08070053 CITY OF CUPERTINO zagY«s�:axa ,, r dress` ""rh s x BUILDINGDIVISIOPA PERNUT NFOPERMITNO
RMA IOIV
Bu1ITP`T�f�9V�E BLOSSOM DR ATLAS—TRILLO HVAC 08070053
OWNER'S NAME: PERMrr BSUE DATE
ANNIE S7U 1965 KYLE PARK CT 07/09/2008
NE: SANITARY NO. CONTROL NO.
(408) 286-8931
ARCHRER/ENGINEER: ,. " ' BUILDING PERMITINFO
BLDG ELECT PLUMB MECH
0
u p Q LICENSED CONTRACTORlunder S DECLARATION
ofCh Job Descri tion
1 hmeby affirm tha 1 am If the Bu muter pmvieiav a(Cl ode. a(commencing is P
=. u lis aam)a, DividonOorlheBYrrsaarw�a (� mylicrnaia RMV&REPLC FURNC & ADD A/C
O m cert full forts SrmO e0 rV,
Date Comracer�Q-�/� T'i/n AIIAC
n£�£ ARCHITECT'S DE IMTIONI
C 1 understand my plans shall be used as public records
D
y u.C t; Licensed Pmfcssional
5 OWNER-BUILDER DECLARATION
I hcrcM1y slum
that I am exempt from the Contractors License Law for the
s O O following mason.(Section 7071.5,Business and Profusions Code:Any city or county
$ which rtquhu a pcomfl to emosutcr,alar,improve,dcmnlish,or repair Say Structure
prior ut is issuance.aed requires the applicant forsuch permit to rile a signed statement
< m,,haiarcensedpursuantmmeprovsionaaftheContractarsLimn,nLaw(chapter9 Sq.F[.Floor Area Valuation
Un H$ (commencing with Section 7000)of Division 7 of thon Business and professions Cock)or $14000
that he Is esempl therefrom and this backs for the alleged eumpdan.Any violation of
Senkn 70715 by an)'applicant for a permit ubjero the applicant in.civil penally of Number e
notmamthanfcsebaedmAAnllars(sm 35906033Occupancy T.E P Y yP
0 i,uo ofthepropony.amymployenwithcagesutheusoumepe m.
wig dothecart andthe he CmtunotfnunGAmawdoshale(Sec.in Sm
and Pmresdans Cede:The r a themems d h.Law eau net apply ll rt owner ar Required Inspections
own
mploy b.pnoririmprowsch impoesMwho dcesauchwmk Mnaelrar thorough his
awn employers,provided them such impmscmm i are ns year o c onoaeactl fh.Wn.if,
builder Nebuwthearimprovement4soldwiddnotWeerorcnprowfrtheower-
San.).rwig love the burden of proving dot he tlitl not build or improve fm purpose of
uleJ.
❑1.as owner of the property.am eaclusinly contracting with licensed contractors to
construct the protea(Sec.7044,Business mot professions Cade:)The Canuactues u.
tens Law does not apply in an owner of property who Wilds or improves thereon,and.
who contracts far such prod.with a conuacter(s)licensed poomm t to,the Contractors
Neve law.
O l Sm eampm under gee .B&P C for this reason
owner Doc
WORKERS COMPENSATION DMC RATION
1 hereby affirm under pevalty of perjury one of the following declarations:
ham and will maintain a Certificate of Conant in self-insure fns Wcre sConpen-
agon.as provided for by Section 3700 of one labor code.for the Performance of tare
work for which this Permit is issued.
t,�d/1 have and will maintain Workers Compensation Insurance,u acquired by Scction
D7t10of the labor Cade.far the performance of Ne work for wbut,this permit is most. '
My Workers Compensation loadandoc carrier and Policy number are:
Cartier: Policy No,: .(
C�T G1EO�16 MPTIONFROM WORKERS'!
COMPENSATION INSURANCE
('Thu road.recd mtbeconplecd if Ne permit is(amen hmtdW doBwa(SIM)
or less)
1 unify met in the perform.of the work for which this Permits issued,l shall nu
employ any person in any ma meran u to become subject in the Workers'Compeasmion
laws of California.Dau
Applicant
NOTICE TO APPLICANT:IL after making this Ccrdricam of Emmlvion,you should
become Subic"he the Workers Compensation previsions of Ne Labor Code.you most
.J Q forthwith comply with such provisions or this Permit rt shall bdeemed emed mwkctl.
z h CONSrRUCIION LENDING AGENCY
[-+ I hereby Spline that dons,u mu
a nanion lending agency Tor thePec perfarmaof
C> thse work far which thus Permit is issued(Sm.3077,CIS.e)
Mrz Landers Name
Z:) Z Lenders Ad"m..
U O 1 certify that 1 haw red this application and wu this the above iafarn aden is
I,, F correct.l agme in comply with all city and county ordinances aM cuss laws mlating to,
QU building conanction,and hereby auandin,acpruautivrs of this city m enter upon ft
aWwc-numdohd pmpeny fns iuspecome pso,ams
F y (Won)agree m ave,Indemnify and kap hamsless the City of Cupertino against
O z 'iabll mcnN,cuk hb adeapenms which may in any my arnu agaivs said City
rte JAW 4ERS7ANDS thisD WIns LL
^ APP ANT ERSfANDs AND WILL COMPLY WITH ALL NON-POINT Issued by:
SOU REGULA NS.
Re-roofs
Sunslurt arApphwnhor
HAZARDOUS MAT047XISISCLOSURE 'te Type of Roof
Will the applicant ar Ind.building amupant core ar lundlc haaudom macriN
as defined by this Cuperde Municipal Code.Chapter 9.13.are.the Health and Safety
Code.Section z."lica7 / All roofs shall be inspected prior to any roofing material being installed.
Y. No
w1u thea Ucanm or
vasre baddin acou If a roof is installed without first obtainingan inspection,I agree to remove
pu g pant use equipment h devices which P
haramnh air matamed.u as defied by Ne Bay Area Air Quality Management all new materials for inspection.
❑Ya u
ad
Ne hvardws materiaHrequimmcns under@epter 6.95 of this califor-
ni alth&5 `Code.Seedo andere 75533am175574.1 undenund Waifdu building
1 only �m tense that i pnmy ormon ihilimy te Mtify she aeeupal ar the
requi ch g a rmiaa,ecafaccnfracamar cop Signature of Applicant Date
Owner or uthmivad agent no All roof coverings to be Class'W'or better
CITY OF CUPERTINO
• 6 ITEMS OF 6 PERMIT RECEIPT OPERATOR: patg
COPY # 1
Sec : Twp: Rng: Sub: Blk: Lot:
APN . . . . . . . . : 35906033 . 00
DATE ISSUED. . . . . . . : 07/09/2008
RECEIPT # . . . . . . . . . : BS000005376
REFERENCE ID # . . . : 08070053
SITE ADDRESS . . . . . : 927 ROSE BLOSSOM DR
SUBDIVISION . . . . . . .
CITY . . . . . . . . . . . . . : CUPERTINO
IMPACT AREA . . . . . . .
OWNER . . . . . . . . . . . . : ANNIE SZU
ADDRESS . . . . . . . . . . : 927 ROSE BLOSSOM DR
CITY/STATE/ZIP . . . : CUPERTINO CA, 95014-4215
RECEIVED FROM . . . . : ATLAS-TRILLO
CONTRACTOR . . . . . . . : TRILLO, STEVE LIC # 4269
COMPANY . . . . . . . . . . : ATLAS-TRILLO HVAC
ADDRESS . . . . . . . . . . : 1965, KYLE PARK CT
CITY/STATE/ZIP . . . : SAN JOSE, CA 95125
TELEPHONE . . . . . . . . : (408) 286-8931
• FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- --------- -------- ---------- ---------- ---------- ----
IBSEISMICR VALUATION 14, 000 . 00 1 .40 0 . 00 1 .40 0 . 00
1EPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 .79 0 . 00
1MPERMITFE FLAT RATE 1 . 00 40 . 79 0 . 00 40 .79 0 . 00
IMRRAA UNITS 2 . 00 122 . 38 0 : 00 122 . 38 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 286 . 94 0 . 00 286 . 94 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
--------------- -------------------
CHECK 286 . 94 #9604
---------------
TOTAL RECEIPT 286. 94
VOICE ID DESCRIPTION VOICE ID DESCRIPTION
---- --------------------------- -------- ----------------------------
505 FINAL ELECTRICAL 507 FINAL PLUMBING
508 FINAL MECHANICAL
•
06
CITY OF CUPERTINO
Q' FURNACE/AC
• OF
CUPERTINO PERMIT APPLICATION FORM
APN # ^ OI O �� J 31C)
Building Address'42-7 RomDN
SSD
Owner's Name: Phone #:
cSzu Yc�ie dl-Ke sl t
Contractor: Phone#: 1fI_ l55
/ U Fax #:
Contractor License#: Cupertino Business License#:
Contact: Phone#: ,
Fax #:
Building Permit Info:
Elect Plumb Mech ❑----'
Residential Commercial ❑
Job Description /- 7j tLQ-C.(—
_A,�(ck ft
For Residential Installations:
Attic ❑ I"floor ❑ 2nd floor ❑
Adhere to minimum setback requirement
For Commercial Installations:
Replacement same weight ❑ Additional weight (structural calcs) ❑
Structural Calculations required for new installation ❑
New installation Planning Approval Required ❑
Coskpf Project:
Type of Construction (Usage Class):
Strapped El On Platform Bonded New Location ❑ Replaceme�
Project Size: Express E�— Standard ❑ Large ❑ Major❑
Valuation:
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.
Revised 6/16/08
am"An
CITY OF CUPERTINO
FURNACE/AC
CITY OF
CUPERTINO FEESCHEDULE
E
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1MCRAA Commercial-Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by this
code.
1 MCREPALT Commercial for the repair of alt/add to M
ea heating appliance,refrigeration
unit,cooling unit,VAV boxes,
absorption unit or ea heathing, cooling
absorption,or evaporative cooling sys,
incl install of controls regulated by
this code. •
1MCSUSHTR Commercial Install/Relocate ea M
suspended heater,recessed wall htr, or
floor mounted unit heater.
1PGASCOM Commerical for ea gas piping System P
1-4 outlets
lBPGAS For each gas piping system of 5 or P
more per outlet.
IMCAPPVNT Commercial for the install/relocate/ or M
replacement of ea appliance vent
installed ¬ incl in an appliance
permit.
1BSEISMICO Commercial Seismic B
1MRRAA Residential Repair/Alteration/Add to M
ea heating appliance,refrigeration unit,
cooling unit,absorption unit,or ea
' heating,cooling,absorption or
evaporative cooling system,incl
installation of controls regulated by
this code.
1MRSUSHTR Residential Install/Relocate ea M
suspended heater,recessed wall htr, or •
floor mounted unit heater.
1MRAPPVNT Residential for the install/relocate/ or M
replacement of ea appliance vent
install & not incl in an a 1 npnnit.
CITY OF CUPERTINO
4
�Zf"
FURNACE/AC
•CUPEVINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Group
FURNACE FURN/AC
1PGASRES Residential for ea gas piping system of P
1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet.
1BSEISMICR Residential Seismic B
1MECPLNCK Mechanical Plan Check M
1MFR=<100 Furnace Syst<=100k BTU install or M
relocate ea forced-air/gravity type
furnace/burner, incl ducts/vents
attached to such appliance up to and
include 100,000 Btu/h
1MFRN>100 Furnace Syst> 100k BTU install or M
relocate ea forced-air/gravity type
fumace/bumer, incl ducts/vents
attached to such appliance over
100,000 Btu/h
/ 1EPERMITFEE Electric Permit Fee E
1MPERMITFEE Mechanical Permit Fee M
/ 1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
1BUSLIC Business License B
•
-a CITY OF CUPERTINO
FURNACE/AC
C1 F
CUPEkTINO FEE SCHEDULE
Quantity Fee ID Fee Description Fee Permit Type
Grou
AIR FURN/AC
CONDITIONING
1BCAIRHAN Commercial A/C Units <= l0k CFM B
1 MCRAA Commercial Mech Repair/alt/add M
IBSEISMICO Seismic Commercial B
IPGASCOM Commerical for ea gas piping System P
1-4 outlets
1PGASRES Residential for ea gas piping system P
of 1-4 Outlets
1BPGAS For each gas piping system of 5 or P
more per outlet. Comm/Resid
IBREMAIRHAN Residential A/C units <= 10k CFM B
IMRRAA Residential Mech Repair/altladd M
IBSEISMICR Seismic Residential B •
IEPERMITFEE Electric Permit E
IMPERMITFEE Mechanical Permit M
1PPERMITFEE Plumbing Permit P
1TRAVDOC Travel Documentation B
IBUSLIC 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 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 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 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 IAQ/Health
A,Srte
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 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 Stormwater Practices 2 Resource pts y=yes 0
7.Protect Water Quality with Landscape Design 2 Resource pts y=yes 0
B.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 IJoists 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
B.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 •
INPUT Resources Energy r
I.Windows
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 Y--yes 0
2.Install Low Heat Transmission Glazing 1 Energy pt y=yes 0
1 1 I
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 IAO/Health pt y=yes 0
4.Clean all Ducts Before Occupancy 2 IAO/Health pts y=yes 0
5.Install Solar Attic Fan 2 Energy pts y=yes 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 31A0/Health pts y=yes 0
b.Water Heaters 3 IAO/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 stovesrnserts 1 IAO/Health pt y=yes 0
b. Install/Replace Dampers 1 Energy pt y=yes 0
c.Install Airtight Doors 1 Energy pt y=yes p
14.Install Zoned,Hydronic Radiant Heating 3 Energy pts y=yes 0
15.Install High Efficiency Filler 4 IAO/Health pts y=yes 0
16.Install Heat Recovery Ventilation Unit(HRV) 5 IAO/Health pts y=yes 0
17.Install Separate Garage Exhaust Fan 3 IAQIHealth pts y--yes p
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 p
1 1 1
L.Natural Heating and Cooling
1.Incorporate Passive Solar Heating 5 Energy pts y=yes p
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
J 10300 Torre Avenue
r YCupertino CA 95014
Telephone(408) 777-3228
CITY OF Fax(408)777-3333
*UPEI�TINO
Building De artment
JOB ADDRESS: PERMIT #
02Rose ossmvt. Oe'07 005.3
OWNER'S NAME: S PHONE # -q-1 � - 9�
GENERAL CONTRACTOR: v " FAX #
I am not using any subcontractors: /V
Signature Date
Please check applicable subcontractors and complete the following information
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/ o Signature Date