08080080 CITY OF CUPERTINO
BUILDINconlY1SION PERMIT CONTRACTORgIIVFORMATION
BUILDING ADDRESS: PERMIT NO.
20666 GREENLEAF CT LOT 2 NEXGEN BUILDERS, INC. 08080080
OWNER'S NAME: PERMIT ISSUE DATE
CUPERTINO GREENLEAF LLC 225 DEMETER ST 08/12/2008
INE: SANITARY NO. CONTROL NO.
(650) 322-5800
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
urns LICENSED CONTRACTOR'S DECLARATION Job Description
rd m 1 bamby aRnn shat l w]flanked under provisions of Chapter 9(commencing P
with Suctiork70M)of Dbislon 3 Orden Buslrte and Pnervatios Code,and my license is REV SLOPE ON SEWR, REV ROUTE ON WTR LINES,
in full face and effort
04 LicenseClaa LIc.N ORIG#07020039
a=q Dow Cental.,
p7W7W
ARCHITEM DECLARATION NOTE: ONLY 1 FEE FOR 3 REV PERMITS FOR LOTS 1-3
W U I undersand my plans shall be used as Public record,
OK
U,
5U, Licensed Pmlcssional
3 OWNER-BUILDER DECLARATION
s� f 1 hereby Affirm Mat 1 am exempt from the Contactors License Law for Ne
e0 e0, following moon.(section 1111 L1,Business and Pmfoaiuns Code:Any city or many
which mquims a Permit.eonsusec4 alar,narrow.demolish.or repair any suuctum
iy
pd..its ear....also aqui.Me applicant retract,permit 101111 as;gncI summer
�< Mu he islicenseMPanama.thepmsisionsOfMeCOOac.r'SumnmLaw(Chapter 9 Sq.F[. Floor Area Valuation
$ (commencing with Secdon7000)9Division 3ofdeBus;nnssand Professions Code)or
—
that he Ise exempt Mue(mm aem
and Me basis far Me alleged cpdon.Any violation of $1500
Semlan 7031.5 by any applicant for a Permit subjects Me applicant.a civil Penalty ofNumber Oe
non mora thm Ow bundmd dNusrs(SSWI 32656028 .' Occupancy T P Y yP
❑1,as owner of Me property,or my employees wish wages as Meir sole compensation.
will do Me wart,,and Me swcuue u not;nMnded sur onead(ansalo(Sec.70N,Bertin...
and Profession Tim C GmYtaYa roto License Law does t apply an awor Required Inspections
sropeny who build,or ire prows dmreon,and who d.such work hinuelr.or through his
awn employes,proWmed Mss woh;mparmanams arc not intended oraRemd forsam.If,
however.the building or improwmtwt Is Ad within one you of cmmpledon,the owner.
Wilder will hale she burden of purring dust he did not halo or impame fa purpose of
ale.).
1,a Owner of Me property am eactusivcly contracting with]focused mnwarn.
moue the project(Sec.7044,Business and Profrutimes Cade:)The Coruacsors U.
came Taw dao not apply to a owner of property who builds or Im seres ft..and.
who conuacta for such pmjeeu with a contractor(,)licensed pursuant.Me Contractor,
Lice.law.
or.. sunder See B&PCfashus maw°
Dwner � Dam $ 11 2
WORKER'S COMPENSATION DECLARATION
1 hereby arm under penalty of perjury am of dm following derlantionc
1 haw and will maintain a Certificate of Corneal to self-insum for Whites Compere
on,a provided for by Section 37M of du Labor Co s,for Me puMrmmca of Me
work for which Mis permit is issued.
D I hose and will maintain Worker,Compensation rewrance,as required by Section
3700.(the Tabor Came.for dm performance of dm wmt for which Mis permit in issued.
My Workers Compenaatim Immranee ander and policy number are
Carrier. Policy No.:
CERTIFICATE OF E)(EMP ION FROM WORKERS'
COMPENSATION INSURANCE
mossacdch need trot he completed itthe permit is(warm hammd Modus(3100)
m.aa)
I lenity Mer in Me performance of dm work for which this permit is issued.I shall not
cmpOyanypcnon in anyma rra aabcco.0 tire-Worken'Compematian
Law,of California.Data
Applicmt • I._
N0710E To APPLICANT.If,after making thus Cen;nwm of Exemption,you Mould
become subJeu.the Wafter',L'ampemrti0n previsions of Me Labor Code You atm
wJz forthwith comply with such pmv(sians Or MU Permit Mail W meemcA maokcd.
'fir V3 CONSTRUCTION LENDING AGENCY
[—t I herby affirm Mat Mem Us encu mctinn lending agency far the perfamume of
W > Me wish(or which Mit Permit is;sued(sec.3197,Civ.C-)
tort 0 Lender,None
z 1<ndae,Adams
U 0 1 comedy Mu 1 haw rad ties wimadon and nam Mad she rave mformatiue is
D. cornea 1 rgme an comply with all city and county ardimrrca,and stam tan misting.
C) building eooumnction,and bemby mboria apmwnudves of this lily an a.upon Me
F Cv t h c-mentioned pmpcny for inspection purposes
(We)agree to saw.indemnify and keep harmless the City of Cupertino against
N Imbilidm,judgments.loth and eapeau which may in ray way meave ams,said City
U Z in consequence of the ganting of this permit.
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURC _jEGU TI NS.
'
Re-roofs
Signature of APplimen Camractar Da.
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Me applicant or future building aavpat now mhandic haardous material
as,defmnd by dm Cupertino Muni'pal Code.Clutter 9.11,and she HWM and Safety
Cada,Section 15531(U7 All roofs shall be inspected prior to any roofing material being installed.
Yet u
Will dm itdant, r m Iain °axr, est ora If a roof is installed without first obtaining an inspection,I agree to remove
nP g w wmPmwt a medm wmm� g P g
it haurdrm air coram; fined by the Bay Arm Air Quality Management all new materials for inspection.
nrim /
pres No
I haw mad Me laccou smamriausmqui¢mm�u unmerCTaptad.93ofthc Calif.,
.in Hculth&Safcry Cade Sections 15505,15533 a115534.I understand dmatif dm building
docs rot cuoendy haw a meson]Mut it u my rommumbdUy ke notify dm mcupat of dm
req"came nth ry;_La_marc a1.CuuOam Occuptex, —Signature of Applicant Date
F- �a- 1-2-10
.a
Owner err aahadsd agent Dam- All roof coverings to be Class'%"or better
nCCITY OF CUPERTINO
CITY
• CUPERIINo REVISION/DEFERRED .
PERMIT APPLICATION FORM
APN # ` Date:
Original Permit #: p 2oa 3J L07 4 Z
Building Address:
Mailing Address (if different from buildinaddress):
ZZ-`� Dc.M6 j�(L moi. �EFS•r YA-uC, f1G,j� ,Cts
Owner's Name: Phone #:
Cs2bEr� L- PrF L-- . t_. 0 . �-S'v _ 322 — -5'�?oa
Co tractor: 1Phone:
�� K(r-siJ �.D�e22S "L�C. .
Fax:
Contractor License #: &-76cjg2_,�5
Cupertino Business License #:
Contact: Phone: l
Fax:
Building Permit Info:
Bldg ❑ Elect ❑ Plumb Mech ❑
Residential Commercial
Job Description: .'`zu�sic +J Rt✓ tlCsc 5 Lal, aq� �� ��
�u�Uls�• �n�.tt`c oA loA�t� Li.�S
Is the project in the Wildland- Urban Interface Fire Area? Yes ❑ No ❑
Type of Construction (Usage Class): * Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ II/III B, IV-HT, V-B 0' 3
Valuation (cost of project):
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
REVISION/DEFERRED
CUPEkTINO
PERMIT APPLICATION FORM
FEE SCHEDULE
Quantity Fee ID Fee Description Fee Group Permit Type
Sq Ft
1REVCOMNEW Revision Commercial New B 1*
IREVCOMTI Revision Tenant Improvement B 1* TI
1REVSFDWL Revision SFDWL B 1R3SFDW
1REVRESADD Revision Addition B 1R3SFDADD
1REVRESREM Revision Remodel B 1R3SFDREM
1DEFINSP Deferred Submittal not R-3 B 1*
Inspection •
1DEFPLNCK Deferred Submittal not R-3 Plan B 1* OR
Check 1* TI
1DEFR3PLNCK Deferred submittal R-3 Plan Chk B 1R3SFDW
1R3SFDADD
1R3SFDREM
•
2 of 3
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 __Lo
C. Foundation 1. Use 15% Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood [Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 __?joints
E. Ext. Finish 1. Composite Decking, (Note/Spec.) AJ 2 points
4. B. Fiber Cement Siding, (Note/Spec.) A-4 2 aints
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 o[nts
G. Electrical 4. E. Ceiling Fans, (Note/Spec.) A-3 4 points
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) AJ 1 point
3. Enerq. V Star Refrigerator, Note/Spec. A-3 1 Dint
P. Other 1. List Green Features on Plans A-1 1 paint
TOTAL POINTS 40 points
Plan Review Process Work Book Page-12-Revised 3/25/08
- I
c
• LEED for Core and Shell v2.0
Registered Project Checklist
Project Name:
Project Address:
Y. 7 No
Prereq 1 Construction Activity Pollution Prevention Required
Credit 1 Site Selection 1
Credit 2 Development Density&Community Connectivity 1
Credit 3 Brownfield Redevelopment 1
Credit 4.1 Alternative Transportation:Public Transportation Access 1
Credit 4.2 Alternative Transportation:Bicycle Storage&Changing Rooms 1
Credit 4.3 Alternative Transportation:Low-Emitting and Fuel-Efficient Vehicles 1
Credit 4.4 Alternative Transportation:Parking Capacity 1
Credit 5.1 Site Development:Protect of Restore Habitat _ 1
Credit 5.2 Site Development:Maximize Open Space i
Credit 6.1 Stormwater Design:Quantity Control 1
Credit 6.2 Stormwater Design:Quality Control 1
Credit 7.1 Heat Island Effect,Non-Roof 1 -
Credit 7.2 Heat Island Effect,Roof 1
Credito Light Pollution Reduction 1
Credit a Tenant Design&Construction Guidelines 1
Vo i No
Credit 1.1 Water Efficient Landscaping:Reduce by 50% 1
• Credit 1.2 Water Efficient Landscaping: No Potable Use or No Irrigation 1
Credit Innovative Wastewater Technologies 1
Credit 3.1 Water Use Reduction:20%Reduction 1
Credit 3.2 Water Use Reduction:30%Reduction 1
Y. 7 No
Prereq 1 Fundamental Commissioning of the Building Energy Systems Required '
Prereq 2 Minimum Energy Performance Required
Prereq 3 Fundamental Refrigerant Management Required
Not.for SAO:All LEED for Com and Shell prelecb registered after June 261X.2007 are required to achieve at least Ivro(2)IIDints under EAci.
® Credit 1 O timize Energy Performance 1 to e
10.5%New Buildings or 3.5%Existing Building Renovations 1
14%New Buildings or 7%Existing Building Renovations 2
17.5%New Buildings or 10.5%Existing Building Renovations 3
21%New Buildings or 14%Existing Building Renovations a
24.5%New Buildings or 17.5%Existing Building Renovations 5
28%New Buildings or 21%.Existing Building Renovations 6
31.5%New Buildings or 24.5% Existing Building Renovations 7
35%New Buildings or 28%Existing Building Renovations s
Credit 2 Onsite Renewable Energy q
Credit Enhanced Commissioning _ 1
Credit 4 Enhanced Refrigerant Management 1
Credit 5.1 Measurement&Verification-Base Building 1
Credit 5.2 Measurement&Verification-Tenant Sub-metering 1
Credit s Green Power 1
continued...
•
Yr v No
Preraq 1 Storage&Collection of Recyclables Required •
Credit 1.1 Building Reuse: Maintain 25%of Existing Walls, Floors&Roof 1
Credit 1.2 Building Reuse: Maintain 50%of Existing Walls,Floors&Roof 1
Credit 1.3 Building Reuse: Maintain 75%of Interior Non-Structural Elements t
Credit 2.1 Construction Waste Management: Divert 50%from Disposal 1
Credit 2.2 Construction Waste Management: Divert 75%from Disposal 1
Credit Materials Reuse: 1% 1
Credit 4.1 Recycled Content: 10%(post-consumer+t/2 pre-consumer) 1
Credit 4.2 Recycled Content: 20%(post-consumer+%pre-consumer) 1
Credit 5.1 Regional Materials: 10%Extracted,Processed&Manufactured Regional 1
Credit 5.2 Regional Materials:20%Extracted,Processed&Manufactured Regionall 1
Credit Certified Wood 1
Yr 7 No
P
Prereq 1 Minimum IAQ Performance Required
Ft Prereq 2 Environmental Tobacco Smoke(ETS)Control Required
Credit 1 Outdoor Air Delivery Monitoring t
Credit 2 Increased Ventilation t
Credit 3 Construction IAQ Management Plan: During Construction 1
Credit 4.1 Low-Emitting Materials:Adhesives&Sealants 1
Credit 4.2 Low-Emitting Materials: Paints&Coatings 1
Credit 4.3 Low-Emitting Materials: Carpet Systems 1
Credit 4.4 Low-Emitting Materials: Composite Wood&Agrifiber Products 1
Credit 5 Indoor Chemical&Pollutant Source Control 1
Credit 6 Controllability of Systems:Thermal Comfort 1.
Credit 7 Thermal Comfort: Design 1
Credit 6.1 Daylight&Views: Daylight 75%of Spaces 1
Credit e.2 Daylight&Views:Views for 90%of Spaces 1
Yes i Ni
Credit 1.1 Innovation in Design:Provide Specific Title 1
Credit 1.2 Innovation in Design:Provide Specific Title 1
Credit 1.3 Innovation in Design:Provide Specific Title 1
Credit 1.4 Innovation In Design:Provide Specific Title 1
Credit LEED°Accredited Professional 1
rm i No
MEN Totals(pre-certification estimates) 61:
Certified: 23 to 27 points. Silver: 20 to 33 points, Gold: 34 to 44 points, Platinum: 45 to fit points
•
LEED for New Construction v2.2
• Registered Project Checklist
Project Name:
.Project Address:
Yea 7 No
Prereq 1 Construction Activity Pollution Prevention Required
Credit 1 Site Selection 1
Credit 2 Development Density&Community Connectivity 1
Credit Brownfield Redevelopment t
Credit 4.1 Alternative Transportation, Public Transportation Access 1
Credit 4.2 Alternative Transportation, Bicycle Storage&Changing Rooms 1
Credit 4.3 Alternative Transportation, Low-Emitting& Fuel-Efficient Vehicles 1
Credit 4.4 Alternative Transportation, Parking Capacity 1
MICredit 5.1 Site Development,Protect or Restore Habitat 1
Credit 5.2 Site Development,Maximize Open Space 1
Credit 6.1 Stormwater Design, Quantity Control 1
Credit 6.2 Storrnwater Design, Quality Control 1
Credit 7.1 Heat Island Effect, Non-Roof 1
Credit 7.2 Heat Island Effect, Roof 1
Credit B Light Pollution Reduction 1
Y. 7 No
Credit 1.1 Water Efficient Landscaping,Reduce by 50% 1
• credit 1.2 Water Efficient Landscaping, No Potable Use or No Irrigation 1
Credit Innovative Wastewater Technologies 1
Credit 3.1 Water Use Reduction,20% Reduction 1
Credit 3.2 Water Use Reduction,30%Reduction 1
.a
Prereq 1 Fundamental Commissioning of the Building Energy Systems Required
Prereq 2 Minimum Energy Performance Required
Prereq 3 Fundamental Refrigerant Management Required
'Nola for EAcl:All LEED for New Conslmction pmlects registered after June 26N.2007 are required to erJneve at least Mm(2)points under EAcl.
®Credit 1 Do timize Energy Performance 1 to 10
10.5%New Buildings or 3.5%Existing Building Renovations 1
14%New Buildings or 7%Existing Building Renovations 2
17.5%New Buildings or 10.5% Existing Building Renovations 3
21%New Buildings or 14%Existing Building Renovations 4
24.5% New Buildings or 17.5% Existing Building Renovations 5
28%New Buildings or 21% Existing Building Renovations 6
31.5%New Buildings or 24.5% Existing Building Renovations 7
35%New Buildings or 28% Existing Building Renovations e
38.5%New Buildings or 31.5% Existing Building Renovations s
1:142%New Buildings or 35%Existing Building Renovations 10
®Credit 2 Onsite Renewable Energy 1 to 3 -
2.5%Renewable Energy 1
7.5% Renewable Energy 2
12.5% Renewable Energy 3
�
Credit 3 Enhanced Commissioning 1
credit 4 Enhanced Refrigerant Management 1
credit 5 Measurement&Verification 1
Credit Green Power 1
• continued... ,
Tr 7 W
4
Prereq 1 Storage&Collection of Recyclables Required •
Credit 1.1 Building Reuse, Maintain 75%of Existing Walls, Floors&Roof 1
Credit 1.2 Building Reuse, Maintain 100%of Existing Walls, Floors&Roof t
Credit 1.3 Building Reuse, Maintain 50%of Interior Non-Structural Elements t
Credit 2.1 Construction Waste Management, Divert 50%from Disposal t
Credit 2.2 Construction Waste Management, Divert 75%from Disposal t
Credit 3.1 Materials Reuse,5% t
Credit 3.2 Materials Reuse,10% t
Credit 4.1 Recycled Content, 10% (post-consumer+t/2 pre-consumer) t
Credit 4.2 Recycled Content, 20%(post-consumer+r/2 pre-consumer) 1
Credit 5.1 Regional Materials, 10% Extracted, Processed&Manufactured Regio 1
Credit 5.2 Regional Materials,20% Extracted, Processed&Manufactured Regio t
Credit 6 Rapidly Renewable Materials t
Credits Certified Wood 1
Yr 7 M
P
$}; Prereq t Minimum IAQ Performance Required
Prereq 2 Environmental Tobacco Smoke(ETS)Control Required
Credit t Outdoor Air Delivery Monitoring t
Credit 2 Increased Ventilation t
Credit 3.1 Construction IAQ Management Plan, During Construction 1
Credit 3.2 Construction IAQ Management Plan, Before Occupancy 1
Credit 4.1 Low-Emitting Materials,Adhesives&Sealants i
Credit 4.2 Low-Emitting Materials, Paints&Coatings 1
Credit 4.3 Low-Emitting Materials, Carpet Systems 1
Credit 4.4 Low-Emitting Materials, Composite Wood&Agrifiber Products t
Credit 5 Indoor Chemical&Pollutant Source Control 1
Credit 6.1 Controllability of Systems, Lighting 1
Credit 6.2 Controllability of Systems,Thermal Comfort 1
Credit 7.1 Thermal Comfort, Design t •
Credit 7.2 Thermal Comfort,Verification 1
Credit 8.1 Daylight&Views, Daylight 75%of Spaces 1
Credit 6.2 Daylight&Views,Views for 90%of Spaces11 191 IN
1
Yr 7 No
5
..Credit 1.1 Innovation in Design:Provide Specific Title 1
Credit 1.2 Innovation In Design:Provide Specific Title t
Credit 1.3 Innovation in Design: Provide Specific Title t
Credit 1.4 Innovation In Design: Provide Specific Title
Credit LEED°Accredited Professional 1
Tr 7 Ne
Certified: 26-32 points, Silver: 33-38 points, Gold: 39-51 points, Platinum: 52-69 points