08060223 CITY OF CUPERTINO �rTh��v.
BUILDING DIVISION PERT CSL\eL� R�°Zl\�QL�lYlt?T1�.N :
PERMR NO.
Bu1LT1gca,ApgREsP,RMONA CT TBD — TO BE DETERMINED 08060223
OW NER''SUNAAME: PERMIT ISSUE DATE
CANTER,NANCY - 06/26/2008
NE: SANffARY NO. CONTROL NO.
ARCHrtECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
u0, LICENSED CONIRACTOWS DECLARATION Job Description
ee U 1 hcmby affirm Nat I am licensed under pmviuons of Chapmr 9(mmmcncing P
with5ection]Of1U)ofDiviuon 3ofthc Buunw aM Profeuiam Code,aedmylicertseu RMV EXTNG PARTCL TYP WD EXTER SIDNG& INSTL NEW
rimy in full foand cfictt
j rte License I
Lie. 66 FIBERCEMNT LAP SIDING
C H O Gate O ConuAcmr 2/4
A-.MCrS DECLARATION
I understand my prism shall W used as public records
A,,t Licmucd Professional
5 OWNER-BUIWER DECLARATION
.c I hereby affirm Nal I am exempt from the Contractors License Law for On
COC following recon.(Section 7031.5,Business and Professions Cade:Any city or county
$ which rcquines A permit Is convect.Iter.improve.demmish,Or ncrw any suunm v
prior m its issuance.also mquims the applicant forsuch permit m file a signed statement
—ss�<
Out Its is licensed pursuant to the provisimu of use Contractor's Lime Law(Chapter 9 Sq.Ft. Floor Area Valuation
yF (commencing with Section 7000)of Division 3 of the Business and Professions Cod,)Or $16154
ye;$— that he is exempt therefrom and the basis for the alleged exemption.Any violation of
Session 7031.5 by any applicant fee a permit subimts the applicant to a civil penalty ofNumber
Out more .man fin hundred dollars 35716114 . Occupancy P Y Type
I,u owner of the pmpaty,ar my employees with wages as their sok compensation.
will do the work and the muerum a not intended or offered for Axis(Sce.7044.Busicess
and Pmreasiom Cade:The Commences License Law does at Apply m an owner of Required Inspections
property who Wildamme,som rhercon,and whoducasuN work himaelror Wough his .
awn employees,provided that such impmvemenu Am not intended oroffcmd for isle It.
however.the Wilding or improvement is sold within one year o(compktion.the owner-
builder will have One buNen of goving Our K did nor Wild or improve for purpose of
Auto.).
❑1.As owner of the property Are exclusively cemmating with Ikerued rnnvxmr,to
mmuuct the poi(Sec.7014.Business and Prafessimu Code:)the CWhA mr's Li.
cense Law dos not apply m an owner of pmpmy who Wilds or improves thereon,and,
who eamoms fee such projects wire a mouacmr(s)livened puruunt to the Commemes
Liave Law.
I am exempt undo SAO. ,B&PC for this reason
Owner Date
WORKER'S COMPENSATION DECLARATION
I hereby arm under penalty of perjury one of the fallowing declarations:
have and will mountain a Certificate:of Content to self-Insure for WoearsCmpen-
sauce,as provided for by Section 3700 club.LaWr Code.for me perfierm.or One
work for which this permit is issued
1 have and will maintain Workers Compensation Insurance,an required by Secdon
370(m(de Labs Code for the perrmmanee of the wmrl[for which this permit is issued
My Worker.Compemuionlnmrana carrier and Policy number tie: r�
Cartier. ST VWix'GL^10 Policy No.: /9Q? Z2 y
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(This semen need WI W completed Bthe permit is froom hundred dollars(Sloo)
or less.)
1 certifv mot to me perfarmanee of the work fm which this permit is tamed.I shall nm
employ anypereen in any manner an as an become subject to the Workers'Compemation
Laws of California,Date
Applicant
NOTICE TO APPLICANT:If.After making this Cenifuc.m of Exemption,you should
become subject It,me Worker's Cmam radon provisions of the V Wr Code,you must
.J az AmO.M comply with such proviuom m this permit shall W damcd mwkcd.
ti O CONSTRUCTION LENDING AGENCY
4 1 hereby obiter this them is s ed(Sec.30 7.Civ. agency for the arfosmena of
the work for which this permit b issued(Sec.7(19],Civ.C.)
fA Q Lenders Name -
.7- z Lcudees Address
UO 1 oenffy,Our have rest thin application aM sum uim the Abeve informauun h
[T.E corm 1 Agra m empty with all city and county ardinames And sum laws minting m
.O building convection,and thereby aurhodm mpmsenwivm ofthis city m crow upon de,
rD] above-mcnuonexul dgmproprny favi expenses
purpmea
F LL (We)agree to save,indemnify and kap homeless the City of Cupenine agalmt
Ul,lZ incomacquedgmenu,cam and expen+es which yin any way A.agalmssald City
z in comegneae or the granting of thulrnni Issued b
'—' APPLICANT UNDER NDS AND L COMPLY WITH ALL NON-POINT y; Dale v
SOURCE RE
6 i� Re-roofs /
Sign rto AM on err Date
US MATERIALS
pact t DISCLOSURE Type of Roof
WIII the applicantor eumm buildingacupantsumre handleesNOmmamrial
as definer by
On Cupertino Municipal Code.CTapter 9.1;and the Health and safety
Code,Seniors❑Yrs 25532(.)7 LWT-- All roofs shall be inspected prior to any roofing material being installed.
Will the appliantorfuture Wilding occupant usecqulpmcnl or devices which If a roof is installed without first obtaining an inspection,I agree to remove
�ha' nus stir cmuminanu As defrad by the Bay Area All Quality Management all new materials for inspection.
Dy. &T4 _
I have read the hnardous mnmats mquirtmnu under Clomw 6.95 of the Califor.
nix Health&Sucty C.dc.&ctiom25A15,25533and25534.1undeaund6aifthe Wilding
Jars rot cuncnlly haw•un.L that it u my '"Iny m nedry the oavpaul of the
rtyvim nrswF mmx Tal less, Accrtifiumaro, Y. Signature of Applicant Dale
Z6 0
Owner oraathorieda em Dam All roof coverings to be Class'A.'or better
p CITY OF CUPERTINO
CITY OF
• CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
APN# Date:
u� ZL, 7.008
Building Address: /0p31 Cmemo v4 BT
C4A,PEJZT1.U0 j CA 450/4/
Mailing Address (if different from building address):
Owner's Name: Phone#: —\
NA•N �A.vTE2 koa);53 -S//q
Contractor:
RnfiS y}.JTAGC— �- Phone: /6) �/SS--�97�
E L Gr!2�^ Fax:
Contractor License#: $ (� (� Q
Cupertino Business License#:
Contact: M Rv RV- GlfE,ev/a6 Phone: S—
. Fax:
Residential Commercial / L /_ n
Job Description: ��jy�p�� Eyy S1+� ���i�(� l/�t Gllaaol
S
4(4r
Building Permit Info:
Bldg Lys Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class):[—] E] Occupancy T�e:
1-A, 1-B MII/V-A I11/11Ian�
III B, IV-HT, V-B ', —
Valuation: id 15-elSquareFootage:
Project Size: Express Standard Large ❑ Major ❑
Green Building: Please complete relevant portion of the Green Building/LEED Checklist & attach it
Points Achieved: to the application or if applicable, include in plan set& the sheet index.
•
For help, contact Build it Green at www.builditareen.or �--
Revised 6/16/08
CITY OF CUPERTINO
CITY OF
CUPERTINO GENERAL BUILDING
PERMIT APPLICATION FORM •
Quantity/Sf Fee-ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
1 BTEMPPER Temporary Building Permit (good for B
30 days)
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 •
1BBOILER4 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.
HIMEETING114R
ELECINSP Other Electrical Inspections (per hour) E
MECHINSP Other Mechanical Inspections (per M
hour)
PLMBINSP Other Plumbing & Gas Inspections P
er hour
Application Meeting B
Cpl- CITY OF CUPERTINO
cirvoF GENERAL BUILDING APPLICATION
CUPEI�TINO
• FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
1 CHIMNEYR Chimney Repair B
FENCES
1FENCE>6FT Non-masonry, over 6 ft in height B
1FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
1FIREPLFAB Fireplace Pre-Fabricated/Metal B
1FLAGPOL>20 Flag pole (over 20 ft in height) B
IMODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
1PILECAST Pile Foundation Cast in place concrete B
1 PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete)
3 of 5
t - CITY OF CUPERTINO
Or OF GENERAL BUILDING APPLICATION
CUPERTINO
FEESCHEDULE •
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1 GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY)
IRETSTN Standard (up to 50 ft) B
IRETSP310 Special Design, 3-10' high(up to 50 `) B
IRETSPIO Special Design, over 10' high (up to B
50'
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft
IRETCRB> Gravity/Crib Wall over 10' high (up to B
50 ft
SIDING
1SIDEST/BK Siding, Stone &Brick Veneer B
(interior/exterior) •
L1 SIDEOTHER Siding all other B
SKYLIGHTS
1 SKYL<10 SF Skylight less than 10 sf B
1 SKYL>IOSF 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)
1STUCOAP Stucco Applications (up to 400 sf) B
additional stucco application
•
4of5
CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPEI�TINO
• FEESCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group IGENRES or
1GENCOM
1 WINREP Replacement windows/sliding glass B
door (ea 8 windows)
1 WINMEWSTR New Window-structural shear B
wall/masonry includes plan ck fee
1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1PPERMITFEE Plumbing Permit Fee P
IELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Phi Ck (hrly) M
I PLMBLNCK 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 B
1TRAVDOC 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
rt g
B. Site 9. Install H.E. Irrigation, (details/spec)' L-1 2 points
11. Permeable Paving, Note L-1 2 points
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. Energy Star Refrigerator, (Note/Spec. A-3 1 oint
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 diversify 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.
A.Site INPUT Resources Energy IAO[Health
1.Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;80%=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 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 pts 0
2.Use Recycled Content Aggregate 2 Resource pts y--yes 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yes 0
1 1 1
C.Structural Frame
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 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 1
INPUT ResDurces Energy 0
I.Windows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes 0
c.Low.Conductivity Frames 2 Energy pts y_yes 0
2.Install Low Heat 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 71AQ/Health
y=yes 0
2.Install Ductwork within Conditioned Space y=yes 0
3.Vent Range Hood to the Outside pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAO/Health pts y=yes 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 3 IAO/Health pts y--yes 0
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 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 stoves/inserts 1 IAQ/Health pt y--yes p
J. 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 31AQ/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 Materials 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes 0
1 1
1 1 I
L.Natural Heating and Cooling
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 pts y=yes 0
1 1 1
•
CITY OF CUPERTINO
. 2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 35716114 . 00
DATE ISSUED. . . . . . . : 06/26/2008
RECEIPT # . . . . . . . . . : BS000005224
REFERENCE ID # . . . : 08060223
SITE ADDRESS . . . . . : 10031 CARMONA CT
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : CANTER,NANCY
ADDRESS . . . . . . . . . . : 10031 CARMONA CT
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014-2850
RECEIVED FROM . . . . : AMERICA' S VINYL EXT
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
- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 16, 154 . 00 1 . 70 0 . 00 1 . 70 0 . 00
1SIDEOTHER SQ FEET 1 . 00 367 . 00 0 . 00 367 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 368 . 70 0 . 00 368 . 70 0 ..00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CREDIT CARD 368 . 70 VISA
---------------
TOTAL RECEIPT 368. 70
•
• CITY OF CUPERTINO
RECEIPT NUMBER: BS000005225
RECEIVED BY: PATRICIAG PAYOR: AMERICA' S VINYL EXT
• TODAY' S DATE: 06/26/08 REGISTER DATE: 06/26/08
TIME: 08 : 12
1
BUSINESS LICENSE TAX AMERICA' S ADVANTAGE EXTER $110 . 00
----------------
TOTAL DUE: $110 . 00
CREDIT CARD: $110 . 00 REF NUM: VISA
TENDERED CHANGE
$110 . 00 $ . 00
•
•
e1 Community Development
�f 10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
*UPERTINO
Building Department
JOB ADDRESS: /0o3/ ei*X wonct C f PERMIT #
Cu "4''AAO of tl l SaZ-Z
OWNER'S NAME: il/� e4wr-F2 I PHONE # / BZG. 47Y4�2
GENERAL CONTRACTOR: A&CAe4r Aal 6e- FAX #
I am not using any subcontractors: �6 O
Signature Date
Please check applicable subcontractors and complete the following ' ormation:
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
• 6/1G�GZ
Owner/Contractor Signature Date