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B-2017-1914 CITY OF CUPERTINO BUILDING PERMIT BUILDING ADDRESS: CONTRACTOR: PERMIT NO:B-2017-1914 6199 SHADYGROVE DR CUPERTINO,CA 95014-4669(375 40 018) WILLOW GLEN ELECTRIC INC SAN JOSE,CA 95155 OWNER'S NAME: CHEN JUIHO AND CHUN FEI • DATE ISSUED: 11/06/2017 OWNER'S PHONE:408-505-0666 PHONE NO:(408)289-9725 LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: License Class C-10 Lic.#591918 Contractor WILLOW GLEN ELECTRIC INC Date 04/30/2018 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 AMPS)-GARAGE 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 performance of the work for which this permit is issued. F. 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:$2290.00 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 buil'ding'construction,and hereby authorize 375 49 018 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 per the Cupertino Municipal Code,Section 9.18. 180 DAYS FROM LAST CALLED INSPECTION. SiM.,,ature ,/1 —Me 11/6/2017 Issued by:Jasmine Archbold Date: 11/06/2017 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 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 I inspection. compensation';will do the'work,and the structure is not intended or offered for sale(Sec.7044,Business.&Professions Code) /. 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: 11/6/2017 { , �S 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 aCertificate 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 s. 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 I 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 e Health&Safety Code,Sections 25505,25533,and 25534. Labor Code,I must forthwith comply with such provisions or this permit shall be deemed revoked. ;le or authorized agent:'''// APPLICANT CERTIFICATION 11/6/2017 I certify that I have read this,appiication and state that the above information is CONSTRUCTION LENDING AGENCY correct.I agree to comply with all city and county ordinance 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 sdurce regulations per the Cupertino Municipal ARCHITECT'S DECLARATION Coded Section 9.18. I understand my plans shall be used as public records. SI Licensed Signature Date 11L6/2017 Professional I W h:11U(::71`k-ff l t.'/V' ` �ALTERNATIVE ENERGY PERMIT APPLICATION � � '� A . .,,•/"' COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION :1,1,,, 10300 TORRE AVENUE•CUPERTINO,CA 95014.3255 C,U,p.RTINO (408)777-3228• FAX(408)777-3333•build' a ti O n r?.-.2-0t'4 — l°1 L`-f PROJECT ADDRESS J ` n c( °"A1)\/ eg^y r DRtve , APN# OWNER NAME Su! 40 p f PHONE O�j OrJ' 0 191b P•_'_IL j d1evi J5 t 9tve :cowl. STREET ADDRESS �-( CITY, STATE,ZIP FAX J43g IMA:-L-A-/QA lA)A y s QVv4u:/o.A-/ g4dg4 CONTACT NAME Mark Londre PHONE (408)289-9725 E-MAIL office@willowglenelectric.com STREET ADDRESS P• 0. Box 8430 CITY,STATE,ZIP San Jose, CA 95155 FAX(408)289-9725 In OWNER 0 OWNER-BUILDER 0 OWNER AGENT SICONTRACTOR 0 CONTRACTOR AGENT 0 ARCHITECT 0 ENGINEER 0 DEVELOPER 0 TENANT CONTRACTOR NAME Mark Londre LICENSE NUMBER 591918 LICENSE TYPE C-1,0 BUS.LIC#1., 4:411.6,01i COMPANY NAME Willow Glen,Electric, Inc. E-MAIL office@willowglenelectric.com FAX :(408)289-9725 STREET ADDRESS P. 0. Box 8430. C1TY,STATE,ZIP San Jose, CA .951.55 PHONE (408)289-9725 l'.. ARCHITECT/ENGINEER NAME N/A ' LICENSE NUMBER BUS.LIC# COMPANY NAME E-MAIL FAX , STREET ADDRESS CITY,STATE,ZIP PHONE ' USE OF tOr SFD or Duplex 0 Multi-Family PROJECT IN WILDLAND PROJECT IN STRUCTURE: ❑ Commercial URBAN INTERFACE AREA El Yes 0 No FLOOD ZONE 0 Yes 0 No : 0 SOLAR PANELS il ELECTRIC VEHICLE CHARGING STATION 0 SOLAR WATER HEATING 0 OTHER: ' 1. 1 FOR SOLAR PANELS: NUMBER OF PANELS/UNITS: KILOWATTS(COMMERCIAL ONLY): TOTAL VALUATION: DESCRIPTION OF WORKn Electric Vehicle Charging Circuit: 1-l4 2-Ali“4 E. /467--A-44-0) ;2d4'o IJ , --C4- tp I I.cD iM14. c-tf2C+,tT U)/ 14-61' :R- -,c-i())`-'41-62-1.; 'ikis 1 RECEIVED BD ' •M ';_`, .'''• . 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 laws relating to building cucggyi,, rize r ;prgntatives of Cupertino to enter the above-identified property for inspection purposes. Signature of Applicant/Agent: / t LTJ Date: . 174 SUPPLEMENTAL INFORMATION REQUIRED (`_ ' 1:: 1 {orncE,.vsEONLY'. :1;ISi OVER-TEE-COUNTER --,':'''ll'.: 011EXPRESSE ` ;b ' 04 STANDARD ' CCCza�� LARGE r� ' N .'1 ❑,MAJOR•• ,i i PV4pp_2011.doc revised 03/16/11 'I Date: WILLOW CLEN ELEC7RFC, INC. To whom it may concern: This letter hereby authorizes all currently authorized persons listed below on behalf of Mark Londre,the owner, operator and C-10 license holder for Willow Glen Electric, Inc.,to sign for any and all building permits and licenses required by our company. These people are authorized to act as an agent on behalf of our company. This authorization shall be valid through December 2018. Ashley Baucom Evan Binns-Smith Eunho Kim Lawrence Lombardo Jennifer Londre Joe Londre Matt Londre Peggy Londre 'Brian Lurker :Anita Maemone Daniel Moore Josh Moreno Virginia Neff Cheryl Palos Will Welch Rafael Yepez Sincerely, Mark T. Londre, President 1085 Warren Ave. Willow Glen Electric, Inc. P.O.Box 8430 San Jose,CA 95155 Phone:(408)289-9725 Fax:(408)289-1410 Lic.#591918-C10 PocuSign'Envelope ID- F772AB79-282F-4454-8453-E2A77COCAEOA SMOKE/ CARBON MONOXIDE ALARMS OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE - CUPERTINO, CA 95014-3255 (408) 777-3228 • FAX (408) 777-3333 • buildincl a.cupertino.orm Permit No. B - 2 017 -1914 Address 6199 Shadygrove Drive #of Alarms Smoke:4 Carbon Monoxide: 1 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN $1 4UR A:ND�F.T�,T�3NF'D TO THE BUILDING DWISION PURPOSE This affidavit is a self -certification for the installation of all required Smoke and Carbon Monoxide Alarms for compliance with 2013 CRC Section R314, 2013 CBC Sections 420.6 and 907.2.11.2 where no interior access for inspections are required. GENERAL INFORMATION Existhig 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 8314 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) X X On every level of a dwelling unit including basements 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 above -referenced property, I hereby certify that the alarin(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 have been tested and are operational, as of the date signed below h ead and a ree to comp! with the terms and conditions of this statement ave r Owner (or Owner Agent's)-Name:.Docusigned by: Tui ho & Chi nfei Chen ...... ............................ ......... . Si natur ... . 6..�-... ......Date /22/2 Contractor Name: 5W2278NBA40_ Si nature .. .... ... ......... .. .......... Lic.ff . Date: Smoke and CO fonn.doc revised 03118114 17 CUPERTINO WATER -CONSERVING PLUMBING FIXTURES OWNER CERTIFICATE OF COMPLIANCE COMMUNITY DEVELOPMENT DEPARTMENT - BUILDING DIVISION 10300 TORRE AVENUE CUPERTINO, CA 95014-3255 (408) 777-3228 - FAX (408) 777-3333 - buifding(a)-cupertino.orq owner Name Jui ho & Chi nfei Chen Permit No. B-2017-1914 Address 6199 Shadygrove Drive, Cupertino, CA 95014 PERMIT CANNOT BE FINALED AND COMPLETED UNTIL THIS CERTIFICATE HAS BEEN SygM AND it��NM TO THE BUILDING DIVISION Please refer to the attached California Civil Code Sections 1101.1 -- 1101.8 which are part of this Certification form. 1. Is your, real property a registered historical site? ❑ Yes Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. Owner' Signature:E „Do��s�gneaav: Date: 11/22/2017 No Go to Question 2. l�ku 5E4F2278E7BA4E3... 2. Does your real property have a licensed plumber certifying that, due to the age or configuration of the property or its plumbing, installation of water -conserving plumbing fixtures is not technically feasible? 0 Yes Civil Code Sections 1101.1 through 1101.8 do not apply. ❑ The licensed plumber's certification has been provided to the Building Division. Sign below and skip the rest of the form. -y -7 DocuSigned by: 11/ 2 2 J G ®1 Owner' Signature: / �, ,,p t , (” �, , ,- Date: C No Go to Question 3, A4E3 1 �` �^�" ' 5E4F2278E7BA4E3... 3. Is water service permanently disconnected for your building? ❑ Yes Civil Code Sections 1101.1through 1101.8 do not apply. Sign below and skip the rest of the form.. Owner' Signature:^DocuSigned by: Date: 11/22/2017 (u No Go to Question 4. J 9z 1�V. SE4F2278E7BA4E3... 4. Is your real property built and available for use or occupancy on or before January 1, 1994? ❑ No My real property is built and available for use or occupancy after January 1, 1994. Civil Code Sections 1101.1 through 1101.8 do not apply. Sign below and skip the rest of the form. �ocuSigned !&UA bye��.,• �C:((� ., 11/22/2017 Owner' Signature: u U `� Date: 19 Yes My real property i dEnai able for'use or occupancy on or before January 1, 1994. Civil Code Sections 1101.1 through 1101.8 apply. Refer to the attached. ❑ My property is a single-family residential real property. See Civil Code Section 1101.4. On and after January 1, 2014, building alterations or improvements shall require all non-compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures throughout the building. On or before January 1, 2017, all non-compliant plumbing fixtures shall be replaced with water -conserving plumbing fixtures (regardless of whether property undergoes alterations or improvements). My property is a multifamily residential real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. On or before Januay 1, 2019,.all non-compliant plumbing fixtures shall be replaced with water - conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). ❑ My property is a commercial real property. See Civil Code Section 1101.5. On and after January 1, 2014, specified building alterations or improvements shall require non- compliant plumbing fixtures to be replaced with water -conserving plumbing fixtures. SB407 2015.doc revised 02104115 D'ocuSign Envelope ID: F772AB79-282F-4454-B453-E2A77COCAEOA On or before January 1, 2019, all non-compliant plumbing fixtures shall be replaced with water- conserving plumbing fixtures throughout the building (regardless of whether property undergoes alterations or improvements). 1/We, the owner(s) of this property, certify under penalty of perjury that non-compliant plumbing fixtures will be replaced prior to date specified above with water -conserving plumbing fixtures in accordance with Civil Code Sections 1101.1 through 110 1.8, the current California Plumbing Code and California Green Building Standards Code, and manufacturer's installation requirements, and that the water-conservingp'it Ig fixtures comply with the requirements as indicated in the table below. Owner's (or Owner Agent's) Signature m" '¢ ' AAKfU "JAN "a"' 5W2278MME3... Upon completing and signing this Certificate, please return it to the Building Division in order to final your permit. Non -Compliant Water -Conserving Plumbing Fixture Plumbing Fixture1 (Fixture Complying with Current Code Applicable to New Construction) Maximum Water Usage/Flow Rate Fixture Type Water Usage 2013 CPC Ch. 4 2013 CALGreen Div. 4,3 2013 CPC Ch. 4 2013 CALGreen Div. 4.3 2013 CPC Ch. 4 2013 CALGreen Div. 5.3 /Flow Rate Single -Family Multi -Family Commercial Residential Residential Exceed 1.6 Gallons/flush Single flush toilets: 1.28 gallons/flush Dual flush toilets: 1.28 gallonsiflush effective flush volume (the composite, Water Closets (Toilets) average flush volume of two reduced flushes and one full flush Urinals Exceed 1.0'' 0.5 gallons/flush Gallons/flush Exceed 2.5 2.0 gallons per minute @ 80 psi. Also certified to the performance criteria of Showerheads gallons per minute U.S. EPA WaterSense Specification for Showerheads (A hand-held shower is considered a showerhead.) For multiple showerheads serving one shower, the combined flow rate of all showerheads and/or other shower outlets controlled by a single valve shall not exceed 2.0 gallons per minute @ 80 psi, or the shower shall be designed to allow only one shower outlet to be in operation at a time. Faucets — Exceed 2.2 gallons Maximum 1.5 gallons per Within units: 0.5 gallonsper minute @ 60 Lavatory per minute minute @ 60 psi; minimum Maximum 1.5 gallons psi Faucets 0.8 gallons per minute @ per minute @ 60 psi; 20 psi minimum 0.8 gallons per minute @ 20 psi In common and public use areas: 0.5 gallons per minute @ 60 psi 1.8 gallons per minute 60 si Exceed 2.2 gallons 1.8 gallons per minute @ 1.8 gallons per minute 1.8 gallons per minute @ 60 Faucets — Kitchen Faucets per minute` 60 psi May temporarily increase @ 60 psi May temporarily psi up to 2.2 gallons per increase up to 2.2 minute @ 60 psi, and must gallons per minute @ default to maximum 60 psi, and must 1.8 gallons per minute @ default to maximum 60 psi 1.8 gallons per minute Where faucets meeting @ 60 psi the above are unavailable, Where faucets meeting aerators or other means the above are may be used to achieve unavailable, aerators or reduction. other means may be used to achieve reduction. usagelflow rate is equal to or lower than the figure shown, it is not required to be upgraded. 1. if the existing plumbing fixture water SB407 2015doc revised 02104115