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B-2017-1293CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO: B-2017-1293 10243 BEARDON DR CUPERTINO, CA 95014-1922 (326 32 025) FALCONE PLUMBING & HEATING INC SAN JOSE, CA 95126 OWNER'S NAME: CHIN GOODWIN RAND ALICE L S DATE ISSUED: 08/07/2017 OWNER'S PHONE: 408-255-6210 PHONE NO: (408) 292-9705 LICENSED CONTRACTOR'S DECLARATION BUILDING PERNHT INFO: License Class C-20. C-36 Lic. #764087 Contractor FALCONE PLUMBING & HEATING INC Date 03/31/2019 X BLDG —ELECT X PLUMB MECH X RESIDENTTAL 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: (1) 100 GALLON APARTMENT WATER HEATER (SAME LOCATION) 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 rformance of the work for which this permit is issued. 4Jhavc 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. p Sq. Ft Floor Area; Valuation: $4000,00 APPLICANT CERTIFICATION I certify that I have read this application and state that the above information is correct. I agree,to comply with all city and county ordinances APN Number: Occupancy Type: and state laws relating to building construction, and hereby authorize 326 32 025 representatives of this city to enter upon the above mentioned property for inspection purposes. (We) agree to save indemnify and keep harmless the City of Cupertino against li ilities, judgments, costs, and expenses which PERMIT EXPIRES IF,WORK. IS NOT STARTED may accrue against said i in consequence of the granting of this permit. WITHIN 180 DAYS OF PERMIT ISSUANCE OR Additionally, appaca t , nderstands and will comply with all non-point sours re tati er - Cupertino Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. ft.,e Date 7 2 17 e hS�$L1� Issued by: Jasrrun Arc bold V OWNER-BUILDER DECLARATION Date: 08/07/2017 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 fust obtaining an inspection, I agree to remove all new materials for compensation, will do the work, and the structure isnot 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: 8n42-017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER r. 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 Worker's Compensation laws of California. If, after making this certificate of material. Additionally, should I use equipment or devices which emit hazardous air contaminants as defined by the ay Area Quality Management District I will maintain compliance with the erti M nicipal Code, Chapter 9.12 and exemption, I become subject to the Worker's Compensation provisions of the thoMpIth & Safety Co e' ecH s 25505, 25533, and 25534. Labor Code, I must forthwith comply with such provisions or this permit shall be deemed revoked. Owner, rd, uthorized agent: APPLICANT CERTIFICATION Da 99 I certifithat I have read this application and state that.the above information is CONSTRUCTION' LENDING AGENCY correct. I agree to comply with all city and county ordinances and state laws reby 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 8/7/2017 Professional CUPEfiil!' O COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE ° CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • building (aD.cupertinD.Ong ZPLUMBING ❑ MECHANICAL 13 -2-c�tZ- ❑ELECTRICAL ❑MISCELLANEOUS PROJECT ADDRESS10215���� y�� ` /� APN # ��J / 3 ^7 _ ®�� (—SEE G-• OWNERNAME PHONE -MAIL STREET ADDRESS CITY, STATE, ZIP/',,JJ',1,A✓Ld �� �`C'/ FAX �J�GZ'= CONTACT NAME .61/i /�/ L -,n /CG?. e- PHOI�)✓ i ! ?7D� EMAIL? /G� C /CSP • Gcs. i STREET ADDRESS �, .> J LI � l�J/.;, �.� . CITY, STATEZIP �.2j , s/?��.c �s� SCSI L•e6 FAX ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT 13tiONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECT' ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTOR NAME ' A �(fn � �f /3/� /'�"//4' � LICENSE NUMBER 7E 4 �7 LICENSE TYPE C •rte c- 3c U5. LIC # -� COMPANY NAME /�'A� LA FAX STREET ADDRESS% �� /� �Q CITY, STATE, ZIP C4 N tl PHONE�`��G ARCHITECT/ENGINEER NAME LICENSE NUMBER BUS. LTC Ir COMPANY NAME, E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE j USE OF ❑' SFD or DUPLEX PE9' MULTI-FAMTLY !BUILDING: E]'COMMERCIAL PROJECT IN WIL.DLAND ❑ YES URBAN INTERFACE AREA ❑ NO PROJECT IN ❑ YES FLOOD ZONE ❑ NO IS THE BLDG AN El YES EICHLER HOME? ❑ NO DESCRIPTION OF WORK i i TOTAL VALUATION: G(%6 RECEIVED BY :By my signature below, I��rceJJJrtify 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 lav ovided '4correct. I have read the Description of Work and verify itIis accurate. agree to comply with all applicable local lordinances and state laws relating t b dirk c Mucrion. I authorize representatives of Cupertino to enter the ab -i 7'iti.fie property for inspection purposes. Signature of Applicant/Agent: ` Date: !. SUPPLEMENTAL INFORMATION REQUIRED z , ;;• OFFICE USE ONLY W r ❑ OVER THE COUNTER ': ' ❑ EJTRESS � ❑ STANDARD U Z. ❑ LARGE R ❑ MAJOR MEPMiscApp_2011.doc revised 06/21/11 IN SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE '�:gx9F COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION X4;1,-0 CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228• FAX(408)777-3333•buildinoc cuoertino.orq ''? {n'7 rit �4+ :2;li -i 5 c-si- v _'t- t.� y'1-ra. ijOA c,-s ..,, 5 iw �' rs J {te'cc a r wF13 3 � y. ` - ?'✓'t nY?Fr O tt:.41 a + '. 4' Vb ii � ... ,r .a .2 ° y s.1 $1 ;': t a „�srn7'T✓.aS�d i<s v`,i/�:r+cf: '.t s .�,:�r �t .v t >�7„� n41f }}y�?�T �� �S�Y '¢���sr yt`} ^i "�f`� h m�iaup� i���{ s�,?5 }�, 4 1 Is }� IC #. AS BEEl'i �+.1�.W"b��'a:, zh-e� Af' � th a ` k'�i- iit�*�, mac. .?3"'v/'sts ar^'k>Iaax ., ,a _et„ O FRXE. ED SIO EDm�'F ', '1iI NE Qa quf i �D -SiO N < a, iY 't..L te,':..:tLv .PIZ c hi – w r&r-S.Pz 'd a`.° s 'ia.°."3'64*a.. r ty'. g„;c 2".fa 2Y+r"ii.r#i'. .. ."'<?a�..9A"'..c�.''xA�'–.s-..#?:�?EBF'3'^'3�?:RRr"C�...*c�.�a.tc�w3.^".f':c..�,..._:,.rn�..:,x;3k.ryd3–'•'Y'„+t......r^?;'33�L�k"4.;Srt�'.rom t� s::..r3".;-:a . 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 L 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 propertyj herebycertify 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. ' `� ���l r Address: i O 2/- i3ec yo�1� L Y, A I , (y. erti.l0 �c .9cOi Permit No..6 1 JP7 � �� Specify Number of Alarms: .11 to #'Smoke Alarms: i3 - #Carbon Monoxide Detectors: /have read and agree to c.!•ply with pe terms and conditions of this statement fJactoeF{d Omer Agents)Name: t� btu, c- j 17,z 11.4 int Signature , bate:4lS7g_ C ntractor Na e J� Signature i... . Lic.# .. ,11,,, Date:050 Smoke and COfornt.doc revised 12/15/16 �. . ..E .� v4m6Se io ido�q e_ Lir cavtvI ''LimiEli k r�rlss� COMMUNITY DEVELOPMENT DEPARTMENT••BUILDING DIVISION .. 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTIN (408)777-3228•'FAX(408) 777-3333.buildino aecuoertino.orq ." Owner Name _ tk,-UA �if 1/01 !_ �Permit No. ='" Address Ia2.43 l3ee.roLo� 6v , °t-c-1 C r/t P ' eu1 0/ - 1.• Is your real property a registered historical site? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Skip the rest of the form and sign bottom of form. 42 g.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? 0 Yes -Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification ha's 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? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not'apply. Skip the rest of the form and sign bottom of form. r4 No Go to Question 4. *4 yot*r Teal property built and available for use.or occupancy t��r ':Vtfe on ar beforeJanuary 1, I994� . , -11Ty real property is built and avatlabble for t:se'or occupancy".after January 1' 1914 4 : Civil Code Sections 1101.1 through 110,1.8, nota I Ski the rest of the form°and sign,bottom of form.. PPy� .. � .- �. . _-myreal property is built and available-foz`iise kFie pancy on or'before January 1, 1994.` ' v - ,� - ;,, Civil Code Sections 1101.1 through 1101.8 apply„'Check one of the three following statements and sign bottom of form.. , 5. Please check ONE of the following: i;"' 0 My property is a single-family residential real property. SeeCivil Code Section 1101.4. On and after January 1,2014, building alterations or i provements 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). ; 0.., My property is a multifamily residential real property. See',Civil'Code Section 1101.5. On and after January 1, 2014,specified building alterations improvements shall require non-compliant plumbing fixtures to be replaced with water-cbnsertiing 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). 0 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 futures will be replaced.prior,to date specified above with water-conserving plumbing fixtures in accordance with Civil Code Sections 1101.I through 1101.8,the curTent California Plumb'i a Code and California Green Building Standards Code,and manufacturer's installation requirements,and that the N - er- mt.erving piumbinv_fixrures comply with the requireiments as indicated in the table on the,following page. 1 ` 1 FP" "P i ” Owner or'Owner Agents Signature: r �� 3,,i7;r71_ , . . ._,, n,{' ,„:„—, ,„ -,4, ,,,..r,,,,,,,,,,,,,,,,,4,....f,,,:l.",,,,,,,w,,-,•,,m.-z--N,-,-.4aqih,-4",,,r.,x,ivg,iirninwf,W"-g;:?",70Fer,V4,,gmm,1".:74,,,Firak:. g•,:',.4.41#94'7PM-14:74Mg:PtPiliaW--",- 64;1,401•4:WviV,erw-4-e:44=F-.94,S5- ....:4,7-.4,,,,,e,,,-;,-..x,7,,,,0 3,,,,,- ,,, ,,,,,,t.,_,,,,,,it,'„,.,.-,",,,,,::',:fw,g,,-, r-4.v,y-„i"lkft,11:3 ,1,'.. 'y e. , , ..,;„,,:- ' . t4 ,, ,,:: . : : ..,:,, , •.: ••, ,, ., i. - • .,,k; ,,,' r.'• .11,:4.11,4: 'W.7.‘: -4,sgrgd . ‘pEll -ft'-'—'5,413.kiT,On13,INkiliElY,AND-CO ' LETERVIRIFI''''' '. ;'z'alWX 4" :33-ig3i,, '',•,.-31.7,4 ..suro.o.4i• ' • •,••••3',37,4,43lik .1.•,,• ,,,A":'...P•s•xl;.... .4.,Ors.g---.eg..A.3137,- .:.,3!Rn A-:-3.,.. -4•243. ..4, ',3::,02•• ;141'::• A-w-,-*„10,1,4tv*if 4 - 4ts-.61-7,Te.V44,44:4044,,,, ?!......... ..3.,_.-'.,'`•:,',,''.4"-*WV2=lttafgr.4, —.. . ....,_ -... Non-Compliant Water-Conserving Plumbing Fixture (Fixture Complying with Current Code Applicable to New Construction) Plumbing Fixturel " 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 onefull flush) _ Urinals Exceed 1.0 0.5 gallons/flush Gallons/flush : Showerheads Exceed 2.5 2.0 gallons per minute a 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 valva'shaltnot 1- ' eigned to exceed 2 G gallons per minute a 80 psi, or the shower shall be de , , • , 'allow only one shower outlet to be in operation ata time. Faucets— ExCeed.2.2-galions ' .Maximum 1.5 gallons per Within units: 03 g,all'onspei minute @ 60 Lavatory per minute ! . minute©60 psi; minimum Maximum 1.5 gallons psi Faucets. ,0:8 gallonsper Mintite.a- per minute a 60 psi; 20 psi minimum 0.8 gallons per-minute@ 20 psi . , In.common and..public , use areas.: 0.5 gallons . per minute a 60.psi 1.8 gallons per minute @60 psi ' Faucets— :2• -Exceed 2gallons . 1.8 gallons per minute a ta gallons per minute 1.8 gallons per minute @ 60 Kitchen 1 per minute ,60 psi a 60 psi psi ,Faucets ,•May temporarily increase - *May temporarily up to 2.2 gallons per increase up to 2.2 .minute a,60 psi,.and must .gallonsper minute-a. II default to maximum 60 psi, and must d- !1.8gillona per minute.@ default ta maximum \t-_, ..1 .- po psi 1:8 gallons per minute 1 . Where faucets meeting • g.60 PSI ifie-above are unavailable, Where faucets meeting ii aerators or other means the above are i' • maybe used to achieve unavailable, aerators or , . „1 - redUctilorr. , .. , other Means maybe , .Ost;c1,toachieVe ' . - - ...' • 1. ,' . • :. ' • r'eduCtioii:/ 11. If.the existing plumbing fixture waterilSagefiloWszte is&dual to or.loWerthau theiguie.shOyht,it is not required to be upgrad .ed -. , . , ., . _. . . „. , , ._ .. , • . i .. • ...,. 1 - 1 . I I i . . . . 3 • ' . , I , ., .....,. • -. , . a •• . . . .•r, • • • • I . • •..' • • . • . I F SB407 20.15,docievised 0.1/05/17 : r , I s I