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B-2017-1889
CITY OF CUPERTINO BUILDING PERMIT . BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1889 20791 GREENLEAF DR CUPERTINO,CA 95014-1818(326 09 003) AFFORDABLE WATER HEATERS AND PLUMBING INC 28358 CONSTELLATION RD VALENCIA,CA 91355 OWNER'S NAME: PARK PETER H AND YOUNGHEE DATE ISSUED: 11/02/2017 OWNER'S PHONE:408-313-9744 PHONE NO:(855)345-9087 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C36 Lic.#627368 Contractor AFFORDABLE WATER HEATERS AND PLUMBING INC Date 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. (N)40 GAL WATER HEATER-(LAUNDRY ROOM) I hereby affirm under penalty of perjury one of the following two declarations: r. 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 Sq.Ft Floor Area: Valuation:$1879.00 permit is issued. APPLICANT CERTIFICATION I rtify that I have read this application and state that the above APN Number: Occupancy Type: information is correct.I agree to comply with all city and county ordinances 326 09 003 and 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 against said City in consequence of the granting of this permit. Additionally, ' e ap•licant understands and will comply with all non-point 180 DAYS FROM LAST CALLED INSPECTION. source regul- ions•the Cupertino Municipal Code,Section 9.18. i Issued by . :Jasmine Archbold Signature ; Date 11/2/2017 Date: 11/02/2017 I t_-B x11111 ' 1 • '.T I RE-ROOFS: I hereby affir ,t I am exempt from the Contractor's License Law for one of the All roofs shall be inspected prior to any roofing material being installed.If a roof is following two rem•ons: installed without first obtaining an inspection,I agree to remove all new materials for 1. I,as owner of the property,or my employees with wages as their sole inspection. compensation,will do the work,and the structure is not intended or offered for sale(Sec.7044,Business&Professions Code) Signature of Applicant: 2. I,as owner of the property,am exclusively contracting with licensed Date: 11/2/2017 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. 1 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 permit is issued. Health&Safety Code,Section 25532(a)should I store or handle hazardous a. 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 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 I will maintain compliance with the C er -. Municipal Code,Chapter 9.12 and Worker's Compensation laws of California. If,after making this certificate of the Health&Safety Code 'ec io s 25505,25533,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 agent: A, be deemed revoked. Date: 11/2/2017 � APPLICANT__CERTIFICATIOP( 41 t t]►!g'? t IN A Y I certify that I have read this application and state that the above information is I hereby affirm that there is a ctrit uction 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 permit is sued(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 of 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 \00/.4COMMUNITY DEVELOPMENT DEPARTMENT • BUILDING DIVISION r C 10300 TORRE AVENUE • CUPERTINO, CA 95014-3255 (�/.�.�— - gt.ty�. � • l r (408) 777-3228 • building�Cupertino.org PEMIT »B- CUPERTINO REVF DEFF ❑ NEW CONSTRUCTION ❑ADDITION ❑ ALTERATION ElT.1. ❑MEP ❑RE-ROOF ❑SWIMMING POOL/SPA PROIECfD)FSS cif ci re4r,)14 r / J r APN► D�� v�E die P /C PH -1 �/ A1)3)3 C3�g-E-MAIL STREET ADDR g/ 67 (a.? l 4-c /) v CfTY�r zfP yl p C4 /s6) CONTRACTOR NAME ❑OWNER-BUILDER Co N E it., I 1 4 11 LegSE NUMBER LICENS TYPE lc( q.iulk 0 •C 'e?DeCiZAY'e\ (pi 6 CI , 6- Syt ° , 10..ko h ,747A 4 3I sS 1 E-MAIL ` ^ a�11 aPO O CsJ 34 `- 52041, 0� BUS.LIQ t _ O/ SZ ❑AR ITECT(OWNER ❑OWNER AGENT �'LONTRACTOR AGENT ENGINEER❑DEVELOPER ❑TENANT oh CONTACT NAME r ` E MAIlk).(:),e--eCA Wiar. , \ STR (V-„rDllt�Sy CITY, TE, l� P ONE t,0 cc?-6 fie. DECRIPTON g.,.,pi,,,,_ 4 v <//C�, i -/- /,, -t-- .SA' 4:,j a°, Z.,.4,vr,of, p.... ❑SINGLE-FAMILY/DUPLEX ❑MULTI-FAMILY 0 INDUSTRIAL 0 COMMERCIAL EXISTING USE EXISTING SF NEW FLOOR SF PORCH SF DECK SF DEMO SF STORIES I TOTAL NET SF USE TYPE OCC SQ.FT. VALUATION($) REMODEL REMODEL KITCHEN REMODELOTHR GARAGE ❑ATTACHED BATHROOM SF SF SF SF 0 DETACHED EXISFIRESNG PRINKLERS❑O CI Yrs EICHLER 0 YES NO SECOND STORY ADDITION ❑❑YES NO DWELLING SECOND DWELLING ❑YES D ATTACHED DETACHED OTHER UNITS! UNIT ADDITON: ❑NO S F POOLS, 0 FIBERGLASS ❑VINYL-LINED 0 GUNITE 0 PREFABRICATED POOL-SF SPA-SF I SPA ATTACHED❑YES 0 NO I TOTAL-SF Illik R EIVED BY: I. TOTAL ALUATION: Commercial or Multi-Fancily Buildings with Public.Swimming Pools requires Department of Environmental Heath approvalAl % S RE-ROOF EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY) REMOVE/REPLACE❑NOI IF NO PLYWOOD EI 1/2" ❑3/8" PLYWOOD TYPE: PITCH: ROOF CLASS El yEs L OF LAYERS THICKNESS❑5/8" OTHER El OSB ❑CDX OTHER •12 A PROPOSED ROOF TYPE:❑BUILT-UP ROOF ❑ASPHALT SHINGLES 0 WOOD SHAKES El WOOD SHINGLES 0 OTHER *Provide a signed copy of the Cupertino's Tear-Off Policy SF aof 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 infor 'ation I • ve provided is correct. I have read the Description of Work and verify it is accurate. I agree to comply with all applicable local or• . .-s y" state laws relating to building construction. I author' e re. esentatives of Cupertino to enter the above-identified propertynspect "n •• poses. I acknowledge and authorize all informatio •nt. ned • this application form to be made available for public rec.`• Signature of Applicant/Agent: Date: ' _ - SUPPLEMENTAL INFORMATIOf UIRED li *New SFD/Second Dwelling Units mily Dwellings:A Demolition permit is required prior to issuance of a building permit for all new construction. *Commercial Buildings: Provide a f ted Hazardous Materials Disclosure form if any Hazardous Materials are being used as part of this project. *Copy of Planning Approval Letter. ting 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 `. SMOKE / CARBON MONOXIDE ALARMS fir OWNER CERTIFICATE OF COMPLIANCEt,r_, COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION (f UPER7thi£> 10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 (408)777-3228•FAX(408)777-3333,buildinacupertino.orq MOW'CANN©T I uvwxD t1NTIi1 TRW CERTIFI+CAT IFAS-BEEN .G D.ANIS RETU1 ED:TO'tit$IJI�DING DIVISION• l� ETES,SIGNE 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 in 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 SuPpl •In dwelling units with no commercial power supply, alamt (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 CSC 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. dtIA 1 re,e,n 1 emc- P1. GA- "1 6i 14' Permit No.S- 20 17 / Ese Specify Number of Alarms #Smoke Alarms 2 J, #Carbon Monoxide Detectors I I have read and agree to comply with the terms and conditions of this statement Owner(or Owner Agent's)Name: Prova :0 / # ► 1!11 119 Signature _ Date: . Contractor Name: / >�ffo i��) �a b l e �NOt---e d' Signature .G- %L/ Lic.# U�Z 7 Ler Date: Heaters Smoke and CO form.doc revised 01/10/2017