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BUILDING DIVISION PERNIIT
CONTkWT,,' 1R',INk'ORM TION
kYf, �d'k`3n
WILDING ADDRESS:
PERMIT NO.
10969 MARIA ROSA WAY
GREENFIELD PLUMBING
08090135
`/NER'S NAME:
PERMIT ISSUE DATE
CHIEN TA—WEI ET AL
3513 MADRID DR
09/19/2008
PHONE:
SANITARY NO. CONTROL NO.
(408)921-8980
ARCHITEC (ENGINEER:
BUILDING PERMIT INFO
BLDGELECTO PO MECHO
LICENSED CONTRACTORS DECLARATION
lob Description
1 Wmby affirm Nal l am licensed under provisions of Chapter 9 (commmming
wit Scclwn 1000)of Division 3nf he Buda. ad Pmf-m- Cook. ant my lion¢ u
REPLACE LEAKING WATER HEATER
in full force and effect
License Class Lie. 0
Dam Contractor
ARCHITECTS DECLARATION
I understand my plans shall M used u public records
Licensed Professional
OWNER -BUILDER DECLARATION
I hcrcby &Rm that 1 ser exempt from Ne Contra«ah License law for the
following meson. (Section 1031.5, Business and Proration Code: Any city or county
which requires a permit to construct, alter. improw, demolim, of repair any structure
prior m ill issuance. atm mind. heapplieanl for such permit m file aaignel summem
to the he Conoacues t.leaom Law (Chapter, 9
Sq. Ft. Floor Area
Valuation
that he it licensed pursuant providov of
(commencing wihScction7000)ofDividon3ofdoBusinessand Pro(etsinnsCodc)or
$650
Jco be u exempt themfr«n and the basis f« thea alleged ass 0. Any violation of
p,�� Number
Occupancy e
P y Typ
Section 1031.5 by any applicant flux permit subjects tc applicant m a mil penalty of
not more than ftw hundred dollars (S500).
35619044 .,Off
❑ L. of the pmpwy.«my. employ. with, wages u tela role mmpemadan,
,
Required Inspections-,
will do he work. and hamumure is no, Intended or offered forlaM (Sec. 1044, Budouas
and Professions Code: The Coameemes License Law d. nut appy to an ow. of
property who bunds «ire proses tcmun. are wM d. such woM1 himself « W ongh his
own employ., provided that such improwmats art not intended oro@rtd forsde. If.
howeser. the building or Improvement is sold within one year of completion, he owner.
Wilder will have Ile b Iden of pmHng that lot did OR build o improve f« purpose of
ask.).
0 I. as ow. of Re pro'", am cxcludvcly contracting wit licensed contractors ad
waawn the project (See. 7044. Business mod Pmfesvaru Cade:) The Comrnufs U.
certse Law does not apply to an owner of property who builds or improves Lemon, and
who Contrary for such profeces who a eOnVYmf(s) IIcCM1Yd puRaam to to Comarsmars
Llcens, law.
❑ I am exempt under Sm B B P C for this reason
w e ' Dam
W KER'S MME SATION DECLARATION
1 hereby m u penalty of perjury ane of not following declarations:
❑ I have and will maintain a Certifiamof Coveram self -insure f« Workds Compen.
nation, u provided fpe by Section 1700 of to labor Code. for he peAormaece of he
wort f« which this permit is issucsd.
❑ 1 have and will main.. Werke, Compensation Insutance, as acquired by Section
3100 of he labor Cede, f« tc performarme of to work far which this permit is illned.
My Workers Compensation Insurance, artier and Policy number are:
Carries. Policy No.:
CERTIFICATE OF EXEMPTION FROM WORKERS
COMPENSATION INSURANCE
flhuxnlm toted rot be completed Uthe permit u foram hundred dollars (SIOIO
or less)
1 certify tat in the performance of he work f« which this permit is issued. I shall Int
employ myPcoomin my mLmLr sec as m baccorC subjcel m the, Worse � am an
Laws of California. D
Applican
NOTICE TO A P : IL of m ng this CcrdOate of Emmp on, you sMul
become mbj. ro t oa& mpcnsetion provisions of he Labor Cdc, you most
comply visions or this p user it shall be dasned newkcd.
CONSTRUCTION LENDING AGENCY
1 hereby, affirm tat hem u a canstvctl n lending agency far do pcdondance of
dot work for which his permit is issued (Sec. 3091, Civ. C.)
,
Under Name
Lenda'a Address
.
I ratify hal l haw read this application sed state that not above hformanun is
Comm I agree or comply with all city and county ordinances and state laws relating to
Wilding consuucdon, atm hereby auldadm mpraenunves of this city h onto, upon tc
a d,e-mentiaMd properly for impaction putp«es.
Indemnify
(We) agree to sem, ad kap handless to City of Cuponho against
liabllides,j Wgmen s.cons and expenses which may in any way saro: agaivt.d City
in COmelp ena of he gaming of this permit.
APPLICANT UNDERSTANDS AND WILL CO PLY WITH ALL NON -POINT
Issued by: � Date
SOURCE REGULATIO
Re -roofs
Signature of Applic onuacm Data
S MATERIALS DISCLOSURE
Type of Roof
Will IM pelican more building aaupantnore of handlchvaduus material
�-
as dented by vino Municipal Cade, Chapter 9.11, and he Homth and Safely
ode. Section 15531(1)y
❑Yes ON.
All roofs shall be inspected prior to any roofing material being installed.
Will he applicant ase future Wilding Occupant tax cyvipment or devices which
If a roof is installed without first obtainingan inspection, I agree to remove
P g
emir h.,ardnur sit contaminants as defined by to Bay Area Air Quality Management
all new materials for inspection.
Dimictl
Of. ❑No
1 hew read the Wassoliw.s materlLLs torl-hcmenb under Chapter 6.95 of the Cdifor-
nuHalhhSdnyCode.5 25505,25533u M34.iundcmmWd ifhc Wilding
does amt curcnlly ham a sur n. Net it u my responsibility to notify de, «cum m of he
requirements which man ., to iguana a fa Camnicate of Oca
Signature of Applicant Date
All roof coverings to be Class ';W' or better
Gwne, or mtha Ld rgeot rote
• 5 ITEMS OF 5
•
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN .....: 35619044.00
DATE ISSUED.......: 09/19/2008
RECEIPT #.........: BS000006141
REFERENCE ID # ...: 08090135
SITE ADDRESS .....: 10969 MARIA ROSA'WAY
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA .......
OPERATOR: SylviaM
COPY # : 1
METHOD OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT :
AMOUNT
---------------
216.56
---------------
216.56
VOICE ID DESCRIPTION
-------- ----------------------------
518 WATER HEATER
REFERENCE NUMBER
--------------------
american express
VOICE ID DESCRIPTION
------------------------------------
OWNER ............:
CHIEN TA-WEI
ET AL
ADDRESS ..........:
10969 MARIA ROSA
WAY
CITY/STATE/ZIP
...:
CUPERTINO CA,
95014-4719
RECEIVED FROM
....:
HUNG WEI
CONTRACTOR .......:
TRAN, TOM LIC
# 20711
COMPANY ..........:
GREENFIELD PLUMBING
ADDRESS ..........:
3513 MADRID
DR
CITY/STATE/ZIP
...:
SAN JOSE, CA
95132
TELEPHONE ........:
(408)921-8980
.
FEE ID
----------
UNIT QUANTITY
-----------------------
AMOUNT
PD -TO -DT
THIS REC
NEW BAL
1BSEISMICR
VALUATION 650.00
--------------------
0.50
0.00
----------
0.50
----------
0.00
1BUSLIC
FLAT RATE
1.00
110.00
0.00
110.00
0.00
1PPERMITFE
FLAT RATE
1.00
40.79
0.00
40.79
0.00
1PRWHEATR
UNITS
1.00
24.48
0.00.
24.48
0.00
1TRAVDOC
FLAT RATE
1.00
40.79
----------
0.00
40.79
0.00
TOTAL PERMIT
----------
216.56
----------
0.00
216.56
----------
0.00
METHOD OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT :
AMOUNT
---------------
216.56
---------------
216.56
VOICE ID DESCRIPTION
-------- ----------------------------
518 WATER HEATER
REFERENCE NUMBER
--------------------
american express
VOICE ID DESCRIPTION
------------------------------------
Rule
CITY OF
SCUPEkTINO
Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB ADDRESS: _
6 myi,, Rose,
PERMIT #
C9 &�o lS
O 'S NAME:
PHONE #
GENERAL CONTRACTOR:
FAX #
u
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information
•e
/Con actor Signature
f-� a
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
Til
•e
/Con actor Signature
f-� a
Date
CITY OF CUPERTINO
f i - WATER HEATER
ciry of
CUPEIOTINO PERMIT APPLICATION FORM
a
C`
M6CIO/ 3s'
APN #Date:
M6W60
9— f9�o�
Building Address:
�QoSa h Cl %moi
Owner's Name:
Phone #:
H
(1/4 �f(f �- 2 �
Contractor:
Phone #:
Fax #:
Cupertino Business License #:
Contractor State License #.
Contact:
Phone #:
Fax #:
Building Permit Info:
Bldg Elect �- Plumb [------- Mech D__
Residential Commercial ❑
Job Description:
k41 Y
Strapped n Platform`J[� —Bonded 0 ---New Location ❑ Replacement
Valuation (cost of project):
Project Size: Express tandard ❑ 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 Building Points achieved:
Revised 6/16/08
SUM-
CITY
OF
CUPEI�TINO
CITY OF CUPERTINO
WATER HEATER
PERMIT APPLICATION FORM
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1PCWHEATR
Commercial Water
HeaterNent
B
PCWHEATR
IBSEISMICOM
Seismic Commercial
B
1PRWHEATR
Residential Water
HeaterNent
B
PRWHEATR
1 BSEISMICRE .
Seismic Residential
B
f
1PPERMITFEE
Plumbing Permit
P
I TRAVDOC
Travel &
Documentation
B
IBUSLIC
Business License
B
r
•
is
0
t
0
•
C�
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
A
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.
A4
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 oint
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
0
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 INPUT Resources Energy A011 -le alth
1. Recycle Job Site. Construction & Demolition Waste:
65%=1 point; 75%= 2 points. BO% 4 points. -
2. Salvage Reusable Building Materials
3. Remodel for Mixed Use, Adaptive Reuse, and
Historic Preservation
4. Protect Native Soil
5. Minimize Disruption of Existing Plants & Trees
6. Implement Construction Site Stonnwaler Practices
7. Protect Water Quality with Landscape Design
B. Design Resource -Efficient Landscapes and Gardens
9. Reuse MaterialsrUse Recycled Content Materials
for Landscape Areas
10. Install High -Efficiency Irrigation Systems
11. Provide for On -Site Water Catchment / Retention
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
2. Use Recycled Content Aggregate
3. Insulate Foundation/Slab before backfill
11
C. Structural Frame
1. Substitute Solid Sawn Lumber with Engineered Lumber
2. Use FSC Certified Wood for framing
(For every 10% of FSC lumber used = 2 points, up to 10)
3. Use Wood I -Joists for Floors and Ceilings
4. Use Web Floor Trusses
5. Design Energy Heels on Trusses 6' or more
6. Use Finger -Jointed Studs for Vertical Applications
7. Use Engineered Studs for Vertical Applications
8. Use Recycled Content Steel Studs for Interior Framing
9. Use Structural Insulated Panels (SIPS)
a. Floors
b. Wall
c. Roof
10. Apply Advanced Framing Techniques
11. Use Reclaimed Lumber for Non Structural Applications
12. Use OSB
a. Subfieors
b. Sheathing
up to 4 Resource pts
4 Resource pts y --yes
4 Resource pts y --yes
2 Resource pts y=yes
1 Resource pt y=yes
2 Resource pts y=yes
2Resource pts y=yes
4 Resource pts y=yes
2 Resource pts
2 Resource pts
2 Resource pts
Up to 5 Resource
2 Resource pts y=
3 Energy pts y=
3 Resource pts y --yes
up to 10 Resource pts
2 Resource pts
yges
2 Resource pts
y=yes
2 Energy pts
y=yes
2 Resource pts
y=yes
2 Resource pts
y=yes
2 Resource pts
y=yes
3 Energy pts
y=yes
3 Energy pts
y=yes
3 Energy pts
y=yes
4 Resource pts
y=yes
3 Resource pts
y=yes
1 Resource pt
1 Resource pt
1. Install Energy -Efficient Windows
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
2. Install Ductwork within Conditioned Space
3 Energy pts
3. Vent Range Hood to the Outside
1 IAO/Health pt
4. Clean all Duds Before Occupancy
2 IAQ/Health pts
5. Install Solar Attic Fan
2 Energy pts
6. Install Attic Ventilation Systems
1 Energy pt
7. Install Whole House Fan
4 Energy pts
S. Install Sealed Combustion Units
14. Install Zoned, Hydmnic Radiant Heating
a. Furnaces
31A0/Health pts
b. Water Heaters
31AQ/Health pts
9. Replace Wall -Mounted Electric and Gas Heaters with
16. Install Heat Recovery Ventilation Unit (HRV)
Through -the -Wall Heat Pumps
3 Energy pts
10. Install 13 SEER/11 EER or higher AC with a TXV
3 Energy pts
11. Install AC with Non -HCFC Refrigerants
2 Resource pts
12. Install 90% Annual Fuel Utilization Efficiency (AFUE) Furnace
2 Energy pts
y=yes
13. Retrofit Wood Burning Fireplaces
10 Energy pts
y=yes
a. Install EPA certified wood stoveslnserts
1 IAQ/Health pt
y=yes
b. Install/Replace Dampers
1 Energy pt
y=yes
c. Install Airtight Doors
1 Energy pt
y=yes
14. Install Zoned, Hydmnic Radiant Heating
3 Energy pts
y=yes
15. Install High Efficiency Filter
41AQ/Health pts
y=yes
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAQ/Health pts
y=yes
17. Install Separate Garage Exhaust Fan
3IAQ/Health pts
y=yes
I 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. Pro -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 =1 B points)
Up to 18 Energy
pts
6. Select Sate and Durable Roofing Materials
1 Resource pt
y --yes
7. Install Radiant Barrer
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
•
E