08030029CITY OF CUPERTINOA
BUILDING DIVISIONPERNIIT
CON—T,
.
B"18ADDV" LUES DR
A
AFFORDABLE HEATERS &
PERMIT NO.
08030029
OWNER'S NAME:
PERMIT ISSUE DATE.
JASON WANG
24707 SAN FERNANDO RD
03/06/2008
NE:
SANITARY NO. CONTROL NO.
ARCHITECT/ENGINEER:
BUILDING PERMIT INFO
REPLACE WTR HEATER
BLDG EIFCT PLUMB MECH
0 0 0
LICENSED CONTRACTOR'S DECLARATION
Job DCSCrIpCIOn
1 bereby affirm that 1 sm licensed under provisions of Chapter 9 (commencing
with Seclitor7 II)af Division 3 of the Business and Pmfeulunry CmIa. and my license is
in full force ander,.. n b (r
�7�
Lima Cass 7V L"c.g
Da¢ Contractor
ARCHf1ELT5 DECL,ARATI N
1 und.rstanJ my plans shall W mese u puhiic Rcords
Licensed Professional
OWNER-9UILI)ER DECLARATION
1 Mashy aRrm that I em ...mit from the Comrmtrs License law for the
fallowing mason. (Section 701.5, Buiness and Professions Code: My city ar mumy
which requires •permit b cannoneer. star, improve, demoltsh, or repair any structure
prior to its iavanm. also ma uma the applkam for such Fermi, or file aA,mu maern m
de Conuacter's Licence law(Chap. 9
Sq. Ft. Floor Area
Valuation
that he ds licensed Pursuant asthe provisions of
(commencing with Section 7") of Division 3 of the Business and Professions Code) or
that W u exempt thmefmm and the buts for the alleged exemption. Any violmian of
APN Number
Occupancy Type
Section 7031.5 by any applicant for a permit subjects the applicant to a civilpen&try of
out mom than five hundred dollars (1570).
❑ L a ownerk. the Property, m my employm wiwages u Na ntities
Re wired Ins ectlonS
(Sec. 70",
will do thework.and, Clumis a, Entities
LMadocofferedws,
up'sot
in of
Cade: The License Lew does tet apply 1f an owner of
Thp, act apply
and Pty,
9 P .
ps theebfa
who Wilda his
who dmsemhwdedor
awnemployee,provided thatsuch impmmmmtaartnot intendedar offered for ak IL
am employees. idmprovechimprove
builder. the Wilding arimprovementissold within ladom.
yw of mproveI
rchrowner-
e,
builder will ham Ux Wrdm of proving Nu W did tet build or improve for purpose of
D I, as owner of tW property, am exclusively contracting with licensed contractors an
constons the pmlcct (Sec. 7W. Business and Praredans Code) The Ccmdmm is Lt.
"
cess. Law does not apply in an owner of property who Wilds or imptvu charms, sad,
who contracts for such projems with a eanlractuds)limaked pommel b the Comrantors
License Law.
❑ 1 am exempt under See , B & P C for the Raman
.
sect., Date
WORKER'S COMPENSATION DECLARATION
1 thereby affirm under perWry, o(perjby We of the fallowing declarations:
D I have and will meintsin a Certiriets Of Coraanl b elf-InsuR fu WorkeluCmnpm"
armee, as provided fm by Section 37M of lW IaWr Cade, fer do, Pont... of the
work for which this permit is issued.
D 1 have end will maintain Workers Compensation Wmanm, as myuircd by Section
3700 of Ne LaWr Code. for the performance of the work for which this permit is issued.
My Worke_fy/�Wr cm;a do kmnnee carrier and Policy number ane (' a '2
Grapier. `r' K X_ Policy No.: Z O�/ 10 7 3
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu acesi.e.o.d not W completed ilth, pound, is fora.. hundred thallus ($1001
less.)
1 certify that in the perfmmmm of the wart for which this permit I. issued, I shell am
employ any person in my manrcrso as b beeomc subject an the Warkcrs'Compewtim
"
Laws ofCalifornia. Data
Applicant
NOTICE TO APPLICANT: If. after making this Cer, ifaae of Exemption, you should
become subject to the Worker's Compensation provisions of the Labor Cede. you must
foMwithcomply with such provisions or Nu permiL,h.11 W deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby.M. user them is a eonsuuednn landing agenry for the perfmonan¢ of
' the work for which this permit is issued (Set 3097, Civ. C.)
"
Undoes Name
-
Lender'sAddm.
1 madly that I have mad this application and sue Nat the above information is
' couccL 1 agree to comply with all city and county ordinances and sum laws testing to
building contraction, and hereby authorize repmsensetivee of this city to mncr upon de
ahoy .mentioned properly for inspection purpaxs.
(Wc) agree to ave, indemnify and keep harmless the City of Cupertino against
j liabilities, judgments, costs and ex sea which may in any way accrue against said City
inconsequenceorthregantingaf is mit.
APPLICANT UNDER ST A WILL COMPLY WITH ALL ON-POINr
y�
Issued by: Date'
SOURCEREGULATI S.
rat
Re -roofs
Type of Roof
Signuurtawl Apps ConDataHAZARDORDO US MATERIALS DISCLOSURE
Will building ampanemrcor Candle enmaterial
.
yth,CEammfMuni
a defined by Ne Cupenioo Municipal Code. Chains, 9.12, and the Health aM Safety
Health
Cuda Section 25532(.)? _/
All roofs shall be inspected prior to any roofing material being installed.
10 Dy. I!i°
If a roof is installed without firs[ obtaining an inspection, I agree to remove
Will me applies.! arfwum Wi ngamupanl usecquipmmtardcvim, which
crit havardous air eamea irunu u RnN by the Bay Arta Air Quality Management
all new materials for inspection.
District'
0 Yes Nu
I have mad thehva me rials Rtryirtmems under Chape,6.95ofthe Glifor-
meR.1h&Saretycod.. 505,25533and 25534.1mdcrsuM that if see Wilding
duce not cumotiY at itis mY responsibility a radfy de, occupant of the
an
myaimmentsw m Priormcaammaracerura,caraepane Os
Signature of Applicant Date
All roof coverings to be Class "B" or better
I .
Own—m.nthmbcd agm, Date
• 4 ITEMS OF 32
11
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ......... 32630001.00
DATE ISSUED.......: 03./06/2008
RECEIPT #.........: BS000004096
REFERENCE ID # ...: 08030029
SITE ADDRESS .....: 20885 ALVES DR
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER ............: JASON WANG
ADDRESS ..........: 20885 ALVES DR
CITY/STATE/ZIP ...: CUPERTINO CA, 95014-1825
RECEIVED FROM ....: EDDIE D NALLEY
CONTRACTOR .......: LEONCE ROUX LIC # 26850
COMPANY AFFORDABLE WATER HEATERS &
ADDRESS ..........: 24707 SAN FERNANDO RD
CITY/STATE/ZIP ...: NEWHALL, CA 91321
TELEPHONE ........: (661)259-7131
FEE ID
UNIT
QUANTITY
AMOUNT
PD -TO -DT
THIS REC
NEW BAL
----------
1BSEISMICR
-------------
VALUATION
----------
1,900.00
----------
0.50
----------
0.00
----------
0.50
----------
0.00
1PPERMITFE
FLAT RATE
1.00
40:79
0.00
40.79
0.00
IPRWHEATR
UNITS
1.00
24.48
0.00
24.48
0.00
1TRAVDOC
FLAT RATE
1.00
40.79
0.00
40.79
0.00
TOTAL PERMIT
----------
106.56
----------
0.00
----------
106.56
----------
0.00
VOICE ID DESCRIPTION
-------- ----------------------------
. 518 WATER HEATER
VOICE ID DESCRIPTION
-------- ----------------------------
CITY OF CUPERTINO
IrOFli
Q' WATER HEATER
•CUPEkTINO PERMIT APPLICATION FORM
APN # 3 Z(0 0 0 0 j. USU
Date:
Building Address: 26 e S
Owner's Name:
Phone #:
j �s6N w� a5
L-10-3sf-s5
Contractor:
'4pro r0aW�1�
Phone #:
Fax #: LG/ 2 Tf — 5 -T -C
Cupertino Business License #:
Contractor State License #:
-2—
(0 Z7 3 (� �
Contact:
S C L i 414, /d
Phone #: L
Fax #: _ Zss- srf-�
Building Permit Info:
Bld ❑ Elect ❑ Plumb Fc��'
Mech ❑
Residential Commercial ❑
Job Description:
Strapped 121�, On Platform ❑ Bonded [� New Location ❑ Replacement
Valuation: C� bU f
Green Building Check must be completed and attached to this application.
Green Building Points achieved:
C.
OF
CUPER,TINO
CITY OF CUPERTINO
WATER HEATER
PERMIT APPLICATION FORM
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1PCWHEATR
Commercial Water
HeaterNent
B
PCWHEATR
1BSEISMICOM
Seismic Commercial
B
1
1PRWHEATR
Residential Water
HeaterNent
B
PRWHEATR
1BSEISMICRE
Seismic Residential
B
IPPER 41TFEE
Plumbing Permit
P
r
1 TRAVDOC
Travel &
Documentation
B
1BUSLIC
Business License
B
n
LJ
•
•
r
'Single, Family Green Point Checklist. date. G roA�
The GreanPolM Checklist Is based on the various gram features Incorporated Into the home and is the
basis for the GreenPoim Rated program. A home can be considered green It It fulfills the prerequisites,
earns at least 50 points, and meets the minimum points per category. Energy (30), Indoor Air Oualltyl
Health (5), Resources (6), and Water (9). Please cantacl Build It Green for a list of qualified GresnPoint
Retire I you are interested in pursuing third -parry verification.
The green building practices listed below are described in the New Home Construction Green Building
Guidelines, avallable at wweu.buili imreen oro. .
g Build It Greed
Smart Solutions From fie Ground UpIII
n-
B.
F n UpP I._._I
FOUNDATION
-� ,,.... -� � J„o _w
Points Available Per Measure
❑
❑
1. Replace Portland Cement in Concrete with Recycled Flyash or Slag
ouMinimum 20%Flyash or Slag ?
b. Minimum 25%Flash or SlagLl
1. Construct Resourc>Efficient Lendscap"
e. No PNatSp Spades listed M eAre Planted
b. No Plant Spades Will Require Hedging
g �
C. 75% of Plants Are Drought -tolerant Cal Natives, Mediterranean, or Other Appropriate Species
� }
0
0
] I
_ 0_
0
2 Use Frost-PT00wed Shallow Foundation in Cold Areas (C.E.C. Climate Zone 16)
p
3
El
a. Use Radon Rall Construction On At -Risk Locations Only)
p
]
❑
4. Design and Build Structural Pest Controls
a Install Termlle Shields A Separate All Ederior Wood -Io cossets Connections by Metal or Plastic Fastanem✓DNiders
❑
C. Use Only Jack and Cripple Studs Required for Load
0
p
- 0
0
b. All New Plants Have Tmnk, Base, or Slam Located At Least 36 Inches from Foundation (
0
1 I
C. LANDSCAPING
-� ,,.... -� � J„o _w
u
Points Available Per Measure
❑
❑
❑
1. Construct Resourc>Efficient Lendscap"
e. No PNatSp Spades listed M eAre Planted
b. No Plant Spades Will Require Hedging
g �
C. 75% of Plants Are Drought -tolerant Cal Natives, Mediterranean, or Other Appropriate Species
� }
_ 0_
0
I 3
2 Use FlreSefe Landscaping Techniques
`1,
D
1
❑
❑
❑
❑
3. Minimize Tud Arae in Landscape installed by Builder
a AU Tud W01 Have a Water Requirement Less than a Equal to Tag Fescue (50.9 plain factor)
b. Tud Shall Not Be Installed on Slopes Excoadng 10% or In Areas Less than 6 Feet Will
c. Tud Is 533% of Landscaped Area (total 2 points)
d. Tud is 510%dLandscaped Area (tNa14 points)
—_ )- 1
❑
C. Use Only Jack and Cripple Studs Required for Load
0
! 2
p
- 0
0
--1 1
_ --p !---
-_.
2
❑
4. Plant Shade Trees
0
! 3
a Beams and Headers
6. Grou Plants by Water Nestle (iydro:oning)
0
l
2
❑
❑
S. Instal High-Effidency Irrigation Symons .
a. System Uses Only Low -Flow Drip, Bubblers, or Lox -flow Spdnklars
b. System Has Smart Controllers
0
1 1
❑
0
1 2
0
_
3
❑
T. Incorporate Two Inches o/ Compost in the To a to 12 inches of Soil
D
! 3
a Mulch All Plentln Beds b the Greelw of 2lnches or Local wow unamanro Requirement
0
I 2
❑
2. Use 50%Salvaged or Recycled -Content Materials for 5D% 01 Non -Plan! Landscape Dements
0
I I I 1 I
Lj
10. Reduce Light Pollution by ShieldingFlzturea an for Directing Light Downward
"g;
0
1 I !
D. STRUCTURAL FRAME & BUILDING ENVELOPS
-� ,,.... -� � J„o _w
u
Points Available Pat Measure
1. Apply Optimal Value Engineering
❑
a Place Raters and Studs at 24 -Inch On Canter Framing
0
(
E]
g. Sao Dow and Window Headers for Load �
—_ )- 1
❑
C. Use Only Jack and Cripple Studs Required for Load
0
! 1
2. Use Engineered Lumber
❑
a Beams and Headers
0
l
❑
b. Insulated Engineered Headers
0
1 1
❑
c, Wood I -Joists or Web Trusses for Flows
0
]
--- .-"-
❑
d. Wood l-Joisle for Root RatanE]
a, e. Engineered or Finger -Jointed Studs for Valfcal Applications
--�-
---.L_._:_��_ _
❑
I. Oriented Strand Board for Subfloor
p'---
❑
g. Oriented Strand Board fa Well and Roof Sheathing
0
1
3. Use FSC- rlmod Wood
❑
a. Dimensional Lumber, Studs and Timber. Minimum 40% '
0
20
❑
b. Dimensional Lumbar, Studs and Timber. Minimum 70%
-
❑
C. Panel Products; Minimum 40%
.O -
-' -" - - - - ---- - -
❑
J. Panel Produce: Minimum 70%
- -
"--
0
02007 Build It Green Single Family GreenPoint Checklist 2007 Version Page 1 of 4
G. PLUMBING
Points Available Per Measure
1. Distribute Domestic Hot Water Efficiently (Malmum 7 Points) .
0
1 1 1
1
❑ L Insulate Hot Water Pipes from Water Heater to (Unhen
❑
b. Insulate All Hot Water Pipn
_
0 _
_
T 1
❑
c. Use Engineered Parallel Piping
0
._
1
❑
J. Use Engineered Pamtlal Piping with Demand Controlled Circulation Loop
_
0
_
❑
e. Use Structured Plumbing with Demand Controlled Circulation Loop
0_
1
❑
1. Use Central Core Plumbing
_
0
_ _ _
1 — 1
2
—[T-2.
Install Only HI hEMciency Toilets; Dual -Flush or 51.28 l)
0
q
0 2007 Build It Green Single Family GreenPolnt Checklist 2DW Version Page 2 of 4
•
•
•
ENTER PROJECT NAME
c
E
2 Design and Build High Performance Homes - %above Title 24- minimum 15% Required 0 2313
❑ J. House Obtains ENERGY STAR with Indoor Air Package Certification - Pffp1 Measum (Totd 45 pointe; read comment) 0 5 2
0
]
❑
Exposed Concrete. FloodngAcaradms Must Hem <50 Sol VOCs
2 Use Low-VOC or Zero-VDC Prim (Maximum 7 Points)
❑
& Minimum 15% of Floor Area
❑
a. Low-VOC Interior WatEdfinp Palms (<50 gpl VOCs (Flat) and <150 girl VOCs (Non -Flap)
D
i]
p
I. RENEWABLE ENERGY
b. Zero-VOC: Interior Wa UCellln Palms (d 0 VOCs (Flat))
Points
Available
Pel Measure
❑
Ll 1. Pro -Plumb for Solar Hot Water Hinting
0
q
L Install Solar Wonder Heading System
0
10
LJ 9. Install Wiring Conduit for Future, Photovoltaic Installation 6 Provide 2D. M of South -Facing Roof
0
2
4. Install Photovoltaic(PV) Panels
S. Uss Re ded-Content Paint
0
❑ &30% cl alechic needs OR 12 kW(total 6 points)
0
6
❑ b.6D% of electric needs OR 24kW(tasl 12 points)
Q
—6-- --"--
❑ c. 9D% M electric need OR 3.6 kW lint 16 poims)
p"
--
J. BUILDING PERFORMANCE Points Available Per Measure
1. Diagnostic EnIUSE( M
❑ a. House Passes Blower Door Test 0 ]
b. House Passes Combustion Safe Backdad Test p '
Points Available Per Measure
2 Design and Build High Performance Homes - %above Title 24- minimum 15% Required 0 2313
❑ J. House Obtains ENERGY STAR with Indoor Air Package Certification - Pffp1 Measum (Totd 45 pointe; read comment) 0 5 2
............. ___
R. FINISHES -
_
Points Available Per Measure
❑
1. Deeign Entryways to Reduce Tracked in Contaminants'
0
]
❑
Exposed Concrete. FloodngAcaradms Must Hem <50 Sol VOCs
2 Use Low-VOC or Zero-VDC Prim (Maximum 7 Points)
❑
& Minimum 15% of Floor Area
❑
a. Low-VOC Interior WatEdfinp Palms (<50 gpl VOCs (Flat) and <150 girl VOCs (Non -Flap)
D
i]
p
❑
b. Zero-VOC: Interior Wa UCellln Palms (d 0 VOCs (Flat))
c. Minimum SD% of Floor Area
0
---
❑
3. Use Low VOC, Water -Barri Wood Finishes (Q50 Sid VDCe)
p
2
ET
❑
4. Use Low-VDC Caulk and Construction Adhesives (00 girl VOCs) for All Adhesives
p
2
3. Floodn Mees W......—. or CRl Green Label Plus Pe uiremenb (50%Minimum
❑
S. Uss Re ded-Content Paint
0
a. ENERGY STAR Qualified &< 25 Cubic Feet Capacity
1
• B Use Environmentally Preferable Materials for Interior Finish: A) FSCLeNfled Wood, B) Reclaimed, C( Rapidly Renewable, D) Recycled-Contsnt
E"'Y'
ERGY STAR Qualified & <20 Cubic Feel Capacity
0
—n-
_14,
or E) FlngerJolnted
0
❑
❑
a. Colorado (50%Minimum)
0
❑
]
❑
b. Interior Trlm (50% Minimum)
p ------
--""-
❑
C. Stalking (50% Minimum)
p
--_---- - -
El
CL d Doors (50% Minimum)---
❑
e. Counted (50%Minimum)
----
7. Roduee Formaldehyde in Interior Flnish (CA SectiDn.135D)
❑
a. SubDoor & Ssir Treads (5D% Minimum)
0
7
❑
b. Cabiros& Counterplot (50% Minimum)
p
---_ -
"-�--
❑
C. Interior Trim (50% Minimum)
p
❑
d. SneMin (50%Minimum)
0
❑
&. ANer Installation of Finishes, Test of Indoor Air Shows Formaldehyde Leval Q7p b
0
I r 3
L. FLOORING
Points Available Per. Measure
1. Use Envimnmentslly Preferable Flooring: A) FSC-Cwtfied Wood, B) Reclaimed or Ra6nshed, C( Rapidly Renewable, D) Rerycled-Conleat E)
❑
Exposed Concrete. FloodngAcaradms Must Hem <50 Sol VOCs
0
❑
& Minimum 15% of Floor Area
0
7
❑
b. Minimum 3D% of Floor Area
p
—___— ...... T--
❑
c. Minimum SD% of Floor Area
0
_.
❑
d. Minimum 75% Of Floor Area
-2.
p
2
ET
Thenal Mau Floors: Floor Covering Other than Carpet on 5o% or Mora of Consists FIDDM
0
1
❑
3. Floodn Mees W......—. or CRl Green Label Plus Pe uiremenb (50%Minimum
D
2 ( 1
M. APPLIANCES AND LIGHTING
Points Available Per Measure
1. install Winer and Energy Efficient Dishwasher
❑
a. ENERGY STAR total I point
0
❑
b. Dishwasher Uses No More than 6.5 GaIIDnMD cls tmal2points)
0
1
2 Install ENERGY STAR Clothes Washing Machine with Weler Factor of 6 or Leu
❑
& Mees Energy Slat and CEE rM 2 requirements (modified energy factor 2.0, Water Facia 6.0) (to el3 points)
D
❑
b. Mees Energy Star and CEE nor 3 requirements (modiled energy factor 22, Water Factor 4.5 or leu(
_
2
(total s points)
p
3. Install ENERGY STAR Refrigerator
❑
a. ENERGY STAR Qualified &< 25 Cubic Feet Capacity
0
Elb.
E"'Y'
ERGY STAR Qualified & <20 Cubic Feel Capacity
0
—n-
_14,
1, Install B.Iltln Recycling Center
0
❑
& Bulb -In Recycling Center
0
❑
b. Bulb -In Composting Center
0
( 1
N. OTHERPoints Available Per Measure
L]1. Ineoryorate GrsenPoinl Rated Checklist in Blueprints; 0 R
❑ 2. Develop Homeowner Manuel of Green FeaturesSon¢fits 0 1 1 1
3. Community Design Measures & Local Pdorides: See the Community Planning & Design sactlon in Chapter 4 of the New Home Guidelines for
measures. Maximum of 20 points for suggested measures. Local requirements may also be faced here.
02007 Build It Green Single Family GresnPoint Checklist 2007 Version Page 3 of 4
_Enter description here, and enter points aeellable for mown In eppropdets caegalee to the right.
Enter Mealplion Mn, and enter points esellaoe for measure in Apiew to categories to the right
Enter duu¢am hen, and ems poets avalleMe tor meuun in appropriate categories to the right.
Enter description hare, and Omer poirde oealloole for measure In appropriate categories to the right.
4. Innovation: Usl Innovative measures that most the green building objectives of the Guidallnes. Enter up to a
wupmu to
in
Total Available Points In Speciflc
Projoct hats not yet most the following rocommondod minimum requirements:
• Total Project Score of At Least 50 Points
- Required measures:
43a: 50% waste diversion by weight
-J2: 15% above Title 14
-NI: Incorporate GreenPolnt Rated Checklist into blueprints
• Minimum points In specific cate0ories:
-Energy (30 points)
-IAQIHealth (5 points)
-Resources (6 points)
-(Nater (9 points)
2+ 66+ 43+
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02007 Bulld It Green Single Famlly GreenPolnt Checklist 2007 Verslon Page 4 of 4
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Bulltl h
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Green
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Checklists
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Guitlellnea
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2+ 66+ 43+
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02007 Bulld It Green Single Famlly GreenPolnt Checklist 2007 Verslon Page 4 of 4
•
CITY OF
�UPEkTINO
0
C-1
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax (408) 777-3333
Building Department
JOB ADDRESS: .PERMIT
zogvr Akj�5 Dvl'
#
X9703 2
OWNER'S NAME:00s t �, w-. Ml
PHONE # voh-- 3S 8 - 5-i14
GENERAL CONTRACTOR:
FAX #
I am not using any subcontractors: --f/6 4's"
Signature Date
Please check applicable subcontractors and complete the following information:
Owner/ Contractor Signature Date
SUBCONTRACTOR
BUSINESS NAME
BUSINESS LICENSE #
Cabinets & Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
Linoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting / Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/ Contractor Signature Date