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B-2017-1516 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1516 7949 CRANBERRY CIR CUPERTINO,CA 95014-4923(362 03 010) AFFORDABLE WATER HEATERS AND PLUMBING INC 28358 CONSTELLATION RD VALENCIA,CA 91355 OWNER'S NAME: CHANG GORDON Y AND KAREN ET AL DATE ISSUED:09/08/2017 OWNER'S PHONE:408-218-3281 PHONE NO:(855)345-9087 .. _ I 1.. lit' I :__:.. Ilk BUILDING PERMIT INFO: License Class C36 Lic.#627368 Contractor AFFORDABLE WATER HEATERS AND PLUMBING INC Date X BLDG _ELECT X PLUMB 09/30/2018 _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 JOB DESCRIPTION: license is in full force and effect. REPLACE WATER HEATER(40 GAL)SAME LOCATION I hereby affirm under penalty of perjury one of the following two declarations: 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 'lipperformance of the work for which this'permit is issued. I have and will maintain Worker's Compensation Insurance,as provided for by ' ?;,e Section 3700 of the Labor Code,for the performance of the work for which this Sq.Ft Floor Area: Valuation:$3327.00 permit is issued. APPLICANT CERTIFICATION p y Typ certify that I have read this application and state that the above APN Number: Occu anc e: formation is correct.I agree to comply with all city and county ordinances 362 03 010 .nd state laws relating to building construction,and hereby authorize representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to save indemnify and keep harmless the PERMIT EXPIRES IF WORK IS NOT STARTED City of Cupertino against liabilities,judgments,costs,and expenses which WITHIN 180 DAYS OF PERMIT ISSUANCE OR may accrue ag.. st City in consequence.of the granting of this permit. Additionally,th= '..-0i'I!`ft understands and will comply with all non-point 180 DAYS FROM LAST CALLED INSPECTION. source regul-,,ons p- 1 Cupertino Municipal Code,Section 9.18. ei Issued by:Kim Dunbar Signa�6 Date 09-08-2017 Date:09/08/2017 O./ JI��S ''D_C :_`;T O. RE-ROOFS: I hereby of- m th;t I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofmg material being installed.If a roof is following tw, reas.ns: installed without first obtaining an inspection,I agree to remove all new materials for i. I, o o er of the property,or my employees with wages as their sole inspection. coin. sation,will do the work,and the structure is not intended or offered for sale(Sec.7044,1Business&Professions Code) Signature of Applicant: 2. I,as owner of the property,am exclusively contracting with licensed Date:09-08-2017 contractors to construct the project(Sec.7044,Business&Professions Code). 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 HAZARDOUS MATERIALS DISCLOSURE performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the 2. I have and.will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will Section 3700 of the Labor Code,for the performance of the work for which this maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the per it is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous 3. I certify that in the,peiformance of the work for which this permit is issued,I material. Additionally,should I use a ipment or devices which emit hazardous shall not employ any person in any manner so as to become,subject to the air contaminants as defined by the B! AA ea -\. Quality Management District I will maintain compliance with the C .- .o, unicipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Cod; . '•s 25 15,25533,and 25534. exemption,I become'subject to the Worker's Compensation provisions of the Labor Code,I must forthwith comply with such provisions or this permit shall Owner or authorized agentIA I, be deemed revoked. Date:09-08-2017 � APPLICANT CERTIFICATION COI __•U yl_Y IJ t J.G GE C_ I certify that I have read this application and state that the above information is I hereby affirm that there is a r onstr I ction 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 permi,is iss 1-d(Sec.3097,Civ C.) relating to building construction,and hereby authorize representatives of this city Lender's Name to enter upon the above mentioned property for inspection purposes. (We)agree 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 sof 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. CONSTRUCTION PERMIT APPLICATION elk. COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 1161'. s 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 t.tmr 20 1 * - l SI Co (408) 777-3228 • building@/ctlpertino.org PEMIT#B- CUPERTINO REV✓r DEF Pi ❑ NEW C9ONSTRUCTION ❑ADDITION El ALTERATION ❑T.I. ! MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESS ® ���(� APN 2— b OWNS 1�,. . E, 1 L PHON os) z e y,,C'°'J� E-MAIL ie i fapvi 01,,,,i) STRE / SS. V. 4. /r� CVV�✓T✓/ �0 W e/ '4, 4`C-0 II. CONTRACTORQNNAAME 12 OWNER-BUILDS COMPANY NAMEI1 LICENSE NUMBER LICENSEE TYPE 9 L� k>ae rr 1 �(�C L) L1ej (52`-3(off c.. (p 1,E,E A�li ESSconsu 1 a..\10rt C STATE, ZIP s A E-MAIR C - NE� R GEN ONTRAtri)N�ENGINEER DEVELOPER TENANT 40010SZ CON 9CT NAME t-, E-MAIL .� orac e.nB '1 S s�R G-s\--Ncet- tea `VIiIc�AZIP as � ' 5 MOO /S3(deo DECRIPTON �I�0� c,.. /-(-64�— /� qi/ c)grVI L' O0 70 01:17{../ (v/ . SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL I • EXISTING.USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES' TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5) REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE 0 ATTACHED BATHROOM SF SF SF SF 0 DETACHED EXISING ❑YES , EICHLER 0 YES SECOND STORY ADDITION ❑YES FIRE SPRINKLERS NO 0 NO 0 N - DWELLING SECOND DWELLING El YES ❑ATTACHED❑DETACHED OTHER UNITS N i. UNIT ADDITON; 0 NO S F u ' POO'LS!' ❑FIBERGLASS' 0 VINYL-LINED ❑GUNITE '❑PREFABRICATED POOL SF , SPA SF I SPA ATTACHED ❑YES 0 NO I TOTAL-SF RECEI/L►"AI I TOTAL ALUATION: Connnernul or Multi-Familu Buildings with Puhlic'Swiumiing Pools requires Department o/Environmental Heath approval / t <, /r • RE-ROOF EXISTING ROOF TYPE:' ❑BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) REMOVE4EPLACE0 NO'. IF NO , PLYWOOD ❑va" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS ' I❑yEs #OF LAYERS THICKNESS❑5/8" OTHER ❑OSB ❑CDX OTHER .12 A PROPOSED,ROOF TYPE:❑BUILT;UPROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES❑WOOD SHINGLES 0 OTHER • *Provide,a signed eopy'of the Cupertino's Tear-Off Policy SF Aof SQUARES By',lily 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 .ave provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable•l'ocal ordi :nces d state laws relating to building construction. I authorize repr sentatives of Cupertino.to enter the:above-identified property for ' .pectio e . poses. I acknowledge and authorize all informatigx�c nt if ed r this application form to be made available for public record. Signature of,Applicant/Agent: �. Date: SUPPLEMENTAL INFORMATIO' RE Jul r ED *New'SFD/Second Dwelling Units/Mulfamil, Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a co i.lete. Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. "copy,of`Plar riing Approval Letter or •eeti'g with Planning prior to submittal of Building Permit application. *HOA=Provide'a letter of approval from the Home Owner's Association • B1dgApp_20/7.doc revised 08/01/17 A F F OR DABLE • a ofttea' AND PLUMBING INC . March 2017 . LETTER OF AUTHORIZATION "I,undersigned, give permission to accept any of the signatures that appear below, on a permit being issued, in lieu of my signature at the counter. I hereby certify under penalty of perjury,that I will comply with all declarations and agreements on the permit, which bears my signature or my representative signature, and as required by the city." The following authorized representatives have my permission to'sign and take receipt of construction permits in the name of my company: Jorge Becerra Leonce Roux ctr'c-k Contractor Name Contractor Signature Date Contractor Information: Affordable Water Heaters & Plumbing,Inc. Phone: 855-345-9048 28358 Constellation Road # 698 Valencia, CA 91355 Contractors State License Number: 627368- Class C 36 Workers Comp Insurance: Insurance Company of the West WSA503249701 Exp. 1.1.18 See Attached Calif" AcknowBedgment See Attached California Acknowledgment 28358 Constellation Road,Suite 698 • Valencia, CA 91355 (855) 345-9048 • FAX: (661) 259-9556 • www.waterheatersandplumbing.com CA State Lic#627368 s ej SMOKE I CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE I 111° I - COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333•buildmoncr.spe-'i--•;2 org I I E A,T.E e ; •TIFlC_: �_ N . s _ A ; ► ti•3i fl I 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 4 420.6 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 induding 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: t q / Y Kr-)/ l t i"'"" Permit No.b 2 0/ 7 —/ > / C,f6 Specify Number of Alarms: #Smoke Alarms:I I � #Carbon Monoxide Detectors: J J. ti I have read end agree to comply with the terms ar o;-ditions of this statement Owner(or Owner Agent's)Name: WILL(� � Signature 41t« a_to; f ContractorCoName: A ��` ��ti� Signature............4f,"(-/ L!c.# (.V 2 7.3 U ,. ©ate; /y T i7 Smoke and CO form,doc r-es ised 12/15;15