B-2018-1348 CONSTRUCTION PERMIT APPLICATION
COMMUNITY DEVELOPMENT DEPARTMENT•BUILDING DIVISION
10300 TORRE AVENUE•CUPERTINO,CA 95014-3255 �/� /2
(408)777-3228• building@cuuertino.org PEMIT#B- fes'/I !0
CUPERTINO REV# DEF#_
NEW CONSTRUCTION ❑ADDITION [—I ALTERATION❑T.I. EP ❑RE-ROOF E]SWIMMING POOL/SPA
PRO]ECTADDRESS , t,s !: yfr_AMS /' - A Np
OWNERNAME H'�j '"J(CJV („,JYP tl'c`^l! E-MAIL
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❑ARCHITECT ❑OWNER❑OWNER AGENT ONTRACTORAGENT❑ENGINEER❑DEVELOPER❑TENANT
CONTACT NAME me-It leo ule-4W✓L �
STRHHT ADDRESS CITY,STATH,ZIP PHONE
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DESCRE'TON -
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❑SINGLE-FAMILY/DUPLEX LTI-FAMILY []INDUSTRIAL ❑COMMERCIAL
EXISTING USE I EXISTING SP NEW FLOOR SF PORCH SP DICK SF 1 DEMO SP 1 STORIES M TOTAL NET SP USE TYPE OCC SQ.FT. VALUATION($)
REMODEL REMODEL KITCHEN REMODEL,OTHR GARAGE ATTACHED
BATHROOM SP E, SP SP ❑DLTACHED
EXISING ❑YESEICHLI{A ❑❑
[3YES SECOND STORY ADDITION ❑NO
FIRESPRINKLERS NO NO
DWELLING SECOND DWELLING A YES❑AITAC IED❑DETACHED OTHER
UNITS# UNIT ADDITON: NO S P
POOLS ❑FIBERGLASS Q VINYI.LINED❑GONER PREF FL=
POOL-SP SPA-SF IBD❑YES ❑NO TOTAL-SF
RrY: U fON:
C ! M - fl 6'Id'g 1h P 67'S P ! D t t f E I I H tl !
RE-ROOr EXISTING ROOF TYPE: ❑BUILT-UP ROOF❑ASPHALT SHINGLES❑WOOD SHAKES❑WOOD SHINGLES❑TILE OTHER(SPECIFY)
REMOVE/REPLACE[]NO IF NO PLYWOOD ❑'h„ 03/8" PLYWOOD TYPE: PITCH: ROOF CLASS
DYES p OF LAYERS THICKNESS❑5/8" OTHER eOSB^Q`eDX-^—OTHER - -�2'`�A
PROPOSED ROOF TYPE:❑BUILT-UP ItOOP SPH*L NGLLS❑WOOD SFIAKES DWOOD SHINGLES❑OTHER
*Provide a signed copy-of-the Cupertino's Tear-Off Policy SF ff CSQUAREs
By my signature below I certify to ch 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 th ' fo ti I have provided is correct.I have read the Description of Work and verify it is accurate.I agree
to comply with all applicable to a1 or aces and state Iaws r lating to building construction. I authorize representatives of Cupertino to
enter the above-identified prope ty fo pec' urposes. I c owledge and authorize all information contai ed on this application form
to be made available for public re o
BA
Pec
of Applicant/Agent: Date:
SUPPLEMENTAL INFORMATION REQUIRED
*New SPD/Second Dwelling Units/Multifamily Dwellings:A D molition 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
B1dgApp_2017.doc revised 08101117
CUPERTINO
PURPOSE
SMOKE [ CARBON MONOXIDE ALARMS
OWNER CERTIFICATE OF COMPLIANCE
COMMUNITY DEVELOPMENT DEPARTMENT e BUILDING DIVISION
10300 TORRE AVENUE • CUPERTINO, CA 95014-3255
(408) 777-3228 • FAX (408) 777-3333 • building(cDcupertino.org
PERMIT CANNOT BE FINALED UNTIL THIS CERTIFICATE HAS BEEN
COMPLETED, SIGNED. AND RETURNED TO THE BUILDING DIVISION
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
bedrooms) - (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 above -referenced property, I hereby certify that the alarms) 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:
00 5 l: C
Permit No. 6 - " 6-
Specify Number of Alarms: # Smoke Alarms: F77 # Carbon Monoxide Detectors:
1 have read and aaree,to j3omoly "the terms and conditions of this statement P V4 c
Owner (or Owner Agent's) Name:
Sinature .................................................................................................................. Date:...................
Contractor Name:
Signature...................................................................... Lic.#........................................ Date:...................
Smoke and COform.doc revised 0111012017