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B-2017-1809 . CITY OF CUPERTINO BUILDING PERMIT • BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1809 955 VERNIE CT CUPERTINO,CA 95014-4346(359 22 051)• AFTERGLOW • ELECTRIC OAKLAND,CA 94602 OWNER'S NAME: SHARMAAYUSH AND SONALI DATE ISSUED: 10/23/2017 OWNER'S PHONE:408-893-6825 PHONE NO:(510)712-4434 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: • License Class CC=10 Lic.#976571 • Contractor AFTERGLOW ELECTRIC Date 09/30/2018 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: (N)EV CHARGING STATION(50 AMP)-GARAGE I her by under penalty of perjury one of the following two declarations: 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. O. 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:$1049.00 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 22 051 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 pe -- upe ino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. leure /�� Date 10/23/2017 Issued by:Jasmine Archbold • Date: 10/23/2017 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 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: 10/23/2017 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 z. I have and will maintain Worker's Compensation Insurance,as provided for by I have readthe 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 . ml. Ationally, ipmhhazardous air ateriacontaminantsddias defined byshould I theuse Bay equArea ent Airor Qdevicesuality MwhicanagementemithaDistrict I Worker's Compensation laws of California. If,after making this certificate of will maintain compliance with the Cupertino Munici.al Code,Chapter 9.12 and exemption,I become subject to the Worker's Compensation provisions of the the Health&Safety Code,Secti t jt t 3,_and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall /� " be deemed revoked. • F authorized agent: '' APPLICANT CERTIFICATION � t` =''0 3 0 I certify that I have read this application and state that the above information is 1►. R TI s E►DI► E Y 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 public records. Signature Date 10/23/2017 Licensed Professional CONSTRUCTION PERMIT APPLICATION COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION B . ..(&.• 10300 TORRE AVENUE • CUPERTINO CA 95014-3255 • <�Y?'fir (408) 777-3228 • buil ding@cupertino.org PEMIT xB- - 1 ).0 CUPERTINO REV# DEF# ❑ NEW CONSTRUCTION ❑ADDITION ElALTERATION ❑T.1. ❑MEP ElRE-ROOF 111SWIMMING POOL/SPA PROJECT ADDRESS �� /g /v �e Co eL. V U APN OWNER NAME i4f' t c k � STREET ADDRESS PHONE t O s g 53 t^ i E-MAIL }` / CITY, STATE,ZIP /'/` rs ✓e ell 1,e Co•�v C61...e... ht4.l(i....0 ( 1672/9 72/9 ❑CONTRACTOR NAME 0 OWNER-BUILDER COMPANY �MElf� rKpee4 LICENSE BER �� LICENSE TYPE` � m I STREET ADDRESS (/ �(r` CITY,STATE, ZIP '✓) L l/O` I 3oopIVicot Ay _ Suc-te9(44 ©a (cl �' 60�2 C'� E-MAILo do (7^ /a4 ,o � HONFL6 `� 8.6- i os 3 BUS.LIC 7 !� 0 ARCHITECT OWNER.❑OWNER AGENT 0 CONTRACTOR AGENT 0 ENGINEER 0 DEVELOPER ❑TENANT V CONTACT NAME E-MAIL e //'Q U W STREP 6� �y�A�.0 kLo 04, ea* a leg CITY,6TA�7 a,ZI7t - ` tiee tc-/Y 7✓s (4- 1 OQ 1 65/C B 15-( I S eg DECRIPTON ) K t( ' c V Lk O �W 01 al / .�5-0 ,`Z `C OV 5-041{ e 1 VI -1--hSZ- VW a 3,5z. , IJ SINGLE-FAMILY/DUPLEX 0 MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES a TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION(5) REMODEL REMODEL KITCHEN REMODELOTHR GARAGE 0 ATTACHED BATHROOM SF SF SF SF 0 DETACHED EXISING 0 YES EICHLER 0 YES SECOND STORY ADDITION DYES FIRE SPRINKLERS 0 NO 0 NO 0 NO DWELLING SECOND DWELLING ❑YES 0 ATTACHED DETACHED OTHER UNITS A UNIT ADDITON: ❑NO 'S F POOLS[_ ❑FTBERGLASS ❑VINYL-LINED 0 GUNITE 0 PREFABRICATED POOL-SF SPA-SF I SPA ATTACHED DYES 0 NO I TOTAL-SF RECEIVED BY: TOT 64017.6 Commercial or Multi-Family Buildings with Public',Sroimruing Pools reQuires Department of EpvirmvuenLil Heath approval 111\r4C4 RE-R0 OF EXISTING ROOF TYPE: ❑BUILT-UP ROOF El ASPHALT SHINGLES WOOD SHAKES E WOOD SHINGLES ED TILE OTHER(SPEC ) REMOVE/REPLACE❑NOI IF NO PLYWOOD 0 1" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS ❑YES{I R OF LAYERS THICKNESS❑5/8" OTHER ❑OSB 0 CDX OTHER •12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF DASPHALT SHINGLES 0 WOOD SHAKES DWOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF Pot 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 ordinances and state la , ' g to building construction. I authorize representatives of Cupertino to enter the above-identified property for inspection pur es. ackn 'ledge and authorize all information contained on this application form to be made available for public record. O /� // Signature of Applicant/Agent: Date: ( l - SUPPLEMENTAL INFORMATION'REQUIRED '� *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 BldgApp_2017.doc revised 08/01/17 b\.,/ SMOKE / CARSON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE ArAig v4. COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION ��� O 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 C (408)777-3228•FAX(408)777-3333•buildinq cupertino.orq PERMITCANNOT BE,FINAEEI)UNTIL TiIIS CERTIFICATE:HAS BEEN COMPLETED,SIGNED AND RI3`' ETE1)TO TAP,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 $1000 00, 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 m the following locations. AREA SMOKE 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 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 Building and California Residential Codes. The alarms specified below have been tested and are operational, as of the date signed below j� f �l� Address ��enie - r(. , 14Y°1001,'''emit No. `' s/ �C� Specify Number of Alarms #Smoke Alarms Mil #Carbon Monoxide Detectors 3 I have read and agree to comply with th terms and conditions of this statement Owner(or Owner Agent's)Name: ��t f\ cc fI&VY 0401\jil Signature Date:11..1Al�°�.� Contracto me: Signature Lic.# Date: Smoke and COform.doc revised 01/10/2017