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08060091 CITY OF CUPERTINO at•S; +eB�-fir 4 ' -- BUILDWGDIVISiON PER JfMIT CW[RAG-TORJINFLUItMATIW r- PERMIT NO "U'll."b' 08060091 OWNERS NAME: OAK WY SOUTH BAY PLUMBING C - PERMRISUEDATE PHOEBE WISE 441 N CENTRAL AVE STE 3A 06/11/2008 IF NE: (408) 370-3535 SANITARY NO. CONTROL NO. ARCHITEC(ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH X00 LICENSED CONTRACTOR'S DECLARATION in� 1 hereby affirm this mm 1 am licensed under provisions of Chapter 9 ommeing Job Description wide Sation 700X0 of Divison 3 of den,Budnry and Professiev Code,and my license u RPLC WTR HTR SAME LOC In full force and effect j i License Class Lk. ct-O Dao: Cmmmmr "3 ARCHITECTS DECLARATION UF 1 understand my plans shall be used u public mc-ds DW gc. pN Licensed professional 3 OWNER-BUILDER DECLARATION I hcmhy affirm that I am exempt from the Communes License Law for the ti O Oyu fallowing won.(Sation 701.5.Butch.and Profession.Code:Any city or roomy 3$K which IequlrG a permit m construct,alter.Improve,dcmelLih,M repair my Mae. _iZ~^ prior to its issuance,also requimn the applicant for such permiuo rile a signed awomem < least heia licensed pmstontmthe pm.isimrsnfthe coWaaa'auansLaw Chapter 9 Sq.FL Floor Area Valuation Y�C (commending with Station 700M of Division 3 of dee Busim. it pmfesam.Code)or $325 y that he u exempt tberefmm and the basis for the alleged assmpuon.Any violation of Seaton 7031.5 by any applicant fa,permit subjects the appliances a civil penalty of Number Oecu ane-Type net more vin five hundred dollars(150)). 34261001.W P Y YP I,ssowner of the pmpmy.mmy cmployca wide wagesuHeir ink compewuon, will de the wort and Neswnuo is notintended or oRaed formic(Sec.7044.Busndas and Ptefessio s;Code:The Commemes License law,does rot apply be an owner of Required Inspections propenywho Wild-orimsoves thercon,and who doessuch work himselforduoogh his own employees,provided thin such improvements sumnot intended oroRered for els.If, howevm,Ne building or impmmnent is mid within ere ycr of wmpkuon tlm owxr. builder will have the burden of serving that tae did not Mid or improve for purpose of sum.). ❑1.u owner of the proper•am velusvaly convicting with seemed mntrmws m construct the project(Sec 70x4,Bvineas and Profasons Cade:)The Comaemfs U. . cave law dura nut apply in an owner of property who builds or impmves thereon.and who contracts for such projects with a conuacmr(s)licensed pursuant m use Comfectof- Lies.law. ❑l am camepp{m ,B&P/C for this remainOwer I rl' a IM-(A�1�. o Dau(4-//-0Cf WORKERS COMPENSATION DECLARATION 1 hereby aRmr under penalty of i mjury one of the following dcclamdov: I his a and will maims.a Ceauf sof Co.,m self-ivumfor Workers Compen- nation,an pmvidcd for by Sauon 3700 of the labor Code.far the Performance of Ne work for which Its Permit is issued. ❑1 have sand will maintain Workers Compevuien Insurance,as required by Scit 37M of the labor Code,for the peRurmance of the wvrls for which our Peron u issued. ' My Wertrfn Campevation W..artier sed Policy number tee: Caskr: Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Thissecum reed net W completed lithe permit is forone hundred dd.(1100) or I'm) I anify Out in use perfamaac of the work fa which this Permit u indeed,1 sad(nm ao employ any pursue in my mnrmssmb - mbjafmthe Wm1mrs'CompmcMms Laws of Califomia Date APPliesum bb_ - NOTICE TO APPLICANT!IL after ar dng this Certificate of P empGon,you�i i'W become--hien m use Workers Compensation pmvi,ion,of the labor Code.yes crus .J,Z feMwith comply with such Provisions or this permitshall be deemed muted. z O CONSTRUCTION LENDING AGENCY r [-+ I herebywhich this Nene uaed(Secunn kndingsageayfnr the srfwm,necof 6i La work for which cites permit V issued(Sec.309'T,Civ.CJ 4 Q Lendues Name - z Lenders Addw U Q 1 cosily that 1 have mad Ibis application and sum Nu the shove inf essamon u D. F cOMM I agree m Comply with in City and Cowry ONirtaae,and stat Was missing an OV Midingconsvucuon,and hereby museum,repmaenuuuesof Nis city menterupnn Nt H ,i above-menu llnu Property for inspection puryssea 6, (Wc)agree to save.indemnify and Yap hmseless the City of Contuse against 2 incoi...jndgmc thecvtsand eapevcnmit. may in any way accrue against said City nc APPLICANT olthe UNDERSTANDS Nis permit ti APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: 6i Date G SOURCE RE?rTION - , Srgnuum ser AppVCe fur pate Re-roofs HAZARDOUS MATERIALS DISCLOSURE Type of Roof Will tie-Pli icant or furme building—Pan4m.or Lundie haurdess material u L=Oned by the Cupertino Municipal Code.Chapter 9.11.and tis Health and Safety Code.Salim 35533(a)? ❑Yon 93N. All roofs shall be inspected prior to any roofing material being installed. Will NC apprtam or future b-ddlag mcup,m me equipment or devices which If a roof is installed without first obtaining an inspection,I agree to remove t hrraednns air conuminanu u dc0ned by the Bay A.Air Quality Management all new materials for inspection. vise CL? QYa �Nu. I have read the ha sommsmaterials requiremcns under Clupkr6.95 of bm Califor- nia He.IN&Safety Cede,Secuwu25ML 35533 and 25534.1 undersand belifthc Wilding dues net currently have a tenant,this,it in my responsibility in notify,de encomium or de mquirementsZ mus hester pior ss,07 of:Cvufcsa¢of Ocmpancy. '�A--^�/l/Ati- A/// g � _�I _pe Signature of Applicant Date owoera,-therasd ag=nt D,te' All roof coverings to be Class'As*or better CITY OF CUPERTINO • 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: pdtg COPY # 1 Sec : Twp: Rng: Sub: Blk: Lot: APN . . . . . . . . : 34261001 . PW DATE ISSUED. . . . . . . : 06/11/2008 RECEIPT # . . . . . . . . . : BS000005084 REFERENCE ID # . . . : 080'00091 SITE ADDRESS . . . . . : 21070 CANYON OAK WY SUBDIVISION . . . . . . . CITY . . . . . . . . . . . . . : CUPERTINO IMPACT AREA . . . . . . . OWNER . . . . . . . . . . . . : PHOEBE WISE ADDRESS . . . . . . . . . . : 21070 CANYON OAK WAY CITY/STATE/ZIP . . . : CUPERTINO, CA 95014 RECEIVED FROM . . . . : PHOEBE WISE CONTRACTOR . . . . . . . : RICK PERKINS LIC # 22605 COMPANY SOUTH BAY PLUMBING ADDRESS . . . . . . . . . . : 441 N CENTRAL AVE STE 3A CITY/STATE/ZIP . . . : CAMPBELL, CA 95008 TELEPHONE (408) 370-3535 • FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ---------- ---------- ---------- 1BSEISMICR VALUATION 325 . 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 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CREDIT CARD 106 . 56 MC --------------- TOTAL RECEIPT 106 . 56 VOICE ID DESCRIPTION VOICE ID DESCRIPTION -------- ---------------------------- -------- ---------------------------- 518 WATER HEATER • ao(p 0011 CITY OF CUPERTINO t,�-�n WATER HEATER CITY OF CUPEkTINO PERMIT APPLICATION FORM APN # Building Address: 501 -- Owner's Name:n4 V 2 Phone #: 33 S/ Contractor: ¢� ��y pPhone #: ►L6$ 3 0 3S- 3S r4(f tA �i6oFax #: Cupertino Business License #: Contractor State License #: a 6 0 5 813 7 .31 Contact: toa tr �- it �-- Phone #: �0.9 370 T53 .5 Fax #: 00,31 72,-9 ��•`�� Building Permit Info: Bldg D Elect Plumb [� Mech ❑'" Residential [I f Commercial ❑ Job Description: Strapped [�— On Platform ['Bonded Ej-� New Location ❑ Replacement Q Valuation: 2 2 S 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. Green Building Points achieved: 511-2 CITY OF CUPERTINO WATER HEATER CUPEkTINO PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Permit Type Group 1PCWHEATR Commercial Water B PCWHEATR HeaterNent 1BSEISMICOM Seismic Commercial B 1PRWHEATR Residential Water B PRWHEATR HeaterNent 1BSEISMICRE Seismic Residential B 1PPERMITFEE Plumbing Permit P • 1TRAVDOC Travel & B Documentation 1BUSLIC Business License B 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, (details/spec)' L-1 72points 11. Permeable Paving, Note L-1 C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 D. Structural 3. Uses Wood 1-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 I A-1 1 point TOTAL POINTS1 40 points • • Plan Review Process Work Book Page A2-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 IAQ1Hea10E A. rte 1.Recycle Job Site Construction&Demolition Waste 65%=1 point;75%= 2 points;80%=4 points up l0 4 Resource pts 0 2.Salvage Reusable Building Materials I 4 Resource pts y=yes 0 3.Remodel for Mixed Use,Adaptive Reuse,and Histodc 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 Stormwater 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 Materials/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 1 1 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 ptsFO 2.Use Recycled Content Aggregate 2 Resource pts y=yes 3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0 11 C.Structural Frame I I 1 1.Substitute Solid Sawn Lumber with Engineered Lumber 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 I-Joists for Floors and Ceilings 2 Resource pts y=yes 0 4.Use Web Floor Trusses 2 Resource pts y=yes 0 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 8.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 C 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 _ _ — I 1 Resource pt y=yes p 1 1 INPUT ReSDUrces Energy 1ACIIHealth xteriorFn ii r.Use Sustainable Decking Materials i a.Recycled content 1 3.Resource pts y=yes 0 • b.FSC Certified Wood 3 Resource pts y=yes 0 l 2.Use Treated Wood That Does Not Contain Chromium/Arsenic I 1 IAQ/Health pt y=yes 0 3.Install House Wrap under Siding 1 IAQ/Health pt y=yes 0 4.Use Fiber-Cement Siding Materials 1 Resource pt e=yes 0 E.Plumbing 1.Install Water Heater Jacket 1 Energy pt y=yes 0 2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0 13.Retrofit all Faucets and Showerheads with Flow Reducers a.Faucets(1 point each,up to 2 points) , Up to 2 Resource pts. 0 b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0 4.Replace Toilest with Ultra-Low Flush Toilets (1 point each,up to 3 points) _ Up to 3 Resource pts. 0 5.Install Chlorine Filter on Showerhead 1 IAQ/Health of y=yes 0 6.Convert Gas to Tankless Water Heater 4 Energy pts y=yes 0 7.Install Water Filtration Units at Faucets (2 points each,up to 4 points) Up to 41AQ/Health pts. 0 S.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0 1 I 1 r.trecmcar 11.lull Compact Fluorescent Light Bulbs(CFLs) 1 (6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) _ I Up to 4 Energy pts. 0 2.Install IC-AT Recessed Fixtures With CFLs(1 point each,up to • 5 points) Up to 5 Energy pts. 0 3.Install Lighting Controls(1 point per fixture,up to 4 points) Up to 4 Energy pts. 0 4.Install High Efficiency Ceiling Fans with CFLs (1 point each,up to 4 points) Up to 4 Energy pts. 0 1 1 1 G.Appliances �1.Install Energy Star Dishwasher ] 1 Energy pt y=yes 0 12.Install Washing Machine with Water and Energy lConservation Features 1 Energy pt y=yes 0 3.lnstall Energy Star Refrigerator I 1 Energy pt y=yes 0 4.Install Built-In Recycling Center _ — 3 Resource pts y=yes 0 H.Insulation 1.Upgrade Insulation to Exceed Title 24 Requirements a.Walls 2 Energy pts y=yes 0 b.Ceilings 2 Energy pts y=yes 0 2.Install Floor Insulation over Crawl Space 4 Energy pts y=yes 0 13.Install Recycled-Conlent,Fiberglass Insulati6ri7wfilli 'No Added Formaldehyde _ 3 IAQ/Health pts y=yes 0 4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0 5.Use Cellulose Insulation a.Walls 4 Resource pts y=yes 0 b.Ceilings 4 Resource pts y=yes C • 6.Alternative Insulation Products(Cotton,spray-foam) a.Walls 4 Resource pts y=yes 0 o.Uenings 4 Resource pts y=yes 0 1 1 INPUT Resources Energy IAO/Heai 1.Wmdows 1.Install Energy-Efficient Windows a.Double-Paned 1 Energy of y=yes 0 b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0 c.Low.Conductivity Frames 2 Ener t - Energy pis y=yes 0 2.Install- -Low Heal Transmission Glazing 1 Energy pt y=yes 0 1 1 1 J.Heating Ventilation and Air Conditioning 1.Use Duct Mastic on All Duct Joints 2 Ener is 9Y P Y=Yes 0 2.Install Ductwork within Conditioned Space 3 Energy pts y=yes 0 3.Vent Range Hood to the Outside 1 IAQ/Health of y=yes 0 4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 7 0 5.Install Solar Attic Fan 2 Energy pts y=yes 0 6.Install Attic Ventilation Systems 1 Energy pt y=yes 0 7.Install Whole House Fan 4 Energy pts y=yes 0 8.Install Sealed Combustion Units a.Furnaces 31AQ/Health pts y=yes 0 b.Water Heaters 31AQ/Health pts y=yes 0 9.Replace Wall-Mounted Electric and Gas Heaters with Through-the-Wall Heal Pumps 3 Energy pts y=yes 0 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 0 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 11AQ/Health pt y=yes 0 • b. Install/Replace Dampers 1 Energy pt y=yes 0 c.Install Airtight Doors 1 Energy pt y=yes 0 14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0 15.Install High Efficiency Filter 4 IAQ/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 0 2.Install Solar Water Heating System 10 Energy pts y=yes 0 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 0 6.Select Safe and Durable Roofing Matenals _� 1 Resource pt y=yes 0 7.Install Radiant Ba ner- - - � -- ---- 3 Energy pts y=yes 0 1 L.Natural Heating and Cooling 1 1 1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0 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 pis y=yes 0 1 1 1 • M. n oor Air ftality and Finishes INPUT Resources Energy �AQ/Healt" r1.Use LowMo-VOC Paint 1 IAQ/Health is es 0 _ P Y=Y 2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 ff3.Use Low/No VOC Adhesives 3 IAQ/Health is es 0 l`—� -- — ._-_--- - P y=y Z.Use Salvaged Materials for Interior Finishes 3 Resource pts y=yes D 5.Use Engineered Sheet Goods with no added Urea Formaldehyde 61AQ/Health pts y=yes 0 6.Use Exterior Grade Plywood for Interior Uses 1 IAQ/Health pts y=yes 0 Y.Seal all Exposed Particleboard or fv1DF __ __J 4 IAQ/Health pts y=yes 0 8.Use­FSC Materials for Interior Finish 4 Resource pts y=yes 0 9.Use Finger-Jointed or Recycled-Content Tim 1 Resource pts y=yes0 10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes D 1 1 1 N.Flooring 1.Select FSC Certified Wood Floodng 8 Resource pts y=yes 0 2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0 3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0 4.Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pts y=yes 0 5.Use Exposed Concrete as Finished Floor 4 Resource pts y=yes 0 6.Install Recycled Content Carpet with Low VOCs 4 Resource pts y=yes 0 1 1 Total Points A 1 1401 1301 57 Total Points Project Received: 0 0 0 • G:datalprogsrgreenbuilNngguidelineslremodelersrgreenpointsf nal2.12.04protected.xls • Community Development �N„ 10300 Torre Avenue Cupertino CA 95014 Telephone(408) 777-3228 CITY OF Fax(408)777-3333 `WUPERTINO Building Department JOB ADDRESS: ,z/ 0' 6 C u�s D cP� GUa PERMTT # dj-z 6 �l� OWNER'S NAME: Plic e d V r S e PHONE # I'So 6 9 43 3 y GENERAL CONTRACTOR:So c M I3 vk ti FAX # I am not using any subcontractors: Signature Date Please check applicable subcontractors and complete the followinginformation: SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE # Cabinets &Millwork Cement Finishing Electrical Excavation Fencing Flooring: Carpeting Linoleum/ Wood ADGlass/ Glazing Heating Insulation Landscaping Lathing Masonry Ornamental Sheet Metal Painting/ Wallpaper Paving Plastering Plumbing Roofing Septic Tank Sheet Metal Sheet Rock nTile ^ / I Owner/Contractor Signature Date