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B-2017-1149CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR. PERMIT NO: B-2017-1149 10270 PARKWOQD DR APT 4 CUPERTINO, CA 95014-1515 (326 27 037) THERMAL MECHANICAL SANTA CLARA, CA 95054 OWNER'S NAME. AVERY GLENBROOK LP DATE ISSUED: 07/26/2017 OWNER'S PHONE: 650-961-8330 PHONE NO: (408) 988-8744 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO' License Class C-4. C -1 0:C -36-C-38 Lic. #256057 Contractor THERMAL MECHANICAL Date 01/31/2018 X BLDG X ELECT X PLUMB I hereby affirm that I am licensed under the provisions of Chapter 9 (commencing X MECH X RESIDENTIAL _ COMMERCLAL with Section 7000) of Division 3 of the Business & Professions Code and that my license is in full force and effect. JOB DESCRIPTION. BLDG #6/UNIT #4, ADD (N) A/C; REPLACE FURNACE, SAME I hereby affirm under penalty of perjury one of the following two declarations: LOCATION, N WASHER AND DRYER HOOK UPS, N ELECTRICAL i. I have and will maintain a certificate of consent to self -insure for Worker's SERVICE (70 AMP); (N) GAS LINE FOR STOVE, (1) RECEPTACLE Compensation, as provided for by Section 3700 of the Labor Code, for the OUTLETS; (1) LIGHT, (N) BATHROOM EXHAUST FANS. performance of the work for which this permit is issued. i I have d 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: $20000.00 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 326 27 037 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 upertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signature 7/26/2017 Issued by AbbyAyende / Date: 07/26/2017 OWNER -BUILDER DECLARATION 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 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: 7/26/2017 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. 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 equipment or devices which emit hazardous shall not employ any person 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 Cupertin Municipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the the Health & Safety Code, Spedbuls 2j.05, 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: 7/26/2017 I certify that I have read this application and state that the above information is �ONSTRUC ION LENDING AGENCY 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 7/2612017 professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ti (408) 777-3228 • FAX (408) 777-3333 • buildingp-)_cupertino.orgCUPERTINO NFWC.0NSTRTT('TT0N n A111TTTINT IXI ArronnITn—/— l 2.01-1- 4'�1 ------ u +W.+.++�+r vvi i.iuVa:✓ V1V11.J 11V!]L SL'1�1V1111f PROJECTADDMss 10270 Parkwood DR, BLDG 6, Unit#4 APN# OWNERNAME Aver/ Glenbrook LLC PHONE E-MAIL650-961-8330 avert'@pacbell.net, STREET ADDRESS 130 East Dana Street . CITY, STATE, ZIP Mt. View, CA 94041 FAX 650-961-0571 coNTACT NAME Rob Moyer PHONE 408-593-8115 E-MAIL rmoyer@thermalmech.com STREET ADDRESS 425 Aldo ave. i'.. CITY, STATE, ZIP Santa Clara, CA 95054 FAX 408-988-0233 OWNER ❑ OWNER-BUMDER 0 OWNER AGENT IX CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT ❑ ENGINEER ❑. DEVELOPER ❑ TENANT CONTRACTORNAME Thermal Mechanical hanical LICENSE NUMBER 256057 LICENSE TYPE BUS. LIC 299 C-4,10,20,36,38 COMPANY NAME Thermal Mechanical E-MAILrmoyer@thermalmech.com FAX 408-988-0233 STREET ADDRESS 425 Aldo ave. cTTY°STATE, zIP Santa Clara, CA 95054. PHONE 408-988-8744 ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LIC # COMPANYNAME - - - E-MAIL _. FAX STREET ADDRESS CITY, STATE, ZIP - PHONE DESCRIPTION OF WORK add new AC, replace furnace in same location, (N) washer/dryer hook ups, (N) electrical panel (70 AMP); (N) gas line for stove, (N) electrical outlets, (N) light, (N) bathroom exhaust fan EXISTINGUSE - PROPOSED USE CONSTR. TYPE # STORIES 1 USE TYPE OCC. SQ.FT. VALUATION ($) EXISTG NEWFLOOR DEMO. TOTAL - - AREA AREA AREA NET AREA - BATHROOM KITCHEN - OTHER - - REMODEL AREA REMODELAREA REMODEL AREA PORCH AREA DECK AREA - TOTAL DECK/PORCH AREA - GARAGE AREA: DETACH - - ATTACH - #DWELLINGUNITS: IS A.SECOND UNIT ❑YES SECONDSTORY ❑YES - - BEING ADDED? ONO .. ADDITION? ❑NO ' r PRE. -APPLICATION ❑YES IF YES, PROVIDE COPY OF IS THE BLDG AN ❑ YESMCE By.,`; rr ! TO ALUAT N'._ PLANNING APPL # FIND PLANNING APPROVAL LETTER EICHLER HOME? ❑ NO r ; By my signature below, I certify to each of the following: I am the property owner or authorized agent to, act o 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 build" n cI- n. I authorize re r ntatives of Cupertino to enter the above-identi d prop for inspection purposes. o Signature of Applicant/Agent: Date: L JUFFLEMbN 1 K ,1NFUKMAHUN F—EQUIKN�/ New SFD or Multifamily dwellings: Apply for demolitionpermitfor existing building(s). Demolition permit is required prior to issuance of building permit for new building. Commercial Bldgs: Provide a: completed Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. _ Copy of Planning Approval Letter or Meeting with Planning prior to submittal of Building Permit application. BldgApp 2011.doc revised 06/21/11 I i . . SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE 64" COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228• FAX(408)777-3333 • buildina(a cudertino.orq r ! i F 4 v iiiµ �f -_ -s I t, in r s5.4 . i .1, r:lt�,.r t IIA t - i 1 k4i���etls{.������� �I'L 1����-u � i��Y w � '� r a vE '^;E v(F sir r at;s+Y �,�t tCa� .k� _s*��h�4j�''k"n,;�.i as kin�,`a1�.r S 1�'Rrr tY .k:� +�ivt 7"} a:4 I 1 > ,S"Sx H � .: }'��11} J . t . Y la e i tf {fir a.,X� fggi Ph l,. J v r � � ii r � a x?l Sy • `-, ER14MiattagoITI CANNOVBE IST EOUP•Inti t1 eERIIFI;F e 8 6! � } , � CO,ATTI LET£+D sIG TED° IkR TSL ED' .OT � WRIAYISIOW - ,., x -��' .> ?may a rzr r, cid L z� tr .. v. sP"s �i".:. z�u3z ...x"dr'p .u'i*sc.""; .ts.vrt4 z .a si �'w'+•'.i ''v*'n .��.arfig�,�"`�,.'a".' �:a^?^r�.tt���� g'.��'"""7:'�:•�^`.i� :�-. ..., ->.; .,�-m=X.'�a^s?':"�.�-^"..'�F�.'°?^��..'";aR.,.xK:7.v7 �:lm',�"'..Via.,. ..� 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 ho 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: 1. AREA SMOKE ALARM CO ALARM . j 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. � Address: /02 70 Pa(�G Gtie.90.67 J / 6-0" Permit No.g--2.01 -)1"/ ? Specify Number of Alarms: # Smoke Alarms: I 2 J #Carbon Monoxide Detectors: Lim 1,have read and a.ree to compl with the tem-nd conditions of this statement _ Owner(or Owner Agent's)Name: Signature Date7A1;1,4.440E D� ? LGo. g Contractor.Name:. Z 56e S 7 /, v'eC ee,44t7+Ga( Signature Lica Date: ��7 �� cmnlo marl(Y)fm-111 dnn rnnicnil n0/J7/lc