B-2017-1342CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS:
CONTRACTOR:
PERMIT NO: B -2017x1342
7571 ERIN WAY CUPERTINO, CA 95014-4320 (359 20 010)
ODC CONSTRUCTION
INC
SAN LORENZO, CA '
94580
OWNER'S NAME: KAO ERIC C AND LIN MICHELLE M
DATE ISSUED: 08/14/2017
OWNER'S PHONE: 408-398-0225
PHONE NO: (510) 230-9705
LICENSED CONTRACTOR'S DECLARATION
BUILDING PERMIT INFO:
License Class 51 Lic. #1003636
Contractor ODC CONSTRUCTION INC Date 05/31/2019
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:
KTI'CHEN REMODEL (200 SF)
I hereby affirm under penalty of perjury one of the following two declarations:
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
erformance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance, as provided for by
I
2 Section 3700 of the Labor Code, for the performance of the work for which this
`�ermit is issued.
Sq. Ft Floor Area:
Valuation: $7000.00
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 haws relating to building construction, and hereby authorize
359 20 010
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 regulations per the Cupertino waisipaI Code, Section 9.18.
180 DAYS FROM LAST CALLED INSPECTION.
Signat _ Date OS -14-2017
Issued by: Kim Dunbar
Date: 08/14/2017
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from -the Contractor's License Law for one of the
RE -ROOFS:
following two reason's:
All roofs shall be inspected prior to any roofing material being installed. If a roof is
r. 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: 08-14-2017
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 subjeci to the Worker's Compensation provisions of the
the Health & Safety C Sectio s 05, 25533, 5534.
Labor Code, I must forthwith comply with such provisions or this permit shall
be deemed revoked.
Owner or authorized age
APPLICANT CERTIFICATION
Date: 08-14-2017 ,
I certify that I have read this application and state that the above information is
CONST CTION LENDING AGENCY
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 08-14-2017
Professional
CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
PEMIT #B -
(408) 777-3228 • building@cupertino.org
CUPERTINO
❑ NEW CONSTRUCTION ❑ ADDITION ❑ ALTERATION ❑ T.I. ❑ MEP ❑ RE -ROOF ❑ SWIMMING POOL/SPA
PROJECT ADDRESS ` A vi
APN # ^ O _ Q 1!! C)
OWNER NAME PHONE
E-MAR.
o16
STREET ADDRESS�v i V1_
-/1 0
CITY, STATE, ZIP
CON CTORNAME [],OWNER -BUILDER
COMPANY NAMELICENSE
NUMBER
LICENSE TYPE
oI)L ��-����
D03 6
-9
STREET ADD ESS v�S��
f11
CITY,`TmATE,, Z� 9 / �_ �
L 7 Cl/�J
E -(MAIL
PHONE
_0 o - 2 — 2S�-
BUS. LIC # .
❑ ARCHITECT ❑ OWNER ❑ OWNER AGENT 1;91CONTRACTOR AGENT El ENGINEER ❑ DEVELOPER ❑ TENANT
CONTACT NAME
E-MAIL
STREET ADDRESS
CITY, STATE, ZIP PHONE
DECRIPTON
CO
SINGLE-FAMILY/DUPLEX ❑ MULTI -FAMILY ❑ INDUSTRIAL []COMMERCIAL
USE
TYPE
OCC
SQ.FT.
VALUATION ($)
EXISTING USE
I EXISTING SF
NEW FLOOR SF
PORCH
SF DECK SF
DEMO SF
STORIES #
TOTAL NET SF
REMODEL
REMODEL KITCHEN
REMODEL OTHR
GARAGE ❑ ATTACHED
BATHROOM SF
SF 2pD r
SF SF
❑ DETACHED
EXISING ❑ YES
FIRE SPRINKLERS ❑ NO
EICHLER ❑ YES
❑ NO
SECOND STORY ADDITION ❑ YES
❑ NO
DWELLING ❑ yES ❑ ATTACHED ❑ DETACHED OTHER
ISECONDI)WELLING
UNITS # UNIT ADDNON: ❑ NO S F
POOLS ❑ FIBERGLASS ❑ VINYL -LINED ❑ GUNITE ❑ PREFABRICATED
POOL - SF SPA - SF SPA ATTACHED []YES ❑ NO TOTAL - SF
RE
AL Vt�LUUATIUN:
Commercial or Multi-Fmuilu Buildings with Public Smimuline Poals requires Depnrtme��t of Euviranu�etitnl Heath approval
i f� ff �U%
RE -ROOF
EXISTING ROOF TYPE: ❑ BUILT-UP ROOF ❑ASPHALT SHINGLES❑ WOOD SHAKES ❑WOO
SHINGLES ❑ TILE OTHER (SPECIFY),
REMOVE /REPLACE ❑ NO
I IF NO
PLYWOOD ❑'� ❑ 3/8"
PLYWOOD TYPE:
PITCH:
12
ROOF CLASS
❑ YES
# OF LAYERS
THICKNESS ❑ 5/8" OTHER
❑ OSB ❑ CDX OTHER
A
PROPOSED ROOF TYPE: ❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑ WOOD SHAKES ❑ WOOD SHINGLES ❑ OTHER
*Provide a signed copy of the Cupertino's Tear -Off Policy SF . #o'f SQuAREs
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 accurate. I agree
to comply with all applicable local ordinances and state laws relating to building construction. I authorize representatives of !Cupertino to
enter the above -identified property for inspec 'o purpos I acknowledge and authorize all informationcontained on d*1app 'cation form
to be made available for public record.
I �—
Signature of Applicant/Agent: / Date:?
SUPPLEMENTAL INFORMATION FrQUIREEVl
*New SFD/Second Dwelling Units/Multifamily Dwellings: A Demolition permit is required prior to issuance of a building permit for all new construction.
*Commercial Buildings: 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.
*HOA -Provide a letter of approval from the Home Owner's Association
BldgApp 2017.do'c revised 08101/17
>fl SMOKE / CARBON MONOXIDE ALARMS APill24/t-7
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ;
CUPERTINO 10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
(408)777-3228• FAX(408)777-3333.•buildinq(a cugertino.orq
y✓z',x'D a x .r Nx Zd x t e0 a 1 5-v' "n a r �
Ov PERIVIIT~CANI OT BE F.INI tiiir�IL THIS CERTIFICATE HA -BEEN
s� t 00:P ', ,. r t fthA
it CO.l PLETED,SIGNED, l RETURNED OI H=E BUILDINTappl:SION
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 COALARM
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: '21 I i X) in
�7 Permit No. - 2°Y�r 3 42
Specify Number of Alarms: #Smoke Alarms: I v ( #Carbon Monoxide Detectors: 1
1
I have read and agree to comply ydth the - ms and conditions of this statement
Owner(or Owner Agent's)Name:
Signature . j 9 '7/ /a /ate:
Contractor Name:
Signature Lic.# Date:
Smoke and CO fonn.doc revised 12/15/16