ed is ect I have read the Description of Work and verify it is accurate, I -ee to comp with all applicable local
ordinances and state laws relating to b r' g cons n. I authorize representatives of Cupertino to enter the abo -Iden 'fled pr e r ction purposes.
Signature of Applicant/Agent: I'
SUPUENTAL INFORMATION REQUIRED
o> FicE usE oi\�Y
U
}
OVER THE COUNTER `
EITRESS
❑ STANDARD
J
LARGE
F
MAJOR
MEPA1iscApp_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(d)cupertino.org
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, 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 witYSmoke 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 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 CRCSection 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. �* I
Address: In 7� r C/ /" I g C e a r(f, Permit No, Z 0 -Z 2 -
Specify
Specify Number of Alarms: # Smoke Alarms: = # Carbon Monoxide Detectors:
I have read and agree to comply with the terms and conditions of this statement
Owner (or Owner Agent's) Name:
Signature.................................................................................................................. Dater
.................................................................................................................................
C n ptoyNarrppe:
T D l-Gt' a - W aft
1 n
Signature ......... .... :................. ......................... Lic.# ... .222.....Date: 7
�a e>^s
.................................................................................
Smoke and CO form.doc revised 12/15116
CUPERT N' 0
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 building(cDcupertino.org 2,01 �
i S Permit No.
10 t Oi✓ e --i
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.
d 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.
Skip the rest of the form and sign bottom of form.
No Go to Question 3.
3. Is water service permanently disconnected for your building?
Cl Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
�j 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. PA ease check ONE of the following:
1 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).
❑ Myproperty.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 perjurythat 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 -conserving plumbing fixtures comply with the requirements as indicated in the
table on the followine Dace. fi . v
Owner or Owner Agent's Signature: e�A,_4/ 0/• 6r� Date: mel &6i
Upon completing and signing this Certificate, please return it to the Building Division in order to final your building permit.
SB407 2015. doe revised 01105117
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.,
SB407 2015.doc revised 08/26115
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
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 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.,
SB407 2015.doc revised 08/26115