B-2017-1234CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B-2017-1234
10359 BONNY DR CUPERTINO, :CA 95014-2948 (359 13 010)
RANDO AAA HVAC
INC
SAN JOSE, CA 95125
OWNER'S NAME: MOREHOUSE CHARLES C AND HONOR W TRUSTEE
DATE ISSUED: 07/27/2017
OWNER'S PHONE: 408-446-4212
PHONE NO: (408) 293-4717
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class C43- C20 Lic. #7688711
Contractor RANDO AAA HVAC INC Date 09/30/2017
X BLDG _ELECT —PLUMB
X 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:
REPLACE FURNACE (2) (SAME LOCATION) ; INSTALL (N) AC UNIT
I hereby affirm under penalty of perjury one of the following two declarations:
(2)
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.
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:. $22000.00
permit is issued.
APPLICANT CERTIFICATION
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
359 13 010
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 re a er the Cuper)ino Municipal Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.,
Signature Date 7/27/2017
Issued by: JASMINE ARCHBOLD
TION i
OWNER-BLi1T DER DECLARATION:
Date: 07/27/2017
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:
t. 1, 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: 7127/2017
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
maintain compliance with the Cupertino Municipal Code, Chapter 9.12 and the
permit is issued.
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
material. Additionally, should I use equipment or devices which emit hazardous
shall not employ any person in any manner so as to become subject to the
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 'ons125355005, 25533 and 25534.
Labor Code, I must forthwith comply with such provisions or this permit shallbe
4�
deemed revoked. `
Owner or authorized :agent: _
APPLICANT CERTIFICATION
Date: 7/27/2017
CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
I hereby affirm that there is a construction lending agency for the performance
correct. I agree to comply with all city,and county ordinances and state laws
of work's for which this permit is issued (Sec. 3097, Civ C.)
relating to building construction, and hereby authorize representatives of this city
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,
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.
Licensed
Signature Date 712712017
Professional
SMOKE / CARBON MONOXIDE ALARMS �Taiv I_
OWNER CERTIFICATE OF COMPLIANCE• COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
CUPERTINO10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333• buildinci a(�cupertino.orq
7.z4 r a� s�>` �s v 3 � zt"'�^«' 1 a� x'a?v�'S'e�tr �.�+ / ;� s a -° �: x - Yr
�t t �r x � x � s VV
� ERMITCANNOT FALSCHEN
s. FT
�COMPLETED,SIGNEDARET r O� BUILDINGD SIN f,
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 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 eachseparate sleeping area in the immediate vicinity of X X
the bedrooms)
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 dowelling 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.
Address: i> vl I3O n� Df v V Permit Noe-2-011'423+
Specify Number;of Alarms oke a n I .! 7 `.ar ,tk. cagoo.+1,7 ra_tegt c;:
1 have read and agree comp wit he terms and c itions of this statement
lgnatsr' . . .... . . . r, Da e. 7 \-k-
Contractor Name:; —1 (~�P I
alm' !kanclu Signature ........ Lic.# ...... ... . Dat .
iel
Smoke and CO forrn.doc revised 12/15/16
' • WATER-CONSERVING PLUMBING FIXTURES WIN1I
OWNER CERTIFICATE OF COMPLIANCE
h
° . COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
CUPERTINO10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
(408)777-3228•"FAX(408)777-3333• building a(�cupertino.orq �] f -\^�, Ie21
wno- egg L' UritS More-to u s e_ Permit No.r) LL-l1 p l,r
gess ) 3C 8 o kin i )ri vJ� CoTtet ivto cA °15014,-,-
Is
01 -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.
yNo Go to Question 2.
Fa 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.
S. No' Go to Question 3.
ES Is water'service permanently disconnected for your building?
❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form.
❑ No. Go to Question 4.
IMIr Is your real property built and available for use or occupancy on or before January 1, 1994?
❑ No My realprbperty 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 fonn.
64 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 forth..
Ffil Please check ONE of the following:
❑ 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 Mixtures shall be replaced with water-conserving plumbing fixtures (regardless of whether
property undergoes'alterations or improvements).
IA 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.
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 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 1'101.8;the current California Plumbing Code and California Green Building Standards Code, and manufacturer's
installation requirements, and that the water-conserving plumbing fixtur s comply with the requirements as indicated in the
table on the following page. I
„
Upon completing and signing this Certificate,please return it to the Building Division in order to final your building permit.
SB407 2015.doc revised 01/05/17
•
•
BUII;iNG PEAR 11IIT CA1 OT BE FINAI:ED. TD O1VlPLETE'7J I.11iIS `.
to CER I grATE IiA tpL,,, t�IGNED < ETURNNNEJ TOi TN�BBI LMWePIWIO Ti
•
Non-Compliant Water-Conserving Plumbing Fixture
Plumbing Fixture ' (Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usage/Flow Rate •
Fixture Type 2016 CPC Ch. 4 2016 CPC Ch. 4 2016 CPC Ch. 4
Water Usage 2016 CALGreen Div. 4.3 2016 CALGreen Div. 4.3 2016 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
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 @`6b:16,'01'r;
the}above'are unavailable, Wlere faucets meeting
aerators or other means the above'are
maybe usedto achieve unavailable, aerators or
av .. �. r;. tit
reduction' ` other means mayrbe`
•
tJ
..
1. If the existing plumbing fixture wafe usage/flow rate is equal to'o lower than the:figure shown;'it is not'required to be upgradediipead8d.
.t e _ i § . a ,`,7e. _ _ _ tit 1 ,V>:1.04
t-.i, y�l r s,;>.a j.- . �..,. z art: e•a'' •
:' ;}5�. :?{3,a- tT..�v `+ )i.;�,i . ?'1' i ,,.-? ;t. .,; u,t° ,-..*r'`i{ �_- - .,r>i;•,: t.'t
�.,f r . ..z -it; !t.)4' i, '2', f. .3_.. _ Fi is �i-.:• `
1 z- 11.!- ,.t. - �... 't �r _+. .:�.: r ', - . •j
��,=s 9 z, r n..fi.... ;NA• :.i.. - '). r .,�..
y(.:75;` ' r, SB407 2015.doc revised 01/05/17