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B-2017-1747 • CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1747 7457 ROLLINGDELL DR CUPERTINO,CA 95014-5812(359 32 008) ROOTER HERO PLUMBING INC MISSION HILLS,CA 91346 OWNER'S NAME: LEE TERRY G AND RONA H LIFE ESTATE DATE ISSUED: 10/11/2017 OWNER'S PHONE:408-252-3147 PHONE NO:(888)929-4376 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: • License.Class CC=36 Lic.#973014 Contractor ROOTER HERO PLUMBING INC Date 05/31/2018 X BLDG _ELECT X 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: REPAIR SEWER LINE NEAR LOWER LATERAL;INSTALL CLEAN- I hereby affirm under penalty of perjury one of the following two declarations: OUT 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. 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: Valuation:$4092.00 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 ' 359 32 008 • 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'regulatio. •er the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signa,,, Q .(�.d-� � Date 10-11-2017 Issued,by:Kim Dunbar • Date: 10/11/2017 ' 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. 1,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: 10-11-2017 ' 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 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 material. Additionally,should I use equipment 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 Bay Area Air Quality Management District 1 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,Sec' ns 5505,25533)and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall I , be deemed revoked. Owner or authorized agen • . I �+-- 'APPLICANT CERTIFICATION Date: 10-11-2017 I certify that I have read this application and state that the above information is CONSTRUC ION 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 i 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 public'records. Licensed Signature • Date 10-11-2017 Professional CONSTRUCTION PERMIT APPLICATION \ .- B COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION rib 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 ..x, •«5���'ss, (408) 777-3228 • buildinOcu eLtino.orP PEMIT#B,2619- -14- T CUPERTINO REVS DEF S Al NEW CONSTRUCTION ❑ADDITION ❑ALTERATION ❑T.1. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROJECT ADDRESSG APN S 11(1/ d i°/I D C' OWNER NAME J PH NE E- AIL PonetGem CS---zs z-3( V- Ca-I-heti Ne( -0y441,(,. Ce STREET ADDRESS 7-G/�� , 1// �/ �y^ C("Opp r l ATPZIP iP l K O 93-0 ` 0 / c "CONTRACTOR NAME ❑OWNER-BUILDER COM1PAN?NAME I • LICC NSE NUMBER( LICENSE TYPE /\4d c15 lie• ©� lLc �'t°rb lraM- �o I `/ ., 3 I STREET ADDRESS �] //J C ,STATE, ZIP c. _ I E-M IL PHONE /BUS.LIC A la . co\u►N o)ubr ;�/�ef,� c. Ve ‘0I(' a7 3 3 0 ARCHITECT 0 OWNER ❑OWNER AGENT 0 CONTRACTOR AGENT ENGINEER❑DEVELOPER 0 TENANT CONTACT NAME E-MAIL ' STREET ADDRESS CITY,STATE,ZIP PHONE DECRIPTON rr 7 ° 1`e Ca c`J' (Loei- NGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL I EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES 0 TOTAL NET SF USE TYPE OCC SQ;FT. VALUATION($) • REMODEL REMODEL KITCHEN REMODEL OTHR GARAGE ❑ATTACHED BATHROOM SF SF . _ SF SF 0 DETACHED EXISING ❑YESEICHLER ❑ YES SECOND STORY ADDITION 12YES FIRE SPRINKLERS 0 NO ❑ NO 0 NO DWELLING SECOND DWELLING ❑YES 0 ATTACHED DETACHED OTHER UNITS.S UNITADDITON: ❑NO S F POOLS' ❑FIBERGLASS 0 VINYL-LINED ❑GUNITE 0 PREFABRICATED e POOL-SF SPA-SF I SPA ATTACHED 1=1 YES ❑ NO I TOTAL-SF RECEIVED BY: TSA ALUAT,}ON: Commercial or Multi-Family Buildings with Public Swimming Pools respires Department of Environmental Heath approval Y�l 77 l r `f(1 !{'�J / RE-RO OFI EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES WOOD SHAKES E WOOD SHINGLES'['TILE OTHER(SPECIFY)*? REMOVE/REPLACE Q NO IF NO PLYWOOD ❑'4" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS El yEs S OF LAYERS THICKNESS El 5/8" OTHER ❑osB ❑CDX OTHER •12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES ❑WOOD SHAKES❑WOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF Sof 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 is accurate. I agree to comply with all applicable local ordinanc-. and state laws relating to building construction. I authorize representatives of Cupertino to enter the above-identified property for i e on purposes. acknowledge and authorize all information contained on this application form to be made available for public recor•. Jv /j /J Signature of Applicant/Agent: �— e- Date: / . SUPPLEMENTAL INFORMATION EQUIRED *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 B/dgApp_2017.doc revised 08/01/17 ���`�osa®.79.„,45. `\t !% CUPERTINO SANITARY DISTRICT C 20863 Stevens Creek Blvd#100, Cupertino, CA 95014 /s, Tel(408)253-7071 • Fax(408)'253-5173 `:P., isxeo'"§"' CUPERTINO SANITARY DISTRICT PERMIT LETTER Cupertino Sanitary District has adopted Resolution No. 1263. Building Permit Request KSingle (Over-the-Counter) Family Project n Multi-Family Project nCommercial Project Project Address: 1L)57i2(li k d-e/( v,_, Permit Number: b--to ti--^ ( T —c Scope of Work: 54( -et- 1&--Pi'&/ .' PflaM 'r /`nyl/ p1. do. Owner/Applicant Name: P,r /Lem Phone: mak- I/0O -0533 l Address: Date: L 6 1 f—1 Prepared By: K(,0„...40, . City Authorized Representative I, as property owner or authorized agent, acknowledge that all Cupertino Sanitary District requirements will be met and all required fees will be paid prior to the approval of final inspection for proposed;project. Date: Signature: Owner/Authorized Agent , , CUPERTINO SANITARY DISTRICT OFFICE USE ONLY . n Pre-inspection Required \KI Final Inspection Required Date Scheduled: (( �� Date: Conditional Approval By: . '+ Authorized Representative Cupertino Sanitary District District will notify owner of the required fee within 5 days after Pre-Inspection has been completed,and cc City of Cupertino. Inspection Fee Paid Date Paid: /O7 ' 147 p Ins ection' Fees: JCI $250/unit-Single Family Residential already connected, but new cleanout is required 0 $150/unit-Single Family Residential already connected with existing cleanout in working order 0 $350 Minimum—Commercial and Retail Actual Amount: 0 $200/each—Disconnect and/or abandon lateral service Connection Permit Fees: I= $350/unit-Single Family Residential connecting to existing lateral 0 $650/unit—Single Family Residential connecting with new lateral 0 $100/unit—Multi, Hotel, Living Units, etc. Actual Amount: 0 $500/connection -Commercial and Retail Actual Amount: Connection Use Fees(See Attached Calculation Sheet): 0 Area and Frontage Fees Amount: El Residential Excess Fees over 3.5 unit/acre Amount: 0 Commercial and Retail Connection Fees Amount: . 0 Commercial and Retail Change in Use Fees Amount: Date: /0 ui/i 7 Final Approval By: . . /' ../' ..Au -•riz-d Representative Cu ''o Sanitary District SMOKE / CARSON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•building( cupertino.orq PERl4IIT"CANNOT BE FINALEI)UNTIL THIS CERTIFICATE HAS:BEEN COMPLETED,SIGNED.,ANDRETIl12NED 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 2016 CRC Section R314,R315,2016 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existing_single-fam ly-an.d.multi-famil._y-cl-wellings_shalLbe.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,R315, and CBC Sections 907.2.11.5 and 420.6 require that Smoke Alarms and/or Carbon Monoxide Alaiins be installed in the following locations. AREA SMOKE E ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the X X bedroom(s)—(Smoke alarms shall not be located within 3 feet of bathroom door) On every level of a dwelling unit including basements and habitable attics 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 907.2.114 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 14._„,t-7 4jioi ° / i l j "r �, � ( Permit No. Ir -Z/9`" 7V7 Specify Number of Alarms #Smoke Alarms I I #Carbon Monoxide Detectors. 13 I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: °m. - - (� Signature Date: Contractor Name: Signature Lic.# Date: Smoke and COform.doc revised 01/10/2017