08030134 CITY OF CUPERTINO x �* 7kkrgc. =s•rAY.;:i T "t -y7�,�♦r�•� ^
BUILDING-DIVISION. PERMIT yot,.!J,' ryC°1Q�A, � kY+lyt r
B 'TfflflTd3aOLLYMAN LN VALLEY HEATING & COOLING - P080S0134
OVER'S NAME: PERhffI65UEDATE
LOVE JOHN N ET AL 1171 N 4 TH ST 03/24/2008
PHONE: - SANITARY NO. CONTROL NO.
(408) 294-6290
ARCHr1ECTfENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
-ore LICENSED CONTRACTOR'S DECLARATION Job Description
1 hnoby affirm Thu 1 w Remand under Preview of Chapter 9(commencing
w+th Sectio 7tlfkl)oroividon5aruw eutiwWProresewns coda, ime�ie REPLACE FURNACE
in mf fume and erten. _ v
i g 3 Liaenm CI Lm,g
c
Dam Co..
5 ARCHITECTS DECLARATION
i
1 wWerwnd mY Plans"Ibe wamN
ed u public Is
y C� Licenced Professional
OW NER-BUILDER DECLARATION
S I hereby affront that I em exempt from the Committees License Law for the
C O o following moon.(Soden 70313,Bualtca and Pmrwalow Code;Any city or tens..
9 which mqulru a permit to construct.alter.hnpmve.demolish,w repair any stsumme
Y lar to its iteu ea.arm requires the for each permit le(ile,signed�<
that he is licensed purmant to der Provisions of the Convector's Liccwe Law(Clupter9 Sq.Ft. Floor Area $5002 Valuation
9 (eommencingw,h Secdon7OOMof Div on3ofthe Businmand Profession,Cnde)Or
.. dot M u exempt dersefmm and the ham,for the alleged exemption.Any vinladon of
Zpr
Section 7071.5 by any applicant fa•permit subjects the applicant W a civil penalty ofNumber Occupancy
at mom than five hundred dollan(550d). 35922054 Penc Y Type
❑I,uvwner of llie pmParrY,amy wplaym widu mgnu duetr tele camptwUon,
wiR do the work,and Ute rtmn.isnot intended w offered rorsale(Sec.70e6,Buairtm
and Pmfaaiom Cada:The Omm mum's Lac.Law dean net apply M an awns or Required Inspections
property Who Wilds aimpmMJ thamM.md Whadaaf ellcll weak hintalfml6magh his
own employees,Provided that such imprwemenY sm not intend W eroRetN oasis If•
h ldcs .thebttildile proving
told within one Searwamovefordrownu-
builda will how the burden of proving Nat Ito did not NtiW a Improve(w purpose of
ateJ.
0 1.u owner of not property.am exeAwively contracting with licensed contractors to
ammuet the project(Sec.7064.Business and Pmfeaaions Code)That Concent,U
mere Law does art apply W an owner of property who builds or improve Ihemen,and.
who contacts for such projects with a comvamr(O lknmsed pm use,to the Camuctots
L P-ns law.
❑late cocmpt under Sea ,B&P C fes this moon
Dam
WORKER'S COMPENSATION DECLARATION
1 homey,fano under penalty of perjury can of the following aecisatimW
u pm atM will maintain•Certificate of Consent to self-swum for WorkefsCarmpetrN -
a , mvidcd far by Secden 3700 of der labor Code,far the parformmon ter the
work for which this permit is issued.
0 I hue and will amount Workefs Compensadan Insurance,as required by Section
370D of the Latter Code.fes duo pufomreca of the work for which this permit is Wood. '
My Worket ompama6o Insurance carrier and Policy T see:
t
Carttee Polley No.;
Licit?Fl OF ON FROM
WORKERS'
COMPENSATION
INSURANCE
(TMs action Iced rot Im cernptewd lithe permit is fwone hundred drums(SI00)
or lass)
1 cenify that In the performance of the work for which this Permit is issued.I shall am
emplay my petonn in my manner.u m become subject to doe Wukers'Compenutim,
laws of California.Date
Applicant
NOTICE TO APPLICAND IL not making this CeniBcate of Exemption,you slwuld
become subject to the Worker's Compensation Provisions of the talar Code,you most
.,z foMwilh comply with such provisions or this permit Nall he damcd revoked.
z'O CONSTRUCTION LENDING AGENCY
[—t Ibeem,mirm ter them isa..do.lending agency for duo perfmmuce or
C> the some far which ads Permit is mad(San.3097.Civ.C.)
Landoes Name
r7 z Lander's Address
U Q 1 certify Nat 1 have mN this application arta saw that the above information u
V.t cotmrt 1 alta to comply with W city and county ordinances and atste laws totting W
_Q building construction,and hereby mNorim representatives of this city W enter uPrm tic
LLl +hove-mmdaxd property for impaction purports.
�" gy
(Wo)alta to ave,indemnify ad kap harmless the City of Cupertino against
V7 liabilities,judgments.costs and repenter which may in my my memo agalwt said City
in
APPL CANT UNDERSTANDS AIN WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCE REGULATIONS.
Re-roofs
Signuum ter ApplimntiCrnuutor Dow
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or fuium building accepted nese or NNIe haalloss motorist
dellnod by tie Cupenitm Municipal Code.Chapter 9.11.and do Health and Safety
Student 155314)7
❑Yan ❑No All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or devkes which If a roof is installed without first obtaining an inspection,,I agree to remove
omlt harardow air contaminants a defined by the Bay Arco Air Quality Management all new materials for inspection.
District?
Oyer ONO
I have mal alto Industrious materials Iequiremmuund rCNpor6.95Ofthe Colder.
nice Health&SafctyCow,Sadow25505,25533uw25534.I.&w dthcifdc Wilding
docs at currently hew a wnane Ibat it is my responsibility to netitj do oceupant of the
requirements whi tome to iaemce ofa Certircew araeupmry. Signature of Applicant Date
Owmor s , ori N.&aik Dam All roof coverings to be Class'"or better
• CITY OF CUPERTINO
6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35922054 .00
DATE ISSUED. . . . . . . : 03/24/2008
RECEIPT #. . . . . . . . . : BS000004245
REFERENCE ID # . . . : 08030134
SITE ADDRESS . . . . . : 20885 JOLLYMAN LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LOVE JOHN N ET AL
ADDRESS . . . . . . . . . . : 20885 JOLLYMAN LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4315
RECEIVED FROM VALLEY HEATING & CO
CONTRACTOR . . . . . . . : ATKINSON, THOMAS LIC # 141
COMPANY VALLEY HEATING & COOLING
ADDRESS . . . . . . . . . . : 1171. N 4 TH ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
• TELEPHONE . . . . . . . . : (408) 294-6290
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- -- -- ---------- ---------- ---------- ---------- ---
1BSEISMICR VALUATION 5, 002 . 00 0 . 60 0. 00 0. 60 0. 00
1EPERMITFE FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
1MPERMITFE FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
IMRRAA UNITS 1. 00 61 .19 0. 00 61. 19 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 224 .95 0. 00 224 . 95 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK ---------224_95 #173-63 q
TOTAL RECEIPT 224 . 95 I
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- ------ ----------------------------
505 FINAL ELECTRICAL - _r--507 FINAL PLUMBING
508 FINAL MECHANICAL
•
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
• CITY OF CUPERTINO
PERMIT INVOICE OPERATOR: patg
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35922054 . 00
INVOICE DATE. . . . . . : 03/24/2008 _
REFERENCE ID # . . . : 08030134
SITE ADDRESS . . . . . . : 20885 JOLLYMAN LN
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : LOVE JOHN N ET AL
ADDRESS . . . . . . . . . . : 20885 JOLLYMAN LN
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4315
CONTRACTOR . . . . . . . : ATKINSON, THOMAS LIC # 141
COMPANY . . . . . . . . . . : VALLEY HEATING & COOLING
ADDRESS . . . . . . . . . . : 1171 N 4 TH ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE . . . . . . . . : (408) 294-6290
• FEE DESCRIPTIONDUE FOR AMOUNT DUE PAID BALANCE
---------- ------------ - --------- ---------- ---------- ----------
SEISMIC RESIDENTIAL PRINTING PERMIT 0 . 60 0. 00 0. 60
ELEC PERMIT ISSUANCE PRINTING PERMIT 40 .79 0.100 40 .79
MECH PERMIT ISSUANCE PRINTING PERMIT 40 .79 0. 00 40.79
RES MECH REPAIR/ALT/ADD PRINTING PERMIT 61 .19 0. 00 61 .19
PLUMBNG PERMIT ISSUE PRINTING PERMIT 40 .79 0. 00 40.79
TRAVEL & DOCUMENTATION FEE , PRINTING PERMIT 40 .79 0. 00 40.79
---------- ---------- ----------
224 .95 0. 00 224.95
VOICE ID DESCRIPTION. VOICE ID DESCRIPTION
-------- ---------------------------- -------- ------------------ ----
505 FINAL 'ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
•
-� OX03 013 �
CITY OF CUPERTINO
FURNACE/AC
® CUPEkTiNO PERMIT APPLICATION FORM
APN# o5-LI, o U Date: '3
Building Address: /
Owner's Name: Phone #:
LdV 2 4N -c2-5-a? — /
Contractor: �yJ Phone#:
V6eG// i Fax #: -70 E5c2547
Contractol License#: Cupertino Business License#:
as-8
Contact: Phone#: L`p�� etc, 6a5D
Orl e5- Fax#: Rol
Building Permit Info:
Elect ❑ Plumb ❑ Mech
Residential Commercial
Job Description:
1` G.Fie_
For Residenti Installations:
Attic ❑ 1" floor 2nd floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Cost of Project: Type of Construction (Usage Class):
Soft a
Strapped ❑ On Platform ❑ Bonded New Location ❑ Replacement
® Valuation:
Green Building: Must attach Green Building Check list to this application
Ya. t„ CITY OF CUPERTINO
FURNACE/AC
• CUPERITY TINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
_ Group _
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by this
code.
1MCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
• absorption,or evaporative cooling sys,
incl install of controls regulated by
this code.
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,rec.essed wall htr, or
floor mounted unit heater.
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1MCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed &riot incl in an appliance
permit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
% cooling unit,absorption unit,or ea
heating,cooling,ab sorption or
evaporative cooling system,incl
installation of controls regulated by
• this code.
1MRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1MRAPPVNT Residential for the install/relocate/or M
replacement of ea appliance vent
install & not incl in an appl permit.
CITY OF CUPERTINO
C FURNACE/AC
I
CUPERTiNO FEE SCHEDULE
Quantity Fee ED Fee Description Fee Permit Type
Group
FURNACE FURN/AC
IPGASRES yResideu ial-for ea—gas system of- P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
113SEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst <=100k BTU install or M
relocate ea forced-air/gravity type
• furnace/burner, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance over
100,000 Btu/h
1EPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
IPPERMITF.EE Plumbing Permit P
/ 1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
CITY OF CUPERTINO
FURNACE/AC
CUPEkT`iNO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units<= lOk CFM B
1MCRAA Commercial Mech Repair/alt/add M
1BSEISMICO Seismic Commercial B
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
1BREIVIA.II2HAN Residential A/C units <= 10k CFM B
• 1MRRAA Residential Mech Repair/alt/add M
1BSEISMICR Seismic Residential B
IEPERMITFEE Electric Permit E
1MPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
3-Zc<
g$ o
U �
• /.U&e Solid Well Systems(Includes SIP&,ICF&,6 Any Non-Stick Frame Assembly) —
❑ aFloom 0 2 2 i
❑ b.Walls 0 2 2
❑ c.Root D+ 2—
5.Reduce Pollution Entering the Home from the Garage
❑ e.Tightly Seel the Air Barrer between Garage and Living Area I
V9.
h.lnmall Gere a Exhaust Fen OR Bulltl a Detached Gara s 0Desi n Energy Ase s on Trusses(75%of Attic Insulation Hel ht at Outside Edge of Exterior Wall 0Del n Roof Trusses Accommodate,tAccommodate,Ducbeork - DUse Recycled-Content Steel Smds for Bu%of interior Well FremtngDThermal Macs Wells:full Drywall on All Interior Walls or Wells Weighing more than 401h1cu.lt 0 1
10.Install Overhangs and Gutters
{-] -
aMinimum 16-Inch Duerhangs and Guttarc - - - - -- - - - -- ---- -- 0 -_-_— - - 1 __
❑ b.Minimum 24-Inch Overhangs and Gumars 0 1
Total Pool Available in StrucNrzl Building Frame and Envelope 361 0
E.EXTERIOR FINISH Points Available Per Measure
1.Use Recycled-Conten(No Virgin Plastic)or FSC.CaNfied Wood Decking 0
2 Install a Rein Screen Wall System 0 2
].Use Durable and Noneombustlble Siding Marshals 0 1
77 /.Sdect Durable and Noncombustible coaling Materials 0 i - 2 ;
Total Palo Avallace In Extoor Finish 71 0
F.INSULATION Points Available Per Maasura
1.Install Insulation with 75%Recycled Content
❑ a.Walls anrllor Floors 0 1
1—I---
2.Install Insulation that is Low-Emhdng(Certified Section 0135D) -
❑ L Walls endlor Floors 0
❑ b.Callnos 0 I
].In&Pen Ouallty of lnsuldion Installation before Applying Drywall - 0 1
Toral Points Available In Insulation=51 0
G.PLUMBING Points Avallable Per Measure
1.Distribute Domestic Hot Water Efficiently(Maximum 7 Pointe). 1
❑ a Inas is Hod Water Picas from Water Hadar to Khchan 0
• ❑ b.InsulateAll Het Wale Pipes 0
E) UEn � 1
c.Use Engineered Parallel Piping 0 I 1 I 1
❑ d.Use Engineered Radial Piping with Demand Connoted Circulation Loop 0 _ 1
❑ e.Use Structured Plumbing with Demand Controlled Circulation Loop .0. _ 1
❑
I.Use Centre]Core Plumbing 0 1 r 1 2
❑ 2.Install Only High Efficiency Toilets(Dua4Flush at s128 gpo 0 1 4
Toad Pat=Available in Plumbing Total 12 0 _
H:HEATING VENTILATION&AIR CONDITIONING Points Available Per Measure
1.Design and Insall HVAC System to ACCA Manual J,D.and 5 Recommendations _ q
L Install Sealed Combustion Wits
[� LFurranes 2
❑ b.Water Heaters r 0 U U 1 2 1 I
],Install Zoned,Hydronlc Radiant Heating with Slab Edge Insulation
4.Install High EKclancy Air Conditioning with Environmentally Responsible Rshigeronts - -1
S.Design and Install Effective Ductwork '
❑
A.Install HVAC Unh and Ductwork within CondbDned Space 3 1 _
❑ b.Use Dun Made on All Durk Jaime and Seams " IF 1
❑ c.Install Du-WA under Attic insulation(Buried Ducts) 0 i
❑ J.Pressure Belaroe the Ductwork System __ 1
❑ e.Pmisn Ducts during Commotion antl Clean All Ducts b9lDre Occupancy 1
B.Insta11 High Efficiency HVAC Filter(MERV 6t) 01-
7.
1-7.Don't Install Fireplace or Install Seated Gas Fireplaces with Efficiency Rating Not Less Than 6D%
using CSA Standards —
e.Install Effective Exhaust Systems in Bathrooms and gtchana
❑
a.metal ENERGY STAR Bathroom Fans Vented to the Outside —
❑ b,All Bathroom Fans Are on Tuoar or Humidistat
❑ c.Instal Kitchen Range Hood Vented to the Oursida � D
9.Install Mechanical Ventilation System for Cooling(Maximum 4 Points) .
❑ a Install ENERGY STAR Ceiling Fans 6 Ught Kits in Living Areas 6 Bedrooms 0 1
❑ b._Install Whole House Fan with Variable Speeds t0'o _ i ! _
❑
C.AUMmadcelly Controlled Integrated System 0 7
❑ d.Automatically Controlled Integrated System with Variable Speed Control 3
10.Install Mechanical Fresh Air Ventilation System(Maximum 3 Points)
• ❑ a Any Whole House VBntlafim System That Masts ASHRAE 622 A 0 _I_2
❑ D.
Intel AIr-to-Al Ham Exchanger that maeb ASHRAE 622 0 1 r 2 I
71.Install Carbon(doncxide Alarm(s) 0 1
Total Points Available in Heating,Ventilation and Air Conditioning=301 0 1
02007 Bulld 11 Green Single Famlly GromPoint Chacklisl 2007 Version Page 2 of 4
i Q E u S
• - ❑ _Enter eescllplKYlham.and enter points wallaleeierme05un,lntggmpn'9ts C01B8d1ee01ha llpnl..___-_._______.__._______..__..- D _p_ _AEnter description here and anter pons$evallaGe ter maavura In propnae can es to the d ht. 0 D�_.._ fEnlerdad ionhire endanlerpoinmp_aR ce�onesfithergL _ _❑ Enterdescripfionhere and enter points avallable fw measure In appmpnap Lelegones mlhe rightI D 0
4.Innovation:List Innovative measures that meet the green building objectives of the Guidelines.Enter up to a IBulld n Green Checklists and
maximum combined total of 20 ots.See Innovation Checklist for suggested measures,using the link to the right Guidelines!
Innwatlon in Community:Enter desorition here,and enter oinis available for measure in rodate caleories to me right 0 0 O D 0JD
Innwdionin Ene y;Emyr desui tion hare,end enter points available fa measure in priah ctepores to then L 0D ___ 0DInnevalion In IAOIHeenh:Enter des^' 'on here,antl enter 'ms waflaNe,to measure in L tt 'as Io the right 0 0 _ 0 D 0LJ Innwatlon in Pevources:Enter delividfon here,antl enter ims a ell fm measure in cgrlate catapones Io the d ht D 0 � 0D 0Innwefion In Wetec Enter description here,antl enter points evetiable io measure In appropriate Letapmies to the right 0 0 o D o
Total AvallablePNnts in Other_43 D
Total Available Points in Specific Categories' 4+ 96+ 42+ 66+ 43+
Minimum Points Required in Specific Categories 0 30 5 6 9
t s e e e c
Project hes not yet met the following recommended minimum requirements:
-Total Project Score of At Least 50 Points
-Required measures:
-A33:50% INaste diver5ioin by weight
-'�1.5?5-dbpv2 Title-Z4 _.
-NI:Incorporate GreenPoint Rated Checklist into blueprints
-minimom points in specific canegones:
-Energy(30 points)
-IAQ/Haalch(5 Points)
-Resources(6 points)
-Water(9 points)
•
020J7 Build It Green Single Family GreanPolnt Checkfs12007 Version Pap=_4 of 4
Community Development
� t 10300 Torre Avenue
xf' Cupertino CA 95014
Telephone(408)777-3228
O PCITY OF
EkTINO Fax(408)777-3333
IJfC 1 '�1
Building Department
JOB ADDRESS: PERMIT #
0016 3a<2 y
OWNER'S NAME: j ko PHONE # c
GENERAL CONTRACTOR: Ce a FAX #
I am not using any subcontractors: �dl�
Signature Date
Please check applicable subcontractors and complete the following information:
60 SUBCONTRACTOR BUSINESS NAME BUSINESS LICENSE #
Cabinets &Millwork
Cement Finishing
Electrical
Excavation
Fencing
Flooring: Carpeting
iLinoleum / Wood
Glass / Glazing
Heating
Insulation
Landscaping
Lathing
Masonry
Ornamental Sheet Metal
Painting/ Wallpaper
Paving
Plastering
Plumbing
Roofing
Septic Tank
Sheet Metal
Sheet Rock
• Tile
.1,1��OlvnerlContractor Signature Date