08090128 'CITY
BUILDING DIVISION PERMIT N;CQONTRACTO-.�R,,INQRMArTION
BUILDING ADDRESS: PERMIT NO.
7830 MC CLELLAN RD PRIME CUSTOM CONSTRUCTION . 08090128
NER'S NAME: 19]LMn'LSSUEDATE
SOSO DOLORES C AND THOMAS N 3652 WESTCHESTER DR 09/19/2008
PHONE: SANITARY NO. CONTROL NO.
ARCH=IENGINEER: BUILDING PE0.MR INFO
NEW WATER HEATER BLDG ELECT PLUMB MECH
w0o LICENSED CONTRACTORS DECLARATION O O O
I hereby aftim that 1 m Iimn.•A under Provisions of Chapter 9(commencing Job Description
xx with Section 7")of Dividors 3afNC Busier••and ProfessionWmy license is
^=in in full for¢and eRett� �(3�
p Z Licenx u Lrc.
e ARCHITECTS DECLARA 0
I understand my plans shall tk used as Public rtcorN
A.
gQ� Licensed Profcuion.I -
OWNER-BUHDER DECLARATION
s� f 1 booby affirm that I am exempt from the Contractor's License Law far the
O following mason.(Section 70313,Business and Pmfrssions Code:Any city or county
$ which squirts a permit to consume,+Per.impur e.demolim,ar repon my statim
Prim N its issuance,calx requires do applicant far such permit in file.signed stsement
<
mat Ito is licensed pursonant to the provisions of the Contractor's Uccure Law(Chapter 9 Sq.Ft. Floor Area Valuation
Y�g (commencing with Section 7000)or Division 3 of the Business aM Professions Code)m
— that he inesempt therefrom and the basis fm the alleged exemption.Any violation of
Section 7031.5 by any applicant fm a permit subjects Ne+pplicant to a civil penalty of APN Number
tet mere than five hnadxd dollars(Sw). Occupancy TYPe
❑1,u otter of Ve property,m my ruplaycn with v+gn u tie'v trine compewuan,
wid Pr tie work and Ne he Cera a noHmmens m a w do souk(Sec.in as.Business
And arty- W Cma:The Cantucmra License Law don out apply lf an magh is Required Inspections
propertylayerbuildsviicepratesthermpr and who donstintsulkhimselfedthrough his
awns er.the n,Provided i pr vemuch improvements art not ear of d monereal forsalthe ow er.
however,the building u improvement V said within Atte year of mprove for
the uwmr-
builder will have the burden of proving that K did rot beim m impose fm puryose of .
❑1.u ower of the propny w exclusively contracting with liceund mmmeta s us
mrtsuer the project(Sec.70th,Business and Professions Cade:)The Cmincmr'a V-
cerem Law doe+ML Apply m an owner of property who Wilda or improves themOn.and.
who contracts per such Minces with a contractor(s)limned purausnt An the contractors '
Licenx Law.
0 IamexemptunalesSec ,B&PCrmthismuan
err Data
WORKER'S COMPENSATION DECLARATION
I hereby air=under petty,of parity arc of the following decimations:
I Nw and will msintsie aCutifom ofConscm m xlf-insure Ice Wmtcr'a Comps
umm,as provided for by Section 37W of the Isbm Code,for the Performance of the
wort for whim this Permit is issued.
❑I have and will m+inuin Wmkeh Compensation insurance,as required by Section
3700 of the Lubar Cade,fm the performance or the wok for which this permit u issued.
My Worker' Compertsaua.lnsmanttcarri aMPolhynumbram/:�
Cartier. ry P 4U'
CQ lI, r4 Poli No.:1'R6
CERTIFICA OFEKEMMON MOM WORKERS'
COMPENSATION INSURANCE
(T isxctim need tet W completed Hose permit tsfome hundred depaa(5100)
or ICaa)
I cudfy that in the pmfamaee of ft wank fm which this Permit u issued.I shill Act
couplet any penon in try manner an As to became subject to Ve Workers Compare aeon
Isws of Califamia Date
Applicant
NOTICE TO APPIJCAW.If,after making this Cenirteae of Exemption.you should
became Subject in the Worker's Compensation provisions a the Lmor Cade,you must
.J O forthwith comply with such pov)sians m msh
Nis pait all be decned mated.
d.
CONSIRUCnON LENDING AGENCY
(-+� I herthy cfm Ne Vert4 Wood(Sec.
Cingagemy far the perfomanm or
a. r1 Le wok fur which this Amit Is ivued(Sec.3097,Civ.C)
�W Q Looses None
� z LeMer's AJCm..
U O I ceNfy that 1 haw Lead this application aM sure dw the above information u
W comm.l agree m comply with all city And my andmantts and soon laws relating in
p building construction,and hereby authariu repmxntauws of this city to enter upon Ve
[27 above-menudgm property fAn inspection puryases
E-t fY (We)agree te saw,indemnify And trop hamktss the City of Cupertino against
rn incaivaijudgmenu,coats aM expenses which may In try wy+ttme gainstsaid City
U Z in PLIC I nm a(the granuegof thispermit.WILL
APPLICANT UND STANDS AND WILL COMPLY WITH ALL NON-POINT Issued by: Date
SOURCER ONS.
Sngnuurt of APplicmSuacor par Re-roofs
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
Will the applicant or factum building Occupant name or handle huudons material
dUnc❑ins INN.d by the Cupertino Municipal Cade.Chapter 9.12 Sed the Health And Safety
.Section 25532(+)7 All roofs shall be inspected prior to any roofing material being installed.
Will the applicant or future building occupant use equipment or device which If a roof is installed without first obtaining an inspection,I agree to remove
eemnacrit hwardnns air contaminants As deposal by the Bay Arta Air Quality Management all new materials for inspection.
Di
❑Yrs pj Nu
1 haw real the harardats maenals nomimments under Clasper 6.95 of be Ca ifor.
nix Health&SarcoyCede,Sections 25505,25533 and 35534.1 understood Vast if the building
does nm cunendy have A v^•^L than it u my m-asmadulity m nmiry,Va o¢upaol of the
requinernems p#hprostbemeaProt eiuuanmofaCerninas,ofOccu�rySignature of Applicant Date
Owner or aauthhorinddaag/VenLt� /Ts 9D,e All roof coverings to be Class';q"or better
► ;. Community Development
c 10300 Torre Avenue
Cupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
*UPERTINO
Building De artment
JOB ADDRESS: V3?e /tq (rt PERMIT #
OWNER'S NAME: . , SoS c, PHONE / ylrf - SQG�
GENERAL CONTRACTOR Pj FAX #
I am not using any subcontractors:
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
• 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
CITY OF CUPERTINO
• 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: SylviaM
COPY # 1
Sec: Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35903051 . 00
DATE ISSUED. . . . . . . : 09/19/2008
RECEIPT # . . . . . . . . . : BS000006134
REFERENCE ID # . . . : 08090128
SITE ADDRESS . . . . . : 7830 MC CLELLAN RD
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : SOSO DOLORES C AND THOMAS N
ADDRESS . . . . . . . . . . : 7830 MCCLELLAN RD
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4221
RECEIVED FROM . . . . : AZ CUSTOM CONST
CONTRACTOR . . . . . . . : ALEX ZHUCHENKO LIC # 30094
COMPANY . . . . . . . . . . : PRIME CUSTOM CONSTRUCTION
ADDRESS . . . . . . . . . . : 3652 WESTCHESTER DR
CITY/STATE/ZIP . . . : ROSEVILLE, CA 95747
• TELEPHONE . . . . . . . . : (916) 752-8873
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
1BSEISMICR VALUATION 800 . 00 0 . 50 0 . 00 0 . 50 0 . 00
1PPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 .79 .0 . 00
IPRWHEATR 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. : 106 . 56 . . 0 . 00 106 . 56 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 106 . 56 1053
---------------
TOTAL RECEIPT 106 . 56
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
-------- ---------------------------- -------- ----------------------------
518 WATER HEATER
•
CITY OF CUPERTINO
A` WATER HEATER
CUPEf1;T`iNO PERMIT APPLICATION FORM
o$0,701 ZZk
APN # Date:
Building Address:
Owner's Name: Phone #: /�3 j ��a G�
To� sono l
Contractor: rF;✓w'L c.c r,7L > ^ we f e:� ;v✓� Phone #:
( Fax #:
Cupertino Business=#: Contractor State License #:
�SSl� 3
Contact: Phone #:
Fax #:
Building Permit Info:
Bldg Elect Plumb rq Mech ❑�
Residential Commercial ❑
Job Description:
Strapped [ On Platform Bonded New Location ❑ Replacement
Valuation (cost of project):
v (-'-) t ,
Project Size: Express Standard L4 Large ❑ Major ❑
Green Building:.Please complete relevant portion of the Green Building Checklist & attach it to
P'
application or if applicable, include in plan set & the sheet index.
Green Building Points achieved:
Revised 6/16/08
SAS
CITY OF CUPERTINO
WATER HEATER
CITY OF
CUPERTINO PERMIT APPLICATION FORM
Quantity Fee ID Fee Description Fee Permit Type
Group
1PCWHEATR Commercial Water B PCWHEATR
HeaterNent
1BSEISMICOM Seismic Commercial B
1PRWHEATR Residential Water B PRWHEATR
HeaterNent
/ 1BSEISMICRE Seismic Residential B
1PPERMITFEE Plumbing Permit P
I TRAVDOC Travel & B
Documentation
1BUSLIC Business License B
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 Pavin , Note L-1 2 oinis
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
•
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.Srte INPUT ReSDurces Energy IA01HM19W�
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 Materials4 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 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 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=yes 0
1 1 1
C.Structural Frame
1.Substitute Solid 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 0
8.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
b.Wall 0
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 p
1 1 1
INPUT Resources Energy IAO/Heafth
I.Windows .{
1.Install Energy-Efficient Windows •
a.Double-Paned 1 Energy pt Y--yes 0
b.Low-Emissivity(Law-E) 2 Energy pts y=yes D
c.Low.Conductivity Frames 2 Energy pts y=yes D
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
J.Heating Ventilation and Air Conditioning
1.Use 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 D
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts Y--yes D
8.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y--yes 0
b.Water Heaters 31AQ/Health pts y=yes 0
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 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 stoves4nserts 1 IAQ/Health pt y=yes 0
b. 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 0
15.Install High Efficiency Filter 4 IAQ/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 31AQMealth pts y=yes 0
1 1 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 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=18 points) Up to 18 Energy pts 0
6.Select Safe and Durable Roofing Materials 1 Resource pt y=yes 0
7.Install Radiant Barrier 3 Energy pts y=yes 0
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes D
2.Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes 0
3.Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes D
/ 1 1 1 •