08090017 CITY OF CUPERTINO v -
BUILDINGLIVISIONSI', PERMIT <CONTRAGTORINFORMATION`V,I
BUILDIry GARqRFSS: PERMITNO.
`.1.3 1) -RUNIRIDG[: AVE BLDG 10 DRAEGER CONSTRUCTION INC 08090017
Or,
NER'S NAME: PERMIT samm DATE
1 RA/I NISI CORPORATION 605 COMMERCIAL ST 09/04/2008
liSNE: SANITARY NO. CONTROL NO.
AacxrtEcrrenclNEm: BUILDING
SIDNG & WTRPRFNG RPRS, 275SQ BLDG ELETTPER O
PLUMB MECH
O p LICENSED CONTRACTORS DECLARATION' O O
JOb Description
U F I Macby affirm that l am fRxnmd under Provisions ar Chapter 9(mmmencmg
`Yf with Section 701f)of Dindon 3 of ate Bumxv and Proicsomm,Cade,.rand my licanau
in full form and eRem
^ i Liceve CJav�Lie• l�
DaleConuacmr
ARCHITECTS DECLA N
I undamand my plans shall W uad as public an
JyU
y o� Licensed Pmfcssionel
5OWNER,BUILDER DECLARATION
I barony.'an that I An exempt from IN Contractors Lieena Law for the
i pe O following reason.(Scdon 70313,Business and Profeuium Cale:Any city or county
m which rtquiras a permit in cnnsuuct,altar,impmw.d.mnlivh,or repair any shonure
,a pnorm its lssuame.mat naquirea ftapplicant for such permit in file a signal sucumnt
_i
p mat beulicensedpusauantlomeprovisionsoftheContractorsLianaLaw(Chapar9 Sq.Ft. Floor Area Valuation
(commencing with Section 70W)of Division 3 of the Business and Pmfmdams Cade)no
e5 9 mat heti eanmpl therefrom and the btu for the alleged aamption.Any viodauon of
Section 7031.5 by Ary applicant fa a pump Mbjecu the applicant to a Civil Penalty of APN Number Occupancy e
na mom dun flhundred dallam DOM. P y EYP
0 I,as owner arthe popmy.a my emplayem wit wages u mcirsole ccor,m adon,
will da the mal,end than mray..is not intomad oraaervA for sale(Sac.7014,Business
and Profudnm Calc The Catucmrs Limme Law dao rct apply m an owrcs M Required Inspections
propar ywho builds orimprovesmesean,and whodnessmh work himulfor through bis
own emplayem,prodded IWI inch impmaemems art tam intended orafiaed fm sale B. .
however.the building or impmvmoem issold within aro year of comPlation.the owner
buildu will hale Uta bmda of panning dist W did trot build or improve for purpom of
0 1,as owner M the property,am exclmiwlr contracting with liaoacd contractors in
comroct the project(Sec.7061,Busirom and Profaidom Cade:)The Canbacmrs U. .
come Law dors not apply M an owner of property who Wilds or improves thereon,end
who cammacss for Such pmleea with a mnuactar(s)Iiamad pursuant W mW COMORClara
Limtsa Law. .
O l An exempt undo Sm. ,B&P C for this reason
Owner Dm,
WORKERS COMPENSATION DECLARATION
I boaeby affirm under penalty of perjury am of the following declantiam:
1 ban and will mainain aCudBma of Comdata in sclf-WYrt for WmkcraGampcn-
radon.M provided for by Section 3700 of the Labor Cade.for the pc,(am.of the
work for which this permit is issued.
0 1 have and will maintain Warkces CompcmNan Insuna a,m mqu orad by Section
3700 Mme labor Code,for the perforra.of the work forwbicht this permit is issncd.
My Workers Compenadan In.mna curia and Policy n-ugmbcr are:
Comer. L9Gh �� Policy No.: / I�C I 2.172
, U
CERTIFlGTE OF EKEMP ION FROM WORKERS'
COMPENSATION INSURANCE
(Tbisscctan entad ant W conplcmd lfthe permit u forarc hundred down(SI00)
or Imt)
1 cenifv than in the Winmena M ft work for which this pamit is iuucd,l Mall Out
employ any portion in any ma marc A m accurate Subject m the Worked Campenssdan .
Laws of California.Dam
Applicant
NOTICE To APPLICANT:IL after making this Cenificam of Eamption,you shomW
become subjal u,the Worker's Compewtion pmvisiom of ma labor Cold,you am
.0,z faMwith comply with such provision,or this permit shall W domed mwkad.
Z O CONSTRUCnON LENDING AGENCY
[+ IWreby affirm mar mart Lia construction andingagenry for the pmformnec of
!Yi 0th wish for which Thu permit u road(Sec.3097,Civ.C.)
MLU Q Lenders Name '
z lenders Address
U O I cont vel 1 have dud mit application W fuse the the above information at
4, F mora I agme in comply with all city and county ordinances and man laws relating in
.OU building communion,and hemby authoia mpmsenlatim of this city m cow upon the
abuw-menudgm pmpcnY far cxNr on puryaas
(�„ O. (War)ague m con,inthar ify and tap harmless the City of Cupertino against
m..s h inconties,juan of .erauand expemas,nit. they In any way accue agvmtsaiO City
U z A APPLICANT
of INgrantingor thisD WILL
^ APPLICANT UNDERSTANDS AND WILL COMPLY WITH ALL NON- 1 Issued by: Date ✓G �7
SOURCE REGULATIONS
Re-roofs ��---
Sigmaumafar ontrrno - n
HAZARDOUS MATERIALS DISCLOSURE Type of Roof
W10 the applicant or to.building—notatmm or NMI.haurdom mamrial
A dcfircd by de Cupertino Municipal Code.CNpmr 9.12.and the Health and Safety
Cak:.Section 25532(x)7 All roofs shall be inspected prior to any roofing material being installed.
0Ym (aj Na
ppliana or fuwrt building occupant ua equipment or dcHaa which g Pe
If a roof is installed without first obtaining an inspection,I agree to remove
Will the a
J15�hrvNom air co mammae,m dcrim:d by the Bay Asa Air Quality Managcmcnl all new materials for inspection.
0Yc. vl {o
I haw sal mrd Nardous mahoada mquNmcou under Chapmr 6.95 ofdm Califon
nim Ninth&SMcty Coda.ScctionaMW5,25533 and 25534.1 umlcnand that if the Wilding
dou trot cuaenlly Nw a mnm that it u my mal ond,liny in miry the axopanm of me
regYire awbmh I artoitsuanaofacarareemofampancy. Signature of Applicant Date
owner .thmiadagcnI All roof coverings to be Class's¢'or better
• r
CITY OF CUPERTINO
• 3 T`CEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot :
APN . . . . . . . . : 31606037 .B10
DATE ISSUED. . . . . . . : 09/04/2008
RECEIPT # . . . . . . . . . : BS000005990
REFERENCE ID # . . . : 08090017
SITE ADDRESS . . . . . : 19500 PRUNERIDGE AVE BLDG 10
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO -
IMPACT AREA . . . . . . .
OWNER IRVINE CORPORATION
ADDRESS . . . . . . . . . . : 19500 PRUNERIDGE AVE BLDG 10
CITY/STATE/ZIP . . . : CUPERTINO, CA 95014
RECEIVED FROM . . . . : FRANK E BLEFARI
CONTRACTOR . . . . . . . : DRAEGER, JOHN EDWARD LIC # 21895
COMPANY DRAEGER CONSTRUCTION INC
ADDRESS . . . . . . . . . . : 605 COMMERCIAL ST
CITY/STATE/ZIP . . . : SAN JOSE, CA 95112
TELEPHONE (408) 536-0420
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
113SEISMICR VALUATION 28, 000 . 00 2 . 80 0 . 00 2 . 80 0 . 00
IFOUNDREPA EACH 1 . 00 734 . 00 0 . 00 734 . 00 0 . 00
].SIDEOTHER SQ FEET 275 . 00 367 . 00 0 . 00 367 . 00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 1103 . 80 0 . 00 1103 . 80 0 . 00
•
0090017
CITY OF CUPERTINO
CITY OF
CU
PERTiNO GENERAL BUILDING
PERMIT APPLICATION FORM
APN # �I W D] P O 7. Date: 3 O
Building Address:
l Sw P¢�t:zeri v e SO /()
Mailing Address (if different from building address):
Owner's.Name: Phone#:
iwe , 12—54/
Contractor: Phone:
X536 Oti'2o
u+ti Fax: S to 0,/ZS-
ContTactor Lidense#: 6/ G�v
Cupertino Business License#:
Contact: /`� / � /r/, Phone: yog 5/s .Zg-52-
• /� P/� Fax: 5G 536
Residential Commercial
Job Description:
Sr4j/, 4 �.�k.�.���j ,*pIVI-S. 27S
Building Permit Info:
Bld Elect ❑ Plumb ❑ Mech ❑
Type of Construction (Usage Class): Occupancy Type:
1-A, 1-B ❑ II/III/V-A ❑ I1/1II B, IV-HT, V-B 92,
Valuation: 2 D� Square Footage:
Project Size: Express Ff—Standard ❑ Large ❑ Major ❑
[For
een Building: Please complete relevant portion of the Green Building/LEED Checklist& attach it
to the application or if applicable, include in plan set& the sheet index.
• ints Achieved: ?3�
hel , contact Build it Green at www.buildit reen.or
Revised 7,' y/f'3
r
A- ll CITY OF CUPERTINO
OF
CUPEkTINO GENERAL BUILDING
PERMIT APPLICATION FORM
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1 BBOILERI 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
113BOILER2 Installation/relocation of ea M ,
boiler/compressor over 3 horsepower
to &incl 15 horsepower, or ea
absorption sys over 100,000 Btu/h
1 BBOILER3 Installation/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
11313OILER5 Installation/relocation of ea boiler or M
refrigeration compressor over 50
horsepower, or ea absorption sys over
1,750,000 Btu/h
1 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.
1ELECINSP Other Electrical Inspections (per hour) E
iMECHINSP Other Mechanical Inspections (per M
hour)
1PLMBINSP Other Plumbing & Gas Inspections P
(per hour •
1MEETINGIHRApplication Meeting B
'' - CITY OF CUPERTINO
• CUCITY
TYOF O GENERAL BUILDING APPLICATION
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
ACOUSTICAL
REVIEW
IACOUSFDW SFDWL/Duplex New B
IACOUSRESAD SFDWL/Duplex-Addition/Alteration B
IACOUSCOM Multi-Family/Commercial B
CHIMNEY'S
1 CHIMNEY Chimney B
1CHIMNEYR Chimney Repair B
FENCES
1FENCE>6FT Non-masonry, over 6 ft in height B
1 FENCEMAS>6 Masonry, over 6 ft in height B
FIREPLACES
1FIREPLMAS Fireplace Masonry B
IFIREPLFAB Fireplace Pre-Fabricated/Metal B
1 FLAGPOL>20 Flag pole (over 20 ft in height) B
IMODUSTRU Modular Structures B
FOUNDATIONS
1FOUNDREP Foundation Repair B
/ 1PILECAST Pile Foundation Cast in place concrete B
1 PILEDRIV Pile Foundation Driven (steel, pre- B
stressed concrete
3 of 5
CITY OF CUPERTINO
11119111 GENERAL BUILDING APPLICATION
CUPEkTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
RETAINING
WALL(CONCRETE
OR MASONR
1RETSTN Standard (up to 50 ft) B
IRETSP310 Special Design, 3-10' high (up to 50 `) B
1RETSP10 Special Design, over 10' high (up to B
50'
1RETCRB< Gravity/Crib Wall, 0-10'high (up to B
50 ft)
1RETCRB> Gravity/Crib Wall over 10' high(up to B
50 ft
SHED-(EACH) Shed Over 120 sq ft B •
SIDING
1SIDEST/BK Siding, Stone & Brick Veneer B
(interior/exterior)
27 ISMEOTHER Siding all other B
SKYLIGHTS
1 SKYL<10 SF Skylight less than 10 sf B
1 SKYL>1 OSF Skylight greater than 10 sf or B
structural
1STAIRS Stairs-first flight/ea addt'l B
STORAGE RACKS
1 SRACKS<=8 Storage Racks 0-8' high (up to 100 sf) B
1 SRACKS>8 Storage Racks over 8' high(up to 100 B
st) •
4of5
° - CITY OF CUPERTINO
CATV OF GENERAL BUILDING APPLICATION
CUPERTINO
FEE SCHEDULE
Quantity/Sf Fee ID Fee Description Fee Permit Type
Group 1GENRES or
1GENCOM
1STUCOAP Stucco Applications (up to 400 sD B
additional stucco application
1 WINREP Replacement windows/sliding glass B
door ea 8 windows
1 WINMEWSTR New Window-structural shear B
wall/maso includes plan ck fee
1 EPERMITFEE Electrical Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
1 PPERMITFEE Plumbing Permit Fee P
1ELCPLNCK Stand Alone Electric Pln Ck (hourly) E
1MECPLNCK Stand Alone Mechanical Pln Ck (hrly) M
1PLMBLNCK Stand Alone Plumbing Pln Ck (hrly) P
1 STPLNCK-(3 Hr Min Standard Plan Check (when no EN") B
when not over counter) hourly-stand alone
1BSEISMICR Seismic Residential B
1BSEISMICO Seismic Commercial B
1TRAVDOC Travel & Documentation B
1BUSLIC Business License B
5 of 5
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 I-Joist, (See Spec.) S-2 2 points
5. Use Truss with heels, (detail) S-2 2 points
6. B. OSB Sheathin 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 point
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
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.
INPUT Resources Energy A011-lealth
A.Site
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 Materials 4 Resource pts yeses 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 yeses 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
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 litigation Systems 2 Resource pis y--yes 0
11.Provide for On-Site Water Catchment/Retention 2 Resource pts y--yes 0
1 1 I
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--yesl;; 0
1 1 1
C.Structural Frame
1.Substitute Solid Sewn 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 hJoists 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 0
b.Wall 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 0 •
i 1 1 1
1 I.Wmdows IMPUT Resources Energy IAO/Health
1.Install Energy-Efficient Windows
• a.Double-Paned 1 Energy pt y=yes 0
b.Low-Emissivity(Low-E) . 2 Energy pts Y--yes 0
c.Low.Conductivity Frames 2 Energy pts yryes 0
2.Install Low Heat Transmission Glazing 1 Energy pt Y--yes 0
1 1 1
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 7 0
5.Install Solar Attic Fan 2 Energy pts yryes 0
6.Install Attic Ventilation Systems 1 Energy pt y=yes 0
7.Install Whole House Fan 4 Energy pts y--yes 0
8.Install Sealed Combustion Units
a.Furnaces 3 IAQ/Health pts y=yes 0
b.Water Heaters 3 IAQ/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 O
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 stoves(nserts 1 IAQ/Health pt y=yes C
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 31AQ/Health pts y=yes 1 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 yryes 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 Barrer 3 Energy pts yryes p
1 I 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes 0
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 0
1 1 1
•
_ Community Development
10300 Torre Avenue
Cupertino CA 95014
Telephone(408)777-3228
CITY OF Fax(408)777-3333
WUPEkTINO
Building Department
JOB ADDRESS: �9�OD fPXze�va^,,dq if, PERMIT #
OWNER'S NAME: j�pro, 4e,4 PHONE # $'jL oYZb
GENERAL CONTRACTOR: FAX #
I am not using any subcontract ��� G
Signature Date
Please check applicable subcontractors and complete the followinginformation
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 ate