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CITY OF CUPERTINOCom'-ra�}'�-
'a
BUILDING DIVISION PERMIT
.�CONTR &AoRiINFORMATION
BUILDING,ADOa$.,-GROVE DR
1{1V
TORREY LEON
PERMIT 08060135
OWNER'SNAME:
PERMIT ISSUE DATE
TORREY LEON
901 FERNGROVE
06/19/2008
ONE:
SANITARY NO. CONTROL NO.
ARCHTIECDENGINEER:
BUILDING PERMIT INFO
BLDG ELECT' PLUMB MECH
t� 0
LICENSED CONTRACTOR'S DECLARATION
Chapar v
Job Description '
p
1 hereby alBnn err 1 am lianaem uMer pmvidous of (commencing
with SaJon7lm)of0ivisian lafw Busirev arW Proressiom Code.and myllecnseu
FINAL FOR SERV UPGRADE
in run rot¢ and cff.L
License Class Ce.9
Dam Commcuo
ARCHITECTS DECLARATION
1 understand any plans shall he used as public mcords
Liccnmd Professional
OWNER -BUILDER DECLARATION
I hcroby aRno that I am ucmpt from the Conlracleas License Law (or the
fallowing mason. (Section 703 1.5, Business and Professions Code: Any city or county
which RQYIIG a Permit to comomeI, aluer. morrow, demolish. or repsir any aWenme
prior to its issuance. alw requires the applicant for Such permit o file a signed statement
that he is licensed Forwent to We provisions of see Contracarh Liana Law (chapter 9
Sq. Ft. Floor Area
Valuation
(commencing with Section 7000) of Division 3 of NC Business and Professions Code) or
$100
1 that he is eaempt wmfrom and the beau for Ne alleged exemption. Any violation of
Section 7031.5 by any applicant fora permit subjects the applianuo a civil penalty ofNumber
37539053:
Occupancy Type
nos more Nan Ea hundred dallms(SM
Pane Y
0 1. as awry of w property. or my employee with wages as their sole campensadon,
will do rework. and w awnum is out unarmed ser a Rued for sale (Se.' .Busixho
and Professions Cade: The Oantsacmrs License Law does ooh apply m an owner or
Required Inspections
property who Wilma or im prove therms, and who doessuch work himself or through his
own employ=. provided that such improvements are not inuoded aro@cod forsals. IL
however, the building or ireprowment is sold within ane year of completion, w owner.
builder will have the human of pmving Nal M did out build or improve for purpose of
sale.)
Lj I. u aver of the propcny as exclusively contracting with licensed contractors m
construct de project (Sec. 7016. Business and Professions Cade:) The Commences U.
cewe Law does am apply he an swim of property who builds or impmws wmmr. and
who contracts for such projects; with a mntranorts) licensed pursuant to the Contractors
License
❑lam e:c sunder Set . B&I'(77fo�r/dustessom
OwnrrDaa L,L S. t/L
CrON DECLARATION (l
1 bemby affirm under pu. y of pe ry rn of w following trela aim.
I ham and will mainain aCutiEote of Covent w air -iv, . forWorkers Comics.
'
omen, u provided for by Section 3700 of the Labor Code- for the perf iness m of the
wort for which this Permit is issued.
❑ 1 have and will maintain Workers Compensation Insurance. M myvimd by section
3700 of We labor Come, for the performance of the work for which this permit is issued.
My Workers Compensation lnmrance canner and Policy number art:
.,
Cartier. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
'
(This section need cot tecomple ed if the permit Is forese hundred dollar (6100)
or less.)
1 mnify that c performance of the work fro which this Permit u issued, I shall not
employ any' an in any man rp mbecomc mbjecl m the Waken' Compensation
Laws of C if on,
A,Hmn
NOTICE 7T If• t r mold g this Ccnifiute of Esemption, you wuW
become m w Workers Carpe tion provisions of the Labor Code, you most
foMwith comply with such pmvivans or this pamil shall be deemed mvoked.
CONSIRUCnON LENDING AGENCY
1 hereby afNm that Nee is construction lending agency for w Performance of
the work for which this permit is issued (Sec. 3M, Ci¢ C.)
Lenmeru Name
lenders Address
1 certify Out 1 have Rad this application amW stag that the show information is
ca mM l agree m comply with all city and county ardi. and shoe laws relating m
building construction, and hereby wthoriR ncrummhotives or thus city to enter upon the
above-mentioned property for impenion purposes
(We) agree to eve. indemnify and keep harmless the City of Collators agaiust
liabilities, judgrecnta, costs and umnxe which may in any way werce against aid Coy
in coursecoo"gmndng Of Fermin.
APPLICq UNDERSTND WILL COMPLY WITH ALL NON -POINT
Issued by: /
SOU CATIONS.
Date
Re-roofs
SignkuFi Xkpipficionaeo
a`
HAZARDOUs M AIS DISCLOSURE
Type of Roof
Willwapplicent wfulum EW Ing CCLYpNLatoR whaOmlt llwydow maaflal
u defined by w Cupertino Municipal Code, Chapter 9.11, and the Health and Safety
Code, C3y.on 25332(a)? .9e
All roofs shall be inspected prior to any roofing material being installed.
Will w ause m
pplicant or (atom building acouWnn equipment or eati Mich
'=91lumamim
If a roof is installed. p without first obtainingan inspection, I agree to remove
ns xw dend by Bay Area Air Quality Management
all new materials for inspection.
tiinlar
/u
Oyes 0<
I have mad Ne Wes dour materials requirements underChapter 6.95 of the Califor-
niaHulth sYny Code, Sectiom25M5,1533and15536.1undc.ddmaif&W.Iding
does no only baso a t it u my Rsponsihility m notify the occupant of w
Rqu' an must me araissuanccof,Cenifiatearoccuancy.
Signature of Applicant Date
. All roof coverings to be Class'na' or better
ow th r ant Dat
• 2 ITEMS OF 2
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 37539053.00
DATE ISSUED.......: 06/19/2008
RECEIPT #.........: BS000005162
REFERENCE ID # ...: 08060135
SITE ADDRESS .....: 901 FERNGROVE DR
SUBDIVISION .......
CITY CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER ............: TORREY LEON
ADDRESS ..........: 901 FERNGROVE
CITY/STATE/ZIP ...: CUPERTINO CA, 95014-4664
RECEIVED FROM ....: LEON E TORREY
CONTRACTOR .......: LIC # *OWNER*
COMPANY ..........: TORREY LEON
ADDRESS ..........: 901 FERNGROVE
CITY/STATE/ZIP ...: CUPERTINO CA, 95014-4664
TELEPHONE ........:
•
FEE ID UNIT
-----------------------
QUANTITY
----------
,AMOUNT.
PD -TO -DT
THIS REC
NEW BAL
lEPERMITFE 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
----------
81.58
----------
0.00
---------- ----------
81.58
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT
•
AMOUNT
---------------
81.58
---------------
81.58
REFERENCE NUMBER
--------------------
#2694
CITY of
• CUPEk1lNO
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CITY OF CUPERTINO
GENERAL BUILDING
PERMIT APPLICATION FORM
APN #
9()53, ()0
Date:
O _
Building Address:
qn r FE500 C56C-0 UE p?, Cc
Mailing Address (if different from building address):
Owner's Name:Phone
�� `rz�
#-
LpS-W b—q
Contractor:
Phone:
Fax:
Contractor License #:
Cupertino Business License #:
Contact:
Phone:
Fax:
Residential Commercial ❑
Job Description: . � r� t CAE!� U,pG
Building Permit Info:
Bldg ❑ Elect Plumb ❑ Mech ❑
Type of Construction (Usage Class):
Occupancy Type:
1-A, 1-B ❑ II/IIVV-A E]II/III B, IV -HT, V -B
0--/
Valuation: °`
DU 4— Square Footage:
Project Size: Express []I- Standard ❑ 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
Revised 6/16/08
D�
I OF
CUPERTINO
CITY OF CUPERTINO
GENERAL BUILDING •
PERMIT APPLICATION FORM
Quantity/Sf
Fee ID
Fee Description
Fee
Permit Type
Group
1GENRES or
1 GENCOM
1BTEMPPER
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
1BBOILER3
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
histallation/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
1MECHINSP
Other Mechanical Inspections (per
M
hour)
1PLMBINSP
Other Plumbing & Gas Inspections
P
(per hour)
1MEETINGIHR
Application Meeting
B
C1
J
0
�4,- CITY OF CUPERTINO
CITY OF GENERAL BUILDING APPLICATION
CUPEP\TINO
• FEE SCHEDULE
r
L
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
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
I FENCE>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
I MODUSTRU
Modular Structures
B
FOUNDATIONS
1FOUNDREP
Foundation Repair
B
1PILECAST
Pile Foundation Cast in place concrete
B
'
1PILEDRIV
Pile Foundation Driven (steel, pre-
stressed concrete)
B
3 of 5
CIT or
CUPERTINO
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONRY)
IRETSTN
Standard (up to 50 ft)
B
1RETSP310
Special Design, 3-10' high (up to 50 `)
B
1RETSP10
Special Design, over 10' high (up to
50'
B
1RETCRB<
Gravity/Crib Wall, 0-10'high (up to
50 ft)
B
1RETCRB>
Gravity/Crib Wall over 10' high (up to
50 ft)
B
SIDING
1SIDEST/BK
Siding, Stone & Brick Veneer
(interior/exterior)
B
1 SIDEOTHER
Siding all other
B
SKYLIGHTS
1 SKYL<10 SF
Skylight less than 10 sf
B
1 SKYL>10SF
Skylight greater than 10 sf or
structural
B
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
st
B
1 STUCOAP
Stucco Applications (up to 400 sf)
additional stucco a lication
B
4of5
0
•
1J
U OF
CUPEI�TINO
0
CITY OF CUPERTINO
GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf
Fee ID
Fee Description
Fee
Group
Permit Type
1GENRES or
1GENCOM
1 WINREP
Replacement windows/sliding glass
door (ea 8 windows)
B
1WINMEWSTR
New Window -structural shear
wall/masonry (includes plan ck fee
B
/
IEPERMITFEE
Electrical Permit Fee
E
1MPERMITFEE
Mechanical Permit Fee
M
1PPERMITFEE
Plumbing Permit Fee
P
lELCPLNCK
Stand Alone Electric Pin Ck (hourly)
E
1MECPLNCK
Stand Alone Mechanical Pin Ck (hrly)
M
1PLMBLNCK
Stand Alone Plumbing Pin Ck (hrly)
P
1 STPLNCK-(3 Hr Min
when not over counter)
Standard Plan Check (when no E/M/P)
hourly -stand alone
B
1BSEISMICR
Seismic Residential
B
1BSEISMICO
Seismic Commercial
B
1TRAVDOC
Travel & Documentation
B
1BUSLIC
Business License
B
•
5 of 5
E
•
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
n
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 point
P.
Other
1.
List Green Features on Plans
A-1
1 point
TOTAL POINTS
40 points . .
E
•
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; ,30%=4 points
2. Salvage Reusable Building Materials
3. Remodel for Mixed Use, Adaptive Reuse, and
Historic Preservation
4. Protect Native Soil
5. Minimize Disruption of Existing Plants & Trees
6. Implement Construction Site Stonnwater Practices
7. Protect Water Quality with Landscape Design
6. Design Resource -Efficient Landscapes and Gardens
9. Reuse Matedals/Use Recycled Content Materials
for Landscape Areas
10. Install High -Efficiency Irrigation Systems
11. Provide for On -Site Water Catchment / Retention
B. Foundation
1. Incorporate Recycled Flyashin Concrete
25% Recycled Flyash = 2 points; Add 1 point for every 10%
increase of fiyash, up to 5 points
2. Use Recycled Content Aggregate
3. Insulate Foundation/Slab before backfill
C. Structural Frame
1. Substitute Solid Sawn Lumber with Engineered Lumber
2. Use FSC Certified Wood for framing
(For every 10% of FSC lumber used = 2 points, up to 10)
3. Use Wood I -Joists for Floors and Ceilings
4. Use Web Floor Trusses
5. Design Energy Heels on Trusses 6' or more
6. Use Finger -Jointed Studs for Vertical Applications
7. Use Engineered Studs for Vertical Applications
B. Use Recycled Content Steel Studs for Interior Framing
9. Use Structural Insulated Panels (SIPS)
a. Floors
b. Wall
c. Roof
10. Apply Advanced Framing Techniques
11. Use Reclaimed Lumber for Non Structural Applications
12. Use OSB
a. Subficors
b. Sheathing
up to 4 Resource pts
4 Resource pts y --yes
4 Resource pts
2 Resource pts
1 Resource pt
2 Resource pts
2 Resource pts
4 Resource pts
2 Resource pts y=yes
2 Resource pts y=yes
2 Resource pts y=yes
up to 5 Resource pts
2 Resource pts y=yes
3 Energy pts y=yes
3 Resource pts
up to 10 Resource
2 Resource pts y:
2 Resource pts y:
2 Energy pts y=yes
2 Resource pts y=yes
2 Resource pts y=yes
2 Resource pts y=yes
3 Energy pts
3 Energy pts
3 Energy pts
4 Resource pts
3 Resource pts
1 Resource pt
1 Resource of
•
•
•
I. Windows
2 Energy pts
Y --yes
1. Install Energy -Efficient Windows
3 Energy pts
y=yes
• a. Double -Paned
1 Energy pt
Y --yes
b. Low -Emissivity (Low -E)
2 Energy pts
y=yes
c. Low. Conductivity Frames
2 Energy pts
Y --yes
2. Install Low Heat Transmission Glazing
1 Enerov Dt
v=ves
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 IAQ/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
6. Install Sealed Combustion Units
5 IAQ/Health pts
y --yes
a. Furnaces
31AQ/Health pts
y --yes
b. Water Heaters
31AQ/Health pts
y=yes
9. Replace Wall -Mounted Electric and Gas Heaters with
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 --ye-,
13. Retrofit Wood Burning Fireplaces
10 Energy pts
y=yes
a. Install EPA certified wood stovestinserts
1 IAQ/Health pt
y=yes
b. Install/Replace Dampers
1 Energy pt
y=yes
c. Install Airtight Doors
1 Energy pt
y=yes
14. Install Zoned, Hydronic Radiant Heating
3 Energy pts
y=yes
15. Install High Efficiency Filter
4 IAQ/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 pts
y=yes
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 =16 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 y=yes
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts . y=yes
3. Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes
•
Mvw
CITY OF
*UPEkTINO
•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS: O( FzG ��
v ���
PERMIT #De�U(p O ( 3
OWNER'S NAME:
PHONE #
GENERAL CONTRACTOR:
FAX #
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
Owner/Contract Signature
Jeers --19. ,-c3tQ�
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
ile
Owner/Contract Signature
Jeers --19. ,-c3tQ�
Date