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B-2017-1369
F-7 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR:- PERMIT NO: B-2017-1369 21860 SAN FERNANDO AVE CUPERTINO, CA 95014-2837 (357 15 056) WILLOW GLEN ELECTRIC INC SAN JOSE, CA 95155 OWNER'S NAME: GUSTAFSON STEVE AND CHERI TRUSTEE DATE ISSUED: 08/17/2017 OWNER'S PHONE: 408-406-2622 PHONE NO: (408) 289-9725 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10 Lic. #591918 Contractor WILLOW GLEN ELECTRIC INC Date_ 04/30/2018 3X 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: (l) EV CHARGING STATION (50 AMPS)- GARAGE I hereby affirm under penalty of perjury one of the following two declarations: 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 formance of the work for, which this permit is issued. 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: $1090.00 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 357 15 056 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 1�0 DAYS OF PERMIT ISSUANCE OR Additionally, the applicant understands and will comply with all non -point source regulations per the pertin :Municipal Code, Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. ature4 f Date 8/17/2017 Issued by: Abby Ayende DECLARATION Date: 08/17/2017 OWNER -BUILDER I hereby affirm that ham 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 1. 1, as owner of the property, ofmy 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: 8/17/2017 I hereby affirm under'penaltyof perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS "A" OR BETTER 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 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 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 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 'hocome subjectto the Worker's Compensation provisions of the the Health & Safety Code, Sections 2550 , 2553 , 25534. Labor Code,. I must forthwith comply with such provisions or this permit shall be deemed revoked. weer or authorized agent: APPLICANT CERTIFICATION Date: 8/17/2017 I certify that 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 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 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 8/17/2017 professional Wt 5T/A_�50kj) ALTERNATIVE ENERGY PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT.- BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255' (408) 777-3228 - FAX (408) 777.3333 • bui1di c c Qi n 0 ®� J' 1 ' /, & A o PROJECT ADDRESS LQ FCt A 6 /V G-- -hAPbN( OWNERNAME 370! 'U&TArF&V -�� ,# a6� E-MAIL u�S�Li`YSP STRLET ADDRESS ��VR J��C►r�-/`"J/nrI/�[`bO� CITY,IP v '?,r5044 n,uatI'riAl FAX CONTACT NAME Mark Londre PHONE (408)289-9725 E-MAIL office@wiIlowglenelecteic.com STREETADDRESSR O' Box 8430 CITY, STATE, ZIP San Jose, CA .95155 FAX (408)289-9725 ❑ OWNER ❑ OWNER -BUILDER ❑ OWNER AGENT CONTRACTOR ❑ CONTRACTOR AGENT ❑ ARCHITECTS ❑ ENGINEER ❑ DEVELOPER ❑ TENANT CONTRACTORNAME Mark Londre, LICENSENUMBER 591918 LICENSEM013 ^-10 BUS. LIC# 15897 COMPANY NAME Willow Glen Electric, Inc. E-MAIL office@willowgleilelectric.com, FAx (408)289-9725 STREET ADDRESS P O. BOX 8430' CITY. STATE, ZIP San Jose, CA 95155 PHONE (408')289-9725 -7.ARCHITECTlENG1NEERNRME l Y/A LICENSE NUMBER BUS. LIC # COMPANY NAME E-MAIL FAX STREET ADDRESS CITY, STATE, ZIP PHONE USE OF SFD or Duplex ❑ :Multi -Family STRUCTURE: ❑ Commercial PROJECT IN WILDLAND URBAN INTERFACE AREA ❑ Yes 0 N PROJECT IN FLOOD ZONE ❑ Yes ❑ NO ❑ SOLAR PANELS ELECTRIC VEHICLE CHARGING STATION ❑ SOLAR WATER HEATING ❑ OTHER: FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS (COMMERCIAL ONLY): TOTAL VALUATION: 9` O Lio iP d DESCRIPTION OF WORK Electric Vehicle;Char in Circuit: V-t2AW c H 1 s77 c- L, (') a vA/; 01d'0up b e A I LA-r-C;7b Q_e` .T C� 149i -moi iU C Fd46�C�, G ii;s L'- 5 . RECEiVBD HYE \, , 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 beha f. I have ead 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 building c c nze rgpntatives of Cupertino to enter the above -identified property for inspection purposes. 1 44Signature of ApplicanttAgent: Date: SUPPLEMENTAL INFORMATION REQUIRED t USEiONLX r "Lm � W a DOVETER r �4l O EXPRESS � 0~ STANDARD i , LARGE' ❑ MA40i2.'' - fl PY4pp_2011.doc revised 03116111 DocuSign Envelope ID:8E69E3ED-E083-4D47-AE7B-0C66B486D5F9 / SMOKE,/CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinciecupertino.orq Permit No.B-2017-1369 Address 21860 San Fernando Avenue #of Alarms Smoke: 8 Carbon Monoxide: 3 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE, ` HAS BEEN,SIGNED AND RETURNED TO THE BUILDING DIVISION 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 no interior access for inspections are required. GENERAL INFORMATI,ON Existing single-family and,multi-family dwellings shall be provided with Smoke Alarms and Carbon Monoxide alarms. When!thevaluation of additions,alterations,or repairs to existing dwelling units exceeds $1000.00,CRC Section R314 and,CBC Sections 9072.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alarms be installedi in:the following locations: AREA SMOKE ALARM CO ALARM Outside of'each separate;sleeping area in the immediate vicinity of the X X bedroom(s) On every level of a dwelling unit including basements; X X Within each sleeping room; X Carbon Monoxide alarms are t 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 shallbe approved by the Officeof the State Fire Marshal. Power Supply:In dwelling units;with no commercialpower supply,alarm(s) may be solely!battery operated. In existing dwelling units, ilarms are permitted to;be solely battery operated where repairs or alterations do not result in the removal of walland ceiling finishes or there is no access by means of attic,basement or crawl space.Refer to CRC Section,8314 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 d California Residential Code's.The alarms have been tested and are operational,as of the date signed bel have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: Docusigned by: 2017 Steve Gustafson; signator ...�ft�<..t�44Sfa�ibin. .Date'/10/2017 Contracto f Name: 4B75E19D31 D4489..: Signature Lic.# Date: Smoke and CO form doe revised 03/18/14 DocuSign Envelope ID:8E69E3ED-E083-4D47-AE7B-0C66B486D5F9 v .. \\I !/� WATER-CONSERVING PLUMBING FIXTURES (:0.\:/. OWNER CERTIFICATE OF COMPLIANCE ,5�,,9r4, COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildinq(a.cupertino.orq Owner Name Steve Gustafson Permit No. B`2017-1369 Address. 21860 San Fernando Avenue, Cupertino, CA 95014 ' PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE; HAS BEEN SIGNED AND RETURNED'TO THE BUILDING DIVISION' Please refer to the attached California Civil Code Sections 1101.1 — 1101.8 which are part of this Certification form. 1. Is your real property a registered historical site? ❑ Yes Civil Code Sections 110I.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner'Signature: Docusignedby: Date: 9/10/2017 ❑ No Go to Question 2. STww Atsta66" 4B75E19D31 D4489... 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. Sign below and skip the rest of the form. DocuSigned by: /1 O/2 017 Owner'Signature: Date:9 7 1 G 0 No Go to Question 3. S> sfaw, 4875E1903104489... 3. Is water service permanently disconnected for your building? O Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner'Signature: DocuSlgnedby: Date: 9/10/2017 O No Go to Question 4. gtA,tt, av,SfA. ot&, 4875E1903104489... 4. Is your real property built and available for use or occupancy on or before January 1, 1994? O 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. Sign below and skip the rest of the form. DDocuSSigned by: Owner'Signature: Slcvw St1601n. Date:9/10/2017 ❑ Yes My real property iabonelmnevitable for use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. 0 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). El 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). 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. SB407 2015.doc revised 02/04/15 DotuSign Envelope ID:8E69E3ED-E083-4D47-AE7B-0C66B486D5F9 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). 1/We,the owner(s)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 1101.8,the current California Plumbing Code and California Green Building Standards Code,and manufacturer's installation requirements,and that the water-cons �' 9in�fi tures comply with the requirements as indicated in the table below. Owners(or Owner Agent's)Signature AStab'Sbtt, Date:9/10/2017 -4B75E19D31 D4489... Upon completing and signing this Certificate,please return it to the Building Division in order to final your permit. Non-Compliant , Water-Conserving Plumbing Fixture Plumbing Fixture1 (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type 2013 CPC Ch.4 2013 CPC Ch.4 2013 CPC Ch.4 Water Usage 2013 CALGreen Div.4.3 2013 CALGreen Div.4.3 2013 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 • 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 02/04/15, Steve Gustafson 21860 San Fernando Ave Cupertino, CA. 95014 (650) 333-2577 Install one 240 Volt 50 Amp dedicated circuit with a NEMA 14-50 receptacle behind the outdoor main electrical panel in the garage. This circuit will provide 40 continuous amps for EV charging. House Garage Driveway 200A Main Panel (E) w/ 50A breaker (N) 3/4'' conduit w/ #6 THWN conductors #10 THWN ground (N) NEMA 14-50 receptacle (N) Steve Gustafson Page 1 Abby Ayende 08/17/17 08/17/17 B-2017-1369 Abby Ayende Site Location: Prepared by Steve Gustafson Willow Glen Electric, Inc. 21860 San Fernando Ave PO Box 8430 Cupertino, CA. 95014 San Jose, CA 95155 (650) 333-2577 (408) 289-9725 - office General Lighting and Receptacle Loads [220.12] 3 watts per ft² x 3,506 = Small-Appliance Branch Circuits [220.52(A), 210.1(C)(1)] 1,500 watts x 2 = Laundry Branch Circuit(s) [220.52(B), [210.11(C)(2)] 1,500 watts x 1 = Refrigerator(s) = 780 Instant Hot H2O(s) = 600 Exhaust Fan(s) = Hot Tub = Dishwasher(s) = 960 Hood Exhaust(s) = Jacuzzi Tub(s) = 1,920 Pool Equipment = Garbage Disposal(s) = 600 Gas Range(s) = Radiant Heating = Central Vacuum = Microwave(s) = 1,200 Gas Oven(s) = Steam shower = Sewage Ejector = Trash Compactor = Wine Fridge(s) = 600 Sauna = 30A Circuit = Steamer = = = Garden Shed = Total Fastened-in-place Appliance Load Clothes Dryer(s) [220.54] 80% x 240 x Derating Volts Amps OR = 5,000 80% x 240 x = Derating Volts AND / OR = 1,200 Air Handler/Furnace 115 x 6.0 = Volts Amps Air Conditioners 55% x 240 x 100 = Derating Volts AND / OR = Total Volt-Ampere Demand Load [220.83] Air-conditioning Equipment 13,890 x 100% = Electric Space Heating - x 100% = First 8kVA of all other loads 8,000 x 100% = Remainder of all other loads 19,878 x 40% = Total Current Minimum Amperes 29,841 ÷ 240 =200 Amps (voltage) (minimum amperes) Electric Vehicle [625.14] 125% x 240 x 40 = Continuous Load Volts Amps Minimum Amperes with Added Load Divide the total 41,841 ÷ 240 = 200 Amps volt-amperes by (voltage) (minimum amperes) the voltage. NOTES Fastened-In-Place Appliances [220.53] Kitchen Bath(s) Outisde/Miscellaneous Residential Electrical Load Calculation 10,518 3,000 1,500 15,018 8,000 6,660 5,000 Name Plate Rating of Clothes Dryer Ranges, Ovens, Cooktops, and Other Household Cooking Appliances [220.55]1,200 Name Plate Rating of Cooking Appliances Heating or Air-Conditioning System (Compare the heat and A/C, and omit the smaller.) [220.60] 13,890 Name Plate Rating of Air Handler & AC Units Greater of: 13,890 All References are to 2014 National Electrical Code. 7,951 29,841 17 Current Minimum Size Service or Feeder [240.6(A)] 124.3 currently 12,000 20 Minimum Size Service or Feeder w/ Added Load [240.6(A)] 174.3 with added load Abby Ayende 08/17/17 45500 Fremont Boulevard, Fremont, CA 94538 | May, 2016 | Version 3 The recommended home charging installation for Tesla vehicles is a 240 volt NEMA 14- 50 outlet. This outlet is commonly used for electric ranges and large recreational vehicles. Installed with a 50-amp circuit breaker, this outlet enables a recharge rate of about 25 miles per hour. Consult a licensed electrician to review the electrical load of your home prior to installation. They will design your charging system and obtain a permit for a general purpose NEMA 14-50 outlet from your local building department. After installation, the electrician will schedule an inspection to approve the new electrical circuit and design. This guide provides reference for specifications to install this outlet. Since each installation is custom to the home, all hardware for the NEMA 14-50 outlet will be provided by your electrician. Voltage: Single phase, 208-250 volt AC supply, 60 hertz Circuit Breaker: 50 amp (125% overcurrent protection) Operating Current: 40 amp (maximum continuous current) Conductors: 6 AWG, Copper Wire Only. Upsize wiring for installations over 150 feet Ground Fault Circuit Interrupter: Not required Service Disconnect: Not required Receptacle Recommendation: High quality, industrial grade receptacle Examples: Hubbell part # HBL940A, Cooper part #5754N Ventilation: Not required Outdoors: Install with NEMA 3R rainproof enclosure Abby Ayende 08/17/17