08060144CITY OF CUPERTINO
BUILDING.DIVIUoN PERMIT
>"GONTRAC�'`TORINF�ORMATIQ.N
BUILDING ADDRESS:
PERMIT NO.
1.0349 DENISON AVE
CUPERTINO PLUMBING
08060144
OWNER'S NAME:
PERMIT ISSUE DATE
MILLER RONALD J AND SHIRLEY A
1300 DELL AVE STE'C
06/20/2008
NE:
SANITARY NO. CONTROL NO.
(408)253-0618
ARCHI'IEL7rENGINEER:
BURRING PERMIT INFO
BLDG ELECT PLUMB MECH
LICENSED CONTRACTOR'S DECLARATION
Ib Description
OInx
I hereby affirm that 1 am liad under provisions of Chapter 9 (commencing
P
with Section 7") of Division 3 of dm Business and Profemiov Code, and my license is
COPPER RE-PIPE/WTRY MAIN/WTR HTR
in full fora and elf _
� t/ } C)
License Clue t&. •
DRW ConuxWr
ARCHr1ECrS DECLARATION
1 understand my plans shall W used a public neconks
L ctoo ed Pmfessi...I
OWNER -BUILDER DECLARATION
I hereby aRrm that 1 am exempt from the Connmmurs License Law far IW
following reasons. (Section 7031.5. Business and Professions Cade: My city or county
which requires a pmmit W coruuucl, kites. improve. demolish, or repair any smsmure
prior to its issumm. aisu requires the applicant (orsuch permit re file a signs. mmmenl
is licensed the LiecoseLaw (Chm.9
Sq. Ft. Floor AreaValuation
Loathe punu.nlmpmvisimuortheC.Mos
i
(commencing with section 7000) of Division 3ofdo, Business and PmRu
$sionsCode)or 5000
I
. Nal W u ekempt therefrom and the bass for the alleged aemption. Any violation of
Occupancy Type
Section 7031.5 by airy applicant for a permit subjects the applWmt W a civil penalty ofNumber
cot more than five hundred dollars (5500).
3 1629 053 .'((yin
❑ 1. u owner of the propary, or my employees with wages as their vele compensation,
Required Inspections
will do the work, and the succlure is not intended or offered forsake (Sec. 7066, Benz.
and profession Code: The Contractors License Law Claes cot apply W an owner of
property, who builda m improves thereon, and who does such work himself or through his
own employees, provided cut such improvements an, not intended oroRemd forsake R,
hwevso. the building or impmvemcnt 4 mid within was yea of eompletion, the ownv-
builder, will hne the aden of proving Wt k did net Will or improv for purpose of
sale.).
❑ T, as vent r of the property, am mlclufivcly contracting with lianbed Contractors W
covtvet the project (Sec. 7066. Business and Pmfnsslons CodC:) The Conuacts's U.
_
cove law dans not apply W an owner of property who Wilds or improves thereon, and
who aconin for such projecb with a ConuY101(s) licensed poraWm W the Ganuaelara
Lim. Law.
❑ l ire exempt under See .B&PC for this mason
Owner Date
WORKER'S COMPENSATION DECLARATION
1 hereby aOTne under penalty of perjury one of the following declan ions:
I Mw and will maintain aCertiOote of Conamt W self-ivum far Workers Corn e
Minn. a provided for by Section 3700 of due Labor Code, for the perfvmana of ea
work for which this permit is issued.
❑ T have and will maintain Workers Compensation Insunnce, m required by Section
37W ofthe labor Code, four the pcRormance ofthe work for which this permit is ismCd.
'
My Workce. am vaW.1 nnxnnicrand Policynewrare
n�
Cartier.. Policy No.: 1 �53—2006
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(Thu section need not W completed lithe permit Is forone hundred dollars ($1110)
or Was)
1 mufy that in the perfamencc of that work for which this permit is; isued. I shall nm
employ aWFormn in any maMer W ss W become subject W the Workers' Compenaaioo
Taws of California. Date
Applicant
NOTICE TO APPLICANT: If. after making this Certificate of E`cmption, you should
become subject W the Worker', Compensation provisions of the labor Cow. you most
' forthwith comply with such provisions or this permit shall W deemed revoked.
I
CONsnlUCf10N LENDING AGENCY
1 Wreby allirm Na Vert Is a emssunmino lending agency for the performance of
tho work for which this permit is issued (Sec. 3097, Civ. C.)
l Lenders Name
Lenders Address
j 1 modify Nat 1 have mad this application and state that the move information is
cons. I agree W Comply with all city and county oNinmas and sane laws relating W
Wilding cortsuumion. and worry toolumva rtpuaenuuws of Nis city W aurupon the
a Wve-menumm l properly fm ivpecuon purposes
(We) agree to Save. indemnify aid keep harmless the City of Cupero" against
j liabilities,judgments. casts and exile•.•s which may In any way oma againsl mid City
in mnsegoence of the granting of this permit.
APPLICANT UNDERSTA��ff]]SS ND WILL COMPLY WITH ALL NON -POINT
Issued by: Date '---/J
FiRCE RE ���
��
Re -roofs
Signaurt n Date
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Willthet (mum Wilding handle l
u defined e C.punlor
e. Chapter
haps r9.1 ,
the Cupertino Municipal Code. Chapter 9.11. and the Health and Safety
Health and Safety
io
Code, Schon 153324)?
❑sen o P'
All roofs shall be inspected prior to any roofing material being installed.
SWill the applicant or future Wilding occupant use equipment or devices which
If a roof is installed without first obtaining an inspection, I agree to remove
t havardous air cun mus...la as, defined by Ne Bay Arta Air Quality Management
all new materials for inspection.
Oiadcl7 �.,✓
❑Yes LT`°
1 have mad the hvadws materials mquiamenu undcrchapterd.95 of the Califon
mx Hnldt&SafctyCade Scene. 25505.25533 mot I understand that if Ne Wilding
does cot eTdscndy haw a Imam. that IIu respominility W mor Y the aaupmt of the
icquvemcnts which muuW me n a-ccniOaW arampancy.
Signature of Applicant Date
All roof coverings to be Class'j�"
g or better
owner er sea t� Date'
. 7 ITEMS OF 7
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ... ..... : 31629053.00
DATE ISSUED.......: 06/20/2008
RECEIPT #.........: BS000005175
REFERENCE ID # ...: 08060144
SITE ADDRESS .....: 10349 DENISON AVE
SUBDIVISION .......
CITY CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER ............:
MILLER RONALD
J AND SHIRLEY A
ADDRESS ..........:
10349 DENISON
AVE
CITY/STATE/ZIP ...:
CUPERTINO CA,
95014-2428
RECEIVED FROM ....:
FRANK CARDIA
WATER SERVICE
CONTRACTOR .......:
CARDIA, FRANK
L LIC # 612
COMPANY ..........:
CUPERTINO PLUMBING
ADDRESS ..........:
1300 DELL AVE
STE C
CITY/STATE/ZIP ...:
CAMPBELL, CA
95008
TELEPHONE ........:
(408)253-0618
0.00
• FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
1BPWATER
UNIT
1.00
40.79
0.00
40.79
0.00
1BPWSVCS
WATER SERVICE
1.00
20.40
0.00
20.40
0.00
1BSEISMICR
VALUATION
5,000.00
0.50
0.00
0.50
0.00
1PPERMITFE
FLAT RATE
1.00
40.79
0.00
40.79
0.00
1PRREPIPE
NO OF FIXTURE
8.00
81.60
0.00
81.60
0.00
1PRWHEATR
UNITS
1.00
24.48
0.00
24.48
0.00
ITRAVDOC
FLAT RATE
1.00
40.79
0.00
40.79
0.00
TOTAL PERMIT
----------
----------
249:.35
0.00
----------
----------
249.35
0.00
METHOD OF PAYMENT AMOUNT
---- ---------------
CREDIT CARD 249.35
---------------
TOTAL RECEIPT 249.35
VOICE ID DESCRIPTION
-------- ----------------------------
301 ROUGH PLUMBING
REFERENCE NUMBER
------------
VISA
VOICE ID DESCRIPTION
-------- ----------------------------
507 FINAL PLUMBING
SIM -
CITY
OF
• CUPERTINO
4
O/L
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
PERMIT APPLICATION FORM
APN #
Fee ID
Fee Description
6-zv-o8
Building Address:
1PCSEWER
03U v�
P
1CPSS
O er's Name:
1BPREPIPE
Phone #:
2 S7 — z/ ,5 4 7
Z N/I 11,2r
IPGASCOM
Commercial Gas Piping System
1-4 Outlets
Contractor:
Phone #:
2 53 —G(a l e
!�
�-( ���� 1 icu,�ri/ c.
p
I SEISMICR
Seismic Residential
Fax#:
Contact:
IPRSEWER
Phone #:
9C 9-3 ey
%0'6-
1RPSS
Fax #:
Contractor License #: (� R 4 4 v 5
Cupertino Business License #:
Job Description:
Residential Commercial
❑
Valuation: ,jr()Uv
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.
Green Building Points:
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1PCSEWER
Commercial building
sewer/sanitary sewer
P
1CPSS
1BPREPIPE
Commercial re -pipe per fixture
P
1CPRP
IPGASCOM
Commercial Gas Piping System
1-4 Outlets
P
IBSEISMICOM
Seismic Commercial
p
I SEISMICR
Seismic Residential
p
IPRSEWER
Residential building
sewer/sanitary sewer
P
1RPSS
CITY OF
CUPERTINO
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
FEE SCHEDULE
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1PRREPIPE
Residential re -pipe per fixture
P
1RPRP
1BPWSVCS
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
f
1PPERMITFEE
Plumbing Permit Fee Issuance
P
3y
1PLMBLNCK
I
Plumbing Plan Check
P
1PLMBINSP
Other Plumbing/gas Insp.
P
ITRAVDOC
Travel & Documentation Fee
B
1BUSLIC
Business License
B
Revised 6-16-08
LJ
•
•
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
y
9.
Install H.E. Irrigation, (details/spec)'
B. Site
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 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.
1: Recycle Job Site Construction & Demolition Waste
65%=1 point; 75%= 2 points; B0%= 4 points
up to 4 Resource
2. Salvage Reusable Building Materials `
4 Resource pts
y=
3. Remodel for Mixed Use, Adaptive Reuse, and
2. Use FSC Certified Wood for framing
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=
8. Design Resource -Efficient Landscapes and Gardens
4 Resource pts
y=
9. Reuse Materials/Use Recycled Content Materials
2 Resource pts
y --ye:
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 pts
2. Use Recycled Content Aggregate 2 Resource pts y=yes
3. Insulate Foundation/Slab before backfill 3 Energy pts y=yes
C. Structural Frame
r
r
r
D
r
r
r
r
r
r
r
0
r
r
r
r
0
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 --yes
6. Use Finger -Jointed Studs for Vertical Applications
2 Resource pts
y=ye:
7. Use Engineered Studs for Vertical Applications
2 Resource pts
y=yep
B. 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:
b. 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
pye
12. Use OSB
a. Subfloors
1 Resource pt
y=ye,
b. Sheathing
1 Resource of
y=ye.
i
U
•
r'
r
r
r
D
r
r
r
r
r
r
r
0
r
r
r
r
0
0
-_
i
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•
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1. Install Energy -Efficient Windows
• a. Double -Paned 1 Energy pt
b. Low -Emissivity (Low -E) 2 Energy pts
c. Low. Conductivity Frames 2 Energy pts
2. Install Low Heat Transmission Glazing 1 Energy pt
J. Heating Ventilation and Air Conditioning
1. Use Duct Mastic on All Duct Joints
2 Energy pts
y=yes
2. Install Ductwork within Conditioned Space
3 Energy pts
y=yes
3. Vent Range Hood to the Outside
1.IA0/Health pt
y=yes
4. Clean all Ducts Before Occupancy
2 IAQ/Health pts
y=yes
5. Install Solar Attic Fan
2 Energy pts
y=yes
6. Install Attic Ventilation Systems
1 Energy pt
y=yes
7. Install Whole House Fan
4 Energy pts
Y --yes
S. Install Sealed Combustion Units
5 IAQ/Health pts
y=yes
a. Furnaces
31AQ/Health pts
y=yes
b. Water Heaters
31AO/Health pts
y --yes
9. Replace Wall -Mounted Electric and Gas Heaters wth
Through -the -Wall Heat Pumps
3 Energy pts
y=yes
10. Install 13 SEER/11 EER or higher AC with a TXV
3 Energy pts
y=yes
11. Install AC with Non -HCFC Refrigerants
2 Resource pts
y --yes
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
1 IAQ/Health pt
y=yes
b. Install/Replace Dampers
1 Energy pt
y=yes
c. Install Airtight Doors
i Energy pt
y=yes
14. Install Zoned, Hydronic Radiant Heating
3 Energy pts
y=yes
15. Install High Efficiency Filter
41AQ/Health pts
y=yes
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAQ/Health pts
y=yes
17. Install Separate Garage Exhaust Fan
3 IAQ/Health ots
v=ves
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 pts 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 18 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
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts
3. Plant Deciduous Trees on the West and South Sides 3 Energy pts
CITY OF
�UPEkTINO
is
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS:U 3 y 9 Qn r s, Av- -
/ 0,- or
PERMIT # y
�� U (' D /
OWNER'S NAME: 90.,, l l of
PHONE # 2 S7 44 5-14 7
GENERAL CONTRACTOR:
I am not using any subcontractors: C-- 20 - 08
Signature Date
Please check applicable subcontractors and complete the following information:
Owner/ Contractor Signature
Date
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
Owner/ Contractor Signature
Date