B-2017-0406 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-0406
10660 HALE PL CUPERTINO,CA 95014-1627(326 40 012)110658 HALE PL NUVERA
CUPERTINO,CA 95014-1627(32640 012) CONSTRUCTION INC
PLEASANTON,CA
94566
OWNER'S NAME: JUNG KEVIN Z AND AILEEN I TRUSTEE DATE ISSUED:08/28/2017
OWNER'S PHONE:510-506-1959 PHONE NO:(925)309-8888
.. _I I. Ifta f _ . t;. I. BUILDING PERMIT INFO:
License Class B Lic.#988488
Contractor NUVERA CONSTRUCTION INC Date 11/30/2017 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:
DUPLEX: 10658-FIRST FLOOR BEDROOM
I hereby affirm under penalty of perjury one of the following two declarations: ADDITION/BATHROOM/PLAYROOM(374 SF);
1. I have and will maintain a certificate of consent to self-insure for Worker's 10660-FIRST FLOOR BEDROOM
Compensation,as provided for by Section 3700 of the Labor Code,for the ADDITIONBATHROOM/PLAYROOM(374 SF)
performance of the work for which this permit is issued.
7 Aid a• 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
permit is issued. Sq.Ft Floor Area:748 Valuation:$75000.00
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 40 012 R-3(Custom)
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 nicipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION.
t(ure 'Date 8/28/2017 Issued by:Jasmine Archbold
Date:08/28/2017
OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of the RE-ROOFS:
following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
1. I,as owner of the propertyor 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:8/28/2017
I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
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. 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
a. 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 subject to the Worker's Compensation provisions of the the Health&Safety Code,Sections 25505,25533 and 25534.
Labor Code,I must forthwith comply with such provisions or this permit shall
be deemed revoked. O ", 0 t orized agent: •
APPLICANT CERTIFICATION '° 'a8/ 0
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 source regulations per the Cupertino Municipal ARCHITECT'S DECLARATION
Code,Section 9.18. I understand my plans shall be used as publicrecords.
Signature Date 8/28/2017 Licensed
Professional
•
\rk/ CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION B ,
//,,,,,1394., 10300 TORRE AVENUE•CUPERTINO.CA 95014-3255 B-2017-0406
l'toi)
CUPERTINO (408)777-3228•FAX(408)777-3333•buildinci icupertino,orq - / 0,..
-q-----04-1 ,,_,._.,.-
❑NEW CONSTRUCTION ❑X ADDITION 1:1 ALTERATION/TI 0 REVISION(DEFERRED ORIGINAL PERMIT#___
PROJECT ADDRESS 10658-10660 Hate Place,Cupertino,CA 95014 APN g 326-40-012
OWNERNAME Kevin&Aileen Jung and Michelle&Nathan Dunn PHONE 510-506-1959 E-MAIL kevinjung@gmail.com
STREET ADDRESS 10660 Hale PI CITY,STATE,ZIP Cupertino,CA 95014 FAX n/a
CONTACT NAME Kevin Jung - PHONE 510-506-1959 E-MAIL same as above
STREET ADDRESS CITY,STATE,ZIP FAX
i same as owner information n/a
Iffi OWNER 0 OWNER-BUILDER ❑ OWNER AGENT ❑ CONTRACTOR��TR ❑CONTRACTOR AGENT ❑ ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑TENANT
f CONTRACTOR NAME i[-Fr;,rQlti,_ j❑C A,,, -"'LICENSE NUMBER gg(%Lr/O LICENSE TYPE (� nU'SLI#3qn ' Qi 1:
�/V NM�Y Fi�F �ty rl ' Q eq
b O rJ I"C � G T�
COMPANY NAME Kb/1 l,4f2 vanrt5et,AT E-MAIL o1 ., ,G) r sola �,,_G p„vtp f%FAX
STREET ADDRESS `� /I 0 q 1` asln ,tilt•/CITY,STATE,ZIP/-
ft'
IP[�f ,e\ PHONE. 0e 2 /e r
I
`r 'u Y4SW 7 i' ((J J(J �_c•-:?-1
ARCHITECT/ENOINBER NAME LICENSE NUMBER BUS.LIC#
I'
COMPANY NAME •E-MAIL FAX,
STREET ADDRESS CITY,STATE,ZIP PHONE
'DESCRIPTION OF WORK Add on to existing duplex for—748 square feet. Each unit will get a bedroom and bathroom. This Is a one story addition and has
gone through planning review and approval(see ASA 2016-09). Unit 10658-(374 sq ft),unit 10660-(374 sq ft). . '
EXISTING USE I PROPOSED USE CONSTR.TYPE #STORIES i - '
2 Unit Duplex Same 1 ''USE TYPE OCC. SQ.FT. VALUATION(t)
i '
EXISTG NEW FLOOR DEMO TOTAL R3 748 $75;000.00
AREA 2,731 AREA 748' AREA n/a NET AREA Housing V-B , i ,' 11,
BATHROOM KITCHEN OTHER
REMODEL AREA n/a REMODEL AREA Ilia REMODEL AREA n./a
PORCIH AREA DEC/.AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑❑DTTACH I
n/a Ilia n/a ,
.
#DWELLING UNITS: IS A SECOND UNIT ❑YES SECOND STORY YES
2 BEING ADDED? ❑NO ADDITION? NO
PRE-APPLICATION ❑YES IF YES,PROVIDE COPY OF IS-rUERLOGAli DYES Firp / T C LVALUATION:
PLANNING APDL$ El NO PLANNING APPROVAL LETTER EICHLER HOME? ®NO 2-20/
By any 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 is accurate, I agree to comply with all applicable local
ordinances and state laws relating to buildingldjconsuuctio . I authorize representatives of Cupertino to enter the above-identified property for inspection purposes.
Signature of Applicant/Agent: 0 ' L. y"yam"�(/�/�j� Date: 4/3/2017
/�
SUPPLEMENTAL INFORMATIRERED PLAN CHECK TYPEROUTING SLIP I
_New SFD or Multifamily dwellings: Apply for demolition permit for ❑ OVER-THE-COUNTER 0 BUILDING PLANREVIEIV
existing building(s). Demolition permit is required prior to issuance of building '
permit for new building. ❑ EXPRESS 0 PLANNING PLAN REVIEW
_Commercial Bldgs: Provide a completed Hazardous Materials Disclosure ❑ STANDARD 0 PUBLIC WORKS
form if any Hazardous Materials are being used as part of this project. ❑ LARGE I=1 FIRE DEPT
_Copy of Planning Approval Letter or Meeting with Planning pricy to ❑ MAJOR ❑ SANITARY SEWER DISTRICT
submittal of Building Permit application.
• 0 ENVIRONMENTAL HEALTH
BldgApp 2011,doc revised 06/21/11 , ' '
4. SMOKE / CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
CUPERTINO10300 TORRE AVENUE• CUPERTINO,CA 95014-3255
(408)777-3228•FAX(408)777-3333• buildinq ac cupertino.orq
Y4
' '::„ 3- V,t y�" �� 3y71 3Js'4 tifia'y�'x Tay '. ax *v-} g-,
{� gvR itit-LAN'NOT 3 E fi ED t-STII J H tS<CERTIFICATE HAS BEET
'- .* > ,. t h ? 'kaE-sem: .w. ^*.d�`�i :7a ,a�.t=y ,ye
TVISIOOIV
" 1111 .: z,,.+. ynu §'� .a zQ § .. i of ` A c '�n ,ate'*F' +
�32[c szL&5. ..a.«�� �x�,.,, �il+`b�.� �� ....��
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 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. G y
Address: 1Orpc'i-- (o6�v RAJ., ` ( ( CC.��/�{'l� ( en lS�il (4, Permit No. P,` I? -6((O(p
Specify Number of Alarms: #Smoke Alarms: Uzi #Carbon Monoxide Detectors: Lei
I have read and agreeto comply with the terms and conditions of this statement
Owner(or Owner Agent's)Name:
Signature .. Date: gi zo0 in
Contractor Name: / —
Signature Lic.# Date:
Smoke and CO form.doc revised 12/15/16
WATER-CONSERVING PLUMBING FIXTURES
OWNER CERTIFICATE OF COMPLIANCE
%sem' COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION
C U P E RTI N O 10300 TORRE AVENUE • CUPERTINO,CA 95014-3255
(408)777-3228 • FAX(408)777-3333 •building@cupertino.org
Owner Name: RA/1 �vl e Permit No:13-2D V? d 06
Address: 10((s-ig' lO6Go wok, �( , C`'''Pet( C,q T t t(
CODE REFERENCE(S):
Senate Bill 407(2009)/California Civil Code Sections 1101.1 through 1101.8
2016 California Green Building Standards Code(CALGreen)Section 301
BACKGROUND:
As of January 1, 2014, SB 407 requires non-compliant plumbing fixtures to be replaced with water conserving
plumbing fixtures when a property is undergoing additions, alterations or improvements. Applicants seeking to
obtain permits for any of these types of work will be required to replace noncompliant fixtures prior to final permit
approval or issuance of 'a certificate of occupancy by the local building department. This law applies only to
properties built on or before January 1, 1994.
Per Civil Code section 1101.4, for any single-family residential real property, on and after January 1, 2014,building
addition, alteration or improvement will require all non-compliant plumbing fixtures to be replaced with water-
conserving plumbing fixtures. See list on the following page for scopes of work that are exempt from these
standards.
Per Civil Code Section 1101.5, for any multifamily residential real property and any commercial real property, on
and after January 1, 2014, specified building addition, alteration or improvement will 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 (regardless of whether
property undergoes alterations or improvements):
Type of Property(choose one): 0 Single-Family Multi-Family ; 0 Commercial
Property Information: YES NO
1. Is your real property a registered historical site?If YES,skip the rest of the form and sign bottom of form. 0 11151
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 ❑ 0
fixtures is not technically feasible? If YES,skip the rest of the form and sign bottom of form.
3. Is water service permanently disconnected for your building? If YES,skip the rest of the form and sign 0
bottom of form.
4. Is your real property built and available for use or occupancy on or before January 1,1994? If ❑ 0
NO,skip the rest of the form and sign bottom of form.
I/we, as the owners) 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 1101.8, the current California Plumbing Code and California
Green Building Standards Code, and anufacturer's installation requirements, and that the water-conserving
plumbing fixtures';comply with the requi e ents as indicated in the table on the following page.
Owner or Owner Agent's Signatur • Date: t109//3-
*Upon completing and signing this Certi irate,please return it to the Building Inspector at final inspection in order to final your building permit.*
. SB407 2015.doc revised 08/16/17
.,y, L......�::t.1....'!..f.. ...:.............. .n,........_.....................u.,.. ,..r_n..nu:...;!,!�r,r:.:!;!n::....t,r,. .,iw•.. „ ! .....i.... ,,w ,A.,. :::1,..
::•-r L...11 ..�,.s.!.;:.xr 1 J� ,...:��:xa�.:x..:...�......,_..::,h.� :::�.�.: ,.:... ,.w.,•..� ".Imdk.,.;,.�P":'r+:a„e.::�.:Gz �..!.IL: I kd.,:. �c„'��itay.+a��..33a.rs:>.�wjd,.�,lan:.L nseU:�� ::Y�+n:
�r ! {v w3 ,✓ r !5k sti drx'�r+n :zx:�'su v•yi u.ua 1! F a Yy+e `� tn�UY{ •�
1g40 FrAkit, 4444 ^,f ak ..136-p1.4141,4410,4-41, fr
.^�:... .............. ,... ;.:. ,,... ..... .,:.:,:,,._..s _ ,.....^...........,,... -,.....__. ..,..., ,.....,,�µnitl.Y l.,tti�.Jmq':M�Y.w%:,dx
•
Non-Compliant • Water-Conserving Plumbing Fixture
Plumbing Fixture/ (Fixture Complying with Current Code Applicable to New Construction)
Maximum Water Usage/Flow Rate
Fixture Type 2013 CPC Ch.4 2013 CPQ 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 08/26/15
t- uf _ to
TESTING ENGINEERS, INC.
*go
- 2811 Teagarden St. 510=835=3142 510-834-3777 fax
San Leandro,CA 94577 - 800-660-3142
San Leandro • San Jose a "Martinez -
INSPECTION:REPORT : Week Ending::9/15/17
PROJECT# 65864 TYPE OF INSPECTION:
Epoxied Dowels
PROJECT: PLACE OF INSPECTION:
10658—10660 Hale Place Jobsite
(Addition)
Cupertino,CA =
Permit# B-2017-0406
DATE 9/13/17
HOURS 4
INSPECTOR M.Ardizzone
Reported to Juan at the jobsite as requested.
Inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and the injection of Simpson Set XP
epoxy(exp.4/19). Witnessed the proper insertion of nine(9)#5 reinforcing steel bars,48"in length,embedded 4"into
existing footing connection at.addition.
The preceding work was,to the best of my knowledge,in compliance with approved job plans and specifications,including
revisions by engineer.
Reviewed by:
• D. . Chippero
Special Inspection Division Manager
1cc: Kevin Jung
Lawrence Liao,S.E.
City of Cupertino/Bldg.Inspection Dept.
The results presented in this report relate only to the item(s)tested/inspected and
may be reproduced only in its entirety unless written permission from TEI is obtained.
Page 1 of 1
-�u17 di*
limpr= TESTING ENGINEERS, INC. .
2811 Teagarden St. 510=835=3142 510=834-3777 fax • "
' - San Leandro,CA 94577 800-660-3142
- : San Leandro • San Jose • -Martinez .
• INSPECTION`REPORT Week Ending;:9/15/17
PROJECT# 65864 TYPE OF INSPECTION:
Epoxied Dowels
PROJECT: PLACE OF INSPECTION:
, 10658—10660 Hale Place Jobsite
(Addition)
Cupertino,CA - - _
Permit# B-2017-0406
DATE 9/13/17
HOURS 4
INSPECTOR M.Ardizzone
Reported to Juan at the jobsite as requested.
Inspected predrilled holes for proper diameter and depth. Observed the cleaning of holes and the injection of Simpson Set XP
epoxy(exp.4/19). Witnessed the proper insertion of nine(9)#5 reinforcing steel bars,48"in length,embedded 4"into
existing footing connection at addition.
The preceding work was,to the best of my knowledge,in compliance with approved job plans and specifications,including
revisions by engineer.
• Reviewed by:
• D. `. Chippero
Special Inspection Division Manager
1cc: Kevin Jung
Lawrence Liao,S.E.
City of Cupertino/Bldg.Inspection Dept.
The results presented in this report relate only to the item(s)tested/inspected and
may be reproduced only in its entirety unless written permission from TEI is obtained.
Page 1 of 1