08090006 CITY OF CUPERTINOa: `r '�a'
EUILDIN'G DIVISION PERMIT COINTRACTIORINIaORMAT,ON$&° -
BUILDING!. RFslS:
PERMIT NO.
iAURETTA DR GREAT AMERICAN PLUMBING CO 08090006
( !.
OWNER'S NAME: iNc PERMITISSUEDATE
SUEIi CHUN I AND LI Y P 0 BOX 26942 09/03/2008
vE: (408) 279-1515 SANITARY NO. CONTROL NO.
ARCHrfECTIENGINEER: BUILDING PERMIT INFO
BLDG ELECT PLUMB MECH
oo LICENSEDn ImmadCmR'SDECLARATION
U 1Wrtby(IlionNall 3IkeucdundoprovisiauofsCoft. 9(commencing Job Description
wish Satun]OIKI)ofDidnon 3ofshc Budneu and Pro(csdulu Code.and myliuuCou INSTL PROP LINE CLEAN—OUT
N full farce and e(LFL U/a L
DamContractor si•'c
ARCHn ECI-S DECLARATION
1 uMcrsund my plus(hall W used as public meronts
so)n LiLmuued ProfessiarW .
7 3 OWNER-BUILDER DECLARATION
i i E I Wroby affirm Nal i am exempt from Ne Conuanafs Llan¢Law far ac
COO following mann.(Section 7131.5.Business and predications Code:Any city or county
5 S V which rtquirea a permit to construct.alar,improva.&mulish.or mpmir any uroetum
_Z pnor m is issuance.elm,requims the applieam for such permit to Fitts signed sooduncnl
E O dust heisliccaculrad antmNepmvitlarsofdmConuacmr'sllcenColaw(chaplm9 Sq.Ft.Floor Area Valuation
x $ (commencing with Section 7000)of Division 3 of Ian Business and Profeaiaa Cade)or $1950
must W is exempt Wool.and the basis for the alleged cmmptiod.Any violation of
Station 1031.5 by any applima for a permit subjects Nc applicant to a civil penalty of Number Occupancy
ml mora Than Bm modmd dollars(5500). 32655017 .'V l7' P Y Type
0 Luownaof Nepmpmy.mmy=ploy=a Lr" agassNebmle oro =dm.
will do Newark.an(o:Tim Conte mt s Liao a,Law da ranssm(Sec.7o W,mnu os
and Prty,wh ou cane:The cantmcmr, ndwho law dant ant apply rf rt awns of Required Inspections
carsamplaye WildaorimpravuthimprovrswW Canon wank Mmselrorawu[h his
Owd cmpbyebuipmgor i that swan im Ismid wan aR not ear d c aOBerW for nle n,,
however.the Wilding ur imProproving
wiamr am Far Nc prove for
the adma of
builder will love Ik burdCo of proNng Nal K did ant bulb a improve fa PmPose of
sskJ.
❑1.as owner of the property,am exclusively contracting with IlcerseC convactua to -_
mtuoucl the project(Sec.7014.Business and Professlotu Cade:)The Cmtracards U. SAN
IIIIARY
ceriselawdos motapplero an owner of ptoPmy who Wits.improverthis msodt-S
who contracts for such projects with•canmactur(s)Raased purnunt m the Contra tor's
Lict.taw.
❑lam exempt undo See ,B@PC for this rtssoo
Owova Dam
WORKER'S COMPENSATION DECLARATION
1 hereby dram under miWty of perjury as Of the following decimations:
1 ham and will far
Sectors
37mof Ova ab w Colt-inmrtfaWmkchts,ofu-
seda, r which ed(a by Ss usu 3]000f Ne labor Code.fa Ne pcsfasmance of as
wIXl{for which NY pLIm111314uN.
0 1 ban and will maintain WarkcYs Computation Insurance,as uegdmd by Section
3700of am labor Cada,for mc pcd'ormum Of N°work forwhich Nis permit u issued. '
My Workerss Compensadon Issuan�ce1!�carrics and Policy number a�
Caurim /✓°?21s�'p 0r/aiC.. Polley NO.: Q I7
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
(This senior need mtbocmnplomd lithe Funds i,foram handrail Colima(5100)
Car los)
I wtiry that m the pufamanm of IW work for whkh this pandit is issued.l tbdl Out
employ any person in may manner an as to bacomo subject to Ne WorkeKCompenudon
Laws of California.Date
APPUcant
NOTICE To APPLICANT:If.after making this Ceniriom of Esempdon,yma should
WcOam subim m Ne Workers Compca ulon pmvisims a ma Labe Cade you mus
.J,z forthwith comply wish such provis m s a this permit shall W deemed mvokcd.
z O CONSTRUCTION LENDING AGENCY
f•' IWmby Art.dual sham is a cmauactinn landid[a[bn,,far the parmmanm Of
C' dm wank for which this pmmil u Wood(Sec 3097,Civ,C)
MW0 lunches Name
Z Lander"mcbas
U Q i Carols that I have mad this application and sum Nu IW mWva information u
(g, " cdM1ccL 1 atim to comply with sit city and County Ordinances and sure Ian talaung of
.0 rV` Wilding Conmuction.and hemby auNana mprtaenutimaaf Nu city to ester upon Ne
four
ation
a (aoYPes,jacmdnd.cc and"pm.
which may
(Wa) S.m ssm,indemnify and keep humless the City or Cupenino against
ti h Iiabili accugmcns,cnauand ospcnsuraft. may In anynymrncagalat said City
V z in conCogwame e[sanun[a(Nu permit
APPLI UNDO ANDS A�B'M{ILL COMPLY WITH ALL NON-POINT Issued by: Date C�
SOU EGULATI . ( —py�
J Re-roofs
&gnuurt of Appli stat Canuacmr Data
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will Nb appliamm rutun,Wilding.,asnluom ahanam hamm mmamma
as(brad by mac Capenim Municipal Cadc,chapter 9.13,and than Health and Safety
cane.section 25532(.)? -
❑Yu ON. All roofs shall be inspected prior to any roofing material being installed.
wig thea scant of mtum Wilding oceu sunt am If a roof is installed without first obtainingan inspection,I agree to remove
I'd buardm f air eoaumim nu u defined b that Ba Am Aa,QQualit Maoaa maCrE P
tinct] r r r a all new materials for inspection.
OYu ON.
I have mad the hvardar dumnau mquimmcnu undcs Chmpta,635 of Ne Cmlifor.
nia Health@SafctyCodC.Scctiou 25505.25533 and 25531.1 urrdasunC add ifdm Wilding
d.naft,,andy lumsumanl Nu its my re pOnsiaililym mdry ac acupat of me
ratio' cots mnmuvW Ips iuuauKearacutirmamorOfpupappyG Signature ofApplicant Date
Owararmth.mcdmgmt x(75 J3Dam O All roof coverings to be Class'%"or better
CITY OF 'CUPERTINO
,• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: pdtg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 32655017 . 00
DATE ISSUED. . . . . . . : 09/03/2008
RECEIPT # . . . . . . . . . : BS000005970
REFERENCE ID # . . . : 08090006
SITE ADDRESS . . . . . : 21165 LAURETTA DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : HSUEH CHUN I AND LI Y
ADDRESS . . . . . . . . . . : 21165 LAURETTA DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-1662
RECEIVED FROM . . . t THE GREAT AMERICAN
CONTRACTOR CORPORATION LIC # 18061
COMPANY . . . . . . . . . . : GREAT AMERICAN PLUMBING CO INC
ADDRESS P 0 BOX 26942
CITY/STATE/ZIP . . . : SAN JOSE, CA 95159
TELEPHONE . . . . . . . . : (408) 279-1515
• PEE :ED UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ------—-- ---------- ---------- ------ ---------
13SE1,SMICR VALUATION 1, 950 . 00 0 . 50 0 . 00 0 . 50 0 . 00
IPPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 .79 0 . 00
11?RSFIWER UNITS 1 . 00 20 . 40 0 . 00 20 . 40 0 . 00
1TRAVDOC FLAT RATE 1 . 00 40 . 79 0 . 00 40 . 79 0 . 00
---------- ---------- ---------- ----------
`T'OT'AL PERMIT 102 . 48 0 . 00 102 . 48 0 . 00
ME'1'FIOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHICK 102 . 48 #107264
---------------
TOTAL RECEIPT 102 . 48
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ------------------------ :=------ ----------------------------
106 SEWER & WATER 202 UNDERFLOOR PLUMBING
301. ROUGH PLUMBING 400 SEWER/LATERAL
507 FINAL PLUMBING
•
CITY OF CUPERTINO
�d REPIPE/SEWER/MAIN SERVICE
CUPEkTINO PERMIT APPLICATION FORM
APN # Date:
J�,2 6 55 01 -7, v 0 q- 3 -C�
Building Address: 9/ 1
/ 1 <e 5
Owner's Name: C .� �S N Phone#:
Contractor: Phone#: uS
Fax #:
Contact: Phone#:
Fax #:
Contractor License#: S-0 r O
Cupertino Business License #:
Job Description:
esidential Commercial ❑
Valuation: 11%5"V, c d
Project Size: Express Standard Large 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 Buildin Points:
Quantity Fee ID Fee Description Fee Permit Type
Grou
1PCSEWER Commercial building P 1CPSS
sewer/sanitary sewer
1BPREPIPE Commercial're
pipe per fixture P ICPRP
1PGASC0M Commercial Gas Piping System P
1-4 Outlets
1BSEISMICOM Seismic Commercial p
1BSEISMICR Seismic Residential P
1PRSEWER Residential building P IRPSS
/ I sewer/sanitary sewer
17
CITY OF CUPERTINO
F REPIPE/SEWERIMAIN SERVICE
C1 O
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
IPRREPIPE Residential re-pipe per fixture P 1R-PRP
IBPWSVCS Water Service P 1CPWS or
1R-PWS
IPPRSEWG Private Sewage Disposal System 1 P
1PCESS Cesspool P
IBPWATER Install/alter Water Pipe P
IBPFIXTURE Plumbing Fixture P
1PGASRES Residential Gas Piping System P
1-4 Outlets
1BPGAS Gas Piping System 5+ Outlets P
IPPERMITFEE Plumbing Permit Fee Issuance P
r
IPLMBLNCK Plumbing Plan Check P •
1PLMBINSP Other Plumbing/gas Insp. P
/ ITRAVDOC Travel &Documentation Fee B
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 points t
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/S ec. A-3 1 point
P. Other 1. List Green Features on Plans A-1 1 point
TOTAL POINTS 40 points
•
•
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.Site
1 17 Recycle Job Site Construction&Demolition Waste
65%=1 point;75%= 2 points;60%=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 Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
A 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 Irrigation Systems 2 Resource pts y=yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y=yes p
1 I 1
B.Foundation
1.Incorporate Recycled Flyash in Concrete
• 25%Recycled Flyash=2 points;Add 1 point for every 1001'
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=yesl;;;F p
1 1
C.Structural Frame I
1.Substitute 961'Id Sawn Lumber with Engineered 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 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 p
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
c.Roof 3 Energy pts y=yes 0
3 Energy pts y=yes p
10.Apply Advanced Framing Techniques 4 Resource pts y=yas 0
11.Use Reclaimed Lumbar 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=yesr mill,
p
• 1 Oil 1
INPUT ResDurres Energy 1ADIfieafth
D.Exterior Fmish
1.Use Sustainable Decking Materials -
a.Recycled content 3 Resource pts y=yes 0 •
b.FSC Certified Wood 3 Resource pts y=yes 0
2.Use Treated Wood That Does Not Contain Chromium/Arsenic 1 IAQ/Health pt y--yes 0
;3.Install House Wrap under Siding 1 IAQ/Health pt y=yes D
14.Use Fiber-Cement Siding Materials 1 Resource of Y--yes 0
1 ! 1
E.Plumbing
1.Install Water Heater Jacket
1 Energy pt Y--yes D
2. Insulate Hot and Cold Water Pipes 2 Energy pts y=yes 0
�3.Retrofit all Faucets and Showerheadswith Flow Reducers
a.Faucets(1 point each,up to 2 points) Up to 2 Resource pts. 0
t
b.Showerheads(1 point each,up to 2 points) Up to 2 Resource pts. 0
14.Replace Toilest with Ultra-Low Flush Toilets
j(1 point each,up to.3 points) _ Up to 3 Resource pts. 0
5.Install Chlorine Filter on Showerhead 1 IAQ/Health pt y=yes 0
6.Convert Gas to Tankless Water Heater 4 Enercy pts y=yes D
7.Install Water Filtration Units at Faucets
(2 points each,up to 4 points) Up to 4 IAQ/Health pts. 0
B.Install On-Demand Hot Water Circulation Pump 4 Resource pts y=yes 0
1 1 t
r.tiactncar
:1.Install Compact Fluorescent Light Bulbs(CFCs)
(6 bulbs=2 points,10 bulbs=3 points,12 bulbs=4 points) Up to Energy pts. D
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 i
G.Appliances
1.Install Energy StarDishwasher - 1 Energy pt y=yes D
12.Install Washing Machine with Water and Energy
Conservation Features 1 Energy pt y=yes 0
13.Install Energy Star Refrigerator 1 Energy pt y=yes D
J4.Install Built-In Recycling Center 3 Resource pts y=yes 0
_ 1 1 1
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 IAQ/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=yes 0
b.Ceilings 4 Resource pts y=yes 0 •
6.Alternative Insulation Products(Cotton,spray-foam)
a.Walls 4 Resource pts y=yes 0
o.Uenings 4 Resource pts y=yes 0
I.Windows
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y--yes 0
b.Low-Emissivity(Low-E) 2 Energy pts y=yes D
C.Low.Conductivity Frames 2 Energy pts y=yes D
2.Install Low Hsst Transmission Glazing 1 Energy pt y=yes 0
t 1
J.Heating Ventilation and Air Conditioning
1.Uss Duct 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.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 y=yes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y=yes 0
B.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 31AQ/Health pts y=yes
D
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 p
11.Install AC with Non-HCFC Refrigerants 2 Resource pts y=yes D
12.Install 90%Annual Fuel Utilization Efficiency(AFUE)Fumace 2 Energy pts y--yes 0
13.Retrofit Wood Burning Fireplaces
• a.Install EPA certified wood stovesfinserts 1 IAQ/Health pt y=yes p
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes 0
14.Install Zoned, Hydropic 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 IAO/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAO/Health pts y--yes 0
K.Renewable Energy and Roofing 1 1 1
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=1 B points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials _ - 1 Resource pt y=yes p
7.Install Radianfi3srder - 3 Energy pts y=yes Ip
1 1
L.Natural Heating and Cooling 1
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes 0
3.Plant Deciduous Trees on the(Nest and South Sides 3 Energy pts y=yes 0
1 1 1
M.Indoor Au Quality and Finishes '
1.Use Low/Na-VOC Paint 1 IAO/Health pts y=yes 0
2.Use Low VOC,Water-Based Wood Finishes 2 IAQ/Health pts y=yes 0 •
3.Use Low/No VOC Adhesives 3 IAQ/Health pts y=yes 0
4.Use Salvaged Materials for InteriorFinishes 3 Resource pts y=yes 0
5.Use Enoineered Sheet Goods with no added Urea 7
Formaldehyde 61AQ/Health pts y=yes 0
6.Use Exterior Grade Plywood for Interior Uses 1 IAQMealth pts y=yes 0
7.Seal all Exposed Particleboard or MDF 4 IAQ/Health pts y=yes 0
6.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=yas 0
10.Install Whole House Vacuum System 3 IAQ/Health pts y=yes 0
! 1 1
N.Flooring
1.Select FSC Certified Wood Flooring 6 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/Healih 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 1
Total Points Available: 1 1401 1301 57
Total Points Project Received: 0 0 0 •
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•
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
,40UPEkTINO
Building Department
JOB ADDRESS: PERMIT # D�, v O v
9,i /Gc- 6 q4 . 440- 6'1:• 0j
OWNER'S NAME: C 4"' Su • PHONE #
GENERAL CONTRACTOR: FAX#
I am not using any subcontractors: —
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
Owner/Contractor Signature Date