08090054 CITY OF CUPERTINO -
BUn.oINGQIVkSlofN PERMIT oICONTRACTORINk'QTiMr T.iE`',)1V `-.;.
BUI INC gDRESS: PERMITNO.
9 A461 GREENWOOD DR A B CONSTRUCTION ZINC 08090054
OWNER'S NAME: PERMIT ISSUE DATE
IRWIN ALBERT L AND JANE E 9653 SEA CLIFF WAY 09/10/2008
IgEOTTa'
(916) 284-2206 SANITARY NO, CONTROL NO.
ARCHITEC(ENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
30 ] LICENSED CONTRACIOWS DECLARATION O O O
m I hereby affirm the,I an Karam ander Prov'.:,....of Chapter 9(commencing Job Description
fU wt Section 7")ofonidnn3onhcflusinemand PmrevsiumCode,and myuanssu GAS LINE REPAIR, SHT OFF BY PG&E &PERMT REQD PER
: as ionrdvomeand errecL a.Ss ,CPC 2007
z ticcnic Clic lJc.d
et-q Dam 0.4
ARCHITECTS DECLA X ION
as U
n 1 undersand my plans snail W wed u public records
'0.0 t; Licensed Professional
a3 OWNER-BUILDER DECLARATION
i F I hemby M.ase 1 am exempt from the Comactar'a License Law for Ile ,
is D O fallowing mason.(section?031.5,Busineas and Pmfeninm Cole:Any city or roomy
5$ which mquim a Permit to comtrucL ter.bnprove.demollm.or minor try swamc
_z Y prior b is issuance.also requires the applicant for inch permit to file a signed stamm sol
�Is i1m,Im is licensed purmuuo Ne provislam of the Contractor's Liccnm Law(Clapmr 9 Sq.Ft. Floor Area Valuation
(commencing wit Section 700M of Division 3 of the Business;and Professions Cads)m $2000
$ Nn M m exempt Merchants and Ne basis for me alleged exemption.Any vloladon of
Section?031.5 by any applicant fm a permit¢objects ase app0cant to a civil penalty ofNumber Occupancy
an,mom Nass five heated dellars(SM 37504033 . TYPe
❑I.as owner of the properly,m my employees with.,A as their sem compassom.,
will do the work and the someone Is hot intended or offered foram(Som.71344.Buairca
and Profeatima Code:The Commutes Licame Law does eat apply to an awna of Required Inspections
property,who Wilds Or improves thereon,and whodoessashwork himselfmthmugb his
owes ernploym,proNded Wt such improvements art not intended moRerN fm ale B,
however,the Wilding or improvement is aid within aro year of compledon.the owner-
Wilder will haw do burden of proving that he did rot bold or improve for purpose of
ale).
❑1,as owner of me propeny,am exclusively commuting with licensed contractors to
mruvuct the p,*a(Sec.7134,4.Business and Psafeadou Cade:)The Comdactor's V-
.taw does not apply to a.of property who Wilda or Improves memom.ad
who contracts for such pmjcm with a conwcton(s)licensed pursuant to the Corselets
License law.
❑lamesnsinunder See ,BBPCfarddsmuom
Owner Dam
WORKERS COMPENSATION DECLARATION
I hemby aflir under panty of perjury,on of tic fallowing declaadonu:
I have and will maintain aceati0omof Consent m self-insure for WorkstaComPen-
cation,u provided for by Section 37130 of the later Code.for the performance of me
wart for which this permit is issued.
❑I haw and will maintain Worker's Compensation Insurvnce,as required by Section
37013of the labor Cade.fm the pcdoamarce class work fmwbich tris permit is issued.
My Workeh CompensationfttA carriercad Polley num
Grier: �M— ICAT/aft Policy No.:
CERTIFlC OMPE EXEMPTION ORKFAS'
COMPENSATION INSURANCE
(TMs seem.need matte completed if tic permit is Worse hundred dollar(5100)
or ass.)
I certify cat in me performaace of the work fm which mix Permit is issued:I call has
employ try person in any metre,se u m become abject m the Workers'Compensation
Laws of California-Dam
Applicant
NOTICE TO APPLICANT:IL after making mu Cenifncam of Exemption,you should
become subject to me Workar'S Camperandon provlsima of me labor Code,you muss
.,O fontwim Comply with such pmvidons m this permit stair W tlComrd mwked. - '
z c CONSfRUC130N LENDING AGENCY
[—n I hereby affum ma mart is a construction lending agency fm me performance of
R'i > me work res which this Permit Is issued(Sec 3097,Cih,C.)
0.Q Lander',Name
z L4ndats Add.
U 0 i unify that 1 Mw mad W s apidmu m end sate that the¢bow inforadom u
py comem 1 agme m comply with all city era county oNinuwes and state laws mlding to
"0 building construction,and tembymaknom ropressnatiwa or mu elmy m emmupon to
ab on-m solanmd property for impaction purposes
H a ala) gone to saw.indemnify and keep haulm im City of Cupcnino against
V1 liabllidoet'j meo,c sand"pmum which may in try way acme against sad Gly
U z in canscgm can f me ting of Nu permit.
APPLICA UND ANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOUR UTA 0
Sigmaum of 'licanuContnnor
Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Dam Type of Roof
WII meappllcanlarfu=Wfldingaecupmtmmorlundic v oumdesial
U dolhu d by the,Cupertbm Mmalcipal Coo.mains,9.12,asd the Healm and Safety
Cone,Section 25532(¢)? All roofs shall be inspected prior to any roofing material being installed.
0"❑Yu
If a roof is installed without first obtaining an inspection,I agree to remove
Will the applicant or fumes building occupant use equipment or devices which g P
.in hau,dous mr conuminanu u dotard!by me Bay Amo Air Quality Management all new materials for inspection.
District?
❑Yes )&a
Iltaw comriaH mquimmemsorder Chapter 6.95ofdmGlifm-
niaHcal"saf C etiau2!Rct.25533 and 25534.1 undersand that ifine Wilding
dem nm cam haw ant all it Y my responsibility m edify the occupant of do
mquimmem has br to issuance of a Catifcam ofOccupecy. Signature of Applicant Date
Owner mw rara.Mml o m All roof coverings to be Class'/¢"or better
CITY OF CUPERTINO
• 3 ITEMS OF 3 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 37504033 . 00
DATE ISSUED. . . . . . . : 09/10/2008
RECEIPT #. . . . . . . . . : BS000006044
REFERENCE ID # . . . : 08090054
SITE ADDRESS . . . . . : 19461 GREENWOOD DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO.
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : IRWIN ALBERT L AND JANE E. TRUS
ADDRESS . . . . . . . . . . : 19461 GREENWOOD DR
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : ANTOUN Y BOGHOS
CONTRACTOR . . . . . . . : ANTOUN BOGHOS LIC # 28176
COMPANY A B CONSTRUCTION 1 INC
ADDRESS . . . . . . . . . . : 9653 SEA CLIFF WAY
CITY/STATE/ZIP . . . : ELK GROVE, CA 95758
TELEPHONE . . . . . . . . : (916) 284-2206
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 2, 000 . 00 0 . 50 0 . 00 0 . 50 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 82 . 08 0 . 00 82 . 08 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
------------ --------------- --------------------
CREDIT CARD 82 . 08 . VISA
---------------
TOTAL RECEIPT 82 , 08
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
202 UNDERFLOOR PLUMBING 301 ROUGH PLUMBING
507 FINAL PLUMBING
•
Q� CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
• CUPEIITINO PERMIT APPLICATION FORM
APN # 2-75D 03 5 , 0 O Date:
Building Address:
1%) GaaWWOOD DlLiVe, , CuPen.T1N0
Owner's Name: Phone #:
TEPNX q9t f LA IMANA m4,v7— H 16 7)
Contractor: Phone #:
COn1571UC-1ibt.l 1I INC Fax 9: 1 -q4q- 5933
Contact: —1—bNY 506405 Phone#: ' ef(b— a�4' a906
Fax #: —j b'eL 9111 — 9 3 3
Contractor License#: 679 )a'?
Cupertino Business License#:
Job Description: 6;Ptj L;Ne 11eP4iA % -G?T OFF jy P e , t-jeeD pegeu!
Pel(L CPC
Residential Commercial ❑
Valuation: .20 D d
Project Size: Express EStandard ❑ Large LJ 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 IRPSS
sewer/sanitary sewer
CITY OF CUPERTINO
d` REPIPE/SEWER/MAIN SERVICE
CITY of
CUPEkTiNO 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
1R-PWS
1PPRSEWG Private Sewage Disposal System P
1PCESS Cesspool P
1BPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P'
1PGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
1PPERMITFEE Plumbing Permit Fee Issuance P
1PLMBLNCK Plumbing Plan Check P •
1PLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel &Documentation Fee B
I 1BUSLIC 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 paints
11. Permeable Pavin Note L-1 2 oints
C. Foundation 1. Use 15 % Flyash Concrete, (note) S-1 5 points
D. Structural 3. Uses Wood I.loist, (See Spec.) S-2 2 points
5: Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathing, detail S-2 2 Dints
E. Ext. Finish 1. Composite Decking, (Note/Spec.) A3 2 points
4. B. Fiber Cement Sidin (Note/Spec. A-4 2 ints
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 paints .
H. Appliances 1. Energy Star Dishwasher, (Note/Spec.) A3 1 point
3. Energy 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 Pmcess Work Book Page-12-Revised 3/25/08
Green Points Rating System for. Remodeling Projects
1' 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.
INPUT Resources Energy AD/frealih
A.Site
i 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 p
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 Resowce pts y=yes 0
Ie.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 Inigation Systems 2 Resource pts y=yes 0
11.Provide for Dn-Site Water Catchment/Retention 2 Resource pts y=yes 0
! 1 I
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
!
C.Structural Frame 1 1
Ff.Substitute Solid Sawn Lumber with Engineared Lumberr _ -j 3 Resource pts y=yes p
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
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 p
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts y=yes p
12.Use 088 - - - -
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing _ —
1 Resource pt y=yes p �
1 1
INPUT Resources Energy 1AWHealth
D.Exterior Finish
1.Use Sustairiable.Decking Materials !
a.Recycled content 3 Resource pts y=yes 0 •
I b.FSC Certified Wood 3 Resource pts y=yes D
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAO/Health of y=yes D
i3.Install House Wrap under Siding 1 IAO/Health of y=yes 0
14.Use Fiber-Cement Siding Materials 1 Resource pt y=yes 0
E.Plumbing
i.Install Waier'Heater Jacket 1 Energy pt y=yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
13.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. D
14.Replace Toilest with Ultra-Low Flush Toilets
i(1 point each,up to 3points) _ _ _ Up to 3 Resource pts. D
5.Install Chlorine Filter on Showerhead 1 IAO/Health of y=yes D
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 IAWHealth pts. 0
S.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 ! f
r.eiectricai
11.Install Compact Fluorescent Light Bulbs(CFLs)
1(6 bulbs=2 points,10 bulbs=3 points,12 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 1 1
G.Appliances
F.Install Energy Star Dishwasher 1 Energy pt y=yes 0
12.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 pts y=yes 0
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
i3.Instill Recycled-Content,Fiberglass Insulation with ;
iNoAdded Formaldehyde 31A0/Health pts y=yes 0
4.Use Advanced Infiltration Reduction Practices 2 Energy pts y=yes 0
5.Use Cellulose Insulation
a.Walls 4 Resource pts y=yes0
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
o.uallings 4 Resource pts y=yas D
1 1
I. indows INPUT ReSDUrCiS Energy JAGIReafth
r 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 or y=yes D
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Dud 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 IAQlHealth pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 7
0
5.Install Solar Attic Fan 2 Energy pts y=yes D
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes D
6.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 31AQ/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 stoveslnserts 1 IAQ/Haalth pt y=yes 0
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Door 1 Energy of y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filter 41AQ/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 3 IAQ/Health pts y=yes 0
1 1 1
il
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=16 points) Up to 18 Energy pts 0
�6.Select Safe and Durable Roofing Materials __ _ 1 Resource of y=yes p
7 Install Raciant BarijaF - - 3 Energy pts y=yes p
1 1
L.Natural Heating and Cooling 1
1.Incorporate Passive Solar Heating 5 Energy pts 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 pts y=yes p
1 1 1
•
INPUT ReSDurces Energy lAO/Heatth
M.Indoor Air Quality and Fmishes
!1.Use LowMo.VOC Paint 1 IAO/Health pis y=yes 0 .
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 •
+3.Use Low/No VOC Adhesives 31A0/Heallh pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pis y=yes 0
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 IAO/Health pts y=yes 0
�7.Seal allExposedParticleboard or MDF 4 IAQMealth pts y=yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Flnaer-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes D
1 i 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
F2.Use Rapidly Renewable Flooring Materials 4 Resource pts y=yes 0
3.Use Recycled Content Ceramic Tiles 4 Resource pts y=yes 0
4,Install Natural Linoleum in Place of Vinyl 5 IAQ/Health pis 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 Pro'ect R 1 01 0 0 •
0
G:datalprogslgreenbuildingguidelineshemodelersrgreenpointsfinz2.12.04pmlectedxls
•
_ Community Development
10300 Torre Avenue
5/ Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
OUPEkTINO
Building De artment
JOB ADDRESS: PERMIT #
I°t`Iel (naewC0j) ?01?00-r—
OWNER'S NAME: -nfg,feAIX PHONE # 11b, q,q'so h
GENERAL CONTRACTOR: g 71 1,j,g I FAX # -7b d^944 3 3
I am not using any subcontractors: e9lir_v'?
Signature Date
Please check applicable subcontractors and complete the following ' 0 tion:
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 ock
Til
twn•
er/Contractor Signature Date