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B-2017-1843 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1843 1345 ASTER LN CUPERTINO,CA 95014-5215(366 17 100) STREET PLUMBING AND ROOTER SAN JOSE,CA 95128 OWNER'S NAME: PESTANA NORMAN A AND VICKI TRUSTEE DATE ISSUED: 10/27/2017 OWNER'S PHONE:408-996-2768 PHONE NO:(408)496-1155 LICENSED CONTRACTORS DECLARATION BUILDING PERMIT INFO: License Class C-36 Lic.#582217 Contractor STREET PLUMBING AND ROOTER Date 12/31/2017 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: REPLACE 50 GAL WATER HEATER-SAME LOCATION I hereby affirm under penalty of perjury one of the following two declarations: 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 rformance of the work for which this t is b.F!` Iha a and will maintain Worker's Compensation issued. ionInsurance,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:$1400.00 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 366 17 100 representatives of this city to enter upon the above mentioned property for inspection purposes. (We)agree to saveindemnify 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 Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. ® it gnature Date 10/27/2017 Issued by:Abby Ayende Date: 10/27/2017 OWNER'-B ILDER 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 i; { 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) z 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:10/27/2017 I hereby affirm under penalty of perjury one of the following three declarations: ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER t. ' 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 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,S ctions 255 5533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. eigyaror authorized agent: APPLICANT CERTIFICATION ate:10/27/2017 ,� I certify that I have read this application and state that the above information is CONSTRUON 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 public records. Licensed Signature Date 10/27/2017 Professional 't 13:to 1-1-- IZLI3 - , v...e...1/4, i/' GENERAL PERMIT APPLICATION M- r COMMUNITY DEVELOPMENT DEPARTMENT.*BUILDING DIVISION E p A, N 70300TORRE AVENUE-CUPERTINO.CA 950743255 . - CUPERTINO (408)777-3228-FAX(408)777-3333•buildmqact,perlinO.Orc1M /SC - - PLUMBING OMECHANICAL DELEC7IUCL DMISCE LANEOUS - PRO]ECCADDRESS l34S A5 /E AM- • (i(0P-►1 .10-0 • - NOW,ArN PE-STA-►QA- 1 o8) 99G - 2718 smarAnriuss 13 is- As Tra. LktJi— o� _=C4 p/ I IFAX - CONTACT NAS Aoki, STh- r • - 40$).49!i- U m S cf pG bi S>REErADDRESS • az 93 1t/a.lvtu,+ 6Th. circ �S sc. CA 9srZ8 FA7Clog-496-lls-S 0-owtMt 0 owiestamume El owxatAG$tr YCOMAclog p CalERAcTartAGem, p AR�cr_.0 mama ❑ nEVnr.orm 0 Terrarrr co7micTORNAIIm �A S , IVB - N�5g2217 - TYPE �6. �s.u�a 40076,.3 COMPANYNAM&vLP1UC' pU LKBiMa 1 ro Wfto� I�cvgt. of_ �jiwAli fcwFAX r /0 4 g&-63 azit J TA..... 2193 &IhukraJu � _ amsrz� Tv � 9528 : o 1eit0- It k - Akormcrimmastuum LcENSENUMBEIt 'I BUS.MO Coi -srz` -E-MAIL, i, FAX , STREETADDRESS QTY.STATE,ms PHONE usa , 71:1-.SFT)OF; . �Duplex..,El Multi-Family PAo3ECTIIdWIIDLAI� p1t�1E(.TII3 siRticru tl;•; ❑ Commercial IIRHANII4TERFACEAREA O Yes 0 No FtoorzamtE 0 p Yes No • DESCR@itoNAFwOR[C "6t).-46r- l&-t_ r-- ref , , -- 0- LO / _ I r - 101% 1-, r , ('1) 7-" . L1. TOTAL VALUATION: g Cayce?-R�€-`-` :4I — f _� i . • • BY my signature below,Icedifyrtomelt of i,i.,• Iam;• ;-. own_-st;'' nenttoactonthcp uwn&sbdtalE Ihavenadtl>is application and tbein�ationIhave tize+ - ofW ,:andv®fyrtisaccurat to with allapplicable Iona' ordmancesand staxe,:.. •-.:,t,._ „ ,, I�.r...'. 1,1.1.=.1°., :, Ilr 1� ��.. comply-with ��- t>perW�oto�tatLeabove-',a,�„';ed �,•faa'inspectionPaP� Si�naaileofApplEatNAge� �/-) +� _ , Date. /O Z pE; /.t � u. i.t_ am , .,--;!--(..i- -- t.- - y=am:= y- =.,_ -' -,^- -.- Z 7 = ,��.�”' `tom *-`'- / _�1..rl 1,-ems..,M1p _- ..h=X - - MEPMiscgpp 2011 doc revised 03/l6/Il CUPERTIN€? SMOKE / CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION 10300 TORRE AVENUE • CUPERTINO,'CA95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildina(a cuoertino.ora PESTA1Vi[).T BE Il'3. U1ITTII, TFIIS CE2TII T:..33A.BEEN;. +Ct:1V�L�T:EI��. i�1��A�TI) i�'�fR1�ED T� E BI:�LD��G I�SIO 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 multivfamily d��ellings shall be provided with Smoke Alarms -end 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 in the following locations AREA SMOKE ALARM CO ALARM Outside of each separate sleeping area in the immediate vicinity of the bedroom(s) - (Smoke alarms shall not be located within 3 feet of bathroom door) X X 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 907.2.11 4 and 420.6.2. An electrical permit is required for alarms which must be connected to the building wiring. As owner of -the a6ovo=refe er need property; I lierebp certify that the alarms) ever ferenced above hasjha� e 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 A Address- � s f t' � CU `4P � %�/J�® I' 1y Permit No. S -01 ,,3 Specify Number of Alarms #Smoke Alarms..Carbon Monoxide Detectors . /have read and agree to comply with the terms and condli ns of this statement Owner (or Owner Agent's) Name: .Si natur)11///� .. r /Date:'f .... Contractor Na e fi�� ✓��'-`' _ i ,9,2217 /D Hca Signature Lic.# Date: `..1 ),17 ((( Smoke and COform. doe revised 01/1012017