08070196 CITY OF CUPERTINO � �. � '"" 011
BUILDING DIVISION PERMIT
SUI I O DRES : PERMIT NO.
��JrB R :1,KNAP CT ADVANCED PLUMBING & 08070196
OWNER'S NAME: PERNET ISSUE DATE
alk M 1, LEE 18780 TUGGLE AVE 07/28/2008
NE: (408) 777-0651 SAWARY NO. CONTROL NO.
ARCHITECTIENOINEER: BUILDING PERMrt INFO
BLZG 0 ELECT PLUMB
O 0
LICENSED CONTRACTORS DECLARATION Job Description
1 hereby alrmo Yo I m li¢ead.mlu Pmdd^^s OfCh.Pcr 9(momaKinS
wile Swdm M=ofDWhiom3ofiMBudor WftOkuWm Code.Wmyliw is CHG ELECTRO MN PNL FM 100AMP TO 200AMP
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DBCLARATION
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OWNER-BUILDER DECLARATION
I Mmby'Rum dml I m eamP1 Imm dlo Cmuacht's Licene IAM Nor de
C D O following reuoa(Section 703 IA Budeuo W Pmfatim+Code:Any city Of manly
9 winch towha.pemlt to coamw4 aM,hnprma dcou, ,a mph uy ommmctu c
y pda m lm iouaae.WW mquim de applhnl in,mh pemtl to fib adped mammon,
- < dutM blbotood plemnm tM pmvi-me«the coamemra IJnnm I"(OuPer 9 Sq.Ft.Floor Area $1400 Valuation
y G (mnnteerJ,l3 with Sation 700M of DWWm3 of theBwmaW Pewo loolCade)-
dot he b camp tMnfiam W the ba-a fm the-Iced esmPdm ABY vhdMiah of
Swim 7031.5 by cry appkM for a it mil aabj"the applimntm l civil PamLLy Of 3 6210027 .W Number Occupancy Type
ooh Tae dm intohmdrdd dolaa(31)01.
❑Lumn.0«dlo prapnty,amy a.pkrymwb4 w.Sn ere detreb mmpraoedm,
.El do the wal4 W",,on onb"Wodbd or offered foraab(Sm 71144.End"`'` Required Inspections
W PWCSWM Code:The Conmmrs IJmm Law dot,nor apply e a owner or fl P
pop"who buWsorimpmrda lharcoiuWwbodm tocb wakbimdfarlh=9hbb
om empbym,pmrhbd dol such impmerwh am oot iomeded or aBt,ed locule B.
bowav me Wdldi•S oruoPovemmt 4aold wbh)a os Yem«cwltledaa,me owm-
buildwvEfbowdebadrnofF i.i that he did on,build Or impmv<for pspoe«
uk.).
Q 1.u owner«dm PMPMY,m adocTJy contKllnS wish Encoded mnoemrs to
ommnet ue pmjw(See.7044.Rush m W Pefmimd Ceder)The Cmtrefo%IJ-
erme IAw don,,on,appy to a owner«Poppy who builds wlopmes Ihemm,W.
whocanuacla for wee pmjmo withacnauw n0)licensed P.uont m dlo cmlrmaMa
Lime Law.
❑ice eat,nP and,See ,B R PC fa cider moan
Oulor Dn
WORKERS COMPPNSATWN 13ECLARA770N
t1 herby anion,ander Peo.Ey«prjury am of de following dslroiao:
,1.I haw on, o dnldn a CAnifwAm ofCumrd m slf-iasme Nor WaMJscmpeo-
u pmAded for by Section 3700 of the Labor Cade for the psfarmance of de
work fa which B)a Pwait is mued.
❑1 haw W will mdmin Worker'Caopemtim lonuaa.u mgimed by Swim
my Won M IAbar Code.for pnrfamamx«Ne wort lorwhbh phis pwmB W leased
MY Workers Ca.pmm roatlNmaa ardor W Polity nmbw m:
Caniw: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(This'codon sed not be cmph:W if to Pemh Is for onto hunaW doom(SI00)
or I=)
1 omtify dont is the pwfamaxe or the work For which this Permit W bound,l eh-1 not
.mpbympaaon)emymmermdewuskm'Compemdon .
IAwa of C-vaoi.Ale
A �L bWM✓
NOTiCaTo A�JCANf:o anw CeniOam the m on Pont abmm
haus,con p m Lha Waken.Caopw tide Prmit" be a LAeor Code you conn
.7 0 Imhwim comply wfm.a:h provma,n or Tis introit dWI M dolma rdaaked.
CONSTRUCTION LENDING AGENCY
I hnehy.W.lhm them is.mneredm In dirt aGaY for de Pafamua Of
(Yi
the work for whbh cider pemdl is inued(6'0.'.31191.CW.Q
O3 Q
Undoes
VO 1 mdfy dor I h.w nerd this Wplimim W sere Tho the above Wolin diun h
4Tr cm¢ch 1 aper to caoply with W city W coonty co inaaa W nom Iwo tooio3 In
buiding e9nnsvetion.W hardly mhhoriae apsummdw or this city to color upm the
W
Om-nndamd P^Paty for hopaiao Pape'
(We)cps m ave,indem-fy W kwp hmmleo dm City of Cupadrm caiut
r.rtz, Iiabilidea,jedSmeoa,Com Weapee.n wlkhmryb.ry nYamsaSWws.id LSq -7
U^t APPLICANT UNDERRSIANDS AND WILL COMPLY WITH ALL NON-POINT Issued by:
6
9f" Date
S�ra3-�1 / /SOURCE REGUILAMOKSAfl
Sitnuse«ApPintai- ems Dion, Re-roofs
a
HAZARDOU ATERIALS DISCLOSURE Type of Roof
Will de apPhao W id OO holding occul teraoorbandlehaa«m.mamri-
u,Beed by the Cupertino Municipal Code.Cb.pmr 9.11.W the Hel1h W S-ay
cane•Sudo^2113x•)7 All roofs shall be inspected prior to any roofing material being installed.
❑IFA okNo
Wponot,or hNm whin
Will the applbtm or farm bulking,accupm ere mIf a roof is installed without first obtaining an inspection,I agree to remove
hwndom-r u defined by the Bay Ards Mr Q cdlty MuaSement all new materials for inspection.
Die ct7
❑Ya KN.
I bile mad me haradm.mmntab mqukenmmt under Ch.Pmr 6.91 of de WI.-
-a lkalNRS-aYCodc.Sections 21103.75533 W 21130.1 uMvnu-dudNe ddldin
dons ml conendy has.Gaunt.dol b it my apoodWhy m notify the osupnt or the
rdgaistmem �pa m-pnar iaoaa«,cmirmmar - Signature of Applicant Date
` K� a o All roof coverings to be Class'#'or better
Owner or mthaded agent Dw.
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36210027 . 00
DATE ISSUED. . . . . . . : 07/28/2008
RECEIPT #. . . . . . . . . : BS000005605
REFERENCE ID # . . . : 08070196
SITE ADDRESS . . . . . : 1210 BELKNAP CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : M L LEE
ADDRESS . . . . . . . . . . : 1210 BELKNAP CT
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4904
RECEIVED FROM . . . . : XIANSHANG LI
CONTRACTOR . . . . . . . : XIANSHANG LI LIC # 24013
COMPANY . . . . . . . . . . : ADVANCED PLUMBING & ELECTRIC
ADDRESS . . . . . . . . . . : 18780 TUGGLE AVE
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
TELEPHONE . . . . . . . . : (408) 777-0651
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 1, 400 . 00 0 . 50 0 . 00 0 . 50 0 . 00
IEPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
1TRAVD0C FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 82 . 08 0 . 00 82 . 08 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 82 . 08 VISA
---------------
TOTAL RECEIPT 82 . 08
•
CITY OF CUPERTINO
• CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Date: 8�og
3 (0 07 / 0 7, v v �2
Building Address:
1210 Wje-m Cf CA g 5° 1
Mailing Address (if different from building address):
Owner's Name: 1 n L La Phone#: LAP 8 a,d3,ogf6
Contractor: ✓"I r Phone: 1 .0 a� Z
X7H 'S fAN( ' lz Fax: loU (�L ?77 0 ( l
Contractor License#: 7?- F 3 8, 7
Cupertino Business License#: 24-0►
Contact: as t ^ O'�V� �Sowq e- Phone: as Htc
SGtw,2
• Fax:
Residential Commercial
Job Description:
< � aM�� -�'�2 �(e Cfi Y-1, r4/ m a r4o e
Building Permit Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Type of Construction(Usage Class): 'Occupancy Type:
1-A, 1-B II/IIl/V-A ❑ II/III B, IV-HT, V-B ,`
Valuation: tt Square Footage:
Project Size: Express [3`i andard 0 Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it
to the application or if applicable, include in plan set& the sheet index.
• Points Achieved:
-
For help, contact Build it Green at www.buildi een.or
Revised --7/, '6r
`N CITY OF CUPERTINO
OF
CUPER,TINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1BBOILERI For the installation or relocation of ea M
boiler/compressor to & including 3
horsepower, or ea absorption sys to &
incl 100,000 Btu/h (29.3kw
1BBOILER2 Installation/relocation of ea M
boiler/compressor over 3 horsepower
to & incl 15 horsepower, or ea
absorption sys over 100,000 Btu/h
iBBOILER3 Installation/relocation of ea M
boiler/compressor over 15 horsepower
to & incl 30 horsepower, or ea
absorption sys over 500,000 Btu/h to
& incl 1,000,000 Btu/h
IBBOILER4 Installation/relocation of ea M •
boiler/compressor over 30 hosepower
to & incl 50 horsepower, or for ea
absorption sys over 1,000,000 Btu/h to
& incl 1,750,000 Btu/h
1BBOILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1BAPPLOTH For ea appliance or piece of equip M
regulated by this Code but not classed
in other appliance categories, or for
which no other fee is listed in this
code.
1 ELECINSP Other Electrical Inspections (per hour) E
IMECHINSP Other Mechanical Inspections (per M
hour)
1PLMBINSP Other Plumbing & Gas Inspections P
(per hour) .
1MEETINGIHR Application Meeting B
CITY OF CUPERTINO
CUPERTOF GE GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
I CHIMNEY Chimney B
1CHLMNEYR Chimney Repair B
FENCES
1FENCE>6FT Non-masonry, over 6 ft in height B
1 FENCEMAS>6 Masonry,over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
1 FLAGPOL>20 Flag pole(over 20 ft in height) B
1MODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
1PILECAST Pile Foundation Cast in place concrete B
IPILEDRIV Pile Foundation Driven(steel,pre- B
stressed concrete
3of5
CITY OF CUPERTINO
arr' F GENERAL BUILDING APPLICATION
CUPEkTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONR
1RETSTN Standard (up to 50 ft) B
1RETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSP10 Special Design, over 10' high (up to B
50'
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft)
1RETCRB> Gravity/Crib Wall over 10' high(up to B
50 ft
SHED-(EACH) Shed Over 120 sq ft B •
SIDING
1 SIDESTBK Siding, Stone & Brick Veneer B
interior/exterior
1 SIDEOTHER Siding all other B
SKYLIGHTS
1 SKYL<l0 SF Skylight less than 10 sf B
1 SKYL>10SF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
1 SRACKS>8 Storage Racks over 8' high (up to 100 B
st) •
4of5
_TC , CITY OF CUPERTINO
CITY Of GENERAL BUILDING APPLICATION
CUPEf�TINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 sf B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door ea 8 windows)
1WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee
1 EPERMITFEE Electrical Permit Fee E
1 MPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Permit Fee P
l ELCPLNCK Stand Alone Electric Pln Ck(hourly) E
I MECPLNCK Stand Alone Mechanical Pln Ck(hrly) M
IPLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check (when no E/M/P) B
when not over counter) hourly-stand alone
/ 1BSEISMICR Seismic Residential B
1BSEISMICO Seismic Commercial g
IITRAVDOC Travel & Documentation B
1BUSLIC Business License B
5of5
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
B. Site 9. Install H.E. Irrigation, (detailslspec)' L-1 2 points
11. Permeable Paving, Note L-1 2 oints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 points
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. Ener Star Refrigerator, (Note/Spec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS1 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.
INPUT Resources Energy ACItHealth
A.Site
1.Recycle.Job Site Construction 8 Demolition Waste
65%=1 point,,75%= 2 points;BO%=4 points up to 4 Resource pts 0
2.Salvage Reusable Building Materials. 4 Resource pts y=yes 0
3.Remodel for Mixed Use,Adaptive Reuse,and
Historic Preservation 4 Resource pts y=yes 0
4,Protect Native Soil 2 Resource pts y=yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes 0
6.Implement Construction Site Stonnwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
8.Design Resource-Efficient Landscapes and Gardens 4 Resource pts y=yes 0
9.Reuse Materids/Use Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1 MEN
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 pts 0
2.Use Recycled Content Aggregate 2 Resource pts y=yes 0
3.Insulate Foundation/Slab before backlill 3 Energy pts y=yes 0
1 1 1
C.Structural Frame
1.Substitute Solid Sawn Lumber with Engineered Cumber 3 Resource pts y=yes 0
2.Use FSC Certified Wood for framing
(For every 10%of FSC lumber used=2 points,up to 10) up to 10 Resource pts. 0
3.Use Wood IJoists for Floors and Ceilings 2 Resource pts y=yes 0
4.Use Web Floor Trusses 2 Resourceis es 0
P Y=Y
5.Design Energy Heels on Trusses 6'or more 2 Energy pts y=yes 0
6.Use Finger-Jointed Studs for Vertical Applications 2 Resource pts y=yes 0
7.Use Engineered Studs for Vertical Applications 2 Resource pts y=yes 0
B.Use Recycled Content Steel Studs for Interior Framing 2 Resource pts y=yes 0
9.Use Structural Insulated Panels(SIPS)
a.Floors 3 Energy pts y=yes 0
b.Wall 3 Energy pts y=yes 0
c.Roof 3 Energy pts y=yes 0
10.Apply Advanced Framing Techniques 4 Resource pts y=yes 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y--yes 0
12.Use OSB
a.Subfloors 1 Resource pt y=yes 0 •
b.Sheathing 1 Resource pt y=Yes 0
1 1 I
I.Windows INPUT PesDiurces Energy IAQIHealth
1.Install Energy-Efficient Windows
a.Double-Paned 1 Energy pt y=yes p
b.Low-Emissivity(Low-E) 2 Energy pts y=yes p
c.Low.Conductivity Frames 2 Energy pts y=yes p
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes p
1 1 t
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints 2 Energy pts y=yes p
2.Install Ductwork within Conditioned Space 3 Energy pts y=yes p
3.Vent Range Hood to the Outside 1 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes p
5.Install Solar Attic Fan 2 Energy pis y=yes p
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
B.Install Sealed Combustion Units
a.Furnaces 3 IAO/Health pts yeses p
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heat Pumps 3 Energy pts y=yes p
10.Install 13 SEER/11 EER or higher AC with a TXV 3 Energy pts y=yes 0
11,Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes p
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Furnace 2 Energy pts y=yes 0
• 13.Retrofit Wood Burning Fireplaces
a.Install EPA certified wood stovesrnserts 1 IAQ/Health pt y=yes p
b. Install/Replace Dampers 1 Energy pt y=yes p
c.Install Airtight Doors 1 Energy pt y=yes p
14.Install Zoned,Hydronic Radiant Heating 3 Energy pis y=yes 0
15.Install High Efficiency Filter 41AQ/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAQ/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQ/Health pts y=yes 0
1 1 1
K.Renewable Energy and Roofing
1.Pre-Plumb for Solar Water Heating 4 Energy pts y=yes _ p
2.Install Solar Water Heating System 10 Energy pts y=yes p
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pts y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 points) Up to 18 Energy pts p
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes p
7.Install Radiant Bander 3 Energy pts y=yes p
L.Natural Heating and Cooling 1 1 1
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts _ y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts
y=yes 0
• 1 1 1
k Community Development
10300 Torre Avenue
all1' Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
lCUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
01q�
OWNER'S NAME: M , LES PHONE # tpog o �
GENERAL CONTRACTOR: FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information
SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical V
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
• ��C,,, S lura �/��9&
Owner/ ntractor Signature Date