08070166CITY OF CUPERTINO''t
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BUILDING DIVISION PERNUT
xCON'•TRAC�TOR 1�'F�4ZtMA"CT(�1Y
BUILDING ADDRESS:
1.9020 BARNHART AVE
TBD - TO BE DETERMINED
PERMIT NO.
08070166
OWNER'S NAME:
PERMIT C3UE DATE
ItAMAMURTHY
07/23/2008
NE:
SANITARY NO. CONTROL NO.
ARCHITECffENGINEER:.
BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
0 0 0 0
LICENSED CONTRACTOR'S DECLARATION
9
-
Job Description
(commencing
1 ion? aflinn Nall am fft Bu undo, and Po,aas mLTadc,
Milt Station 70(IU)ofDiviilon3of tlde Business and Profnwiov Code, and mylicemea
WTR MN RPLCMNT ABT 70FT
dlkeom C�lau de Lio..
JD PLUMBING PD FOR BUS LIC 7/23/8 $110.00
Dao: ComracNr
H SDECLARATION
1 undersand my plans "I he used as public records
Lma, dProfesioal
OWNER -BUILDER DECLARATION
1 hereby M. Nat 1 .sin tempt from tiro Cammacors Lieenm law for Ne
following ressan (Section 7031.5. Busircss and Profesaiom Code: My city m county
which rectums a permit to C..k alar. imp row, demnihm. N Riad, any aWelaR
prior a its isuatece. also respires the applicant for such permit to Ot a signed mummer,
that he is licevcd puaanl to Ne provisions of lee Commelarb Uawc Law (Chapter 9
Sq. Ft. Floor Area Valuation
(eammemwitwith Sartim7000) of Division 3oflheBusinessmad Professions Code) err
$1400
That he is exempt therefrom and Ne Was for the alleged exemption Any violation of
.
Sectio 7071.5 by any applicant for a permit subjects tit applicant to a civil penalty of�,p�p
Number
dccU anC
ml mom than fivehundred dollars(S M
37537040.'VV
p yType
1, s owns of the property, or my wployems with wages as their sole compensation,
will do the work, and the swnua isnot ineMod or offered for$ale (See. 70th, Bottoms
and Professions Cad-- The Contractors License Law does not apply to an Owner of
Required Inspections
property who Wild& a impmses me mn. and wMdoessuch work himselfwthrough his
own employees, provided that each impona ments am not intended ashamed for sale It.
however, the building or Improvement a sold within arc year afcamplelion. ft wler-
Wiider will have tit burden Of provNa but he did not ttia or improve for pmpoa of
ab.).
❑ 1. as owner of tnd propeny. w adudwly cantramin& with licaued eanaacros to
-
mmtmn the reject (See. 7044. Bair and Professions Cob:) Tim Contractors LL
cove law does not apply w so was of property who builds a improves leamn. and,
wM c..0 fm such projects with a ca orad (5) IKadad(nPSWnI to me Gmnt(Clara
Lice" law.
❑ Iamaemptunder See .B&PCfaimisaawn
Ower Dag
WORKER'S COMPENSATION DECLARATION
1 heavy drum under penalty Of perjury one Of the following dedara one
1 have and will maintain • CeniOate ofC...t to sel4imum for Workds Campo.-
wion, as provided for by Section 3700 of da Labor Code, for the performance of Ne
wart for which his permit is Owned.
❑ 1 haw and will maintain Wahcrs Compensation Insurvla, as resulted by Sceliw
3700of the Uinta Codefort the performance, Of ft were for which lha permit is issand.
'
My Workert penadrron Inmsnce artier W Policy member are:
Canis. .n <S✓�u'w C%iry No.: (a'(A )
/1
-CERTIFICATE OF EXEMP ION FROM WORKERS
COMPENSATION INSURANCE
(T1ds well lead no(hecanpiesed if Ne pumila forma handed dollars ($100)
volas)
1 a:nifY man's Ne perfwmadece of the ooh for which Nis permit is ivaed. l Shat
employ any person in any toaster an as a become subject to tiro Waramet Compensatim
Law, of California. Dam
Applicant
NOTICE TO APPLICANT: If. afar making this Certificate of Exemption, you should
Weems .Object to the Warner's Compcusktion provisions of the Labor Coda, you Rua
fOrl comply with such proviSoM or Na permit shall be domed revoked.
CONIMUCT70N LENDING AGENCY
1 heahY afTw that were i.. ec mtroctio lending.plw,, for rho perftrm. of
the wort for which tits permit a isucd (Sts. 3097. Civ, Q
Landers Name
Lenders Address
1 edify that I have read this application and sum Na the &bow infermatim is
fa,reR 1 ajRe b emnply with dl city and emn(y mOilanaa and sale laws mladaa w
Wilding conslmelim, and hereby anNoda rtpresenutiva of Na city m rota umn Ne
ma
thaw-m.jadpodpropertyfsa ilaccase
(We) agate to saw, indemnify and trap humus the City of Cupertino ago
Bacinsequlagmma, hick me
athisp which m.rN anyw.y acme &gdnuaaid oily
omnand
in consequence: of the granuvL of this pemlii
APPLICANT UNDERSTANDS AN WILL COMPLY WITH ALL NON.POINr
Issued by: %
SOURCE REGuuUGN✓
Date 2 2 ��
JC-•-TFC---� m��Z 3�V[�
Re -roofs
Sngnaure oro aCanwctor Dat
HAZARDOUSMATERIALS DISCLOSURE
Type of Roof
Willy
fM-mi buildingaxvpantawe tar dandle
Cupenttar
HeaAausmatdd
IM Cupertino Muniripal Code, Chapter 9.13, and tit HcdN and safely
c, Section 25533(a)/
C] Y. lyr[o -
ite, Soc om
All roofs shall be inspected prior to any roofing material being installed.
W01 the. Besot or f'tm\m wadin wins nl ten
PP B W equipment or devices which
If a roof is installed without first obtainin an ins ection, I agree to remove
g p
defied by Ne Bay Area Air Quality Management
P m Nous air couminanppu
all new materials for inspection.
�s
I]Yn No
-
Ihow aadfh aNmsmatrials requirements underCluptr6.95 oftlaCaiifor-
niaHnllh&SafayCade, Seainm 35505.35533 an135534. l undrmaml NatifNe WU.g
den not murentiy haw a l tiw Il a my responsibility b ratify, tit amwpant of tk
ayWrewmwnkn t'pna-w—W a.CertifamOfO.Pba`T.
Signature of Applicant Date
g
rwlZa/cX
ownc,a,w Sent Dat
All roof coverings to be Class '%{" or better
cm
• CUPEIIiI
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
PERMIT APPLICATION FORM
Oeo-7016&
APN# 3-75 3-) ONS v o
Date:
0,F(7, -5 1 OF
Building Address:
Fee
Permit Type
Owra s Name:
U(4X'
Phone #:
4ov 341-S6(e
Contractor:
Phone #: r? 6 A G 37—,!!�6
((
Fax#: 360 cj6
Contact:
Phone #: 6'16 — 3 Z66
�v✓ Qc
Fax#: r' 36p 6' 4
Contractor License #: 6 3 Z
Cupertino Business License #:
1BPREPIPE
Job Description: W` 1
l a J� W) nt'
Residential ( Commercial
❑
Valuation: m
Commercial Gas Piping System
Project Size: Express Standard ❑ Large Major ❑
Green Building: Please complete relevant portion of the Green Building Checklist & attach it to the
application or if applicable, include in plan set & the sheet index.
�C _
Green BuildingPoints:
V
Quantity
Fee ID
Fee Description
Fee
Permit Type
Grou
1PCSEWER
Commercial building
P
1CPSS
sewer/sanitary sewer
1BPREPIPE
Commercial re -pipe per fixture
P
1CPRP
1PGASCOM
Commercial Gas Piping System
P
1-4 Outlets
1BSEISMICOM
Seismic Commercial
p
1BSEISMICR
Seismic Residential
p
1PRSEWER
Residential building
P
1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
a' REPIPE/SEWER/MAIN SERVICE
CUPEkTiNO FEE SCHEDULE
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1PRREPIPE
Residential re -pipe per fixture
P
1R -PRP
IBPWSVCS
Water Service
P
1CPWS or
1RPWS
1PPRSEWG
Private Sewage Disposal System
P
1PCESS
Cesspool
P
1BPWATER
Install/alter Water Pipe
P
1BPFIXTURE
Plumbing Fixture
P
1PGASRES
Residential Gas Piping System
1-4 Outlets
P
1BPGAS
Gas Piping System 5+ Outlets
P
r
1PPERMITFEE
Plumbing Permit Fee Issuance
P
1PLMBLNCK
Plumbing Plan Check
P
1PLMBINSP
Other Plumbing/gas Insp.
P
1TRAVDOC
Travel & Documentation Fee
B
1BUSLIC
Business License
B
Revised 6-16-08
•
L,
•
•
Plan Review Process Work Book Page -12-Revised 3/25/08
Green Building Plan Check
Index of Green Building
Points/Categories
A.
Category
Example of an Index or Table of Green
Plan Sheet or Page
Points
Building Points Categories that must be
shown and referenced on the Project
Plans See below
rt.
B.
Site
9.
Install H.E. Irrigation, (details/spec)'
L-1
11. Permeable Paving,Note
L-1
C.
Foundation
1.
Use 15 % Flyash Concrete, (note)
S-1
7points
D.
Structural
3.
Uses Wood I -Joist, (See Spec.)
S-2
5.
Use Truss with heels, (detail)
S-2
6.
B. OSB Sheathing,detail
S-2
E.
Ext. Finish
1.
Composite Decking, (Note/Spec.)
A-3
2 points
4.
B. Fiber Cement Siding, (Note/Spec.
A-4
2 points
F.
Plumbing
1.
Insulate all H.W. pipes, (Note/Spec.)
P-1
2 points
5.
Tankless W.H., (Note/Spec.)
A-2
2 points
11. A 2500 Gal. Tank, (Note/Spec
L-1
10 points
G.
Electrical
4.
E. Ceiling Fans, (Note/Spec.)
A-3
4 points
H.
Appliances
1.
Energy Star Dishwasher, (Note/Spec.)
A-3
1 point
3.
Energy Star Refrigerator, (Note/Spec.
A-3
1 point
P.
Other
1.
List Green Features on Plans
A-1
1 point
TOTAL POINTS
40 points
•
•
Plan Review Process Work Book Page -12-Revised 3/25/08
Green Points Rating System for Remodeling Projects
Due to the diversity of remodeling project types, assigning a "total points' value to a project to be considered environmentally friendly is •
not feasible. However, 25 measures have been highlighted to signify that every effort should be made to incorporate them into your
projects. These items have been chosen based upon their impact on the environment and the health of the home in coordination with
ease of implementation and relative low cost. These measures can be used as a starting point for "greening" your project.
1, Recycle Job Site Construction & Demolition Waste
3 Resource pts
65%=1 point; 75%= 2 points 8�'/0 = 4 points
up to 4 Resource
2. Salvage Reusable Building Materials
4 Resource pts y=
3. Remodel for Mixed Use, Adaptive Reuse, and
up to 10 Resource
Historic Preservation
4 Resource pts y=
4. Protect Native Soil
2 Resource pts y=
5. Minimize Disruption of Existing Plants & Trees
1 Resource pt y=
6. Implement Construction Site Stormwater Practices
2 Resource pts y=
7. Protect Water Quality with Landscape Design
2 Resource pts y=
6. Design Resource -Efficient Landscapes and Gardens
4 Resource pts y=
9. Reuse Materials/Use Recycled Content Materials
7. Use Engineered Studs for Vertical Applications
for Landscape Areas
2 Resource pts y=
10. Install High -Efficiency Irrigation Systems
2 Resource pts y=
11. Provide for On -Site Water Catchment / Retention
2 Resource ots v=
B.Foundation
1. Incorporate Recycled Flyash in Concrete
25% Recycled Flyash = 2 points; Add 1 point for every 10%
increase of Flyash, up to 5 points up to 5 Resource
2. Use Recycled Content Aggregate 2 Resource pts y
3. Insulate Foundation/Slab before backfill 3 Energy pts y=
C. Structural Frame
1. Substitute Solid Sawn Lumber with Engineered Lumber
3 Resource pts
y=yes
2. Use FSC Certified Wood for framing
(For every 10% of FSC lumber used = 2 points, up to 10)
up to 10 Resource
pts
3. Use Wood I -Joists for Floors and Ceilings
2 Resource pts
y --yes
4. Use Web Floor Trusses
2 Resource pts
y=yes
5. Design Energy Heels on Trusses 6' or more
2 Energy pts
Y --Yea
6. Use Finger -Jointed Studs for Vertical Applications
2 Resource pts
y=ye:
7. Use Engineered Studs for Vertical Applications
2 Resource pts
y=yea
8. Use Recycled Content Steel Studs for Interior Framing
2 Resource pts
y --ye,,
9. Use Structural Insulated Panels (Sips)
a. Floors
3 Energy pts
y=ye:
It. Wall
3 Energy pts
y=ye:
c. Roof
3 Energy pts
y=ye;
10. Apply Advanced Framing Techniques
4 Resource pts
y=ye;
11. Use Reclaimed Lumber for Non Structural Applications
3 Resource pts
y=ye
12. Use OSB
a. Subfloors
1 Resource pt
y=ye:
b. Sheathing
1 Resource pt
y=ye
7J
•
r
r
r
r
r
r
r
r
r
r
0
r
r
r
r
0
0
-_
-_
7J
•
1. Install Energy -Efficient Windows
2 Energy pts
2. Install Ductwork within Conditioned Space
• a. Double -Paned
1 Energy pt
y=yes
b. Low -Emissivity (Low -E)
2 Energy pts
y=yes
c. Low. Conductivity Frames
2 Energy pts
y=yes
2. Install Low Heat Transmission Glazing
1 Energy pi
y=yes
J. Heating Ventilation and Air Conditioning
1. Use Duct Mastic on All Duct Joints
2 Energy pts
2. Install Ductwork within Conditioned Space
3 Energy pts
3. Vent Range Hood to the Outside
1.IAQ/Health pt
4. Clean all Ducts Before Occupancy
2 IAQ/Health pts
5. Install Solar Attic Fan
2 Energy pts
6. Install Attic Ventilation Systems
1 Energy pt
7. Install Whole House Fan
4 Energy pts
B. Install Sealed Combustion Units
14, Install Zoned, Hydronic Radiant Heating
a. Furnaces
3 IAQ/Health pts
b. Water Heaters
3 IAQ/Health pts
9. Replace Wall -Mounted Electric and Gas Heaters with
16. Install Heat Recovery Ventilation Unit (HRV)
Through -the -Wall Heat Pumps
3 Energy pts
10. Install 13 SEER/11 EER or higher AC with a TXV
3 Energy pts
11. Install AC with Non -HCFC Refrigerants
2 Resource pts
12. Install 90% Annual Fuel Utilization Efficiency (AFUE) Furnace
2 Energy pts
Y --yes
• 13. Retrofit Wood Burning Fireplaces
a. Install EPA certified wood stovesfinserts
10 Energy pts
y=yes
3. Pre -Wire for Future Photovoltaic (PV) Installation
1 IAQ/Health pt
y=yes
b. Install/Replace Dampers
1 Energy pt
y=yes
c. Install Airtight Doors
1 Energy pt
y=yes
14, Install Zoned, Hydronic Radiant Heating
3 Energy pts
y=yes
15. Install High Efficiency Filter
4 IAO/Health pts
y --yes
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAQ/Health pts
y=yes
17. Install Separate Garage Exhaust Fan
31AC/Health pts
y=yes
K. Renewable Energy and Roofing
1. Pre -Plumb for Solar Water Heating
4 Energy pts
y=yes
2. Install Solar Water Heating System
10 Energy pts
y=yes
3. Pre -Wire for Future Photovoltaic (PV) Installation
4 Energy its
y=yes
4. Install Photovoltaic (PV) System
(1.2 kw = 6 points, 2.4 kw =12 points, 3.6 kw = 1 B points)
Up to 16 Energy pts
6. Select Safe and Durable Roofing Materials
1 Resource pt
y=yes
7. Install Radiant Barrier
3 Energy pts
y=yes
L. Natural Heating and Cooling
1, Incorporate Passive Solar Heating 5 Energy pts y=yes
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts . y=yes
3. Plant Deciduous Trees on the West and South Sides 3 EnerDY Dts v=ves
0
• 5 ITEMS OF 5
•
•
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ......... 37537040.00
DATE ISSUED.......: 07/23/2008
RECEIPT #.........: BS000005557
REFERENCE ID # ...: 08070166
SITE ADDRESS .....: 19020 BARNHART AVE
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OWNER RAMAMURTHY
ADDRESS ..........: 19020 BARNHART AVE
CITY/STATE/ZIP ...: CUPERTINO, CA 95014
OPERATOR: patg
COPY # : 1
RECEIVED FROM ....: JUAN L DIAZ
CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096
COMPANY ..........: TBD - TO BE DETERMINED
ADDRESS ..........:
CITY/STATE/ZIP .... ,
TELEPHONE ........:
FEE ID
----------
UNIT
-------------
QUANTITY
----------
AMOUNT
PD -TO -DT
THIS REC
NEW BAL
IBPWSVCS .
WATER SERVICE
1.00
----------
20.40
----------
0.00
----------
20.40
----------
0.00
1BSEISMICR
VALUATION
1,400.00
0.50
0.00
0.50
0.00
1BUSLIC
FLAT RATE
1.00
110.00
0.00
110.00
0.00
1PPERMITFE
FLAT RATE
1.00
40.79
0.00
40.79
0.00
1TRAVDOC
FLAT RATE
1.00
40.79
----------
0.00
40.79
0.00
TOTAL PERMIT
212.48
----------
0.00
----------
212.48
----------
0.00
METHOD OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT :
AMOUNT
---------------
212.48
---------------
212.48
VOICE ID DESCRIPTION
-------- ----------------------------
106 SEWER & WATER
507 FINAL PLUMBING
REFERENCE NUMBER
--------------------
VISA-
VOICE ID DESCRIPTION
-------- ----------------------------
301 ROUGH PLUMBING
E
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS: l 4C)Z OM
h a r 4 A \,)C
PERMIT #
O �i D7O1��0
OWNER'S NAME:
PHONE # o
ci (,_ 26
GENERAL CONTRACTOR:
'
FAX #
Cement Finishing
J
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
61
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
actor Signature
O,R (23�0,Y
Date