08080040 CITY OF CUPERTINO
BUILDIN6DIVISIPERMIT N"r3� R -
BUILgINCsgD�a..�:RESCENT RD J.L. PLUMBING 08080040
OW N IERUS UNAME: PERMIT ISSUE DAM
Ii1L,ERATH JON G AND DEBRA A 214 MORSE AVE 08/05/2008
NE: (408) 720-0199 SANITARY NO. CONTROL NO.
ARCHIIEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
opo LICENSED CONTRACTOR'S DECLARATION O O O O
I hereby aRirm dues 1 amiunder pmv onsof Clmpmr9(mmmcncing Job Description
ONwith,e,..7=)p ,fDivuian3ofNeBusinessandProfmiumCo .andmylicewis NEW GAS,RESIZE FRM METER TO FIXTURES
¢fun mme.n
:,t3— License lou
Cig Da¢ Condmma T L ✓L M'1 I
ARCHITECTS DECLARATION
`` 1 understand my Plans shall be used as Public mcoMs
D�u
C Licensed Pmfcuimad
OWNER-BUILDER DECLARATION
1 hereby attunes that I em exempt from the Conommrs license law far the ,
i a O following mason.(Sccaw 7031.5.Business and PmfeesioN Cock:Any city on county
$ which¢quires•Permit to external.Wer,improve,demolish,or repair my stannum
iy prior ta its issuance,also requires the applicant for such Permit to file a signed stammcm
S< Nat he is licensed pur,wnt m the provisions of the Conummh Lowes,Law(Chapon9 Sq.Ft. Floor Area Valuation
y l- (commencing with Section 7000)of Division 3of the Business and Professions Cade)or - $6000
e R g g diet be is exempt therefrom and the basis for the alleged exemption.Any violation of
section 7031.5 by any applicant for a permit subjects the appl¢mt m a civil Penalty of
ant mom Nan Ram hundred dollars(S5(10). 32616070 .)W Number Occupancy Type
❑I.u owner of the property.or my employces with wages as their role compensation,
will do Ne work,and the summum is not intended or offered Im.ake(Son.70/4,Bounces
seed PmfecsloN Cade:The Co ommora License law dons Out apply m an owner of Required Inspections
property who builds or impmwa Nerwn and who docs such work himsel r m through his
moemPloyces.Provided that such improvements ars not intended or offered for Wo.If.
however.the building or improvement is sold within we year of mmpl°do t.the owoer-
builder will lave tls burden Of proving dist he did not wild or improve for purpose of
was.).
1,as owner of the Properly am exclusively contracting with licensed contractors to
exact tic project(Sec.7014.Bacuo.and ftleaV°N Cade:)The Cwummfs u.
ewe Law does not apply as N owner of property who health;or improves thereon.and
when wanness for such pmjem with a eantramor(s)licensed purnant to One,Contracm's
License Taw.
lamcxemprundesSee ,B&PCfm Nismamn
Owner Dam
WORKER'S COMPENSATION DECLARATION
I hereby afar¢under penalty of perjury was,of the following donlarstions:
1 have and will maintain acerti0cam of consent m aelr-alum fn workces compen-
cation,as provided for by Section 3700 of the Labor Code.for the peAormana of the
were for which this Permit is issued.
❑1 have and will m ument Worker's Compensation Insunna,as myvined by ScNan
3700 of the Labor Code.for the performance clubs wort for which Nix Permit is laswd
My WarkrYs Compeesado hays.eanrier and Policy number am:
Carrier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not he completed Bde permit isfmow hundred dollars($)00)
or less.)
I certify Ih,t in the perymmarce of the wank far which this sit u issued,l shall w
employ any Perform inany of eras uWM.sub=Workcri Compwomma
Laws of Califom' ,a
Applicant I -
NOnCE TOA CAM:If.after making this CervUcaa of Exemption,you shwld
bonmne tub' m Ne Woh s Compewaw pmvisiom of the lahnr Code you must
.,O foMwith camP1Y with such Provisions m this permit shall be deemed wound.
,..Z''-' CONSIRUcnoN LENDING AGENCY
(-rte I hereby alarm that Nem u a commuetism lending agency for the Iterformarcc of
C!. Ne work for which Nu permit Is issued(Sec.3W7,Civ.C.)
4 lender's Name
7 Z 1<ndce.Address
U O 1 easily N,t 1 Ma rust dos application and ram this the above infomstaun is
I, comes.I agree of comply with all city and county ordinances and soon laws relating m
.building construction,and hereby authorise repteacnatives of this city an now upon Ne
r era abovcmenaonedprppeifynt for expenses purposewhich my
(We)agree to save,indemnify and tong he mleu de,City of Cupertino against
Z iieconsequence cnis.of the
gats and oftencormal. may in any way ancroe gainslaid City
U Z A APPLICANT
ofthe gnawinggSTANDf thisFormal.WIL. Issued b 01--
=NS
APPLICAM UN���IIISTANDS AND WILL CO PLY WITH ALL NON POINT
SOUR E ,,, Y Date
`fes �U /S'� Re-roofs
Sijinglfffm Of ApphearwConuactor Dam
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will dee applicant ter future building occupant smm ter handle hams ous maLeuak
as dcRned by the Cupcnise MunM WI Code.Chapter 9.1;and the Hca1th and Safety
code.semiw 25532(a)? All roofs shall be inspected nor to an roofing material beim
❑res �'ND P P � Y g g installed.
oWill ac applicant or future building occumant use equipment or deviate which If a roof is installed without first obtaining an inspection,I agree to remove
ft hevaNans air cent arrumnts a de0wd by the Bay Awa Air Amity Management all new materials for inspection.
District?
Yes
I have mal the hnvd°N materials mquimomrN ungerChaPmr6.95 ofthe C,dfOr.
nu H.IN&Safety Cada Saxons 25505.25533 md7553 1 unrkrsand theaifdx building
does ant cunwd he L that II iem r dapoman ty m wary the,asupant of the
mequimmc ch m Pi°r,p;. ita "'fe'¢°tglt"oan `� Signature of Applicant Date
//' a 4l S/W All roof coverings to be Class'W'or better
Owner m0oruc0 age¢ pea'
CITY OF CUPERTINO
• 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32616070 . 00
DATE ISSUED. . . . . . . : 08/05/2008
RECEIPT # . . . . . . . . . : •BS000005696
REFERENCE ID # . . . : 08080040
SITE ADDRESS . . . . . : 10055 CRESCENT RD
SUBDIVISION . . . . . . . -
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ELERATH JON G AND DEBRA A
ADDRESS . . . . . . . . . . : 10055 CRESCENT RD
CITY/STATE/ZIP . . . : CUPERTINO, 95014-1050
RECEIVED FROM . . . . : JOHN A LINDA JR
CONTRACTOR . . . . . . . : JOHN A LINDA JR LIC # 22261
COMPANY . . . . . . . . . . : J.L. PLUMBING
ADDRESS . . . . . . . . . . : 214 MORSE AVE
CITY/STATE/ZIP . . . : SUNNYVALE, CA 94086
TELEPHONE . . . . . . . . : (408) 720-0199
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 6, 000 . 00 0 . 60 0 . 00 0 . 60 0 . 00
IBUSLIC FLAT RATE 1 . 00 110 . 00 0 . 00 110 . 00 0 . 00
1PGASRES OUTLETS 1 . 00 61 . 19 0 . 00 61 . 19 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 253 . 37 0 . 00 253 . 37 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
-------- --------------- --------------------
CREDIT CARD 253 . 37 VISA
---------------
TOTAL RECEIPT 253 . 37
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ------------ ---------- -------- ----------------------------
301 ROUGH PLUMBING - 507 FINAL PLUMBING
•
O�U� oo�v
CITY OF CUPERTINO
4� REPIPE/SEWER/MAIN SERVICE
CUPEI�TINO PERMIT APPLICATION FORM
APN# 2 tP (PO-2 r b Date:
Bu lding Add /CzE/f-5e4�JL/T
Owner's �Name: C�CN Phonel2, 3o ^ 69 7g
Contractor: 02 Phone#: 4t Lle�
`T L AL c4 at/JS/1\.l (T JS �«le ��v��
-72-6)
7
Fax !�v 2d of c(
Contact: Phone#:
�7Uh .� �loS �-179— � S3y
Ll �g J
Fax #:uf33 7W--ol4
Contractor License #: W/
Cupertino Business License#:
Job Description: /
Residential Commercial ❑
Valuation: ev
Project Size: ExpressEl 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.
Green Building Points:
Quantity Fee ID Fee Description Fee Permit Type
Group
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
IPRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPERTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
1PRREPIPE Residential re-pipe per fixture P 1RPRP
1BPWSVCS Water Service P 1CPWS or
IRPWS
IPPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
1BPWATER Install/alter Water Pipe P
IBPFLYTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
/ 1PPERMTTFEE Plumbing Permit Fee Issuance P
/ 1PLMBLNCK Plumbing Plan Check P •
1PLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel & Documentation Fee B
IBUSLIC Business License B
Revised 6-16-08
•
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
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 Refrierator, (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 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.
A.Site
j 1.Recycle Job Site Construction&Demolition Waste
65%=i point;75%= 2 points; 30%=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 D
4.Protect Native Soil 2 Resource pts Y--yes 0
5.Minimize Disruption of Existing Plants&Trees 1 Resource pt y=yes D
6.Implement Construction Site Storrnwater Practices 2 Resource pts y=yes D
7.Protect Water Quality with Landscape Design 2 Resource pts Y--yes 0
Ill.Design Resource-Efficient Landscapes and Gardens _ 4 Resource pts y=yes D
9.Reuse Materials/Us=.Recycled Content Materials
for Landscape Areas 2 Resource pts y==yes D
10.Install High-Efficiency Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment I 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 ReSonrCe pts y=yas 0
3.Insulate Foundation/Slab before backfill 3 Energy pts y=yesl;;F 0
1 I 1
C.Structural Frame
r1.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]-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 p
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
S.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 p
• b.Sheathing
1 Resource pt y=yes 0
.Exter or Fimsh
1.Use Sustainable backing Materials
a.Recycled content 3 Resource pts y=yas 0 •
b.FSC Certified Wood 3 Resource pts Y--yes 0
12.Use Treated Wood That Does Not Contain ChromiumlArsenic 1 IAO/Health pt y=yes p
3.Install House Wrap under Siding 1 IAD/Health pt y=yes 0
�4.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
f 1 1
E.Plumbing
It1.Install Water Heater Jacket
_ _ 1 Energy Pt Y--yes 0
2.Insulate Hol and Cold Water Pipes 2 Energy pts y=yes 0
3.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 Chlodn"a Filler on Showe head 1 IAD/Health pt y=yas 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 4 IAQ/Health pts. 0
6,Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 F
r.eiecmcai
.1.Install Compact Fluorescent Light Bulbs(CFLs)
!(6 bulbs=2 points,10 bulbs=3 points,l2 bulbs=4 points) 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 i 1
G.Appliances
H.Install Energy Star Dishwasher 1 Energy pt y=yes 0
i2.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
3.Install Energy Star Refrigerator 1 Energy pt y=yes 0
4.Install Built-In Recycling Center 3 Resource pis y=yes 0
_ - 1 1 f
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
3.Install Recycled-Content,Fiberglass Insulation With
�No Added Formaldehyde _ 3 IAQ/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pis y=yes 0
5.Use Cellulose Insulation
a.Wails 4 Resource pts y=yes 0
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Colon,spray-foam)
a.Walls 4 Resource pts y=yes 0
o.Ceilings 4 Resource pts y=yes 0
1 1 1
INPUT Hesou.rries Energy 1ADIHeatth
mows
1.Install Energy-Efficienl 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 D
2.Install Low Neat Transmission Glazing 1 Energy pt Y--yes D
! 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints 2 Energy pts 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 pt y--yes 0
4.Clean all Duds Before Occupancy 2 IAQMealth 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 D
7.Install Whole House Fan 4 Energy pts Y--yes D
B.Install Sealed Combustion Units
a.Furnaces 3IA0/Hea1th 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 stovesrnseds 1 IAWealth 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 D
15.Install High Efficiency Filter 4 IAQ/Health pts y--yes D
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 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=1 B points) Up to 1 B Energy pts 0
6.Select Sate and Durable Roofing Materials _ 1 Resource pt y=yes 0
7.Install Redaint Barrier 3 Energy pts y=yes p
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pis y=yes p
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts . y=yes p
3.Plant Deciduous Trees on the West and South Sides 3 Energy pis y=yes D
1 1 1
•
M.Indoor Air Quality an meshes
1.Use LowND-VOC Paint 1 IAO/Health pts y--yes 0
2.Use Low VOC,Water-Basad Wood Finishes 2 IAWHealth pts y=yes 0 •
13.Use Lowm VOC Adhesives 3 IAQ/Health pts y=yes 0
I -_
4.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
f7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 0
S.Use FSC Certified Matenals for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pis y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
! f 1
N.Flooring
1.Select FSC Certified Wood Flooring B Resource pts y=yes0
[.Use Rapidly Renewable Floor rig Materials 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes D
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 1
Total Points A 1 1401 130 57
Total Points Project R 1 01 0� •
G:da,alprogsrgreenbuildinoguidslinesrremodelersrgreenpoin!sf na12.12.04prolsctedx!s
•
Community Development
E 10300 Torre Avenue
��� Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
�UPEkTINO
Building Department
JOB ADDRESS: _ PERMIT #
D 0SS Al 1 p
OWNER'S NAME: C)p PHONE # pe-- 2130 —(meq 7?
GENERAL CONTRACTOR: FAX #
L v\.w1✓j/w/ta Chu/-7• r L t_�i r✓1 / /J
I am not using any subcontractors: ,.0 Gf 5 v
Signature v Date
Please check applicable subcontractors and complete the following information:
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 Z,L, P�-LkA)&
Roofing
Septic Tank
Sheet Metal
Sheet Rock
Tile
Owner/dontractc,rSignature Date
6?141) er— Ll17C5-2 y