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B-2017-1787 • • CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1787 23500 CRISTO REY DR UNIT 309F CUPERTINO,CA 95014-6527(342 53 135) BAY AREA ' ENTERPRISE . SAN JOSE,CA 95148 OWNER'S NAME: BILLS MARY A TRUSTEE DATE ISSUED: 10/18/2017 OWNER'S PHONE:650-537-1523 PHONE NO:(408)238-5043 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class B Lic.#817817 Contractor BAY AREA ENTERPRISE Date 03/31/2019 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: DEMO(E)SHOWER PAN&WALLS;INSTALL(N)CULTURED I hereby affirm under penalty of perjury one of the following two declarations: MARBLE PAN&WALLS;REPLACE SHOWER SHOWER VALVE ' a. 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 dokirformance of the work for which this permit is issued. zI have and will maintain Worker's Compensation Insurance,as provided for by r` Section 3700 of the Labor Code,for the,performance of the work for which this permit is issued. Sq.Ft Floor Area: Valuation:$4500.00 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 342 53 135 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 sourceions per . Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. Signa ure / Date 10/18/2017 Issued by:Abby Ayende Date: 10/18/2017 OWNER-BUILDER DECLARATION I hereby affirm that I ant exempt from the Contractor's License Law for one of the . RE-ROOFS: following two reasons: r All roofs shall be inspected prior to any roofing material being installed.If a roof is '1. , 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: 10/18/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER ' it. 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 i'perrrtif is issued. maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&Safety Code,Section 25532(a)should I store or handle hazardous '1 3.i I certify that in the performance of the work for which this permit is issued,I material. Additionally,should I use equipment or devices which emit hazardous Fshall not employ person in any manner so as to become subject to the air contaminants as defined by the Bay Area Air Quality Management District I I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Mu,' '.,al Code,Chapter 9.12 and , 1 , exemption,I become subject to the Worker's Compensation provisions of the 'the Health&Safety Code,Sectio . 15,25533,and 25534. ;Labor Code,I must forthwith comply with such provisions or this permit shall �' ' • ' '' i be deemed revoked. 00tr1 'or authorized agrw Date:10/18/2017 r �- APPLICANT CERTIFICATION CONSTRUCTION L NDING AGENCY I certify,that I have read this application and state that the above information is N 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 t4 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 tcl 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 public records. Licensed Signature Date 10/18/2017 Professional I ? ZcR— 17-23- V CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION 0-c.,94::, 10300 TORRE AVENUE•CUPERTINO, CA 95014-3255 CUPERTINO (408)777-3228•FAX(408)777-3333•buildingacupertino.org El NEW CONSTRUCTION ❑ ADDITION ❑ALTERATION/TI [ REVISION/DEFERRED ORIGINAL PERMIT# PROJECT ADDRESS 76 (ri .5 7 301.r I APN# 3 9.2._ 5---- __ is 6---- OWNER ®OWNER NAME y ` i I` PHONE&3-0 r 3,3 7 c2 E-MAIL STREET ADDRESSI 4 �, 7 // / 7-3 SVC? Cres f b p fZ . 3 F CITY,ts- r1--, Ln o L A Q 5 o l cL FAX i CONTACT NAME c,,,,9 r c.I, PHONE LiD\-a 3` SM VI E-MAIL 8 rP_6�►5 _)co i C 4t-I©N-e-� STREET ADDRESS [- t' 7 CITY,STATE,ZIP d FAX ` 2-4D 1' atq;V-L ii.) U k SJ � ck� S1 `3 ❑OWNER 0 OWNER-BUILDER 0 OWNER AGENT CONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER ❑ DEVELOPER 0 TENANT CONTRACTOR NAME LICENSE NUMBER LICENSE TYPE BUS.LIC# G•mei Pe/ Sf girl g1/7 13 COMPANY NAME J na ij - - E-MAIL [j r�,i f 'fJ��C6"[ ,/ / FAX d'J dl l/gll fah T-��1 6r!/ l� Ct�c (/ve f- STREET ADDRESS CITY,STATE,ZIP i.., Dr-TONE 2l I u r1isvVy e dl 1<JU y S a C . o So_ c_A- 95�tit6 ' - <log- 233 ,5-0(43 ARCHTTECT/ENGINEER NAME LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX STREET ADDRESS CITY,STATE,ZIP PHONE DESCRIPTION OF WORK t• env Mixt.. - 6S Y /Cell _4.4/ s- -�I_ � /1 A%e 1,1 c vires f( fil G ifl6�C f a A - •a fl • .: ,1-1'', _ 'S kO G✓ U�"�Gte-- --- EXISTING USE ' PROPOSED USE CONSTR.TYPE if STORIES USE 1 TYPE OCC. SQ.FT. VALUATION($) EXLSTG NEW FLOOR ', , . DEMO TOTAL AREA ' AREA AREA NET AREA I _ BATHROOM KITCHEN OTHER REMODEL AREA REMODEL AREA REMODEL AREA 1 PORCH AREA DECK AREA TOTAL DECK/PORCH AREA GARAGE AREA: ❑DETACH I 0 ATTACH #DWELLING UNITS: IS ASECOND UNIT ❑YES SECOND STORY ❑YES BEING,ADDED? ❑NO -ADDITION? 0 N ! , PRE-APPLICATION ❑YES IF YES PROVIDE COPY OF IS THE BLDG AN ❑YES.. RECIi!VED$Y # 5 a ' 4.a:v4. TOTAL ALUATION:._ PLANNING,APPL# ❑NO PLANNING.APPROVAL LETTER EICHLER HOME? ❑NO `� y r (/r:7 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 ve read this ' application and die information I have provided is orrect. 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 buildin co ction. I authorize representatives of Cupertino to enter die above-ide i red p perry for inspection purposes. Signature ofApplicant/Agent: it Date: l D "2--(!)( I.SUPPLEMENTAL INF RMATION REQUIRED .. PLAN cHECIETVPE ,-� i it rrnvGSLtP 1 New:SED or Multifamily dwellings: Apply for demolition permit for a x ` ? F;_ 1 11 If'I 1 ❑ OVER THICOUNTER ❑ SUII.DING PLAN REVIEVP <f x , existing building(s). Demolition permit is required prior to issuance of building ; permit for new building. , II: ❑ EXPRESS' t ❑.,PLANNING PLAN REVIEW ` I 41 y' t 1 1 it I1' k Commercial Bldgs: Provide*corn leted Hazardous Materials Disclosure ® STANDARD ❑ PUBLIC WORKS r s g P ,i E form if any Hazardous Materials'are being used as part of:this project. f ❑ FmEnEPT I II 'I ! ❑ LARGE h + sc f ,-E ,.� n _ a Copy of Planning Approval Letter or Meeting with Planning prior to' ❑ 1l7AORJ `i ^' ❑ SANITARY SEWER DLSTRIC'C submitial.of Building Permit application. r z , ., , fi � , ❑:ENVQtONMENTAL,ARALTH._ . x;, , BldSAPP2011_doc revised 06/21/11 _ • SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE 49.1% COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION CUPERTINO 10300 TORRE AVENUE• CUPERTINO,CA95014-3255 (408)777-3228•FAX(408)777-3333•building( cupertino.orq PERMIT CANNOT BE FINALE!)UNTIL THIS CERTIJjICATE HAS BEEN COMPLETED,SIGNED.,AND=RET TRNED 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-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 $10001)0, CRC Section R314,R315, 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 r 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 whererepairs 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 m compliance with the California Buildmg and California Residential Codes. The alarms specified below have been tested and are operational, as of the date signed below G� Address: 2_7 coo fcr-i- Q12 3° T / Permit No.ZL`7 /7 Specify Number of Alarms #Smoke Alarms ! _ ! #Carbon Monoxide Detectors. -= l have read and agree to comply with the terms and conditions of this statement Owner(or Owner ent's)Name: 4 4' f6- 1 Signat ... . .. • ontractor Name: Signature Lic.# Date: Smoke and COform.doc revised 01/10/2017