08040149 BUIL13INC DOISION PERNHT A'+ �C°/�_��7 •"^ `� •«
PERMIT NO.
BUILDIyfaAPnR ANSDALE AVE PLUMBERS ON CALL 08040149
t,w,c
EERSS.NSAbMtE: L PERMITISTIEDATE
BONVOULOIR A E ET AL 520 E MCGLINCY LN #12 04/21/2008
NE SANITARY NO. CONTROL NO.
(408) 879-0483
HRECT/ENGINEER: BUIIDINGPERMITI FOBLDG MECN
LICENSED CONTRACWR'S DECLARATION IOb Descrl tion
w1 Eamby&farm Nu I ata 1k mscd under pmvim u of Chapter 9(Commercial PwSection7gn0ofDivlsionIndian Budnavand ProfeuionsCods,and mylicenmta REPLC FRSH WTR PIPES FM MAIN INTO HOUSE
n< in full fame end affacc Tal G 7 G
i Licmm Clm e 3, Lie.0 9
Dam connector Araa,...Ae.lJ O�
{a�a+'C3y ARCHf1ECrS DECLARATION
1 understand my plans shall W used as public reCoNs
J
t w� Licensed Profmional
y OWNER-BUILDER DECLARATION
f 1 botchy strip,that 1 am exempt from the Contractor,License Law for the
l.OO fallowing can.(Section 7x71.5.Business and Professions Code:Any city or County
12
P which mqulm a Permit to cnwlrvct,slot.Improve.demolish.Or repair any atrecture
Prior m its Wallace.also mqulra the applicant for each Permit m file a signed statement
dist be is lmenmd purawnt in de,provisions of the Calorimeter's U..Law(chapter 9 Sq.Ft.Floor Area $8600 Valuation
B (cammcradng with Sad.7000)of Divan.3 of the Busmen and Pmfeoons carie)or
this he as mompl Nereftmn and the Was fm the alleged wereptiom At,violation of
Sell HW l.5 by 9"ap thant Tar a permit mbjam the applimin m a civil Fealty ofNumber Occupancy Type
Cot mon man five handled dolers(SSW). 36912008 ,fit '
Laowrca.the prs strucum is 1mounedwithwater uNetrm.mnpuuow,
will dr thewah.andthe he Can ewteenarom La dosised side(Sm.0 an Budrw Required Inspections
propand Pmfeoov Calc He CwumeM1 and
who law does er apply m an&war of q P
own
nem who s,ata aiddpovea thereon,andwWdaaamt.worthimmiraruwnle ref.
awnver.meWiprovidedthat tech Impvvemwuartwtiearof mkd0n.fa ash:x,
builder.Neave Our errimpmvemmnbmid matin cam year ofImrove for Intrinsic the will have Na WAan of proving that k did Out hold m Improve far PuNae a(
ane.).
❑1,as mmer of the Property,me exclusively ContMing with tiervrd Conrmtas to
common the project(Sec.Hasa.Budnm and Pvfeadaw Cade:)The Committees Ll-
cave law does not apply in an owner of property who Milds or improves thereon.and,
who contracts for such pmjecu wish aawtrmmr(O licensed pursuant m due committees
Leensa Law.
❑1 am exempt under Sec .B a P C far this meson
Ownv Dam
WORKER'S COMPENSATION DECLARATION
1 hereby a111m under pevllY of perjury ave of de following declamations: E^�\
El I nam utadde maria echo.=of his[lo o aelf-bnme fa Workers Comp em
soon,r provldad for mi Section 3HW of the labs Code,fm she per(omaner of the W
01 for whoa ill permitishued.
❑I neve and will mainWn Wakeh mmum ar Non Insurame,a acquired by Scow
77W ofdulabm Cadefa thepemesclnCoof thewvrk farnmr a ; permit isl -7
My Worker,Cnmpcwoon Inturaner nrtin and Polar number are: ((
Cartier. SYg CERTIFICATE
E e 1 bs.o� Palley NO GZre 3/ G�
CERfIFl COMPENSATION
OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCTs
rlbas sttUw mad Out W cmnplavA if the omit as famse hundred donsrs(g1 W)
orleu)
1 certify tint in the perfomancs of the wort fa which this permit is lamed.l shall wt
employ any person in my mmwrm as m barnma mbjatm the WOM1rn'Canpensadou
Taws of Califamia.Data
Applicant ..
NOTICE TO APPLICANT.If.after making this Cordilleras of Exemption,you shouse
become subject in the Wallace,Compensation provisions of the labor Code,you mons
,J O faMwith cam",'ung
W such provision a this permit shall W deemed mainland.
CONSTRUCTION LENDING AGENCY
[r I Mashy anion Nat Nem is construction moint agency fa the Performance,at
lYi> the wort for which this perch as issued(Sce.3097,Civ.C.)
W�Q Loaders None
7 z Lender,Adduces
C)Q I cenify that 1 have read this application and sue that the abinfmo
ove mun ir
[L coonco.1 gra m Comply with all city and county ardinavxs and sue laws misting to
Q Wilding construction,and hereby aushorim repmrwtadves of this city to enol upon the
W aWve-mmuoned properly for inspection Oriental.
(We)agree to save,indemnify and keep hamesa the City of Calendar,against
C,) liabilities,judgments,eau and expenses which may In my my amue against aid City
U Z in con¢queme of the trundni of this pemil.
APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date �'L(
SO URFREGULATTONS. �s i y_Z Jb
��/[-Q� ��� Re-roofs
Signasurt OfAppoicantiContractuour Data
HAZARDOUS Type of Roof
WlxdeaCupertafuture leaf Cgaaupapteroma haMkn width material
a dennod by ate Cupertino Municdpal code.Chapter 9.11.and the HNth and Solani
Cade,section 25532(&)7 All roofs shall be inspected prior to any roofing material eing installed.
❑Ya
Will the applicant or future Wilding Occupant use equipment err @vim which If a roof is installed without first obtaining an inspection,I agree to remove
It haralloa air conumivnu u&flmd by the Bay Area Air Quality Management all new materials for inspection.
District? 'A
❑Ya ANu
I hers mad tie handoa m=6&ls mquimmenu under Chapmr6.95 of theCalifor-
niaHcahhasefciyCocSe dov255D5.25533an025534.IundcmwWdmifthe Wilding
dace not currently haw a main.this it as my responsibility b ratify the occupant of the
maul nu whichmtvbeme armivamweancrninerasaraCopSignature of Applicant Date
Y��— �-�"��' &K— . All roof coverings to be Class'%q"or better
Owner or mthorirsd agent Dom
CITY OF CUPERTINO
• 5 ITEMS OF 5 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 36912008. 00
DATE ISSUED. . . . . . . : 04/21/2008
RECEIPT #. . . . . . . . . : BS000004540
REFERENCE ID # . . . : 08040149
SITE ADDRESS . . . . . : 10368 LANSDALE AVE
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : BONVOULOIR A E ET AL
ADDRESS . . . . . . . . . . : 10368 LANSDALE AVE
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014
RECEIVED FROM . . . . : PLUMBERS ON CALL
CONTRACTOR . . . . . . . : ROBIE DOBKINS LIC # 27158
COMPANY . . . . . . . . . . : PLUMBERS ON CALL
ADDRESS . . . . . . . . . . : 520 E MCGLINCY LN #12
CITY/STATE/ZIP . . . : CAMPBELL, CA 95008
TELEPHONE . . . . . . . . : (408) 879-0483
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
IBPWATER UNIT 1. 00 40.79 0. 00 40 .79 0. 00
1BSEISMICR VALUATION 8, 600. 00 0.90 0. 00 0 .90 0. 00
1PLMBLNCK HOUR 1 . 00 122 . 38 0. 00 122 .38 0. 00
1PRREPIPE NO OF FIXTURE 3 . 00 30. 60 0. 00 30.60 0. 00
1TRAVD0C FLAT RATE 1. 00 40 .79 0. 00 40.79 0. 00
---------- ---------- ---------- ----------
TOTAL PERMIT 235 .46 0. 00 235 .46 0. 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 235.46 #0798
--------------- . . ..,
TOTAL RECEIPT 235 . 46
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- -------------------- -- -------- -------------- ---
301 ROUGH PLUMBING 507 FINAL PLUMBING
- - Community Development
10300 Torre Avenue
1 , Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408) 777-3333
WUPEkTINO
Building De artment
JOB ADDRESS: PERMIT# ( �/
OWNER'S NAME: ,¢/ `r 1•o 10 PHONE
GENERAL CONTRACTOR: 2s �,�, cq FAX #
I am not using any subcontractors: �e— Z/—0 8—
Signature Date
Please check applicable subcontractors and complete the following information:
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
2-
Owner/Contractor Signature Date
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
s'
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 POINTS1 40 points
CY
F �(OW-
00 u
APR 112008
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.
INPUT ReSDUIMS Energy IAO[Heahh
ite
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 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 Stonnwater Practices 2 Resource pts y--yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
8.Design Resou ce•Effcient 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 Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes 0
1 1 1
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=yesF 0
1 1 1
C.Structural Frame
1.Substitute Solid Sewn Lumber willi Ergineered Lumber 3 Resource pts y=yes 0
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 Woad IJoists 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 FingeWointed 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 0
11.Use Reclaimed Lumber for Non Structural Applications 3 Resource pts ,y=yes 0
12.Use OSB ------ --—
a.Subfloors 1 Resource pt y=yes 0
• b.Sheathing 1 Resource pt y=yes 0
1 1
xler or n s
1.Use Sustainable Decking Materials
a.Recycled content 3 Resource pts y--yes 0 A
b.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAO/Health pt y=yes 0
3.Install House Wrap under Siding 1 IAO/Health pt y=yes 0
4,Use Fiber-Cement Siding Matedals 1 Resource pt y=yes 0
1 1 1
dumbing
1.Install Water Heater Jacket 1 Energy pt y--yes 0
2.Insulate Hot and Cold Water Pipes 2 Energy pts y--yes 0
3.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. 0
4.Replace Toilest with Ultra-Low Flush Toilets
(i point each,up to 3 points) Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAO/Health pt y=yes 0
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 IAO/Health pts. 0
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
r.erecmcai 1
i.Install Compact Fluorescent Light Bulbs(CFLs)
(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
I 1 1
G.Appliances
1.Install Energy Star Dishwasher 1 Energy pt Y--yes 0
2.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
3.Install Recycled-Content,Fiberglass Insulation with
No Added Formaldehyde 3 IAO/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 pis y=yes 0
b.Ceilings 4 Resource pis y=yes 0
6.Alternative Insulation Products(Cotton,spray-foam) •
a.Walls 4 Resource pts y--yes 0
o.t;eilings 4 Resource pts y=yes 0
1 1 1
In oW3
1.Install Energy-Efficient Windows
• a.Double-Paned { 1 Energy of y=yes 0
b.Low-Emissivity(Low-E) j 2 Energy pts y=yes 0
c.Low.Conductivity Frames 2 Energy pts y=yes 0
2.Install Low Heat Transmission Glaz ng 1 Energy pt Y=Y es 0
1 1 1
J.Heating Ventilation and Air Conditioning
1.Use Duct Mastic on All Duct Joints - j 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 IAQ/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAQ/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts =yes7 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
8.Install Sealed Combustion Units
a.Furnaces 31AQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/Health pts y=yes 0
9.Replace Wall-Mounted Electric and Gas Heaters with
Through-the-Wall Heal 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 stovesfinseris 1 IAQ/Health pt y=yes 0
It. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes
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
Lo 1
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 pis y=yes 0
3.Pre-Wire for Future Photovoltaic(PV)Installation 4 Energy pis y=yes 0
4.Install Photovoltaic(PV)System
(1.2 kw=6 points,2.4 kw=12 points,3.6 kw=18 Points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials __`� 1 Resource pi y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes 0
1 1 I
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pis . y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes 0
1 1 1
INPUT Rescoices Energy 1ADIHealth
. n oor Ir ua y an n s es
1.Use Low/ND-VOC Paint 1 IAQ/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 S
3.Use Low/No VOC Adhesives 3 IAO/Health pts y=yes 0
4.Use Salvaged Materials for Interior Finishes 3 Resource pts 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 IAQ/Health pts y--yes 0
7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y--yes 0
8.Use FSC Certified Materials for Interior Finish 4 Resource pts y=yes 0
9.Use Finger-Jointed or Recycled-Content Trim 1 Resource pts y=yes 0
10.Install Whole House Vacuum System 31AQ/Health pts y--yes 0
1 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 8 Resource pts y=yes 0
2.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 pts 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 I 1
Total Points Avail able: 1 1401 1301 57
Total Points Project Received: -6L- 1 01 01 01
e:daWprogsrgreenbuildnggt idelines/remodeiersJgreenpalntsfinel2.12.04prdeded.cls
•
CITY OF CUPERTINO
REPIPE/SEWERMAIN SERVICE
CUPEkTINO PERMIT APPLICATION FORM
APN # �` ,nl Date:
Building Address: U v
1030' I-A- d41e ,4ve.
Owner's Name: Phone C,0 2—S -z
A1600 j Vo c% &:ez
Contractor: Phone#: �(o fr �� _ p y p.3
/14 r.. �iKS Gh C4lI Fax #:
Contact: Phone#:
Fax#:
Contractor License#:
Cupertino Business License#:
Job Description: /2�4 <e F',td� c �gd e2 P,�rs 7 ,
ih;�& LrmtiIre.
Residential 4E] Commercial 0
Valuation: eiK O O
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.
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
IPGASCOM Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial P
• 1BSEISMICR Seismic Residential P
1PRSEWER Residential building P 1RPSS
sewer/sanitary sewer
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPEkTiNO FEE SCHEDULE •
Quantity Fee ID Fee Description Fee Permit Type
Grou
1PRREPIPE Residential re-pipe per fixture P 1RPRP
1BPWSVCS Water Service P 1CPWS or
1RPWS
1 PPRSEWG Private Sewage Disposal System P
IPCESS Cesspool P
1 BPWATER Install/alter Water Pipe P
1BPFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1 BPGAS Gas Piping System 5+ Outlets P
1 PPERMITFEE Plumbing Permit Fee Issuance P
/ 1 PLMBLNCK Plumbing Plan Check P
1 PLMBINSP Other Plumbing/gas Insp. P
1TRAVDOC Travel & Documentation Fee B
1BUSLIC Business License B
•