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08030100CITY OF CUPERTINO �ONTRA CORINFORMATIO BUILDING DIVISION PERMIT auILD1lrr�r�gp�PssPASADENA AVE TBD — TO BE DETERMINED PERMIT NO. 08030100 OWNER'S NAME: PERMIT ISSUEDATE. SAEED GHAZVINI 03/19/2008 E: SANITARY NO. CONTROL NO, ARCHITECT/ENGINEER: BUILDING PERMIT INFO BLDG ELECT PLUMB MECH LICENSED CONTRACTOR'S DECLARATION 706 Description1 homby affirm Nat I am limmed under provisions of Chapmr 9 (commencing with Sen..701)(1)or Division 3oftlOBasi•... and Peofeuia, Code. and my license It INSTL GASLINES TO 2 TANKLESS WATR HTRS, 2 TNKLS in full forte and effect Llcenma. Lla.11 WHTRS Dam Conmmlor ARCHILECrS DECLARATION 1 understand any plans shall W used as public recoNs j Licensed Professional OWNER -BUILDER DECLARATION I barony alum Not I am exempt Trans, the ConuactneC License Law for the i fallowing moon. (Section 703 1.5, Business and Profesiam Code: Any city or county which mquima a peen.. m cmvruct, eller. improve, demalW, or lepair any Immana prfar. its issuarce. also mauls the tt,licant far such Permit no file a sigtled suNarcnt Ne Conu license law(Chapta9 Sq. Ft. Floor Area Valuation that be u licensed purmanuo Use provisions of ones �• (commencingwidoSation7000)oluivuion3afdmBusinnaandProfessionsCause) m $2200 IOut be is...mpt therefrom and the buss for the allegod exempim. Any vialaum of 717112 A Number Occupancy Type Section 7031.5 by any applicant far a Permit subjecu the application an a Civil Faulty or not mom Nan Bre bundled dollars WITH. 3 5 ❑ 1, u owner of Ilie pmpmy, or my employee with omega u Ncirmlc mmpenudm, Required Inspections ns a will do Nmwo lemd the Comes.. Is nal intended or offered r,sale(Sec. 7014, Busisrs and Professions Code: The Countesses Liam Law duct mL apply . an nvmr of q p . property who builds or improves dement, and who docamch work himself mlhrough but awe employee, proviMd Nal such improvements art Out intatlr4 Or offered for Gala If. however. the Wilding a, improvement Y mid within arc sear acoopledoo. dm owmr- Wilder will have the burden of proving That Im did ml build Or improve for purport of uk.). I ` Q 1, as Owner of the Property, am exclusivcly connecting with lice seed connutms on construct the project (Sec. 7044. Business and Profemiov Code:) The Conuumea U. Comm Law doe not apply on an oven of property who Willis or Improve thenen, and, who .maw for such project with a contractor(s) licensed pusmam in the Contractees License Law. ❑lame mpla.uQQer SeeI�, B d P C far thiscL/rlesson -WORK] COMPENSATION DE RATION I hereby fm under penalty of perjury one of dm following declared.. I have and will mainuinaCenifiam of Conant lo.lf-insole fOr WarkeesCompen- uprovided far S 3'100 of the labor Cade. ror Ne per(omerce of Ih worefor which this permit s issued. ❑ 1 have and will maintain Workers Compensation I,oance. as ma,mad by Swim 3700 of the lobo Code. To tom poformance of Ne want fo which the Permit he i—I ' My Wallace. Compenaatian hsusnce artier and Policy mamba ale: Cartier. Policy No.: CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Dtis auction need an, W completed if the permit Is forane hundred do0an (3100) or leo.) 1 certify Nat in the pc f mol nce, of the wart for which this peornit is issued. I shall not employ any pc.a in any mmrruo^ m beekct m tie Waken' Comparwlmn taws mf a. m NOTICE APP CANTNT: If, after onescing this OcrifficatclorExemption. you should become subject to in. Worker's Compensation pmvisiov of the talar Cade. you moa > roMwith comply with such Provision or this permit shall W decoed revoked. CONSTRUCTION LENDING AGENCY 1hereby tlfmm Out them is. lending agemy for the per(oma�of issued ' theLe work far which Nu permit is iumd (Set 7097, Civ. C.) Name Undees > l.endees Adtlmss 1 coolly that 1 have mad this application nM State that the.hove infoma6. u ' correct. I agree to comply with all city and county amitmme and stale laws missing to building Conswction. and hereby authorim represemadws of Nis city to enmr upon on, Ll shave-memiom:d pm,,ty far {,peed....... a, 4 (We) agree to save, indemnify and keep homluu On City of Cupertino against Liabilities, judgmous.com and expenses which may homy way accrue sgairtst said City > in consegmnce of the &=tin& of this Permit. APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON -POINT Issued by: Date URCER GULAnONS , Roof SRe-roofs ' ignetuof ApplicanVConuec.r Data le HAZARDOUS MATERIALS DISCLOSURE Type of Will Ne appiicam orfumm building accupanutole orhandle houldous material as defined by the Cupertino Municipal Code, Chapter 9.12, and the Health and Safety Conk, Section 25532(a)? Yea NtN. All roofs shall be inspected prior to any roofing material being installed. If a roof is installed without first obtaining an inspection, I agree to remove Will the applicant or future building occupant use equipment a devices which tants u defined by the Bay Aro Air Quality Managancm it natural. air cmmiv all new materials for inspection. uiet? ❑Yes kion I have mad the hamodxts materiels mquircmcrsomkrClupler 6.95 of Ne Califon. niallalNdr Safely Code, Sect.. M (15,25533 and 25534. I mdemamd the if The bonding docs not cuocnd, how a m,n4 Nat it's my responsibility to msify the occupant of the Imments most he atr.iueanceaf.Cerdfil roccupancy. Signature of Applicant Date g -( - D 9 All roof coverings to be Class "B" or better owner or authorcmd.,cut z Dam I_ • 4 ITEMS OF 4 • • CITY OF CUPERTINO PERMIT RECEIPT Sec: Twp: Rng: Sub: Blk: Lot: APN ........: 35717112.00 DATE ISSUED.......: 03/19/2008 RECEIPT #.........: BS000004192 REFERENCE ID # ...: 08030100 SITE ADDRESS .....: 10075 PASADENA AVE SUBDIVISION ....... CITY .............: CUPERTINO, IMPACT AREA ....... OWNER ............: SAEED GHAZVINI ADDRESS ..........: 10075 PASADENA CITY/STATE/ZIP ...: CUPERTINO, CA 95014 OPERATOR: patg COPY # : 1 RECEIVED FROM ....: TERRY M BROWN CONTRACTOR .......: TBD - TO BE DETERMINED LIC # 00096 COMPANY ..........: TBD - TO BE DETERMINED ADDRESS ..........: CITY/STATE/ZIP .... , TELEPHONE ........: FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL ---------- ------------- 1BSEISMICR VALUATION ---------- 2,200.00 ---------- ---------- 0.50 0.00 ---------- 0.50 ---------- 0.00 1PPERMITFE FLAT RATE 1.00 40.79 0.00 40.79 0.00 IPRWHEATR UNITS 2.00 48.96 0.00 48.96 0.00 1TRAVDOC FLAT RATE 1.00 40.79 0.00 40.79 0.00 TOTAL PERMIT ---------- ---------- 131.04 0.00 ---------- 131.04 ---------- 0.00 METHOD OF PAYMENT ----------------- AMOUNT REFERENCE NUMBER --------------- CREDIT CARD 131.04 -------------------- MC --------------- TOTAL RECEIPT 131.04 CITY OF CUPERTINO WATER HEATER •CUPEkTiNO PERMIT APPLICATION FORM t D,�b 3 0 / o v APN #2.5 71 % / / �' o J Date: , L 941 Building Address: Owner's Name: G D 6r�q4 Z VI All( Phone 1#: l Contractor: Phone # — Alt Fax #: Cupertino Business License #: Contractor State License #: Contact: Phone #: Fax #: Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Residential ❑ Commercial ❑ Job Description: IV—S-76 6:,1-5 6"/E-5 60 L! i1 ✓i . / Strapped ❑ On Platform ❑ Bonded ❑ New Location ❑ Replacement ❑ Valuation: Green Building Check must be completed and attached to this application. Green Building Points achieved: � alo CUPER,TINO CITY OF CUPERTINO WATER HEATER PERMIT APPLICATION FORM Quantity Fee ID Fee Description Fee Group Permit Type 1PCWHEATR Commercial Water HeaterNent B PCWHEATR 1BSEISMICOM Seismic Commercial B a 1PRWHEATR Residential Water HeaterNent B PRWHEATR 1BSEISMICRE Seismic Residential B 1PPERMITFEE Plumbing Permit P / ITRAVDOC Travel & Documentation B 1BUSLIC Business License B 0 • • Single Family GreenPoint Checklist date The GreenPoint Checklist is band on the Various green features incorporated into the home and is the basis for the GmenPoim Rated program. A home can be considered green If It fulfills the prerequisites, cams at least 50 points, and meets the minimum points per category Energy (30), Indoor Air Quality] Health (5), Resources (6), and Water (B). Plans contact Build It Green for a list of qualified GreenPoint Raters if you are Imerear ed in pursuing third -parry verification. The green building practices listed below are described in the New Home Construction Green Building Guidelines, avallable at www.buildltomen.mo. g Build It Greed Smart Soluriom From Me Ground Up 8. FOUNDATION - Points Available Per Measure ❑ ❑ I. Replace Portland Cement In Concrom with Recycled Flyash or Slog a Minimum 20% Flyash or Slag h. Minimum 25% FK1ash or Slag 7. ConsWaRasourco-EEfficient Lentlaeepee a. No Invasive Species Listed by Cal -IPC Are Planted to No Plain Spades WL Require Hedging of Parts Are Drought-tole2m Cellfomia Natives, Mediterranean, a Other Appropriate Speoles 0 0 i ] El —0-3. 2. Use Frost -Protected Shallow Foundation in Cold Areas (C.E.C. Climate Zone 16) Use Radon Resistant Construction pn At -Risk Locations Only) 0 0 3 1 ❑ /. Design and Bulitl ancients] Pest Controls a Install Termite Shields 8 Separate All Exeter WooddoConcmte Connections by Metal or Plastic Fasteners DNidars 1 ❑ ❑ [I ❑ 0 0 1 1 1 ❑ El b. All New Plants Have Trunk, Base, or Stem Loeated At Least 35 Inches from Foundallon C. LANDSCAPING Poims Available Par Measure Points Available Per Measure ❑ ❑ E)o.75% 7. ConsWaRasourco-EEfficient Lentlaeepee a. No Invasive Species Listed by Cal -IPC Are Planted to No Plain Spades WL Require Hedging of Parts Are Drought-tole2m Cellfomia Natives, Mediterranean, a Other Appropriate Speoles ❑ e. Place Raftere and Studs at 24 -Inch On Center Framing 0 0 _ 3 2 Use Fie Sete Landscapin Techniques ❑ 0 1 ❑ ❑ [I ❑ 3. Minimize Tud Areas in Landscape Installed by Builder a. Ali Tud Nil Have a Water Requirement less than or Equal to Tail Fescue (50.8 Plant fal b. Tud Shell Not Be Installed an Slopes Ezcal 10% or in Areas Less than 8 Feel Wide C. Tud Is S33% of Landscaped Area (total2 Pon) d. Tud Is 510% of Landscaped Arse(tofal 4 points) ❑ c. Use Only Jack and Cripple Studs Required for Load 0 i f 2 _ 0r _ _ 2 —'-"--'-�—� 0 2. Use Engineered Lumber ❑ ❑ 4. Plant Shade Tres S. Group Plants by Water Needs(Hydrozonin) ❑ 0 0 I 3 2 ❑ Elarr [1-7 6. Install High-EMcancy Irrigation Systeme a. System Uses Only Low -Flow Drip, Bubblers, a Lm flow Spnnkiers b. System Has SmControllers Incorporate Two Inches of Compost in the Top 6 to 121nche of Soil b. insulated Engineered Headers 0I 2 0 0 if 1 3 3 ❑ 1 Muleh All Piendng Beds to the Greater of 2Inches or Local Water Ordinance Requirement rement 0 0 I 2 ❑ 6. Use 50% Selvaged or Recycled -Content Materials for 50% of Non -Plant Landscape Elements 10. Reduce Light Pollution by Shielding Flnurm antllor Directing Light Downwmtl 1 ""--''---"�--- '�`-- 0 0 I I I 1 1 . D. ST'RUCMtAL FRAME All BUD.DING ENVELOPE Poims Available Par Measure t. Apply Optimal Value Engineering ❑ e. Place Raftere and Studs at 24 -Inch On Center Framing D ❑ b. Size Door and Window Honors for Load ❑ c. Use Only Jack and Cripple Studs Required for Load 0 ) 1 2. Use Engineered Lumber ❑ a. Beams and Hell ❑ b. insulated Engineered Headers ❑ c. Wood 6Jotsts or Web Trusses fa Floors 0 ❑ d. Wood 1 -Joist; for Roof Rafters, 0 ❑ e. Engineered or Flnger-JDatind Studs for Vertical AppiicaliDne -- - 6 1 ""--''---"�--- '�`-- ❑ f. Dnenletl Strand Board for Subtitle � ❑ g. Drained Strand Board fa Wail and Root Sheathing _o --' 3. Use FSCCeNfied Wood ❑ a. Dimensional Lumber, Studs and Timber. Minimum 4D% 0 2 ❑ b. Dimensional Lumber, Studs and Timber Minimum 70% T 0— _ - "- -- ' --- -- ❑ c. Panel Products: Minimum 40% - 0 _ _ . _ _=1 E]0'--- tl. Panel Protluets: Minimum 70% ' -f —__� — T 02007 Build It Green Single Family Greeir lm Checklist 2007 Version Page 1 of 4 Total Point, Avallable in Hosing, Ventilation and Ar Conditioning =301 0 1 • 02007 Build It Green Single Femlly GreenPoint Checklist 2D07 Version Page 2 of 4 ENTER PROJECT NAME3 a 4. Use Solid Well Systems (Includes SIPS, ICFs, 6 Any Non-Steck Frame Assembly) ❑ A. Rome 0 > 2 ❑ b. Wale .. .0 ._ z_. _ 2 ❑ c. Roofs 0 2 2 5. Reduce Pollution Entering the Home from the Garage ❑ d Tightly Seal the Air Barrer batsmen Garage and Liming Area 0 Eld. 1=9 Game Exhaust Fen OR Buld a Detached Gere 0_ 1 e. DO l n Ener Heels on Trusses (75% of Aft Insulation Haight at Outside Edge of Exterior Well 0 1 L 0.;Roof Trus. to Accommodate Ductwork 0 1 S. Use Recycled -Content Said Studs for 9110% of Interim Wall Fremin 0 1 9. Thermal Man Welir. fill -Inch Drywall on All Interior Wella or Wells Weighing mon Nen 40IWcu.h. D 1 10. Install Overhangs and Gumun 0 ❑ L Minimum 16 -Inch Overhangs and Guaere ❑ b. Minimum 244roh Overhangs and Bottom D 1 Trial Prints Avarable In Structural Building Frame and Envelope • 35 0 E. EXTERIOR FINISH Points Available Per Measure 1. Use Re clad -Content o Virgin Plsstic or FSC-CeDlOed Wood Docking 0 2 2. Install a Rein Smash Well "m 0 2 J. Use Durable and Noncombustible Siding Materials 0 1 Ej 1. Salem Durable and Noncombustible Roofing Metadale 0 - 2 Total PoNb Available In Exterior Finish =7 0 F. INSOLATION Porn Available Per Measure 1. install Insulation with 75% Rerydad Content _ 0 ❑ L Wage ands Flood ❑ b. Casings 0 I 2. Install insulation that U Low-Emhdng (Cerdfied Section D1350) 0 ❑ A, Walls and/or Foods ❑ b. Cerin 0 1 J. inspect Duality of Insulation Installation before Applying Drywall 0 1 Total Points Available in Insulation.5 0 O. PLUMBING Points Avallable Per Mailable 1. Distribute Domnfic Hol Water Efficiently (Maximum 7 Points) . 0 1 ❑ a. Inaulata Hol Wood Plpee hem Water Hooter to Kitchen ❑ b. Insulate All Hot Water Pipes 0 T 1 1 ❑ c. Use Engineered Parallel Piping _ 0 } ] [3 d Use Engineered Pardol Piping with Demand Cordro6sd Circulation Loop _ ❑ a. Use Structured Plumbing with Demand Commgad Circulation Loop ❑ f. Use Central Core Plumbin 0 1 +1 2lnstall Only High EfficienTolift Dual -Flush or 5176 gP9 0 4 Total Palms Available In Plumbing.Total 12 0 H. HEATING VENTR.ATION h AIR CONDITIONING Ponta Available Par Measure Lj 1. Design and Install HVAC System d ACCA Manual J. D. end B Recommentledon 0 1 4 2. Install Wed Combustion Untie ' ❑ A. Fomeces E] b. Water Heelers —0 0 2 . 7. Install Zoned, Hydronic Radiant Heating with Slab Edge Insulation 0 1 1 4, Install High Efficiency Air Conditioning with Environmentally Responsible Ref igemnd 0 1 S. Design and Install Ell solve Duchvork g_ 3 ❑ a. Install HVAC Unit and Duchvnrk within Conddined Space ❑ D. Use Duo Mastic an All Duct Joints and Seems _ _ 0 ' 1 ❑ c. Install Ductwork under AIG: Insulation (Buried Ducts) _ g _ _ 1 _ ❑ d. Pressure Balance the Ductwork System _ _ 0 _ _ ❑ a. Protect Ducts during Cnstnctin and Clean All Ducts before Occupancy 0 1 El S. install High Efficiency HVAC Flldr (MERV 6v) 0 1 ❑ 7. Don't Install FIMPlen or local Snled Gra Flrepiecn with Efficiency Rating Not Len Than 60% D 1 using CSA Standards 6. Install Effective Exhaust Straddled In Bathrooms and Kitchens 0 ❑ a. Inma6 ENERGY STAR Bathroom Fane Vented to the Outside ❑ b. All Bathroom Fans Are an Timer or Humidistal _ ❑ c. Install Nldhan Range Hood Vented to the Outside D ]. 9. Install Mechanical Ventlddon System for Cooling (Maximum 4 Points) 0 ❑ e. Instal ENERGY STAR Cel Ing Fans 6 Light Kits In Living Areas 6 Bedrooms ❑ b. Install Whole House Fan with Variable Speeds _ 0 1 ❑ C. Au omatically Cnbolled Integrated System _ ❑ J. Automatically Cnucted lntagndd System with Variable Speed Cabal 10, Install Mechanical Fresh Air Ventilailon System (Maximum J Points) _ 0 2 ❑ e. Any Whole House VanOlatlon System That Meats ASHRAE 62.2 ❑ b. Exchanger that meats ASHRAE 62.2 0 1 2 2a,=Heal 11. onoxide Alarmis 0 1 Total Point, Avallable in Hosing, Ventilation and Ar Conditioning =301 0 1 • 02007 Build It Green Single Femlly GreenPoint Checklist 2D07 Version Page 2 of 4 0 J. BUILDING PERFORMANCE Points Available Per Measure 1. Diagnostic Evaluations ❑ e House Pesses Blower Door Test b. House Pisses Combustion Salary Beckdreft Test ❑ 0 g p _ 11 D 2. Design and Build High Performance Homes -%above The 24- minimum 15% Required 0 >_30 ❑ 3. House Obteine ENERGY STAR with Indoor Air Package Certification - Pilot Massure (Total 45 Points; reed comment) 0 5 2 Total Available Pon In Building Performance = 39 0 E. FINISHES Points Available Per Measure ❑ 1. Design Entryways to Reduce Trecketl in Contaminants D ( 1 p ❑ ❑ 2. Use Lce VOC or ZoneVDC Paint (Maximum 3 Points) a. Low-VOC Interim WaIIICelllnp Paims (<50 Ifni VOCE (Flat and <150 gpl VOCs (Non -Flat)) b. Zaro-VOC: Interior WalVCeilin Pelma (eS gpIVOCs (Flat)) 1 +-- 0 T 1 0 1 2. Thermal Mass Floors. Floor Covering Other than Carpet on 50% or More of Concrete Floors p ! 1 ❑ 3. Uss Low VOC, Water -Based Wood Finishes (Q50 I VOCs) 0 2 0 ❑ 4, Use Low-VOC Csulk and Construction Adhesivea (00 gpi VOCs) for All Admisives 0 2 - ❑ 5. Use RerydedContent Paint 0 - 1 ❑ ❑ ❑ ❑ ❑ S. Use Environmentally ty PrPreferable Materials for Interior Finish: A) FSC-CMifiatl Wood, B) Reclaimed, C) Rapidly Renewable, O) RerycledConterrt or E)FlngerJoul intatl a. Cabinets (5D% Minimum) - b. Interior Thin (50%Minimum)- c. Shelving (5D% Minimum) ' d. Do= (50% Minimum) e. Coumartops (So% Minimum) 0 D p -------- --` 0 ( g � -- 1 ❑ ❑ ❑ ❑ 7. Reduce Formaldehyde in Interior Finish (CA Section 0135D) e. Sub3oo& Stair Treads (50% Minimum) b. Cabinets & Countenops (50% Minimum) c. Interim Trio (50% Minimum)�--�'--"--- III. Shelving 50% Minimum 0 g 0 _ ___I_-- —� .r. 0 r 1 - - -- ❑ I. After Installation of Finishes, Test of Indoor Air Shows Formaldehyde Level Q7ppb I D ! 3 I L. FLOORINO Points Available Per Measure ❑ ❑ ❑ ❑ 1. Use Environmentally Preferable Flooring: A) FSC -Certified Wood, B) Reclaimed or Refinished, C) Rapidly Renewable, D) Recycled -Content, E) Exposed Concrete Flooring Adhesives Must Have <50 gpl VOCs. a. Minimum 15% of Floor Area b. Minimum 30% of Floor Area c. Minimum 50%x1 Flom Area d. Minimum 75% at Floor Area p f p 1 +-- 0 T 1 ❑ 2. Thermal Mass Floors. Floor Covering Other than Carpet on 50% or More of Concrete Floors 0 ! 1 ❑ 3. Flooring Meats Section 01350 or CRI Green Label Plus Requirements 150% Minimum) 0 ! 2 ' TMaI GvalUM1le PnIMe In FlnnAnn _> n M- APPLLANCES AND LIGHTING Points Available Per Measure ❑ ❑ 1. Install Water and Enorgy Efficient Dishwasher ' a. ENERGY STAR (load l point b. Dishwasher Uses No More than 6.5 Gandy a dealtpoints) 0 0 1 ❑ E] 2. Install ENERGY STAR Clothes Washing Machine with Water Factor of 6 or Less a. Meals Energy Star and CEE Tier 2 requirements (modified energy factor 2.0, Water Factor 6.0) (total3 points)0 b. Meets Energy Star and CEE Tier 3 requirements (muffed energy factor 22, Water Factor 4.5 or less) (total 5 oints _ _ 0 1 _ _ _ _ _2 _ ( 2 ❑ El 3. Install ENERGY STAR Refrigerator C. ENERGY STAR Qualified & <25 Cubic Feet Capacity b. ENERGY STAR Quaffed &< 2D Cubic Feel Capacity0 0 1 1 I ) 4. Install BUIIHn Recycling Center D - ❑ ❑ e Bul3-In Recycling Center D. Built -In Composting Canter D 0 1 3. Community Design Measures Is Loral Priorities: See the Community Planning & Design section in Chapter 4 of the New Home Guidelines for . measures. Maximum of 20 points for suggested measures. Local requirements may also be listed hare. 02007 Build It Green Single Family Gre x -Point Checklist 2007 Version Page 3 of 4 _Four desolation here, and ante, points arni eels for mum In appropriate categories to the right. Enter desllption hen, and enter poinU eveaabte he mum In epprapdate categories to the right. Ener domptlon Aero, and ane points available fu namm, In appropriate cmgo in to the right. Ernst desm#m hm, and ems points not" he mum In atgrcplate ceupolu to the right. 4. Innovation: Lisl Innovative measures that meet the preen building objectives of the Guidelines. Enter up to a overseas In Total Available Points In Specific Project here not yet met the following recommended minimum requlrer enter: - Total Project Score of At Least 50 Points - Reouired measures: 43a: 50% waste diversion by weight -72: 15% above Title 24 -N1: Incorporate GreenPoint Rated Checklist into blueprints - Minimum points In specific cateoories: -Energy (30 points) -IAQ/Health (5 Points) -Resources (6 points) -(Nater (9 points) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o d 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0- 4+ 96+ 42+ 66+ 43+ G 1 30 1 5 1 6 1 9 02007 Build It Green Single Famlly GreenPoint Checldisl 2007 Version Pape 4 of 4 • op 0/v im D� CITY OF CUPERTINO 0 CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM APN # 3 5 7 / 71 / ,;�o J Date: Building Address: 100-1r V��"� Nv9 fhl� Mailing Address (if different from building address): Owner's Name: Phone #: s4£c0 JJ08 Zs 3 Contractor: Phone: 1� T ?i / 7-6') Fax: Contractor License #: Cupertino Business License #: Contact: Phone: Fax: Residential Commercial Job Description: (l\ST Lt_ GAS Ltt,463. —1() 2 — TAWKLF5S' W T 12 Nt14 f�25 (t=20, yVe7-t TV toCjtTtoj-� bo Lunt. F�> Building Permit Info: Bldg ❑ Elect ❑ Plumb ❑ Mech ❑ Type of Construction (Usage Class): Occupancy Type: 1 FR, I IFR ❑ 11, 111, V-lHR ❑ 11, 111, 1V V -N ❑ Valuation: Square Footage: Project Size: Standard ❑ Large ❑ Major ❑ a CUPEkTINO CITY OF CUPERTINO GENERAL BUILDING PERMIT APPLICATION FORM Quantity/Sf Fee ID Fee Description Fee Group Permit Type 1GENRES or 1GENCOM 1BTEMPPER Temporary Building Permit (good for B 30 days) 1BBOILERI For the installation or relocation of ea M boiler/compressor to & including 3 horsepower, or ea absorption sys to & incl 100,000 Btu/h 29.3kw 1BBOILER2 Installation /relocation of ea M boiler/compressor over 3 horsepower to & incl 15 horsepower, or ea absorption ss over 100,000 Btu/h 1BBOILER3 Instal I ation/relocation of ea M boiler/compressor over 15 horsepower to & incl 30 horsepower, or ea absorption sys over 500,000 Btu/h to & incl 1,000,000 Btu/h 1BBOILER4 Installation/relocation of ea M boiler/compressor over 30 hosepower to & incl 50 horsepower, or for ea absorption sys over 1,000,000 Btu/h to & incl 1,750,000 Btu/h 1BBOILER5 Installation/relocation of ea boiler or M refrigeration compressor over 50 horsepower, or ea absorption sys over 1,750,000 Btu/h l BAPPLOTH For ea appliance or piece of equip M regulated by this Code but not classed in other appliance categories, or for which no other fee is listed in this code. IELECINSP Other Electrical Inspections (per hour) E 1MECHINSP Other Mechanical Inspections (per M hour) 1 PLMBINSP Other Plumbing & Gas Inspections P (per hour 1MEETINGIHR Application Meeting B • 11 WITYF CITY OF CUPERTINO CUPI�GENERAL BUILDING APPLICATION • FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Group Permit Type 1GENRES or 1GENCOM ACOUSTICAL REVIEW IACOUSFDW SFDWL/DuplexNew B IACOUSRESAD SFDWL/Duplex-Addition/Alteration B IACOUSCOM Multi-Family/Commercial B CHIMNEY'S 1 CHIMNEY Chimney B 1 CHIMNEYR Chimney Repair B FENCES 1FENCE>6FT Non -masonry, over 6 ft in height B 1FENCEMAS>6 Masonry, over 6 ft in height B FIREPLACES 1FIREPLMAS Fireplace Masonry B 1FIREPLFAB Fireplace Pre-Fabricated/Metal B 1FLAGPOL>20 Flag pole (over 20 ft in height) B 1MODUSTRU Modular Structures B FOUNDATIONS 1FOUNDREP Foundation Repair B 1PILECAST Pile Foundation Cast in place concrete B 1PILEDRIV Pile Foundation Driven (steel, pre- stressed concrete B 3 of 5 CITY OF CUPERTINO GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Group Permit Type 1GENRES or 1GENCOM RETAINING WALL(CONCRETE OR MASONRY 1RETSTN Standard (up to 50 ft) B 1RETSP310 Special Design, 3-10' high (up to 50 `) B 1RETSP10 Special Design, over 10' high (up to 50' B 1RETCRB< Gravity/Crib Wall, 0-1 O'high (up to 50 ft B 1RETCRB> Gravity/Crib Wall over 10' high (up to 50 ft B SIDING 1 SIDEST/BK Siding, Stone & Brick Veneer (interior/exterior B 1 SIDEOTHER Siding all other B SKYLIGHTS 1 SKYL<10 SF Skylight less than 10 sf B 1SKYL>10SF Skylight greater than 10 sf or structural B 1STAIRS Stairs -first flight/ea addt'l B STORAGE RACKS 1SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B 1 SRACKS>8 Storage Racks over 8' high (up to 100 st B 1STUCOAP Stucco Applications (up to 400 sf) additional stucco application B 4of5 0 Q. CITY OF CUPERTINO CUPERTINO GENERAL BUILDING APPLICATION FEE SCHEDULE Quantity/Sf Fee ID Fee Description Fee Group Permit Type 1GENRES or 1 GENCOM 1 WINREP Replacement windows/sliding glass door (ea 8 windows) B 1WINMEWSTR New Window -structural shear wall/maso includes plan ck fee B 1 EPERMITFEE Electrical Permit Fee E IMPERMITFEE Mechanical Permit Fee M / IPPERMITFEE Plumbing Permit Fee P 1 ELCPLNCK Stand Alone Electric Pln Ck (hourly) E 1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M 1PLMPLNCK Stand Alone Plumbing Pln Ck (hrly) P I STPLNCK-(3 Hr Min when not over counter) Standard Plan Check (when no EAVP) hourly -stand alone B / IBSEISMICR Seismic Residential B IBSEISMICO Seismic Commercial B J 1TRAVDOC Travel & Documentation B 1BUSLIC Business License B 5 of 5