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CITY OF CUPERTINO
BUILDING DIVISION PERMIT
CONTRACTOR INFORMATIONy
BUILDING ADDRESS:
PERMIT NO.
.'.0153 JOHN DR
PLUMB -A -WAY
08080148
OWNER'S NAME:
PEINM ISSUE DATE
DAV 11) MCLEOD
1658 E CAPZTAC EXWY
08/20/2008
NE:
SANITARY NO, CONTROL NO.
(408)391-0930.-
ARCHI1"EC177ENGINEER:
BUILDING PERMIT INFO
BLDG ELECTPLUMB MECH
0 0 o I�
LICENSED CONTRACTOR'S DECLARATION
Job Description
I boaeby all. Nor I am licued under pmvivnns of Chapter 9 (cmemerming
with Suction 7lKID) of Division 3 of lbe Busixv uM ProRssiou Code, and my license is
REPLC LEKNG GALVNZD WTR MN W/COPPER
in full (orae and effect.
License Clan Lic. a
. .
Dab cmuscur,
ARCHITECTS DECLARATION
1 undcmand my plane about W used as public record
Licensed Pmfesimed
OWNER -BUILDER DECLARATION
I hereby a1Erm that 1 am exempt from the Conuscmts License Law for the
following mare. (Suction 7031.3. Business and Professions; Cade: Any city or county
which mquima a permit b eowrocL stmt. Improve, demalW, m repair any Nueone
prior b its iuuaxe, also requims the applicant for such permil Or file a signed sammonl
teat W is Reenact pursuant to tW pmvisiou of the Conuacmrs liccato Law(Chapmr 9
Sq. Ft. Floor AreaC Valuation
(rnmmencingwith Section7000)of Division3ofde Busin and Pmfusriom Cade)or
$1450
dw he u eumpt tiY9efrom and the basis for the alleged caempdwa Any violation of
Section 70313 by any applicant for a permit subjects the applicant b a civil Penalty of
Number
Occupancy Type
notmore Chun five hundred "We (S300).
36933038.
pane y
0 1, as Owner of the property, Or my employees with wage u then vele compeneation,
will do the work. and thesswclum is not imended or offered forsslf (See. riN6, Business
and Pmfetoone Code: The Conlrxar's Liaue Law dais Oat apply In an owner of
Required Inspections
properly who Wildorimprovet Jemon,aM whodoessuch work himself or Wough his
own employers, provided dust such improvements are not inteMed oroffered for self. IL
h.... the Wilding or improvement is Cold within mm Yost .1 completion. Ne owner -
builder will have the burden of proving that he did not build or imprme for purpose of
ask.).
IBJ 1, as owner of the property, w exclusively convecting with Ikenard centnctam Of
construct tum project (Sec. 7006, Business sad Profussions Code) TW Convacbr'r U.
-
Cense law doer not apply to an owner of Property, who Wild or improves thereon, and,
who contests for such pmjems with a contactor(U licensed pursuant to the Convector's
IYenm Law,
01 am rousups sun B@PCfmthismm.n
Owner /lX. 'L 2P a .,FSG V!/� Dam
- -
WORKElt COMPENSATION DECLARATION
I hereby affirm under penalty of Perjury one or the following declarations:
jok
PF 1 hem and will maintain a Cenilicaue ofConeent to self -imam fm Worker's Co olsm.
aadon. as provided for by Section 3700 of the labor Code. for the performance of the
wont for which this Permit is issued.
0 1 have and will Tainan. Worker's Compensation Ineuranca, as required by Section
3700 of the, Labor Cod, for Ne Nfformonee of the work for which this Permit's rested.
'
MY WorkCea Comp .dation lusuranca earlier and Poliry number, am:
Gorier: Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS'
COMPENSATION INSURANCE
(ThuseNon need not the completed if the .It a furanehundmd dullest (SIM)
Or lea)
1 cenify that in the puffumume or bon y0r rm ich Nis pe it is issued, 1 shall am
employ any person in anymanrc b-�M/M_i/,_ b' Worker' Compensation
Laws of Calirnmia. Dab
Applicant
NOTICE TO APPLICANT: If, after mak S Nu Centficab of Exemption, you should
became subject he the Worker's Compensation provisions Of the Labor Code, you most
foohwith comply with such provisions or this permit shall W deemed remkcd.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that three is a cousvuctinn funding agency for the perfmon. of
the work fm which this permit is ivued (Sec. 3097, Civ. C.)
lender's Nauru
lender's Address
I oertify the, I have read this application and sum this the above iafomutim is
Correa 1 acme ed c—P1Y with all city and County Ordinances and sale laws rtbting of
Wilding consuvction, nerd thereby authads rtpmsonuti es of this city to enter upon the
aW W -mentioned PmPmtY for inspection Purposes
(Wer) agree to save, indemnify and keep harmlaa the Cly of Cupcnnto against
liabilitica,judg... Q. cuts and experuca which may In any any ataue agalnet said City
in conmquence of the Sting of this permit
APPLICANT UNDERSTANDSAND WI L COMPLY WITH ALL NON -POINT
Issued by: Date
SOURCERE
".7y)—'
Re-ros
of
Signature OfApphiaMConvxmr m
HAZARDOUS MATERIALS DISCLOSURE
Type of Roof
Will the applicant m future Wilding occupant came or, handle haurdous manonfat
as defined by Ne Cupertino Municipal Code. Chapter 9.1x, and the Hcalth and Safely
Conte. section 25532(a)7 4No
❑Yca
All roofs shall be inspected prior to any roofing material being installed.
Win see a licant or future Wilding occa
Pp a pan, use equipment w dvicca amen
If a roof is installed without first obtaining an inspection, I agree to remove
g
rm«�nus air conaminants as dfircd by the Bay Area Air Quality Manegement
all new materials for inspection.
Y.
0
I havemalthehv mabriavrequiremcrosunder CTepbd6
uoftW Wilding
6 uWx33l/.l undersantl thuifthc Wilding
doHeovhk Soul yhave
a..4 th3303.233I1
Jona not currently hart a mnanl Charit u my mspo�hililY b ratify de oeeupml.f see
req=imm=ntswdghae masa a rw,m.r
Signature of Applicant Date
Dow
All roof coverings to be Class '4" or better
;
m�
ownermauthathmi ed age., f
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ......... 36933038.00
DATE ISSUED.......: 08/20/2008
RECEIPT #.........: BS000005839
REFERENCE ID # ...: 08080148
SITE ADDRESS .....: 20153 JOHN DR
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER ..... I........
DAVID MCLEOD
1.00
ADDRESS ..........:
20153 JOHN DR
0.00
CITY/STATE/ZIP ...:
CUPERTINO,
95014
RECEIVED FROM ....:
DAVID MC LEOD
VALUATION
CONTRACTOR .......:
CUONG NGUYEN
LIC # 25129
COMPANY ..........:
PLUMB -A -WAY
0.50
ADDRESS ..........:
1658.E CAPZTAC
EXWY
CITY/STATE/ZIP ...:
SAN JOSE, CA
95121
TELEPHONE ........:
(408)391-0930
0.00
is FEF. ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
1BPWSVCS
WATER SERVICE
1.00
20.40
0.00
20.40
0.00
.1BSETSMICR
VALUATION
1,450.00
0.50
0.00
0.50
0.00
IPPERMITFE
FLAT RATE
1.00
40.79
0.00
40.79
0.00
7.'PRAVDOC
FLAT RATE
1.00.
----------
40.79
0.00
40.79
0.00
TOTAL PERMIT
102.48
----------
0.00
--------
102.48
-
------
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
102.48
---------------
102.48
VOICE ID DESCRIPTION
-------- ----------------------------
106
------ -- ------
106 SEWER & WATER
507 FINAL PLUMBING
0
REFERENCE NUMBER
--------------------
#2014
VOICE ID DESCRIPTION
----- ----------------------------
301 ROUGH PLUMBING
.ro
clry of
JUPEkTINO
•
49
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS: x0(53 .TOhn DYl 'v -p—
PERMIT # O d U
U/ C /(P
OWNER'S NAME: D7W 'd 4AYffAl
PHONE # -f-0 8 6
1,6 .0
GENERAL CONTRACTOR C,(40
FAX #
J ✓ 't
I am not using any subcontractors:
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
CI J
CUPEkTINO
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
PERMIT APPLICATION FORM
C./,o (y�
APN # � � � J � C . U �
Date: 14
Building Address: aO %S 3 Sdti r
Owner's Name: J rw 1q t/(� I j d
Phone #:
(�
Contractor: "+K — X— W �J /N,
Phone #: 40$ 39/ X930
Guon� Ngkyen
Grou
Fax #:
Contact:
Phone #:
P
Fax #:
Contractor License #: }99 903
Cupertino Business License #:
Job Description:
R�pl?cGG ���,�2t'n� 9 ZcQ l/� h i7.�2Q (�ll�i.�e.✓
MX/'/') 14/1 ftk & qp Y
Residential Commercial ❑
Valuation: It rtfi 5—�
Project Size: Express Standazd Lazge 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:L
Quantity
Fee ID
Fee Description
Fee
Permit Type
Grou
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/sanitazy sewer
ano
CUPEkTINO
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
IBPFIXTURE
Plumbing Fixture
P
1PGASRES
Residential Gas Piping System
1-4 Outlets
P
IBPGAS
Gas Piping System 5+ Outlets
P
1PPERMITFEE
Plumbing Permit Fee Issuance
P
IPLMBLNCK
Plumbing Plan Check
P
IPLMBINSP
Other Plumbing/gas Insp.
P
1
1TRAVDOC
Travel & Documentation Fee
B
IBUSLIC
Business License
B
Revised 6-16-08
40
•
A
Ll
•
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
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
NOMMINNOM
TOTAL POINTS
40 points
Ll
•
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.
A. Bite INPUT Resources Energy 1ADIHeafth
Recycle Job Site Construction & Demolition Waste
65%= 1 point; 75%= 2 points; BO%= 4 points up to 4 Resource pts 0
'2. Salvage Reusabla Building Materials 4 Resource pts y=yes 0
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 Resource pts y --yes 0
fB. Design Resource -Efficient landscapes and Gardens _ _ 4 Resource pts y=yes 0
9. Reuse Matenals/Us=_ Recycled Content Materials
for Landscape Areas 2 Resource pts y=yes 0
10. Install High -Efficiency Irrigation Systems 2 Resource pts y=yes 0
11. Provide for On -Site Water Catchment / Retention 2 Resource pts y=yes 0
I I I
B. Foundation
1. Incorporate Recycled Flyashin 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
r
r,
r
r
0
r
r
0
0 ..
r
r
r
r
0,
Y. Substitute Solid Sawn Lumber with Engineered Lumber
3 Resource pts
y ye
2. Use FSC Certified Wood for iraming
-_
(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=ye,
4. Use Web Floor Trusses
2 Resource pts
y=yep,
5. Design Energy Heels on Trusses 6" or more
2 Energy pts
y --ye!
6. Use Finger-Jointad Studs for Vertical Applications
2 Resource pts
y=ye!
7. Use Engineered Studs for Vertical Applications
2 Resource pts
y=ye:
S. 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=yes
b. Wall
3 Energy pts
y=yes
c. Roof
3 Energy pts
y=yes
10. Apply Advanced Framing Techniques
4 Resource pts
y=yes
11. Use Reclaimed Lumber for Non Structural Applications
3 Resource pts
y=yes
12. Use OSB
a. Subfloors
1 Resource pt
y=yes
• b. Sheathing -
1 Resource pt
y=yes
r
r,
r
r
0
r
r
0
0 ..
r
r
r
r
0,
- 0.
-_
l_
1. Use Sustainable backing Materials
a. Recycled content
3 Resource pts
y --yes
b. FSC Certified Wood
3 Resource pts
Y --yes
!2. Use Treated Wood That Does Not Contain Chromium/Arsenic
1 IAO/Healih pt
y=yes
3. Install House Wrap under Siding
1 IAD/Health pt
y=yes
!4. Use Fiber -Cement Siding Materials
1 Resource pt
y=yes
E. Plumbing
11. Install Water Heater Jacket
1 Energy pt y=yes
2. Insulate Hot and Cold Water Pipes
2 Energy pts y=yes
3. Retrofit all Faucets and Showerheads with Flow Reducers
1 Energy pt
a. Faucets (1 point each, up to 2 points)
Up to 2 Resource pts.
Showerheads (1 point each, up to 2 points)
Up to 2 Resource pts.
(b.
4. Replace Toilest with Ultra -Low Flush Toilets
Y --ye!
(1 point each, up to points)
Up to 3 Resource pts.
5. Install Chlorine Filter on Showerhead
1 IAQ/Health pt y --yes
6. Convert Gas to Tankless Water Heater
4 Energy pts y=yes
7. Install Water Filtration Units at Faucets
31AQ/Health pts
(2 points each, up to 4 points)
Up to 4 IAQ/Health pts.
B. Install On -Demand Hot Water Circulation Pump
4 Resource pts y=yes
P. uecvrcai
1. Install Compact Fluorescent Light Bulbs (CFCs)
!(6 bulbs=2 points, 10 bulbs =3 points, 12 bulbs = 4 points) Up to 4 Energy pts.
2. Install IC -AT Recessed Rxtures with CFCs (1 point each, up to
5 points) Up to 5 Energy pts.
3. Install Lighting Controls (1 point per fixture, up to 4 points) Up to 4 Energy pts.
4. Install High Efficiency Ceiling Fans with CFLs
(1 point each, up to 4 points) Up to 4 Energy pts.
G. Appliances
11. Install Energy Star Dishwasher
1 Energy pt
12. Install Washing Machine with Water and Energy
1. Upgrade Insulation to Exceed Title 24 Requirements
Conservation Features
1 Energy pt
I3.Install Energy Star Refrigerator
1 Energy pt
14. Install Built -In Recycling Center
3 Resource pts
H. Insulation
O
O
1. Upgrade Insulation to Exceed Title 24 Requirements
a. Walls
2 Energy pts
y=ye:
b. Ceilings
2 Energy pts
Y --ye!
2. Install Floor Insulation over Crawl Space
4 Energy pts
y=ye:
*3. Install Recycled -Content, Fibarglsss Insulation with
INoAddedFormaldehyde
31AQ/Health pts
y=ye;
4. Use Advanced Infiltration Reduction Practices
2 Energy pts
y=ye:
5. Use Cellulose Insulation
a. Walls
4 Resource pts
y=yep
b. Ceilings
4 Resource pts
y=ye!
6. Alternative Insulation Products (Cotton, spray -foam)
a. Walls
4 Resource pts
y=ye
c. uemngs
4 Resource pts
y=ye
0
Ll
O
O
-
0
Ll
0
Q.
-
0
Ll
1. Install Energy -Efficient Windows
- 2 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 Energy pt
y=yes
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.IAO/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
8. Install Sealed Combustion Units
a. Furnaces
31AQ/Hsalth pts
y=yes
b. Water Heaters
3 IAQ/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,
13. Retrofit Wood Burning Fireplaces
2. Install Solar Water Heating System
. a. Install EPA certified wood stoveslnserts
1 IAQ/Health pt
b. Install/Replace Dampers
1 Energy pt
c. Install Airtight Doors
1 Energy pt
14. Install Zoned, Hydropic Radiant Heating
3 Energy pts
15. Install High Efficiency Filter
4 IAQ/Health pts
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAQ/Health pts
17. Install Separate Garage Exhaust Fan
3 IAQ/Health pts
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 = 18 points)
Up to 1 B Energy pts
6. Select Safe and Durable Roofing Materials
1 Resource pt
y=yes
T 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
40
11. Use LowMo-VOC Paint
1 IAQ/Health pts
y--yes2.
Use Low VOC, Water -Basad Wood Finishes
2 IAQ/Health pts
y=yes
13. Use Low/No VOC Adhesives
3 IAQ/Health pts
y=yes
4. Use Salvaged Materials for Interior Finishes
3 Resource pts
y=yes
5. Use Engineered Sheat Goods with no added Urea
5 IAQ/Health pts
y=yes
Formaldehyde
61AQ(Health pts
y=yes
6. Use Exterior Grade Plywood for Interior Uses
1 IAO/Health pts
y=yes
J. Seal all Exposed Particleboard or MDF
4 IAQ/Health pts
y=yes
6. Use FSC Ce tified Materials for Interior Finish
4 Resource pts
y=yes
9. Use Finger -Jointed or Recycled -Content Trim
1 Resource pts
y=yes
10. Install Whole House Vacuum System
3 IAQ/Health pts
y=yes
N. Flooring
1. Select FSC Certified Wood Flooring
B Resource pts
y=yes
[2. Use Rapidty Renewable Flooring Materials .
4 Resource pts
y=yes
3. Use Recycled Content Ceramic Tiles
4 Resource pts
y=yes
4. Install Natural Linoleum in Place of Vinyl
5 IAQ/Health pts
y=yes
5. Use Exposed Concrete as Finished Floor
4 Resource pts
y=yes
6. Install Recycled Content Carpet with Low VOCs
4 Resource pts
y=yes
Total Points Available:
Total Points Project Received:
•
1401 1301 57
01 01 01 •
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0