08040140CITY OF CUPERTINO
$UILDINE DIVISION PE
CONTRACTQR NFORiVIAMo
BUILDING DRESS:
PERMIT NO.
10�c11 PHAR LAP DR
TBD - TO BE DETERMINED
08040140
OWNER'S NAME:
PERMIT ISSUE DATE
CALLITA MOORE
04/21/2008
NE
SANITARY NO. CONTROL NO.
ARCHITECTIENGINEER:
BUILDING PERMIT INFO
'BLDG ELECT PLUMB MECH
LICENSED CONTRACTORS DECLARATION
Iob'Description
1 remit alarm Nn 1 em licensed under prevision of Chapter 9 (commencing
with Section 7000)ofD+vision 3 of tho Busimen add 'up. CgdO�nd my ....in
COPPER RE -PIPE & MAIN WATER SERVICE. BAY LINE
in to= and effexl 8C.�171
O
ifunll
Log
PLUMBING PD FOR BUS LIC
Date `� Conuwmr
'
ARCHITECt'SDECLARATION
17
1 undenund my plants shall be ward u Public rteords
Licensed Professional
0\YNER-comp E0. DECLARATION
Law for the
I hmaso .(Sere that 11. exempt from to Centras
o e:cense
following recon. (Saito ]0)1.5, Business and Professions Code: Any em m county
which mquira a permit re enmucL alter, improve, de or mash any
permit 1
applicant for such permit mriteice as+gw alatemenl
statement prior m its issuance. else requires the
9
Sq. Ft. Floor Area
Valuation
Iwhahneeowdpumtionmthcrvn•ismrc
po
[[. 7500
3offtBlrmmf.0 Prolsow(chapm
wit Seaton ](roof of theierA and R Calc) of
y
t(commencing heIt My b
is esempt themfrmli and the basis for siteRed uvnpnus Any WWaaon of
Nu m basis f r
!�� Number
Occupancy Type
ube
Studio70313then by a vat for a perm+t subjects Red applicant m. ow Penalty or
i
nm come Uuv Rw huMmtl dolmrs (g500).
hundred
3 2 6 3 9 0 51
,
I,uownv of the prepedy,mmy wploym with wgvuteb cele compemdn,
Required Inspections
witmthewort,Code:
heComisrctsLicensmawdors et applyadan.9udrc„
and Cade: Them trmmis law does apply w an awrcr
or his
arty wh ban Hereon, and who donouch work Mmwlradth is
property who builds nd who
man providedthat ouchImprevemenu anenor earof caro@red rsob
owneer,
n,ping
ReoueIr,
or I pr aro year ori completion. the owner-
me Improvement Is
however, the building
for
bulldv will have dm buaden of proWng Har h tlitl ret ddW m improve fm purpose of
a that n did
ware.).
❑ I. u wtmr a the properly. am —1mu lY momomis with noosed ammismors he
cmwmct the prefect (Sec ]Gad. Businm and Profession Codt) The Co maewfa Li-
ne Lou den eat apply to an owner of pr," wlm builds or Imposes demon. and
who concocts for such projects MH a contrmmr(s) licensed ptmnnt in the Conuscwfs
Licarms Law.
.
❑ Iunesemmundvsec. .B&PCrmthis wa
e
Owner Data
WORKER'S COMPENSATION DECLARATION
I hereby a@rm under perW ry of perjury am of to following daWatmw
have aha NI morby •ondfiwm
Wmkefs Compan-1,1
1UtIJ/\\\\v\
Of the Loner Coda.farte
, provided for by Second 7]00 of the IAbm Catle. fm He perfanuax ct the
wart Its which w, perms u coat
r
I �\
❑Ihave model will maintain
Compensation Irmo, Comby Salon
whihmis permit is iwamd.
On Often wart for which
He
tf He Con Codrouts
..or
My Workefs Cempenation Insunnee amu aha Poliry number art: :
My sear.
Cartier. Policy No.:
CERTIFICATE OF EKEMPrION FROM WORKERS'
COMPENSATION INSURANCE
I
mo ssectln and rot becmnpketed liters permit is fmone hundred "M ($100)
or 4a)
1 anify dant in the perfonauco of the work for which this permit is issued I slWl net
-
cmployanYpereaniriarry jtcrm^ mbrmweatbjatm de Workem'Compensadon
Laws of Caliromin. Dam err `` ,,
Applicant
NOTICE TO APPWCA Mr making this Certificate of Exemption, you should
become ,ubjem in Ho Worker', Compensation prevision of the Labor Code You mom
rorthwiH comply with such provisions or this permit shall be deemed mvebed.
L'ONsTRUCnON LENDING AGENCY
1 hemby affirm new Hem t a consuuctin ludieS.Concy for the perfmman d of
de wink fm which this permit b issued (See. 1(1 Civ. C.)
'
Latices Name
Leedefs Addmas
I ceNry thus I haw read this application and sate Hu the above information is
'
correct. I agree to comply with all city and county onfl.s and awe Ian refiring w
Wilding construction, and hereby authotim mpmaenulim of Nis city in enter upon the
above-menturcd property for Inspection purposes.
(We) agree w wave, led ... try and lose beemlm He City of Cupvdno against
Ilabllltn, judgments. PoN and expensem which may In my way sense, agalnt,aid City
in masse. of the granting of His pmmit.
APPLICANT UNDERSTA AN WI COMPLY WITH ALL NON -POINT
Issued by: Date C
iG Q
SOURCE REGULATION
U CI
Re -roofs
Type of Roof
Signature idApplicansCmur ROF Data
HAZARDOUS MATERIALS DISCLOSURE
Will did applicant or forum building occupanluo a or handle hnwtlous material
Us defined by the Cupediro Municipal Cade. Chapter 9.12. and He H9Hth and safety
cede. Section 25612(
gNo
All roofs shall be inspected prior to any roofing material being Installed.
❑tins
If a roof is installed without first obtaining an inspection, I agree to remove
Will He applicant or to= building occupant use equipment or device which
tit hvudan sir cwm nsinnts a defircd by He Bay Arta Air Quality Mmagemci t
all new materials for inspection.
District?
❑lbs �Nu
I have read the harardautromsdals requirements u ide,cuipter 6.95.4. Califor.
ilia Hcalth& SefcLyC000ddd��c...s.edensri505.255v aw25511.I mdanund thanlf the Wilding
doer not nen have na(it, Wt y ma muiohty to notry He eavpant or He
rtquimmcn hichm t\ie miwamneeeraced;Rmanetfomnpmey.
Signature of Applicant Date
x'�-
All roof coverings to be Class 'W' or better
Dom -
Owner or agent
CITY OF
OUPERTINO
•
Community Development
10300 Torte Avenue
Cupertino CA 95014
Telephone (408) 777-3228
Fax(408)777-3333
Building Department
JOB AADDRESS: P h G LQ
�010OWNER'S
PERMIT #o 8o / O l vo
NAME: C \ jMMT-Q–
PHONE# ylS' 2-14 (6, `21 Z
GENERAL CONTRACTOR U 2 P
FAX #
I am not using any subcontractors: C _o. 9 ' Z l - C
Signature `�— Date
Please check applicable subcontractors and comDlete the followine information:
Ll
Owner/ Contractor Signature
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
Tile
Ll
Owner/ Contractor Signature
Date
is
•
6 ITEMS OF 6
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 32639051.00
DATE ISSUED.......: 04/21/2008
RECEIPT #.........: BS000004532
REFERENCE ID # ...: 08040140
SITE ADDRESS .....: 10211 PHAR LAP DR
SUBDIVISION .......
CITY .............: CUPERTINO
IMPACT AREA ....... -
OPERATOR: patg
COPY # : 1
OWNER ............: CALLITA MOORE
ADDRESS ..........: 10211 PHAR LAP DR
CITY/STATE/ZIP ...: CUPERTINO, CA 95014-1115
RECEIVED FROM ....: BAY LINE PLUMBING
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 HAL
----------
1BPWATER
-------------
UNIT
----
1.00
-
40.79
----------
0.00
----------
40.79
----------
0.00
1BPWSVCS
WATER SERVICE
1.00
20.40
0.00
20.40
0.00
1BSEISMICR
VALUATION
7,500.00
0.80
0.00
0.80
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
1TRAVDOC
FLAT RATE
1.00
- 40.79
0.00
40.79
0.00
TOTAL PERMIT
----------
253.57
----------
0.00
------
253.57
----
0.00
METHOD OF PAYMENT
-----------------
CHECK
TOTAL RECEIPT :
AMOUNT
---------------
253.57
---------------
253 57
VOICE ID DESCRIPTION
-------- ----------------------------
106 SEWER & WATER
507 FINAL PLUMBING
REFERENCE NUMBER
--------------------
#1061- -
VOICE ID DESCRIPTION
-------- ----------------------------
301 ROUGH PLUMBING
•
Plan Review Process Work Book Page -12-Revised 3/25/08
RECEM
APR A i 2M
Q
����
.p�
`
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 Paving, Note
L-1
2 points
C.
Foundation
1.
Use 15 % Flyash Concrete, (note)
S-1
5 points
D.
Structural
3.
Uses Wood 1 -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 oint
P.
Other
1 1.
List Green Features on Plans
A-1
1 point
aSM110M
TOTAL POINTS1
40 points
•
Plan Review Process Work Book Page -12-Revised 3/25/08
RECEM
APR A i 2M
Q
����
.p�
III
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.
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
2. Use Recycled Content Aggregate 2 Resource pts y
3. Insulate Foundation/Slab before backfill 3 Energy pts y
C. Structural Frame
2 Energy pts y:
1. Recycle Job Site Const action & Demolition Waste
l 3 Resource pts y:
2. Use FSC Certified Wood for framing
65%=1 point; 75%= 2 points; 80%= 4 points
up to 4 Resource
12. Salvage Reusable Building Materials I
4 Resource pts
y=
3. Remodel for Mixed Use, Adaptive Reuse, and
2 Resource pts y:
b. Wall
Historic Preservation
4 Resource pts
y=
4. Protect Native Soil
2 Resource pts
y=
5. Minimize Disruption of Existing Plants & Trees
1 Resource pt
y=
6. Implement Construction Site Stormwaler Practices
2 Resource pts
y=
7. Protect Water Quality with Landscape Design
2 Resource pts
y=
8. Design Resource•Eflicient Landscapes and Gardens
4 Resource pts
y=
9. Reuse Materials/Use Recycled Content Materials
for Landscape Areas
2 Resource pts
y=
10. Install High -Efficiency Irrigation Systems
2 Resource pts
y=
11. Provide for On -Site Water Catchment / Retention
2 Resource pts
y=
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
2. Use Recycled Content Aggregate 2 Resource pts y
3. Insulate Foundation/Slab before backfill 3 Energy pts y
C. Structural Frame
2 Energy pts y:
1. Substitute Solid Sawn Lumber with Engineered Lumber
l 3 Resource pts y:
2. Use FSC Certified Wood for framing
2 Resource pts y:
(For every 10% of FSC lumber used =2 points, up to 10)
up to 10 Resource
3. Use Wood I•Joists for Floors and Ceilings
2 Resource pts y:
4. Use Web Floor Trusses
2 Resource pts y:
5. Design Energy Heels on Trusses 6' or more
2 Energy pts y:
6. Use Finger -Jointed Studs for Vertical Applications
2 Resource pts y:
7. Use Engineered Studs for Vertical Applications
2 Resource pts y:
B. Use Recycled Content Steel Studs for Interior Framing
2 Resource pts y:
9. Use Structural Insulated Panels (SIPS)
a. Floors
3 Energy pts y:
b. Wall
3 Energy pts y:
c. Roof
3 Energy pts y:
10. Apply Advanced Framing Techniques
4 Resource pts y-
11. Use Reclaimed Lumber for Non Structural Applications
3 Resource pts y:
a. Subfloors 1 Resource pt
• I b. Sheathing __ 1 Resource pt
4
1. Use Sustainable Decking Materials
a. Recycled content
3 Resource pts
y=yE
b. FSC Certified Wood
3 Resource pts
y --ye
2. Use Treated Wood That Does Not Contain Chromium/Arsenic
1 IAQ/Health pt
y=yE
3. Install House Wrap under Siding
1 IAO/Health pt
y=yE
4. Use Fiber -Cement Siding Materials
1 Resource pt
y=yes
/ iumbing
1. Install Water Heater Jacket
1 Energy pt y=yes
2. Insulate Hot and Cold Water Pipes
2 Energy pts Y_—Yes
3. Retrofit all Faucets and Showerheads with Flow Reducers
Up to 4 Energy pts.
a. Faucets (1 point each, up to 2 points)
Up to 2 Resource pts.
b. Showerheads (1 point each, up to 2 points)
Up to 2 Resource pts.
4. Replace Tollest with Ultra -Low Flush Toilets
Up to 4 Energy pts.
(1 point each, up to 3 points)
Up to 3 Resource pts.
5. Install Chlorine Filter on Showerhead
1 IAO/Health pt y=yes
6. Convert Gas to Tankless Water Heater
4 Energy pts y=yes
7. Install Water Filtration Units at Faucets
4 Resource pts
(2 points each, up to 4 points)
Up to 4 IAO/Health pts.
8. Install On -Demand Hot Water Circulation Pump
4 Resource pts y --yes
r. crecmcai
1. Install Compact Fluorescent Light Bulbs (CFLs)
1 Energy pt
(6 bulbs=2 points, 10 bulbs =3 points, 12 bulbs = 4 points)
Up to 4 Energy pts.
2. Install IC -AT Recessed Fixtures with CFLs (1 point each, up to
1 Energy pt
5 points)
Up to 5 Energy pts.
3. Install Lighting Controls (1 point per fixture, up to 4 points)
Up to 4 Energy pts.
4. Install High Efficiency Ceiling Fans with CFLs
3 IAO/Health pts
(1 point each, up to 4 points)
Up to 4 Energy pts.
G. Appliances
1. Install Energy Star Dishwasher
1 Energy pt
2. Install Washing Machine with Water and Energy
2 Energy pts
Conservation Features
1 Energy pt
3.Install Energy Star Refrigerator
1 Energy pt
4. Install Built -In Recycling Center
3 Resource pts
H. Insulation
1. Upgrade Insulation to Exceed Title 24 Requirements
a. Walls
2 Energy pts
b. Ceilings
2 Energy pts
2. Install Floor Insulation over Crawl Space
4 Energy pts
3. Install Recycled -Content, Fiberglass Insulation with
No Added Formaldehyde
3 IAO/Health pts
4. Use Advanced Infiltration Reduction Practices
2 Energy pts
5. Use Cellulose Insulation
a. Walls
4 Resource pts
b. Ceilings
4 Resource pts
6. Alternative Insulation Products (Cotton, spray -foam)
a. Walls
4 Resource pts
o. Cemngs
4 Resource pts
•
•
1. Install Energy -Efficient Windows
• a. Double -Paned 1 Energy pt y --yes
b. Low -Emissivity (Low -E) 2 Energy pts y=yes
L c. Low. Conductivity Frames _ 2 Energy pts y=yes
2. Install Low Heat Transmission Giazing 1 Energy pt y=yes
J. Heating Ventilation and Air Conditioning
11. 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 IAQ/Health pt
4. Clean ail Ducts 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
6. Install Sealed Combustion Units
14. Install Zoned, Hydronic Radiant Heating
a. Furnaces
3 IAQ/Health pts
b. Water Heaters
3 IAQ/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 stovestinserts
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, Hydronic Radiant Heating
3 Energy pts
y=yes
15. Install High Efficiency Filter
41A0/Health pts
y=yes
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAQ/Health pts
y=yes
17. Install Separate Garage Exhaust Fan
3 IAQ/Health pts
y=yes
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. Pre -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 =18 points)
Up to 18 Energy
pts
6_Select Safe and Durable Roofing Materials Y
1 Resource pt
y=yes
7. Install Radiant Barrier
3 Enerov ots
v=ves
L. Natural Heating and Cooling
1. Incorporate Passive Solar Heating 5 Energy pts y=yes
2. Install Overhangs or Awnings over South Facing Windows 3 Energy pts y=yes
3. Plant Deciduous Trees on the West and South Sides 3 Energy pts y=yes
0
1. Use Low/No-VOC Paint
2. Use Low VOC, Water -Based Wood Finishes
3, Use Low/No VOC Adhesives
4. Use Salvaged Materials for Interior Finishes
5. Use Engineered Sheet Goods with no added Urea
Formaldehyde
6. Use Exterior Grade Plywood for Interior Uses
7. Seal all Exposed Particleboard or MDF
6, Use FSC Certified Materials for Interior Finish
9, Use Finger -Jointed or Recycled -Content Trim
10. Install Whole House Vacuum System
N. Flooring
1. Select FSC Certified Wood Flooring
2. Use Rapidly Renewable Flooring Materials
3. Use Recycled Content Ceramic Tles
4. Install Natural Linoleum in Place of Vinyl
5. Use Exposed Concrete as Finished Floor
6. Install Recycled Content Carpet with Low VOCs
1 IAO/Health pts
21A0/Heallh pts
31A0/Health pts
3 Resource pts
61A0/Health pts
1 IAO/Health pts
41AO/Health pts
4 Resource pts
1 Resource pts
3 IAO/Health pis
6 Resource pts
y=yes
4 Resource pts
y=yes
4 Resource pts
y --yes
5 IAO/Health pts
y=yes
4 Resource pts
y --yes
4 Resource pts
y=yes
•
Total Points Avai able: 1 140 130 57
Total Points Project Received: Q 1 01 010 •
G:Bala/progsrgreenbulldingguidelines mmodelersrgmenpolntsfinal2.12.e4proleGed.xls
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-� CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
CUPErjTIN0 PERMIT APPLICATION FORM
"'3.2-(3 Off_I'O`%
Fee ID
Date:
/
Building Address:
Permit Type
102, l) Lo,
IPCSEWER
Owner's Name:
P
Phone #:
Ccs\\��a mCOr�
iBPREPIPE
415. 2-9(o, 111 z
Contractor: ((�
VQ� �-1 rIUrl�biY�
1CPRP
Pho�C& to q I' 09 9
1PGASCOM
Commercial Gas Piping System
1-4 Outlets
Fax #:
Contact:
Phone #:
SQL
P
/
1BSEISMICR
Fax #:
Contractor License #: '1 0
Cupertino Business License #:
1PRSEWER
Job Description:
P
COv pk` re- P Q -Q,
r-,a`� n w ale i( s ex v c CSS
Residential]]
Commercial 0
Valuatio
complete
Green Building: Please 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
Group
Permit Type
IPCSEWER
Commercial building
sewer/sanitary sewer
P
1CPSS
iBPREPIPE
Commercial re -pipe per fixture
P
1CPRP
1PGASCOM
Commercial Gas Piping System
1-4 Outlets
P
1BSEISMICOM
Seismic Commercial
P
/
1BSEISMICR
Seismic Residential
P
1PRSEWER
Residential building
sewer/sanitary sewer
P
1RPSS
�,%NTY0
CUPERTINO
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
FEESCHEDULE
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
1 PRREPIPE
Residential re -pipe per fixture
P
1RPRP
1BPWSVCS
Water Service
P
1CPWS or
1RPWS
1 PPRSEWG
Private Sewage Disposal System
P
1PCESS
Cesspool
P
1BPWATER
Install/alter Water Pipe
P
1BPFIXTURE
Plumbing Fixture
P
IPGASRES
Residential Gas Piping System
1-4 Outlets
P
1BPGAS
Gas Piping System 5+ Outlets
P
1 PPERMITFEE
Plumbing Permit Fee Issuance
P
1PLMBLNCK
Plumbing Plan Check
P
1PLMBINSP
Other Plumbing/gas Insp.
P
/
1TRAVDOC
Travel & Documentation Fee
B
1BUSLIC
Business License
B
•