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BUILDING DIVISION PERMIT
C�t\'11�t1C QnLY.It1�I�11\ y
A0.�'1f,
Bu1L�tr�lr,�gif N PORTAL AVE
CUPERTINO PLUMBING
PERMIT N0.
08090101
OWNER'S NAME:
PERMIT LSUBDATE
CHANG JOHN N AND HELENA K
1300 DELL AVE STE C
09/17/2008
NE:
SANITARY NO. CONTROL NO.
(408)253-0618
ARCHTECfIENGINEER:
BUILDING PERMIT INTO
BLOC ELECT PLUMB MECH
CON
LICENSED CONIRACnOR'SDECons Qade.a 9
Job Description
p .
of (mmmercing
1 bombs 0Rm that 1 3 licensed under pmsiaiom of
withSectionoWn 7OKD orDividon Sof the Budneasmd Proressiuos Code. and mylicense u
COPPER REPI PE/WATER MAIN
in full
"3 f_ (2 V S o S
lass sec. 111
Dam-t7-ov CMIIL:Iof �.P. Plbc
ARCHffECI'S DECLARATi�,
1 understand my plans shat) b= used at public records
Licensed Professional
OWNER -BUILDER DECLARATION
1 hereby aorto that I am exempt from the Contractors License Law for the
following reason. (Section 70 L5, Business and Pmfes'um Code: Any city Or county
which Rgnires a permit to construct. aILLY. hormone. dcomb b, M RWl my NYCtme
! prior to its issuance. also require the.pplicant far such permit m fileasigned summem
he is liccnwd or the Contractor's License Law (chapter 9
Sq. Ft. Floor Area
Valuation
that pursumttothe provisions
(commencing who Seen.7000) of Division 3 of the Business and Profusions Codc) or
$4000
! that be is tromps therefrom and the basis for he alleged earmpdon. MY Nolation of
�p�t Number
31621042
Occupancy
P Y Type
Section 7031.5 by a, applinn, for. permit wbjccu the.pplu m, in .civil aunty of
nut mem thanRrsxsDo
hundred
.)W
01,aso oftitpmp=rty,amywplo wird"rAwthe'trsolemmpenssdon,
BnLMII
will de111Cwerl, arldue The Gnus MlYnmdense Law dos M apply an
and Pmfwh obu Code: The Contrcmrs Law docs not apply in an own== of
'
_ Required Inspections
red who mugs h
builds ofimpmwa thereon, um who dmssuint wmkhimsemccal
man crtywho
f
eex. provided that such impmwmmt rt ret interisland woRewd far talc .
m.
hmwo th ofc owner..
Wildingruimpmwmmt4hat mthinot )tarofmprmforn. theoseo
Wilder viB haw the Wmen of Proving dist he did ret Wild m improve for purpose of
Wilder will
sale.).
O I. as owner of the property. W exclusively comRging with Desucd mntranms m,
mtu,mc, du pmjeas (Sec. 7W. Susinm and Prophetic. Code:) The Co.trcso'. Li -
mm= Law does no, apply in an owner of property who Wilds or impact. ft... and
who contracts for such projects with a conVm,nt(s) licensed Forward m the contractors
License Law.
El lamexemplunderSec ,B&PCfor Numason
Owner Date
WORKERS COMPENSATION DECLARATION
1 hereby a1Bmh under perWty of perjury One of the following declarations:
I haw and will nob uin. Certificate of Co.., in se161mum for Wmkses Compen.
sation. as provided fee by Section 37W of du labor Cade. for the perrormarwe of the
work for which this permit is issued.
Zg ave end will maintain Workers Compeosadmn hourro e. as restored by Section
37W of the labra Code, for the performance of the writ for which this permit is issurd
'
My Wcolon ss+C�ompensatiorn-IImm. carder and Policy number.ts:
Cartier. —+� Polity Ne: / 8 -3/ -V 2T
6t
.
CERTIFICATE OF EXEMP71ON FROM WORKERS'
COMPENSATION INSURANCE
(Thu seehon need Out W cmnplemd if tW permit is forow hundred dolbas ($100)
or less)
I «tdfY dal in the perfmma en of the Mark for which this permit is issued. I shail not
employ airy person in my hummer sts u In become subject o dm Workers Compensation
Laws of Califomia. Dam
Applicant
NOTICE TO APPLICANT: Ir• after making this Ce tiGum of Exemption, you slmukl
become subject m the Worker's Compensation provisions of the labor Code. you most
forthwith comply with such pmvislotu or this permit Nail W deemed mwted.
_
CONSTRUCIION LENDING AGENCY
- -
1 hereby affirm that hem is a construction lending aphey for the Performance of
he Murk for which his permit Is honest (Sec. 3097, Civ. C.)
-
fandersName
'
Lender's Address
1 chary hat 1 haw Rad this application W item that the aWw inrormolun is
cormm. 1 agm m comply with all city and county ordfnamem and mm Ire misting in
Wilding construction• and bemby mthorire mprcaenutim of Nu city in enter upon ft
ii o -men iotmd pmpeny for imps pion purposes
(We) agree to save• indemnify and keep harmless the City of Cupertino
against
liabilities judgment• cow and espenser which tory In my way nurse agWm said Cry
in eovegtunce of he granting of this permit.
APPLICANT UNDE S A DM LL COMPLY WITH ALL NON -POINT
souscsRecau'O /N
Issued by: Dale
Re roofs
Type of Roof
shgnuumy ppuon nuaaor
HAZARDOUS MATERIALS DISCLOSURE
oDate us
Will the applicant sh future building mcupml stem or handle hmudoos material
by dm Co
m Municipal Code. Chapter 9.12, and he Hath and Safety
as dO.
Sec
Gndc. p o. Z553Z(q' �_
32(.)?
All roofs shall be inspected prior to any roofing material being installed.
Wire the. Eeant.1 future Wilding oav ret ton ret m dMam which
PP e w
If a roof is installed without first obtainingan inspection, I agree to remove
P
it hvardnos air emuminmu a tied Ra by he Bay Area Air Guaiity Man.gemen,
t. Air
all new materials for inspection.
stric,T
❑Yes
1 haw Rad the haallous materials mquimmeot undcrClupter6.95ofdu Califor-
nis Health &safety Co@, Sections 25505.25533 and 25534.1 undemennd thuif the Wilding
does not cutmn,ly h.w . mnane tha I, u my mpemibilitY m anufy dm omupant of the
Tire W orm iss ram of Occt
�_ /e�
Signature of Applicant Date
All roof coverings to be Class '%Q" or better
own= thori agent Dam
5 ITEMS OF 5
•
CITY OF CUPERTINO
PERMIT RECEIPT
Sec: Twp: Rng: Sub: Blk: Lot:
APN ........: 31621042.00
DATE ISSUED.......: 09/17/2008
RECEIPT #.........: BS000006104
REFERENCE ID # ...: 08090101
SITE ADDRESS .....: 10137 N PORTAL AVE
SUBDIVISION .......
CITY CUPERTINO
IMPACT AREA .......
OPERATOR: patg
COPY # : 1
OWNER CHANG JOHN N AND HELENA K
ADDRESS ..........: 10137 N PORTAL AVE
CITY/STATE/ZIP ...: CUPERTINO CA, .95014-2322
RECEIVED FROM ....: FRANK CARDIA
CONTRACTOR .......: CARDIA, FRANK L LIC # 612
COMPANY CUPERTINO PLUMBING
ADDRESS ..........: 1300 DELL AVE STE C
CITY/STATE/ZIP ...: CAMPBELL, CA 95008
TELEPHONE ........: (408)253-0618
FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
1BPWSVCS
WATER SERVICE
1.00
20.40
0.00
20.40
0.00
1BSEISMICR
VALUATION
4,000.00
0.50
0.00,
0.50
0.00
1PPERMITFE
FLAT RATE
1.00
40.79
0.00
40.79
0.00
1PRREPIPE
NO OF FIXTURE
8.00
81.60
0.00
81.60
0.00
1TRAVDOC
FLAT RATE
1.00
40.79
0.00
40.79
0.00
TOTAL PERMIT
----------
----------
184.08
----------
0.00
----------
184.08
0.00
METHOD OF PAYMENT
-----------------
CREDIT CARD
TOTAL RECEIPT
AMOUNT
---------------
184.08
---------------
184.08
VOICE ID DESCRIPTION
-------- ----------------------------
301 ROUGH PLUMBING
E
REFERENCE NUMBER
--------------------
VISA
VOICE ID DESCRIPTION
-------- ----------------------------
507 FINAL PLUMBING
ll
"OF
• CUPEkliINO
4
OS09 0/v/
CITY OF CUPERTINO
REPIPE/SEWERIMAIN SERVICE
PERMIT APPLICATION FORM
APN # 21 , ^ rl I v Dh
Date:
Fee Description
1 V
Permit Type
— / - 09
Building Address:
Commercial building
sewer/sanitary sewer
1013-2 N• f�r+, /v --
1CPSS
Owner's Name:
Phone #:
2153 - -26 51
P
ICPRP
Contractor:1I11
Phone #:
2 S 3- Uta 1 f3
Ck W n O P) l vrr b
Fax #:
1BSEISMICOM
Contact:
Phone #:
3o'? -'3 c/ it
fr- 1,
1BSEISMICR
Seismic Residential
p
Fax #:
1PRSEWER
Contractor License #: (oa q 9 v S
P
Cupertino Business License #:
Job Description:
CoF'?Residential
Commercial ❑
Commercial
Valuation:.,, OCTA
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 Building Points:
Quantity
FeeID
Fee Description
Fee
Group
Permit Type
IPCSEWER
Commercial building
sewer/sanitary sewer
P
1CPSS
1BPREPIPE
Commercial re -pipe per fixture
P
ICPRP
1PGASCOM
Commercial Gas Piping System
1-4 Outlets
P
1BSEISMICOM
Seismic Commercial
p
/
I
1BSEISMICR
Seismic Residential
p
1PRSEWER
Residential building
sewer/sanitary sewer
P
1RPSS
ai
C" of
CUPEI,TINO
CITY OF CUPERTINO
REPIPE/SEWER/MAIN SERVICE
FEE SCHEDULE
Quantity
Fee ID
Fee Description
Fee
Group
Permit Type
gIPRREPIPE
Residential re -pipe per fixture
P
1RPRP
/
1BPWSVCS
Water Service
P
1CPWS or
1RPWS
1PPRSEWG
Private Sewage Disposal System
P
1PCESS
Cesspool
P
1BPWATER
Install/alter Water Pipe
P
1BPFIXTURE
Plumbing Fixture
P
1PGASRES
Residential Gas Piping System
1-4 Outlets
P
1BPGAS
Gas Piping System 5+ Outlets
P
I
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
Revised 6-16-08
•
•
0
•
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
B.
Site
9.
Install H.E. Irrigation, (details/spec)'
L-1
2 points
11. Permeable Paving, Note
L-1
2 Dints
C.
Foundation
1.
Use 15 % Flyash Concrete, (note)
S-1
5 points
D.
Structural
3.
Uses Wood IJoist, (See Spec.)
S-2
2 points
5:
Use Truss with heels, (detail)
S-2
2 points
6.
B. OSS Sheathing, detail
S-2
2 points
E.
Ext. Finish
1.
Composite Decking, (Note/Spec.)
AJ
2 points
4.
B. Fiber Cement Siding, (Note/Spec
A-4
2 oints
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 Dints
G.
Electrical
4.
E. Ceiling Fans, (Note/Spec.)
A-3
4 points
H.
Appliances
1.
Energy Star Dishwasher, (Note/Spec.)
A4
1 point
3.
Ene Star Refrigerator, (Note/Spec.)
A-3
1 Dint
P.
Other 1
1.
List Green Features on Plans
1 paint
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. Sde
F. 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
Histodc 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
i8. besign Resourcettcient Landscapes and Gardens 4 Resource ptsy=yas D
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
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
C. Structural Frame
;1. Subslitute 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 kJoists for Floors and Ceilings
4. Use Web Floor Trusses
3 Resource pts
up to 10 Resource
2 Resource pts y:
2 Resource pts y:
5. Design Energy Heels on Trusses 6' or more
2 Energy pts
Y --yes
6. Use Fingar,lointed Studs for Vertical Applications
2 Resource pts
y=yes
7. Use Engineered Studs for Vertical Applications
2 Resource pts
y --yes
B. Use Recycled Content Steel Studs for Interior Framing
2 Resource pts
y=yes
9. Use Structural Insulated Panels (SIPS)
a. Floors
3 Ener is
9Y P
Y=Yes
b. Wall
3 Energy pts
y=yes
c. Roof
3 Energy pts
y=yes
10. Apply Advanced Framing Techniques
4 Resource pts
y=yes
11. Use Reclaimed Lumber for Non Structural Applications
—
3 Resource pts
y=yes
12. Use OSB --"
a. Subfloors
b. Sheathing
1 Resource pt
y=yes
•
1 Resource pt
y=yes
1. Use Sustainable Decking Materials
a. Recycled content
3. Resource pts
y—yf
b. FSC Certified Wood
3 Resource pts
y=y(
2. Use Treated Wood That Does Not Contain Chromium/Arsenic
1 IAQ/Health pt
y --yr
13. Install House Wrap under Siding
1 IAQ/Hsalth pt
y=yf
14. Use Fiber -Cement Siding Materials
1 Resource of
Y --yes
E. Plumbing
jL Install Water Heater Jacket _ — 1 Energy of yeses
2. Insulate Hot and Cold Water Pipes
2 Energy pts y=yes
'3, faetmfi all Faucets and Showerheads with Flaw Feducers
0
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 Toilest with Ultra -Low Flush Toilets
Up to 5 Energy pts,
(1 point each, up to 3 points) _
1 Up to 3 Resource pts,
5. Install Chlorine F Iter on Showe head
1 IAQ/Health pt y=yas
6. Convert Gas to Tankless Water Heater
4 Energy pts y=yes
7. Install Water Filtration Units at Faucets
(2 points each, up to 4 points)
Up to 4 IAQ/Health pts
B. Install On -Demand Hot Water Circulation Pump
4 Resource pts y=yes
r. necmcai
U
1. Install Compact Fluorescent Light Bulbs (CFLs)
0
I(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
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
(1 point each, up to 4 points)
Up to 4 Energy pts
G. Appliances
1. Install Energy Star bishwashet
2. Install Washing Machine with Water and Energy
Conservation Features
13.lnstall Energy Star Refrigerator
A. Install Built -In Recycling Center
H. Insulation
1, Upgrade Insulation to Exceed Title 24 Requirements
a. Walls
b. Ceilings
2. Install Floor Insulation over Crawl Space
�3. Install Recycled -Content, Fiberglass Insulation with
No Added Formaldehyde .
4. Use Advanced Infiltration Reduction Practices
5. Use Cellulose Insulation
a. Walls
b. Ceilings
6. Alternative Insulation Products (Cotton, spray -foam)
a. Walls
b. cenings
1 Energy of
1 Energy pt
1 Energy pt
3 Resource
2 Energy pts
2 Energy pts
4 Energy pts
31AQ/Health pts
2 Energy pts
4 Resource pts
4 Resource pts
y=yes
4 Resource pts y=yas
4 Resource pts y=yes
f
•
E,
U
r
r
U
0
y=yes
4 Resource pts y=yas
4 Resource pts y=yes
f
•
E,
1. Install Energy -Efficient Windows
2 Energy pts
2. Install Ductwork within Conditioned Space
• 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 of
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 IAQ/Health pt
4. Clean all 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
B. Install Sealed Combustion Units
a. Furnaces
31AQ/Health pts
b. Water Heaters
3 IAQ/Health pts
9. Replace Wall -Mounted Electric and Gas Heaters with
Through -the -Wall Heat Pumps
3 Energy pts
10. Install 13 SEERl11 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
13. Retrofit Wood Burning Fireplaces
• a. Install EPA certified wood stoveslnserts
1 IAQ/Health pt
b. Install/Replace Dampers
1 Energy pt
c. Install Airtight Doors
1 Energy pt
14. Install Zoned, Hydronic Radiant Heating
3 Energy pis
15. Install High Efficiency Filter
41AQ/Health pts
16. Install Heat Recovery Ventilation Unit (HRV)
5 IAQ/Health pts
17. Install Separate Garage Exhaust Fan
3 IAQ/Health pts
K. Renewable Energy and Roofing
1. Pre -Plumb for Solar Water Heating 4 Energy pts y=
2. Install Solar Water Heating System 10 Energy pts y=
3. Pre -Wire for Future Photovoltaic (PV) Installation 4 Energy pts y=
4. Install Photovoltaic (PV) System
(1.2 kw = 6 points, 2.4 kw =12 points, 3.6 kw =18 points) Up to 18 Energy
6. Select Safe and Durable Roofing Materials _ _ 1 Resource pt y=
7. Install Radiant Barrier 3 Energy pis y_
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
`1 . Use Low%NaVOC Paint
2. Use Low VOC, Water -Based Wood Finishes
0. 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. Teal all Exposed Perficaboard 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
12. Use Rapidly Renewable Flooring Materials
3. Use Recycled Content Ceramic Tiles
4. Install Natural Linoleum In Place of Vinyl
5. Use Exposed Concrete as Finished Floor
6. Install Recycled Content Carpel with Low VOCs
1 IAQ/Health pts
y=yes
2IAQ/Health pts
y=yes
3IAO/Health pts
y=yes
3 Resource pts
y --yes
61AQ/Health pts
y=yes
1 IAQ/Health pts
y=yes
41AQ/Health pts
y --yes
4 Resource pts
Y --yes;
1 Resource pts
y --yes
3 IAQ/Hsalth pts
y --yes
6 Resource pts
Y --yes
4 Resource pts
y=yes
4 Resource pts
y --yes
5 IAQ/Health pts
y=yes
4 Resource pts
y=yes
4 Resource pts
y=yes
Total Points Availab e:
tal Points Project Received:
�i
•
1401 1301 57
0 0 0 •
9.117-d*r
G:de:arpmgslgreenbuildingguitlelineshemodele.,sJgreenpointsf na127204prrneded.xis
r
1
L_i
Community Development
10300 Torre Avenue
Cupertino CA 95014
M Telephone (408) 777-3228
CITY OF Fax (408) 777-3333
46,UPERTINO
Building Department
•
•
JOB ADDRESS:
/0/ 37 Wdu -.
PERMIT #
DkOq 0 1 0 1
OWNER'S NAME: G n -4 ,\e. ,
PHONE #
GENERAL CONTRACTOR: C P
FAX #
' 0
I am not using any subcontractors:
Signature Date
Please check applicable subcontractors and complete the following information:
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
Owner/Contractor Signature
Date